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#Science

CBD: The current state of research

21/04/2020 5 MIN. READ Mirko Berger
21/04/2020 5 MIN. READ Mirko Berger

Cannabidiol, or in short CBD, has been all the talk lately. It's one of the many cannabinoids that naturally occur in the cannabis plant and is now gaining in popularity over its psychoactive cousin, THC.

CBD has been garnering a lot of media attention recently, and in particular the creators of CBD products love to make claims of all the wonders CBD can do. While there is also a lot of scientific research on CBD, it is only high in quantity, not in quality.

What do the scientific studies on CBD say?

The results from animal tests and cell research aren’t applicable to humans. To conduct studies on humans, it takes a lot of effort, time, and most importantly, money. To study the effects of CBD on humans, companies with sufficient financial resources would have to sponsor the research, which means that there would need to be a financial motivator in it for them. Unless it’s possible to use patents to protect and monetize their research, companies will generally not take much of an interest in investing multiple millions into CBD research.

If you read enough scientific publications on CBD, you´ll encounter a common phrase. It may vary a bit from paper to paper, but generally it stays the same: “Further research is needed.”

And it´s true: It is quite rare to find studies on CBD that provide evidence of any proven repeatable effects. Since we live in a time of evidence-based medical research, the lack of evidence of beneficial effects from CBD treatments can pose a big problem. Nonetheless, the lack of current evidence isn’t proof that there is no real effect, or as the saying goes: “Absence of evidence is not evidence of absence”.

Below you’ll find a summary of the current state of research on CBD.

Epilepsy

There is plenty of thorough research on treating epilepsy with CBD. While there still aren’t enough high-quality RCT-studies (RCT stands for “randomized controlled trial” and is seen as the bare minimum when it comes to scientific evidence), the ones that have been conducted show very promising results. The majority of patients taking CBD to treat epilepsy have noticed a substantial decline in the frequency of their episodes.

This led to the development of Epidiolex, a medical product containing CBD, which was released in 2018 in the US market. A year later in 2019 it was launched in Germany and the EU under the name Epidyolex. Treating epilepsy with a combination of CBD and standard therapy (e.g. with clobazam) offers a new treatment option that is especially helpful in treating forms of therapy resistant epilepsy, such as Lennox-Gastaut and Dravet-Syndrome which typically affect children. Research on treating other forms of epilepsy and seizures also shows promising initial results. But as always with cannabis: “Further research is needed.”

Stress and Anxiety

CBD is known to have a relaxing and soothing effect on us, especially when it comes to anxiety in social settings. To test this, researchers have developed a test that would make most of us cringe: “Public Speaking Stress Studies”. In this test, subjects hold a one-minute speech on a random topic that is revealed to them only right before their presentation- and all this in front of an audience. This creates a situation that would trigger stress in pretty much anyone without there being any actual danger or threat involved.

The result: In acute stressful situations, CBD can have an anxiety-relieving effect. However, you must exercise caution, as getting the dosage right is very important. Researchers describe the effects of CBD in these situations as an “inverted U-shaped dose-response curve”, i.e. the effects follow the shape of an upside-down “U” depending on the dosage. In the experiment, participants taking a mid-range dosage (300mg CBD) experience the highest level of stress reduction, whereas those taking a lower or higher dosage don´t experience as much of a stress-relieving effect, and, counterintuitively, it was found that higher dosages can even increase their anxiety levels.

In short: The more the CBD dosage is increased, the more it will have an anxiety-reducing effect. However, if the dosage is raised over the ideal mid-range dosage, the desired effect will decrease. In extremely high doses, it can even create the opposite effect and induce anxiety. When treating other symptoms, it is assumed that the effects of CBD will follow this same model which has also been proven to be true in animal studies.

Sleep

A study in 2019 has confirmed that CBD can help improve sleep quality. In this study, two out of the three test participants experienced an improvement in sleep in their first month of taking CBD. However, in the second and third month, the soporific effect seemed to decrease. There are a couple of possible explanations for this: The CBD dosage the patients consumed was relatively low (25-175mg per day) and the effect could have worn off after a while due to acclimation. Another possible reason could be that the patients had a much higher expectation for CBD than with other medications because of cannabis´s infamous reputation. This is known as the “Meaning Response” or Placebo-Effect. Unfortunately, this study didn’t have a control group and it was “open-label”, which means that both the patients and researchers knew when and how much CBD the patients were given.

Unfortunately, this study can’t prove anything with the results as the test subjects weren’t chosen randomly and were aware of the test parameters. Still, there are countless positive testimonies of CBD patients and scientific research that show CBD can improve your quality of sleep.

Dermal Health

Testimonies of the benefits of cannabis for our skin reach back thousands of years. And it seems to be true: researchers can prove that our skin has its very own endocannabinoid system (a.k.a. ECS). The endocannabinoid system of our skin plays a vital role in maintaining our skin physiology, and if there’s an imbalance, we may develop various threatening skin diseases. Because of this, researchers strive to better understand the modulation of the ECS as a way to possibly treat skin diseases.

A study in 2019 shows that using a CBD ointment, even without THC content, to treat skin diseases is a safe and non-invasive alternative to the standard treatments, especially if they cause inflammation. CBD ointments are beneficial in treating conditions such as psoriasis or inflammatory skin reactions caused by dermatitis. The study was conducted only on 20 test subjects since research regarding the core mechanisms of CBD’s anti-inflammatory effects has already been conducted and described in scientific literature.

It's important to keep in mind that any successful treatments in this area can drastically improve a person’s quality of life.

Pain

For thousands of years, it has been common knowledge that cannabis has pain-relieving qualities. This effect also exists with CBD: A study in 2019 shows that CBD absorbed through the skin significantly reduced neuropathological pain and has no apparent negative side-effects associated with most pain medications.

In conclusion

We can safely say that CBD seems to help relieve various pains without any serious side-effects. This can be seen in historical accounts as well as in current scientific literature and studies. However, hard scientific evidence testifying to the beneficial effects of CBD remains lacking, and consequently the modern medical and pharmaceutical industries continue to view CBD skeptically.

It’s uncertain if it will ever be possible to attain the needed scientific evidence for the positive effects of CBD. This requires rigorous, repeatable studies, and only major investments can ensure this level of scientific research. In the absence of patents, a primary mode of financial protection for those companies investing in research and development, the only financial motivator for CBD clinical trials would be broad market access and high demand for any resulting products, a much riskier proposition.

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