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14 min read
Lydia Kariuki
Google searches over the last four years have shown that increasingly more people are seeking to understand the benefits of CBD. At the same time, the demand for CBD products has risen drastically, with CBD oil leading the charge. The UK CBD market is expected to be valued at almost £1 billion by 2025, and this is only expected to grow exponentially as more research into CBD becomes available.
In this article, we explore the many possible health benefits of CBD that have been revealed by science so far.
CBD, like other cannabinoids, interacts with the endocannabinoid system (ECS) as well as modulating the output of other neuropathic and physiological systems, such as serotonin production. The ECS is a unique system with a complex network of receptors and neurotransmitters spread throughout the body. It regulates physiological processes such as mood, appetite and energy levels, ensuring that the body remains in a state of homeostasis.
But unlike THC, CBD does not interact directly by binding to either the CB1 or CB2 receptor. It has a weak affinity for both and may modulate their activity through alternative signalling pathways that we are yet to fully understand. CBD acts as a negative allosteric modulator of CB1 receptors. This means that it limits the activity of these receptors without binding directly to them. While some sources have claimed that CBD is able to block some negative effects of THC by binding to this receptor, others have disputed it.
In addition, current evidence suggests that CBD works through other pathways outside the ECS to exert its effects. For example, some studies have shown that CBD is able to boost serotonin levels through its interaction with the serotonergic system. While the exact mechanisms of CBD have not been fully deciphered, it is evident that CBD may exert significant therapeutic effects through multiple pathways.
To date, hundreds of studies have been carried out to investigate the benefits of CBD. While most of the studies have been preliminary, a number of randomised trials have been carried out in the last four years.
In 2019, the first-ever CBD-based drug (Epidyolex) was approved for administration in treating severe forms of childhood epilepsy.
Other randomised trials include trials for substance use disorders, acute low back pain, neuroinflammation, and relief of side effects brought on by conventional cancer treatments, among others. CBD research is on high momentum, and it is expected that in the next few years, the therapeutic potential of CBD will be better understood.
Many people take CBD to relax and unwind. CBD bath bombs, which are specially designed for relaxation, have become a fast-moving category in the CBD niche. However, not many people understand how the possible processes that CBD might offer enhances relaxation.
Most CBD products are broad spectrum, meaning that they contain the full profile of available compounds produced by the plant, instead of just one specific cannabinoid. Terpenes are among these, and are one part of the building blocks of essential oils that may enhance the therapeutic benefits of CBD as well as other cannabinoids. Some terpenes such as limonene, linalool, and ocimene have been shown to possibly offer a sense of relaxation. When added to CBD, they produce a powerful relaxing effect through what is referred to as the entourage effect.
The entourage effect is a hypothesis that cannabinoids and terpenes work synergistically to produce an effect that's greater than the sum effects of the individual compounds.
CBD also may support relaxation through its interaction with the endocannabinoid system (ECS) which regulates stress response. CBD interacts with endocannabinoid receptor CB2 and may bump up serotonin production in the brain to relieve anxiety and stress and hence promote relaxation.
Research has shown a possible link between CBD and other neurotransmitters outside the brain, such as serotonin and GABA. Both these neurotransmitters are involved in mood regulation. CBD may enhance the activity of these receptors and hence promote relaxation.
While the mechanisms by which CBD supports relaxation are not fully understood, the current evidence suggests that CBD may have a range of potential therapeutic benefits for promoting relaxation and reducing stress and anxiety. As the body of research into CBD grows, the science will be able to provide clearer answers as to how the cannabinoid produces these positive effects.
A 2019 study found that CBD may help reduce the symptoms of anxiety. The study design was a retrospective case series that was conducted at a psychiatric clinic where CBD was offered as adjunctive therapy for anxiety and sleep. The patient charts included monthly documentation of anxiety scores using validated instruments. This study was done using 103 adults split into groups. The researchers concluded that CBD could very well be useful in relieving anxiety and depression.
An open-label phase 2 clinical trial investigating the potential of CBD in treating anxiety found that CBD offered potential benefits in reducing anxiety and was well tolerated. In this outpatient trial, 14 patients with moderate to severe anxiety were treated with a full-spectrum, high-CBD sublingual solution. There were no reported cases of intoxication or serious adverse effects.
While a number of preclinical and clinical studies have demonstrated CBD’s possible utility in managing anxiety disorders, such as generalised anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD), the results are not yet conclusive.
Therefore, further research is needed to better understand CBD's specific effects on anxiety.
There’s mounting preclinical and clinical evidence that points towards the potential of CBD in relation to pain and inflammation. But one thing to keep in mind is that there is a large, partially unregulated CBD market in the UK. Always source all therapeutic products, cannabis or not, from trusted sources. In the UK, medicinal cannabis is only available to patients who are suffering from a condition that has been approved for this type of treatment option. It also must be prescribed by a doctor that is registered and qualified to do so.
A survey to investigate the efficacy of CBD in managing arthritis pain was conducted between May 5th 2020, and November 5th 2020 by the Arthritis Foundation and Savvy Cooperative. CBD treatment was associated with a possible reduction in pain and an improvement in sleep and physical function. The benefits were more pronounced in the osteoarthritis group as compared to the groups with rheumatoid arthritis and other autoimmune arthritis.
A 2021 study that was conducted by Syracuse University also found that while CBD may not reduce pain intensity, it could make the pain sensation feel less unpleasant.
The cannabinoid THC also shows potential promise for pain-relieving qualities.
And what is pain?
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
According to the researchers, CBD may make the pain less bothersome.
However, other studies have found that “CBD is no better than placebo” when it comes to pain relief. A 2022 randomised placebo-controlled double blind study that was conducted to investigate the effectiveness of oral CBD in treating lower back pain found no significant difference between the group that received CBD and the group that received placebo. The amount of CBD offered was 400 mg. The CBD was offered to patients presenting in the ER with acute pain.
A more recent study that was published in the Journal of Urology also found no significant difference between the CBD and the placebo group in terms of pain management after stent placement for kidney stones.
Where is the truth about CBD and pain management?
Several things are yet to be understood about how CBD affects pain. For the studies that have shown no improvements between CBD and placebo, some questions have been raised. The dosage of CBD applied as well as the duration of offering the CBD. Studies that have shown positive benefits have generally involved CBD offered for an extended duration rather than for an acute situation. That said, there’s more evidence pointing towards the possible effectiveness of CBD in managing chronic pain and inflammation. Further studies investigating the appropriate dosage and duration of offering CBD are therefore needed.
Sleep disorders are caused by a variety of factors, and one of these is anxiety. Studies investigating the possible effectiveness of CBD in relieving anxiety and therefore improving sleep have demonstrated the potential for positive benefits. A 2022 study found that a combination of THC and CBD may be effective in improving both the quantity and the quality of sleep. Patients with sleep disorders related to anxiety are likely to benefit from CBD.
Neurological diseases are often chronic and often difficult to treat. Furthermore, they are likely to diminish one’s quality of life as they progress. The category of neurological diseases includes conditions such as epilepsy, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and migraines.
CBD research has demonstrated the possible effectiveness of CBD in managing severe seizures and epilepsy. A 2021 (albeit small in scope) study investigating the role of CBD in neurological diseases found it may offer positive benefits in humans, but researchers considered the results to be inconclusive, given the low number of participants.
A different study found that CBD could be effective in relieving symptoms of MS. Given that most neurological conditions are difficult to treat, it is important to have more in-depth studies that will paint a clear picture of how CBD may affect the central nervous system and by extension, neurological conditions.
It is theorised that CBD could have a role to play in the management of insulin-dependent diabetes.
CBD may help to reduce inflammation and oxidative stress that may trigger or aggravate diabetes.
It may also boost pancreatic health by preventing damage from overactive immune cells, says Rory Batt MSc, who conducted a study investigating the relationship between the endocannabinoid system, CBD, and type 2 diabetes.
In addition, CBD has the potential to help to prevent or relieve diabetic neuropathy, which occurs in advanced diabetes when high blood sugar levels damage peripheral nerves.
Before we go into CBD and cancer, we have to make it totally clear that there we are not suggesting, in any way, that CBD can cure cancer. The following studies do show some potential promise in helping deal with certain aspects relating to cancer patients, but there is simply not enough clinical research to make concrete claims either way.
One of the most intriguing discoveries on CBD is its possible action against glioblastoma (an aggressive form of brain cancer).
A 2021 study found that CBD could inhibit the progression of glioblastoma by modulating the microenvironment of the tumour. The CBD which was given in inhaled form was well tolerated, easy to administer, and showed enough possible effectiveness that it could warrant further research.
A subsequent 2022 study found that CBD may enhance the antitumor activity of temozolomide (a form of chemotherapy) in patients with glioblastoma. Both these studies have been preclinical, and hence there is a need for clinical studies to confirm the true potential of CBD in treating glioblastoma. CBD may also help cancer patients manage the more general symptoms of cancer such as anxiety, pain, and nausea brought on by chemotherapy and radiation therapy.
Opioid use disorder is at almost epidemic levels in the UK, and it appears that CBD may be able to help. A 2019 study that was published in the American Journal of Psychiatry found that CBD could reduce the cue-induced craving for heroin, and also may help cut the level of anxiety related to withdrawal. This shows that CBD may help to wean addicts off heroin and other addictive drugs. CBD shows no signs of being addictive whatsoever.
Anecdotal reports have suggested that CBD may help reduce aggressive behaviour patterns in autistic patients, and could help to calm them down. A 2019 case study found that CBD may be useful in improving social interactions generally.
The nine benefits listed above are not representative of the full potential of CBD. As mentioned, what is understood now is just the very beginning. As cannabinoid science evolves and matures, the benefits of CBD will become more evident.
In 2019, the UK approved the first plant-derived and pharmaceutical-grade cannabidiol (CBD) to be taken as a medicine. So far, Epidyolex has been approved for three indications: Lennox Gastaut, Dravet’s syndrome (severe childhood seizure), and tuberous sclerosis complex.
Epidyolex was developed and patented by Greenwich Biosciences, a subsidiary of GW Pharmaceuticals. In 2019, the European Commission authorised the marketing of Epidyolex and this made the drug a licensed CBPM in the UK. Physicians through the UK Health Service can now prescribe Epidyolex.
From most studies so far, CBD oil, and other forms of medical cannabis oil, are safe for the majority of people when taken in appropriate amounts. However, some people may experience some mild side effects that may include the following:
It is also important to note that CBD has the ability to negatively interact with several pharmaceutical medications and will either potentiate or reduce their effects. This includes blood thinners, antidepressants, and some anticonvulsants, among others. This only further highlights the need to consult with a doctor that has been registered to prescribe medicinal cannabis before you begin administration if you are taking other medications.
Contaminated CBD may cause unwanted effects due to the added contaminants. For example, CBD that's contaminated with THC may cause intoxication. In extreme cases, CBD may be contaminated with toxic cutting agents such as vitamin E Acetate which was linked to the 2019 vaping crisis. To help combat this issue, always ensure that you source your CBD products from trusted sources. But generally, CBD is considered safe, and it is also well tolerated by most individuals, both young and old.
Is CBD approved as a medicine in the UK?
While medical cannabis was legalised in the UK in 2018, CBD was approved as medicine a year later. In 2019, the EU legalised the first ever CBD-based drug called Epidiolex which is now available and legal in the UK.
All approved medicines in the UK must be regulated by the UK's Medicines and Healthcare Products Regulatory Agency (MHRA). Therefore, CBD vendors are not allowed to make any medical claims about CBD at this stage, but it is allowed to be prescribed by specialist doctors.
As explained above, the possible therapeutic potential of CBD looks to be large in scope, and researchers are only beginning to scratch the surface. Most of the CBD products in the market currently are uniquely designed to support the core functions of the ECS and hence restore homeostasis. CBD products are also designed to improve general health and well-being.
CBD is available in the UK in different formulations. This includes tinctures, capsules, soft gels, gummies, topicals, isolates, flowers, and vape products among others. When purchasing CBD in the UK, take the time to scrutinise the certificate of analysis (COA) and ask for it if it's not available on the product. This should provide a guarantee that the CBD is pure and not contaminated.
Future research on CBD is likely to focus on the safety of CBD across demographics and at different doses. The interaction of CBD with other cannabinoids as well as terpenes will also be an area of focus. The efficacy of CBD in treating or alleviating symptoms of certain diseases will also take centre stage. Lastly, the development of pharmaceutical-grade CBD products may offer new treatment options for certain medical conditions.
As more research is conducted and results published, CBD will continue to gain acceptance as a potential therapeutic agent. Overall, the future perspectives for CBD as a potential therapeutic agent are promising, but more research and regulatory clarity will be needed to fully realise its potential benefits.
If you need an alternative approach to manage your health condition, Releaf is here to help. Our monthly packages are based on your cannabis prescription, and we offer specialist consultations for medical cannabis and a unique medical cannabis card for protection.
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Am I eligible?Lydia Kariuki, a medical nurse and journalist with a diploma in clinical research, specialises in translating complex cannabis research into accessible content, fostering public understanding and awareness.
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