Snake oil or wonder drug? Rarely has one supplement inspired so much excitement—or skepticism—as cannabidiol (CBD). From marketers and early adopters to serious researchers, cannabis fans are touting benefits for all sorts of illnesses. The results of early studies are tantalizing: Scientists have observed therapeutic benefits in everything from anxiety to epilepsy to neurological conditions like Parkinson’s. And they’ve seen few, if any, side effects, which may be the greatest promise in this age of pharmaceuticals that may bankrupt, addict, or even kill you.
What we do know is that CBD interacts with a system of neurotransmitters within the body and brain called the endocannabinoid system (ECS). Scientists recognize that the ECS plays a crucial role in all kinds of physiological functions, helping to regulate movement, pleasure, the gastrointestinal system, appetite, bone health, seizures, and pain sensation—just to name a few.
The complicated ways in which CBD influences the ECS make it attractive for alleviating all kinds of symptoms and conditions. CBD can interfere with the brain activity that causes seizures, helping control severe epilepsy (particularly in children). It interacts with the bodily systems that cause nausea and vomiting, gaining promise as a treatment for cancer patients dealing with the side effects of chemotherapy. CBD influences appetite and the way the body stores and burns fat, which means it may help with obesity and weight loss. It can even regulate how the brain processes the high caused by dangerous drugs, helping to fight substance abuse and addiction to opioids, alcohol, and other drugs.
Much, much more research is needed to build beyond-a-reasonable-doubt evidence of CBD’s healing powers. Some doctors are unconvinced, claiming that CBD has, at most, a psychosomatic benefit. What follows is a survey of the thinking and research that exists for a range of maladies. If you suffer from any of these, take heart—but consult a physician before changing your treatment regimen, as every type of CBD won’t work for every individual or type of affliction, and drug interactions are possible.
We’re living in a full-blown drug crisis, with 2.1 million Americans abusing opioids and more than 115 people dying every day in the United States from an overdose. Highly addictive opioid drugs—including prescription painkillers, heroin, and fentanyl—are devastating families and destroying entire communities.
Not too long ago, we thought of addiction as a character flaw—people must continue using, even as the habit destroyed their lives, because they were too weak to quit. Now scientists understand that drug addiction is a brain disease. Drugs—from illegal substances like cocaine and methamphetamines to legal ones such as prescription opioids and alcohol—cause physical changes in the brain that make it very, very difficult to stop. But therein lies CBD’s potential to help: The body’s endocannabinoid system is involved with the euphoric feeling that makes many drugs so addictive, so using cannabinoids to block that “reward” holds great promise as a treatment. Studies have shown that CBD interferes with the heroin high, which could reduce its draw on people with addiction. CBD has also been identified as a helpful therapy for heroin cravings and relapse. And research shows that CBD is safe for people to take along with opioids as a potential therapy. Not only that, but another study suggested that CBD’s anti-anxiety effect can also help treat the symptoms associated with addiction and withdrawal, to help prevent relapses.
Studies have shown that CBD interferes with the heroin high, which could reduce its draw on people with addiction. CBD has also been identified as a helpful therapy for heroin cravings and relapse.
Researchers believe CBD can help treat other types of addiction, along with the brain damage that comes with drug abuse. Excessive alcohol use kills neurons in the brain, causing cognitive and behavioral problems and likely making it much tougher to quit drinking. But a couple of studies have found that CBD actually protects the neurons from binge drinking, raising its profile as a potential treatment for alcoholism. Other studies suggest that CBD may help with addiction to nicotine, cocaine, and methamphetamines.
Nobody ever said getting older was easy. Thankfully, CBD can make senior life a little easier by alleviating some common health complaints. Creaky, painful joints? CBD’s anti-inflammatory, pain-fighting qualities have people turning to it for help with arthritis. And a CBD-based drug has been shown to reduce pain from rheumatoid arthritis. Some patients also turn to CBD for relief from gout attacks.
Promising research has singled out CBD as a potential treatment for Parkinson’s disease because of its neuroprotective qualities. And among its many other functions, the body’s endocannabinoid system plays a role in bone metabolism—which makes cannabinoids a potentially attractive therapy for osteoporosis and loss of bone mass.
Racing pulse, sweaty hands: Everyone has been there at some point. But an anxiety disorder goes well beyond the temporary nervousness that comes before a big presentation—it’s long-lasting and wreaks havoc on daily life. Whether it’s panic attacks (panic disorder), crippling fear about being around other people (social anxiety disorder), or feeling constantly restless and worried without a clear reason (generalized anxiety disorder), the realities of anxiety make it hard to function normally and enjoy life.
Unfortunately, anxiety can be difficult to treat. Of the 40 million Americans who suffer from anxiety or anxiety-related disorders or about 18% of the adult population, only about 36% receive treatment. Conventional treatment for anxiety disorders often includes costly medications like antidepressants or benzodiazepines—drugs with serious side effects such as insomnia, weight gain, headaches, sexual dysfunction, and, in the case of benzodiazepines, dependence.
Anxiety and depression are thought to be caused in part by the lack of an important chemical in the brain called serotonin. CBD has been shown to mimic the effect of serotonin in the brain, capable of binding to and activating serotonin receptors (known as 5-HT1A receptors). For this reason, it appears that CBD has anxiolytic (anti-anxiety) and antidepressant characteristics, as shown in preclinical studies on mice that were exposed to stressful situations.
Evidence is accumulating that adding CBD to your routine can have a clear therapeutic benefit, without the side effects. Animal research that subjected mice to stressful situations demonstrated that CBD had both anti-anxiety and anti-depressive characteristics. And brain scans of humans with generalized social anxiety disorder found that the subjects who took CBD showed different brain activity in the areas that process emotions—and reported feeling less anxious. Another fascinating study had subjects with generalized social anxiety disorder perform a simulated public speaking test; the ones who took CBD beforehand had less anxiety, cognitive impairment, and discomfort than the placebo group.
Stiff, inflamed, and aching joints affect more than 50 million adults and 300,000 children in the U.S. In the most common form, osteoarthritis, the protective cartilage surrounding the joints can wear away over the years, allowing the bones to rub against each other—a sometimes severely painful condition that keeps sufferers from doing the activities they love. Rheumatoid arthritis, on the other hand, is an autoimmune disorder where the body attacks its own joints, but the inflammation and pain are similar.
Arthritis sufferers often turn to opioid painkillers, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs), all of which have side effects ranging from damage to the heart, kidneys, and stomach, to bone loss, to addiction.
By contrast, CBD has no known negatives. It tackles arthritis on two fronts—by mitigating inflammation and pain. It does this by activating the body’s endocannabinoid system, which regulates a number of physical processes, among them inflammation and pain sensitivity. Studies suggest the benefits may not stop there. One reported that a topical CBD gel reduced joint swelling and pain without side effects. Another observed that not only did CBD lessen arthritic inflammation, it actually stopped the progression of the disease. And another found CBD both relieved osteoarthritic pain and prevented later pain when taken prophylactically.
Additional research shows how CBD helps with rheumatoid arthritis. This data comes from clinical trials of the drug nabiximols (brand name: Sativex), which is approved in some countries to treat the disease—and is widely considered effective and safe.
More than 300,000 sports-related concussions happen every year in the U.S., and new findings over the past few years mean athletes, coaches, and the public are finally beginning to understand how serious these brain injuries can be. People who sustain a blow to the head—common in soccer, football, and basketball, among other sports—can suffer dizziness, headaches, memory issues, anxiety, and depression, sometimes for months after the injury. But some scientists are excited about CBD’s potential to help with concussions, too: Researchers at the University of Miami are currently studying CBD as a treatment for these traumatic brain injuries. The idea: CBD-based medication could reduce brain inflammation, ratcheting down a concussion’s debilitating symptoms.
The World Health Organization (WHO) estimates that depression affects 300 million people, or more than 4% of us, making it the planet’s #1 source of disability. And that count is probably significantly understated given the stigma surrounding this illness. As with anxiety disorders, though, CBD has become a source of hope.
Recent research points to some potentially antidepressant-like effects of the compound – and a link between depression and low endocannabinoid levels. One study showed that CBD can boost levels of the body’s natural “bliss” molecule anadamide. Another connected CBD to higher levels of serotonin in the brain; this enzyme is known to have an anti-depressant effect. Others have suggested positive impacts to mood-improving processes in the hippocampus, and to CBD’s value in reducing neuron damage and brain inflammation.
In addition to clinical trials, anecdotal evidence suggests that CBD can be effective either in conjunction with or in place of traditional antidepressant treatments. A survey of 2,400 HelloMD community members, for instance, found that 80% of those polled found CBD to be extremely effective at treating their illness and 42% stopped using traditional medicines in favor of using CBD. While this data is promising, it can’t be taken as anything close to proof. Depression is an extremely complex illness, and much more research is needed.
People have been using cannabis to treat seizure disorders since the 11th century, and CBD’s potential as an epilepsy treatment is generating intense excitement. This neurological disorder causes abnormal brain activity and seizures; it affects about 3 million adults and 470,000 children, in many cases significantly harming quality of life. CBD therapy is particularly relevant to several types of hard-to-treat childhood forms of epilepsy, including Dravet syndrome and Lennox-Gestaut syndrome. These syndromes cause frequent, severe seizures, intellectual delays and disabilities, and an increased risk for seizure-related death. But evidence is mounting that CBD-based medicine can be very effective—to the degree that in April 2018 an advisory panel to the Food and Drug Administration unanimously recommended approval for Epidiolex, a CBD-based drug used to treat Dravet and Lennox-Gestaut syndromes. Proponents point to growing evidence that CBD can be tapped for broader forms of epilepsy, too.
Scientific data suggests that the body’s endcannabinoid system plays a role in seizure generation and can affect seizures and neurodegeneration in complex ways. CBD itself is not only both anti-inflammatory and neuroprotectant (it helps keep neurons healthy), it’s also anti-convulsive, with the power to reduce the frequency of seizures. Studies have demonstrated CBD cuts down on the severity and fatality of seizures in animals and that the seizure reduction benefits come with few side effects.
Some of the strongest evidence for CBD’s healing power relates to its efficacy in treating severe childhood forms of epilepsy like Gravet and Lennox-Gestaut. In 2017, a review of three high-quality trials reported that CBD reduced the frequency of specific types of seizures in patients with those disorders, and earlier research consistently pointed to CBD’s potential for such children. Surveys of parents whose kids tried CBD treatment were also positive, with many children seeing a reduction in seizures without major side effects. CBD can indeed be a game-changer for children suffering from these forms of epilepsy, as conventional anti-seizure medications often don’t work at all for them.
All of us are familiar with the queasy, sick-to-the-stomach feeling that comes with occasional gastroenteritis—along with its sidekick, vomiting—so we can imagine how crippling long-lasting nausea would be. Normally, nausea and vomiting are a temporary, beneficial response to some kind of toxin or invader in the body. But it’s when they strike because of something else, such as movement or chemotherapy, that these conditions become more serious and harder to manage.
People have been reaching for cannabis for help with nausea for centuries; today, researchers are working to understand just how CBD relieves nausea. Animal studies have shown it to be helpful, while other work examined how CBD targets specific neural receptors to produce its anti-nausea, anti-vomiting effects. Evidence also suggests that CBD could be especially effective for cancer patients undergoing chemotherapy to treat difficult-to-manage nausea and anticipatory nausea (symptoms that begin even before the chemo as a conditioned response). And another study found that cannabis-based medication was safe and well-tolerated as an anti-nausea supplement. Researchers know it works; they just need to determine how so they can tailor its use to particular afflictions.
For many, weight loss is about a lot more than looks. Being overweight raises the risk for a host of serious health problems, from type II diabetes to heart disease to kidney disease to some cancers—contributing to some of the leading causes of death in the U.S. A number of factors play into to the country’s very high obesity rate (more than a third of adults are obese), such as lack of access to healthy food and/or education about a healthy diet, sedentary lifestyles, and genetics. The good news is that in many cases, changing your nutrition and exercise habits will help. And science is discovering the ways that CBD and weight loss are connected.
Studies have examined how the endocannabinoid system helps regulate food intake and energy balance by acting on targeted areas of the brain and how it influences metabolism and fat storage. Scientists also know that when the system is thrown out of whack, obesity and its attendant health issues follow—raising the profile of cannabinoids as a possible form of therapy.
Research suggests CBD can supplement a weight loss plan in several ways. One involves the two types of body fat: brown fat and white fat. Brown fat burns calories as it generates heat, reducing deposits of inactive white fat (what we usually think of when we picture body fat). A recent study found that CBD helped the body turn white fat into that calorie-burning brown fat and promoted fat burning in general, earmarking it as a potential preventative therapy for obesity. And an animal study examined cannabinoids and appetite: While THC has an appetite-inducing effect (ever heard of the munchies?), this research found that CBD actually reduced food intake.
Whether you’re dealing with the aftermath of an injury, a recurring flare-up, or long-lasting, chronic suffering, pain interferes with your life, liberty, and pursuit of happiness. But CBD can offer relief: A number of studies have backed up CBD’s power to alleviate pain related to multiple sclerosis, cancer, and inflammation, as well as neuropathic/chronic pain. And CBD products are also being used to treat athletic pain and injury, back pain or sciatica, and muscle aches—all of this without the side effects and addictive potential of opiate painkillers and other drugs on the market.
Studies have backed up CBD’s power to alleviate pain related to multiple sclerosis, cancer, and inflammation, as well as neuropathic/chronic pain.
Scientists know the body’s endocannabinoid system plays a key role in how we process painful sensations, so perhaps it’s no surprise that cannabinoids can help short-circuit pain signals. The drug nabiximols (brand name Sativex), which contains both THC and CBD, has been widely studied and found to be both safe and effective in treating neuropathic pain (chronic pain related to the nervous system), as well as pain related to cancer, rheumatoid arthritis, and multiple sclerosis. Thirty countries, including Canada and much of Europe, have approved its use to treat chronic pain, rheumatoid arthritis, and cancer pain.
About a million people are currently living with Parkinson’s disease in the U.S. The disease—which overwhelmingly affects people age 50 and up—is caused by the degeneration of neurons that produce the neurotransmitter dopamine, leading to tremors and other movement problems, stiff limbs, difficulty with balance and walking, and slurred speech. Parkinson’s disease progresses as neurons continue to break down, and there currently is no cure.
Conventional treatment for Parkinson’s disease often includes medications—commonly, levodopa—that have side effects including cognitive effects, anxiety, increased tremors and uncontrollable movement, and nausea. Conversely, preliminary evidence points to CBD as an effective treatment to slow degeneration and improve quality of life in Parkinson’s patients—without those downsides.
Parkinson’s specifically targets neurons in midbrain that regulate movement. And the body’s endocannabinoid system acts on the same part of the brain in complex ways—including by boosting dopamine levels, as recent research suggests—pointing to cannabinoid-based treatments as potentially rich therapies for Parkinson’s disease and other neurodegenerative disorders.
Part of CBD’s appeal is its anti-inflammatory, antioxidant properties, which help protect neurons; other science shows that CBD acts on a number of areas in the brain related to neurodegenerative diseases. And indeed, smaller studies have found that CBD does improve quality of life measures for Parkinson’s patients as well as helps treat Parkinson’s-related psychosis.
Too many veterans returning from the service face more than the already-daunting challenges of reintegrating into home life. The gamut of PTSD symptoms—intrusive memories or flashbacks of traumatic events, nightmares, irritation, jitters, fear, vague feelings of mistrust, and trouble with relationships—affect up to 20 percent of veterans in a given year. These issues are often highly disruptive, causing both veterans and their loved ones undue distress. And they’re not just limited to veterans: PTSD affects people from all walks of life who’ve suffered trauma.
Fortunately, CBD could play a key role in therapy and treatment. It starts with cannabis’s known anti-anxiety effect. Cannabinoids have been shown to help with common PTSD symptoms such as sleep issues and hyperarousal. CBD might also help keep people with PTSD from resorting to risky self-medicating behavior; one clinical study is currently investigating whether CBD can reduce alcohol abuse in PTSD patients.
But CBD’s role in healing may extend well beyond that: A number of studies have begun to explore how the substance can actually help people process their traumas, or even prevent PTSD altogether. Animal studies suggest CBD can reduce the severity of the fear response and disrupt the way the brain stores fearful memories. And promising new research has shown that CBD helps with “extinction learning,” or forgetting traumatic memories. Therapy-based treatments for PTSD involve revisiting and reprocessing disturbing events until they no longer trigger the same reactions—so taking CBD in conjunction with therapy could make treatments that much more effective.
Reporting by Tessa Buchin, Andy Lindquist, Alec Surmani, Raneem Taleb-Agha, and Nick Wright
How About My Pet?
Promising studies show CBD’s benefits for dogs, cats, and horses
CBD’s therapeutic powers for humans are becoming more and more established: It’s an effective anti-inflammatory, pain reliever, anti-nausea agent, and anti-anxiety compound. So might man’s best friends reap the same benefits?
Veterinarians are beginning to examine that important question. Though research on CBD in animals lags behind human research, recent clinical trials have shown positive results in treating osteoarthritis and epilepsy in dogs. A groundbreaking 2018 study from Cornell University reported both pain relief and increased activity in arthritic dogs. The Colorado Veterinary Medical Association notes increasing interest among pet owners in CBD for chronic pain management and cancer therapy. Some vets encourage trying CBD for conditions such as anxiety and chronic joint pain, and for bowel issues, cancer, or asthma in cats. And anecdotal evidence shows promise for the substance for treating conditions like cancer pain in dogs and ligament disease in horses.