Study: Smoked Cannabis More Powerful Than CBD Extracts for Back Pain
by Bethan Rose
Cannabidiol (CBD) is one of the natural compounds found in the cannabis plant. Because it does not produce a “high” feeling, CBD has grown incredibly popular in the past few years for the treatment of medical conditions like chronic pain, anxiety, inflammation, and epilepsy. It is readily available in various forms like CBD oil, lotions, tinctures, hemp flower, gummies, etc. This beginner’s guide to CBD covers everything you need to know, including types of CBD, dosages of CBD, the legality of CBD in the U.S., and more.
Cannabidiol, also known as CBD, is an extract of the cannabis plant that is mixed with a carrier oil to form CBD oil. In states that have legalized recreational and medical cannabis, there are varieties of high-CBD strains of cannabis that you can purchase at your local dispensary.
CBD only products are usually extracted from hemp as opposed to cannabis, because they contain higher amounts of CBD instead of the larger amounts of Δ9-tetrahydrocannabinol (THC) that are found in cannabis. To extract CBD oil from hemp or the cannabis plant, a CBD extraction machine is required. Solvents such as ethanol are also typically used in this process. New extraction methods for CBD oil, such as supercritical CO₂, are now available and make cleaner, more purified CBD products. This is because it balances the temperature and pressure of the plant during extraction, eliminating the need for solvents.
Prescription CBD oil, called Epidiolex, can be safely administered by a doctor for children suffering from seizures due to certain epilepsies. CNN’s medical correspondent Doctor Sanjay Gupta hosted a documentary highlighting CBD for children diagnosed with epilepsy and seizures. In the documentary, Weed 4: Pot vs Pills, Doctor Sanjay Gupta emphasizes the medicinal value of cannabidiol.
Many doctors and proponents of holistic and all natural medicine trust in the therapeutic component of CBD as an alternative medicine to reduce various symptoms to alleviate or play a potential role in the following conditions, according to the World Health Organization (WHO): “nausea, inflammatory bowel and Crohn’s disease, anxiety, depression, psychosis, cancer, neuropathic pain, asthma, Alzheimer’s disease, Parkinson’s disease, rheumatoid arthritis, inflammatory disease, multiple sclerosis, cardiovascular diseases, diabetic complications, and infection.”
CBD is generally well-tolerated and has a good safety profile. Major studies from the scientific community continuously appraise the medicinal benefits of CBD. It is clearly evident that more research needs to be done to prove the effectiveness and long-term outcomes of this medicine. Our country can no longer rely on doctors continuously prescribing suboptimal or even addictive medications that aren’t giving patients relief.
The WHO reported in 2017 that no “public health related problems” have been connected to the use of pure CBD. The report adds that, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential.” CBD is a generally safe option alternative treatment, as long as you consult your doctor to be sure that CBD won’t interfere with your other medications.
However, CBD may also carry mild temporary side effects, including drowsiness, decreased appetite, nausea, vomiting, diarrhea, and abnormal liver function tests. Most of the abnormal liver function tests were reported to be reversible in the Epidiolex clinical studies with adjustment of CBD dose or seizure medication dose.
You should always learn how CBD products affect you before driving, operating machinery, or increasing your dose, as higher doses increase the probability of side effects. The efficacy, drug interactions, or long-term effects of cannabis or cannabinoids are not yet fully known, and may not be suitable for everyone. Thus, always talk to your healthcare provider first before taking cannabis or CBD products for any reason.
Δ9-tetrahydrocannabinol (THC) is a chemical component that causes the intoxicating effects of the cannabis plant. However, high-CBD and low-THC strains of cannabis do not produce intoxication, but offer the ability to alleviate many ailments including seizures. These strains, such as Charlotte’s Web, highlight the medicinal characteristics of cannabis.
Cannabinoids are chemical compounds that naturally occur in the cannabis plant. Cannabis contains around 150 cannabinoids; the two primary and most popular cannabinoids are THC and CBD. As cannabis research evolves, we are learning more about other cannabinoids like cannabigerol (CBG), cannabinol (CBN), and cannabichromene (CBC). These natural cannabinoids can play a major role in the endocannabinoid system, a system of the human body that was not in the limelight until recently and is still being explored.
Although it is one of the oldest biological systems of the human body, you may have never heard of the endocannabinoid system. Our bodies come equipped with this entire system that is responsible for managing a multitude of physiological processes. The endocannabinoid system, or ECS for short, is a map of cannabinoid receptors located throughout the body.
The purpose of the endocannabinoid system is to regulate a variety of bodily functions such as mood, memory, fertility, appetite, hormones, and responses to pain or stress. In the end, the ECS helps our bodies maintain homeostasis or balance.
In fact, the discovery of the cannabinoids found in the cannabis plant led to the naming of the ECS. “Since the time when exogenous cannabinoids revealed their existence, the entire natural complex came to be called the ‘endogenous cannabinoid system,’ or ‘endocannabinoid system’ (ECS),” according to Dr. Bradley E. Alger in his 2013 paper published in Cerebrum.
In other words, endocannabinoids are the body’s natural endogenous cannabinoids. Endocannabinoids are neurotransmitters that activate the cannabinoid receptors of the ECS.
However, we also react to exogenous (meaning external) cannabinoids like those found in cannabis. Phytocannabinoids, “phyto” meaning plant-derived cannabinoids, also attach to our receptors that initiate a physiological response. Essentially, our receptors are the lock and cannabinoids are the keys that unlock feedback.
At this time, there are two known receptors in the ECS: CB1 and CB2. Both are dispersed all over the body; however, CB1 receptors are mostly found in our brain and nervous system, while CB2 receptors are condensed in our organs and immune system. Each of the two types of receptors are responsible for strategically keeping order of our immune and nervous system functions.
Emerging evidence indicates that cannabinoid receptors may bond with each other, and that cannabinoids may also interact with adenosine, opioid, serotonin, and dopamine receptor families. In due time, we’ll be able to learn more about our other receptors and their effects when more research is conducted.
Most are familiar with THC, the cannabinoid responsible for the intoxicating and euphoric effects of marijuana that causes “impairment.” THC’s molecular form is very similar to our bodies’ naturally occurring endogenous neurotransmitters.
Hemp and cannabis are the same species of plant, but hemp is federally legal and contains less than 0.3% THC content, meaning that it does not intoxicate users like most cannabis in the recreational market does. Essentially, the word hemp refers to low THC variations of the same plant. Another main difference between hemp and cannabis is the use of hemp for industrial purposes like the production of paper, building materials, skincare products, food, and clothing.
There are hundreds of different types of organic compounds found in the cannabis plant. When ingested, virtually all of these cannabinoids and other compounds work together and produce a complete, well-rounded effect known as the entourage effect. Dr. Raphael Mechoulam, the founder of THC, conducted research in 1999 that introduced the concept of the entourage effect. Today, the term is used to describe how individual chemical components synergistically work together to produce superior effects and improve the cannabis experience.
So what else plays a role in the entourage effect? There are six main cannabinoids:
The last four are less popular but are beginning to get more attention. Terpenes are another component of the cannabis plant that create the scents of individual strains and are believed to contribute to the entourage effect. Cannabis researcher Dr. Ruth Fisher points out that terpenes can increase the body’s rate of absorption of cannabinoids. The entourage effect, in other words, is the idea that CBD is enhanced by the other cannabinoids and compounds found in cannabis and/or hemp derived plant medicine.
The answer to this is a little complicated. CBD alone won’t produce an outright intoxicating response or get you high. In fact, CBD can be used to counteract the intoxicating effects of THC. However, it is important to note that CBD is technically psychoactive, meaning that it affects the mind.
CBD affects the mind in positive ways like alleviating stress and anxiety, boosting mood, improving depression and addiction as well as helping with sleep. These are just a few of its health benefits. It is more widely used for pain and inflammation. Some who are more perceptive of their physiology might feel a subtle uplift in their mood.
But it won’t be enough to cause a mind-altered state, reduced cognition, paranoia, or anxiety like THC can. CBD will not make you lose your control or even alter your behavior. Though, be aware that there are some risks depending on what products you use like supplements and medications.
CBD Is Psychoactive but Doesn’t Induce a High
Many people also believe that the word psychoactive automatically implies something bad or negative, but something that affects your mind is not always a bad thing. We consume many foods and compounds that have psychoactive properties without any adverse effects. Chocolate is one such example. Chocolate does have psychoactive properties, particularly dark chocolate. For example, both chocolate and CBD influence serotonin activity.
When individuals see the word “psychoactive,” they automatically associate it with the effects of THC. Due to this stigma, companies end up putting CBD under the “non-psychoactive” label. It also creates some distance from intoxicating cannabis strains containing high potency THC that are popular at recreational dispensaries.
You’ll want to become familiar with the differences between broad-spectrum CBD and full-spectrum CBD products, because full-spectrum products utilize the entire plant and have very little THC in them. And for CBD to be legal, it is required to have less than 0.3% THC. Although rare, those who are sensitive to THC might experience minimal intoxicating effects when using full-spectrum CBD goods. Broad-spectrum products have undergone processing that removes all THC compounds, therefore virtually eliminating the risk of feeling high. We cover different types of CBD oil in depth in the next section of this guide.
CBD Binds to Receptors Differently Than THC
While CBD won’t provoke an intense response from our CB receptors like THC, it will impact them and the way they operate. It’s not limited to just our CB receptors either! CBD can bind to other receptors in the body and influence them as well. For example, CBD has known effects on our serotonin receptors that reduce stress. While at the same time, it can also inhibit functions in others like our pain receptors.
Although this is all good news, the way in which the cannabinoid compounds interact with our brain is yet to be fully understood. Many studies are still underway while experiments exploring potential treatments are being tested on mice. Rest assured, while we may not have definitive evidence on a lot of aspects regarding CBD, its safety has been repeatedly confirmed and remains unchallenged.
If you’ve been following the recent CBD craze, you’ve likely encountered products on the market labeled as broad-spectrum, full-spectrum, or Isolate. These terms can be confusing for everyone, especially for beginners and curious folks alike. We are happy to enlighten you on the key differences in these descriptions and how to use CBD oil. We briefly touch on the subject in the video below, but let’s explore these terms in depth.
Full-spectrum CBD, or whole plant CBD, is created using the whole hemp plant, meaning that it still contains different components of the plant like multiple cannabinoids (CBD, CBN, CBG, etc.), terpenes, and flavonoids. THC is also present but still below 0.3% (otherwise it would not be federally legal).
A study published in 2018 in the journal Frontiers in Neurology analyzed medical records and patient surveys for those being treated with CBD for refractory epilepsy. The researchers found that “CBD-rich extracts seem to present a better therapeutic profile than purified CBD, at least in this population of patients with refractory epilepsy. The roots of this difference is likely due to synergistic effects of CBD with other phytocompounds (aka Entourage effect), but this remains to be confirmed in controlled clinical studies.” In the study, patients taking full-spectrum CBD needed lower average doses of CBD in comparison to those taking pure or isolated CBD.
Broad-spectrum products belong in a category that is somewhere between full-spectrum and isolates. While all of the organic plant matter is processed, the THC molecules are isolated and thoroughly excluded. Those that use broad-spectrum products are able to experience the benefits from the entourage effect, because all of the other collaborating cannabinoids and terpenes remain included in the product.
Isolate means that only the CBD compounds have been extracted from the plant. The original plant matter has been extensively refined to narrow down and separate molecules, so that the only thing left is CBD. Isolate is 99.9% pure CBD. Sometimes, additives like artificial terpenes and flavonoids are included to enhance the taste, smell, or consistency. Otherwise, there should be virtually zero traces of any other compounds in it.
“Will I fail a drug test if I take CBD?” is a question we often hear (see the video below). Those who are subject to regular drug screenings such as federal employees often wonder if CBD will pose an issue for them. The answer is yes, depending upon the type of CBD product you ingest, cannabinoids can show up on a drug test.
It’s not unusual for CBD consumers to feel confused when the terms on the product labels aren’t generally well-known. Refer to the above section for the differences between full-spectrum, broad-spectrum, and isolate CBD. While it is extremely rare, full-spectrum CBD products have the ability to produce a positive result on drug tests that screen for THC.
Since all THC molecules are eliminated, broad-spectrum products are less likely to show up in routine drug testing and may be a good choice for those who want to refrain from consuming THC. CBD isolate is a great option for those who want to avoid the euphoric effects of THC or are concerned about passing a drug test, because the THC molecules have been virtually eradicated.
Are you one of the millions of people turning to the CBD market as an alternative or addition to prescription meds? More Americans are substituting opioids with cannabis, which unlike opiate-based medications, are non-lethal and many find that they experience fewer side effects with CBD.
Between the years 1999 and 2017, drug overdoses killed 702,568 people in the United States and almost 400,000 of those deaths involved the use of opioids. This is according to the Centers for Disease Control and Prevention (CDC), which claims that from 2015-2016, illicitly manufactured synthetic opioids like fentanyl killed more people than any other drug category.
Thankfully, cannabis may produce some of the same sedating and pain-relieving effects produced by drugs in the opiate class, causing a reduction in opioid use. CBD is being widely used as a natural and safe pain management treatment. In fact, a recent study published in the American Journal of Psychiatry revealed how CBD could even reduce opioid cravings and craving-related anxiety in a double-blinded, randomized placebo-controlled trial setting.
If you’re using CBD for another purpose, such as for anxiety relief or as a means of establishing proper overall health and wellness, the following information will be equally as important for you to absorb. But how do you take CBD oil? Read on to learn more about dosage considerations.
Now, we are going to talk about dosage and what is the optimal amount of CBD to use for you personally. While you can’t overdose from this cannabinoid, the likelihood of side effects increases with the dose. Determining the best CBD dosage generally depends on the following factors:
In addition to the aforementioned guidelines for choosing a CBD dosage, you should pay attention to the concentration of whatever product you end up buying. Low potency would be in the range of 1-10 mg per serving, whereas a medium potency oil should deliver around 10-25 mg of CBD per serving, e.g. per capsule, per spray, per tincture, etc. Anything higher than this is considered highly potent.
CBD products are gaining popularity on their own aside from the legalization movement of cannabis worldwide. Times are changing in the cannabis industry as the U.S. federal government is taking the necessary steps to end the War on Cannabis. Effective September 28, 2018, the Drug Enforcement Agency (DEA) made a groundbreaking announcement:
“With the issuance of this final order, the Acting Administrator of the Drug Enforcement Administration places certain drug products that have been approved by the Food and Drug Administration (FDA) and which contain cannabidiol (CBD) in Schedule V of the Controlled Substances Act (CSA). Specifically, this order places FDA-approved drugs that contain CBD derived from cannabis and no more than 0.1 percent tetrahydrocannabinols in Schedule V.”
It’s important to be informed about the terminology behind these products. CBD that is derived from industrial hemp is federally legal in every state. However, each state sets their own laws regarding hemp as well as medical or recreational cannabis use. Check out this guide regarding CBD laws to see where your state stands in terms of CBD legality. In order to meet legal requirements, all CBD goods MUST contain less than 0.3% THC. Check out the next section for more information on the differences between cannabis and hemp.
Legalized CBD-Derived Medication
It is important to note that the pharmaceutical medication Epidiolex is the only CBD-based medicine approved by the Federal Drug Administration (FDA). Epidiolex itself is now no longer classified as a controlled substance by the DEA. Under the DEA’s Schedule V status, CBD is now classified as the least restrictive controlled substance.
Epidiolex is an oral solution that is supposed to treat seizures associated with Lennox-Gastaut syndrome and Dravet syndrome in children of two years and older. Recently in 2020, it was also approved for seizures associated with tuberous sclerosis complex in children over age one. Ever since the Food and Drug Administration (FDA) panel approved Epidiolex, people have been confused about the legal status of this substance.
Since CBD is a targeted medicine for the treatment of epilepsy and given to children to treat their seizures, the lack of intoxication makes CBD a perfect medicine for treating medical problems in children. For the first time in U.S. history, a hemp-derived medication won federal approval in the US.
There is a legal distinction between cannabis and hemp. Cannabis is typically bred for recreational dispensaries and is high in THC content, which provides inebriating effects. On the other hand, hemp is bred and grown for the industrial use of fiber as well as seed, and all hemp must legally contain below 0.3% THC. With hemp, there is no way to induce intoxication by consuming any reasonable amount of it. Hemp-derived CBD products are available to purchase in stores (not just dispensaries) and online.
All that being said, the 9th US Circuit Court of Appeals upheld a DEA rule that defines any cannabis extract as a Schedule I controlled substance if it contains one or more cannabinoids, a definition that CBD seems to fit.
“Contrary to some early reports, this ruling does NOT classify hemp-derived cannabidiol (CBD) as a controlled substance, nor does it signify that the popular hemp product is federally illegal…In short, the DEA’s ‘marijuana extract rule’ does not apply to hemp or derivative products such as hemp-derived CBD. Period…Anybody out there that says the law is definite one way or another is lying.” –Jonathan Miller, The Hemp Industry’s Lawyer
Until the situation becomes clearer, it’s best to check out the laws in the city or state in which you live.
Where to buy CBD oil is a question that many readers ask us. Just about anyone in the U.S. can purchase CBD derived from hemp online right now. There are lots of CBD products available such as oil, lotion, coffee, shampoo, candy, beauty products, and vape juice.
If you don’t live in a state in which cannabis is legal, you may have some difficulties with finding legitimate CBD products. Whenever you’re buying online, make sure to do some due diligence and read some reviews, because there are no required testing regulations to see if the product is effective or not.
Always look for the “Certificate of Analysis” (COA) to ensure purity and potency. These results should detail the levels of various cannabinoids, terpenes, and solvents used in the manufacturing process. It also helps ensure the product is free of harmful contaminants and unwanted ingredients like pesticides and heavy metals. Avoid buying hemp products from overseas, as they are more likely to contain such contaminants. You can also look for any additional certifications like “USDA Certified Organic Hemp” or “BSCG Certified” for more credence.
Yes, there are companies that comply with the 2018 Farm Bill, and they can ship their products anywhere in the U.S. with the right commercial licensing. This bill differentiates cannabis from industrial hemp and allows the cultivation of hemp within the United States.
As of April 2021, there are currently 36 U.S. states that have medical marijuana programs. Note that some of these states only allow CBD in oil form containing a low percentage of THC, and some only allow CBD oil for the treatment of pediatric epilepsy as part of their medical cannabis programs. As of 2018, the following states have no rules regarding whether CBD comes from cannabis or hemp as well as any laws limiting CBD:
The following states have medicinal cannabis programs that only allow CBD oil:
CBD is an option for those who need relief from their medical ailments without the intoxicating effects of THC or other drugs like opioids. CBD is a chemical compound that occurs naturally in the cannabis and hemp plants and is not a mind-altering substance, unlike the plant’s well-known intoxicating constituent THC.
While you can’t overdose from CBD, it can provide plenty of therapeutic effects for the human body. Studies show that extracts with a high-CBD content tend to work well as a candidate anxiolytic (meaning that it reduces anxiety), antidepressant, and antipsychotic.
Below are some of the many conditions for which CBD is used to alleviate symptoms:
Thanks to the pain relieving effects of CBD, some patients are able to stop taking addicting opioid medications for their chronic pain. According to Consumer Reports, CBD works to fight inflammation (it is an anti-inflammatory), addiction, and anxiety. Speak to your doctor and make sure that taking CBD won’t interfere with any of your prescription medications or supplements.
Unlike most pain medications that are often prescribed by doctors, such as Hydrocodone (prescribed 127,859,000 times in 2017), Oxycodone/OxyContin (16,440,000), and Morphine sulfate (9,658,000), CBD consumption is by no means limited to consuming a capsule. CBD comes in many forms like CBD edibles, beverages, topicals, tinctures, and more. You can read more about ways to take CBD oil in the next section.
It’s always important to be well informed on how remedies work and the effects that they may have on your body. Again, speak with your doctor before using CBD, especially if you are currently taking other medications, and see if it’s the right thing for you.
CBD oil – whether in its isolated, full-spectrum, or broad-spectrum form – can be baked into edibles for slow-releasing effects, taken sublingually (under the tongue) in the form of a tincture, vaporized for fast symptomatic relief, spritzed onto the tongue for quick absorption into the bloodstream or consumed in the form of a suppository or capsule. CBD can even be applied topically to affected muscles or areas of skin for localized relief in the form of topicals and lotions.
The best way to take CBD oil is going to be different for each individual depending on their preferences and needs. CBD can be delivered to your body in multiple ways, ranging from applying topical cream over your skin to eating CBD infused products. High-quality CBD products are available for users from high-quality chocolates to refreshing infused beverages. There are endless possibilities with infused foods and drinks ranging from CBD coffee, to CBD candy, and even hemp seeds for smoothies.
We emphasize doing your due diligence and making it a point to only purchase CBD products that have been thoroughly lab tested and have a Certificate of Analysis (COA) available.
To summarize, cannabidiol (CBD) is one of the hundreds of compounds found in the cannabis plant. The substance has a wide range of medicinal and therapeutic effects that have been shown to be beneficial for different medical conditions, including insomnia, chronic and neuropathic pain, depression, anxiety, and even for children with epilepsy.
Remember to speak with your doctor before using CBD to learn if it’s right for you, especially if you are taking prescription medications. At Veriheal, we can set up an appointment for you with a medical marijuana doctor or a cannabis coach to learn more about how cannabinoids like CBD and THC may be able to alleviate the symptoms of your condition(s).
Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.
This guide is a compilation of blog posts written by Chane Leigh, Lo, Anthony Dutcher, and Bethan Rose.
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September 6, 2021 at 8:10 am
I was struggling with anxiety and mental health issues but didn’t want to resort to any heavy pharmaceutical medicine. I was so glad I found CBD! It is truly nature’s gift to us.
LINDA LANE says:
September 14, 2021 at 12:13 pm
I have just started taking cbd. My main reason is pain in both knees. I can only do house work for about 30 minutes without pain. After 30 minutes i must sit down for atleast 10 minutes to stop the pain. I am looking for great results.
Thank you for the article on CBD. It answered my questions.
Voibon Blog says:
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