The Cannabis Health Index (CHI) is an evidence-based scoring system for cannabis (in general, not just CBD effects) and its effectiveness on various health issues based on currently available research data. Refer to cannabishealthindex.com for updated information and more about studies related to specific types of pain. Considering all of the studies together, which number over forty (for various types of pain), CBD and cannabis are shown to have a rating of likely probable efficacy. It is one of the best-substantiated medical uses of cannabinoids.
Sativex, an oral spray containing both CBD and THC, can treat MS-induced pain. During one study, researchers gave Sativex to 47 participants with MS. Results were largely positive. Patients who used this spray felt notably better. Their muscle and walking spasms decreased, and they felt pain relief. Thanks to studies such as this one, several countries approved using Sativex in MS treatment.
CBD is derived by growing cannabis, drying it out, pulverizing it, and then, often, using a rotary evaporator filled with an ethanol solvent to extract the CBD. (There are some other methods, but the ethanol one is common.) It’s a pretty old and fairly low-tech technique, but it’s effective. What you end up with is, hopefully, about 99 percent pure CBD in the form of white powder, which is called CBD isolate. (Some CBD is billed as “full spectrum,” which means it contains other things from the cannabis plant, like a bunch of other cannabinoids, but there’s no formal definition for full spectrum.)
Sativex, a cannabis plant–derived oromucosal spray containing equal proportions of THC and CBD, has been approved in a number of countries for use to treat specific types of pain. Numerous randomized clinical trials have demonstrated the safety and efficacy of Sativex for treatment of central and peripheral neuropathic pain, rheumatoid arthritis, and cancer pain. 
Cannabidiol—CBD—is a cannabis compound that has significant medical benefits, but does not make people feel “stoned” and can actually counteract the psychoactivity of THC. The fact that CBD-rich cannabis is non-psychoactive or less psychoactive than THC-dominant strains makes it an appealing option for patients looking for relief from inflammation, pain, anxiety, psychosis, seizures, spasms, and other conditions without disconcerting feelings of lethargy or dysphoria.
In recent years however, with increasing state legalization of cannabis and a burgeoning multibillion-dollar cannabis industry, US farmers have increasingly lobbied to remove federal restrictions against growing hemp. The Agricultural Act of 2014 (aka the 2014 Farm Bill) signed by President Obama set the stage for this to happen by loosened restrictions on hemp, allowing universities and state agriculture departments to grow it for research purposes. Now the 2018 Farm Bill opens those gates more broadly, allowing licensed farmers to grow hemp and transport it across state lines based on agreements and regulations to be established between states and the federal government.
To calculate the cost per milligram of CBD, simply divide the dollar amount of the product by the total milligrams of CBD in the bottle. So for instance, a product with 600 mg CBD in a 1 fluid-ounce bottle costing $80 is equal to about 13 cents per mg of CBD; a product with 100 mg of CBD in the same size bottle selling for $40 works out to 40 cents per mg of CBD. In this case, it pays to splurge on the $80 bottle.
CBD edibles are foods and beverages infused with CBD for oral consumption, and they are immensely popular thanks to their delicious taste as well as their soothing effects. From CBD fruit rolls to CBD-infused coffee, CBD edibles include a wide array of shapes, dosages, and mouthwatering flavors. CBD edibles offer an easy and discreet way to never forget your daily dose of CBD. Besides their fun and fruity taste and appearance, Green Roads CBD Edibles offer all the benefits of CBD in a convenient 30-day supply so you’ll never run out whether you need a short-term fix or long-term relief.
A review published in 2017 in the journal Frontiers in Pharmacology described how CBD may work to protect the hippocampus — the part of the brain responsible for several important functions, such as learning, memory and navigation — during times of stress, and may also help prevent brain-cell destruction that results from schizophrenia. Another 2017 review published in the journal Annals of Palliative Medicine summarized a handful of studies that suggest cannabis oils containing THC or CBD, or both, may help with chronic pain management, but the mechanism is unclear.
CBD primarily interacts with the body’s endocannabinoid system, a grouping of millions of cannabinoid receptors found throughout your body, but are primarily clustered in the brain and central nervous system. While CBD is a phytocannabinoid, or plant-based cannabinoid, your body also naturally produces cannabinoids, known as endocannabinoids. Almost every organ of your body, including your skin and digestive tract, contains cannabinoid receptors. The endocannabinoid system has four primary purposes including neuroprotection, stress relief, immune response, and regulating the body’s general state of balance, impacting faculties such as appetite, sleep, mood, and pain.
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Cannabidiol (CBD) is a naturally-occurring constituent of industrial hemp (cannabis sativa) plants. It is the most abundant non-psychoactive cannabinoid found in cannabis and is being scientifically investigated for numerous reasons. Most people have heard of a cannabinoid called THC, which is the ingredient in cannabis that gets users high. Unlike THC, CBD (cannabidiol) is a non-psychoactive cannabinoid and does not cause a high.
For this study, 24 people with social anxiety disorder received either 600 milligrams (mg) of CBD or a placebo an hour and a half before performing a simulated public speaking test. Additionally, 12 other people with social anxiety disorder performed the same test without receiving any CBD treatment. Results revealed that pre-treatment with CBD significantly reduced anxiety, cognitive impairment, and discomfort while participants were delivering their speech.
Condensed CBD oil can be taken as a thick paste, but this is the least pleasant option. More commonly, the CBD oil is mixed with a carrier oil, such as hemp oil or coconut oil, to a specific concentration of CBD. The distinctive taste — which comes from the terpenes and not the cannabinoids — is often masked with chocolate, mint, or other flavorings. It typically comes in a small bottle with a dropper to administer the oil mixture.
Cooper recently got funding from the National Institutes of Health for a study looking at cannabinoids — including CBD in isolation — as a substitute for opioids, and numerous other clinical trials of CBD are underway. It will be several years before results are available, but these studies should help clarify both what benefits the substance may provide and any side effects it may come with. Most of the adverse effects so far associated with cannabis, such as impairments in short-term memory, coordination and judgment,2 come from products that contain THC as well as CBD, Cooper said, but we need to do more studies to find out for sure whether CBD has fewer risks. Studies are also needed to identify the best way to administer and dose CBD. “I get emails from people asking me what dose of CBD to use, and the truth is, we really don’t know,” Cooper said.
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You then take your first drop of CBD oil, wait 45 minutes, then ask the questions again. If you feel no different and there’s no change in the way you answer those questions, you increase the dose by small increments until you do notice a difference. You can continue this process over several days – and at some point, you’ll find that taking more doesn’t change your scores. That is your minimum effective dose.
A couple of studies dealt with drug and substance abuse. From them, we’ve learned that if you use CBD, you can decrease your drug-seeking behavior and be less dependent. CBD oil has a notable effect on the brain circuits responsible for addiction. Once it alters your circuitry, you’ll have less desire to depend on any substance. Can you use CBD to quit smoking and prevent other addictions?
The side effects and risks involved with consuming marijuana-based products aren't clear, either, Bonn-Miller said. It's important to "determine cannabinoids that are useful therapeutically while understanding and using cannabinoids that are associated with less risk," he said. At least with CBD, he said, it doesn't appear to have the potential for addiction. That's different from THC, which has been associated with addiction, he said, and negative side effects, including acute anxiety.
In relation to sleep apnea, a 2002 animal study observed the ability of THC to restore respiratory stability by modulating serotonin signaling and reducing spontaneous sleep-disordered breathing. In 2013 a trial using the pharmaceutical drug dronabinol, a synthetic THC mimic, noted improvements in fifteen out of seventeen study participants following twenty-one days of treatment.
However, cannabidiol as an anxiety reducer has almost none of these issues. One study had participants who took either 600 mg of CBD or a placebo drug. In a speaking test that followed, the group which underwent CBD oil treatment showed less anxiety. They also had a smaller degree of cognitive impairment and felt less discomfort overall as they spoke. In other words, their results were better than those of the placebo group.
Two additional studies in this area were done using CBD oil. In the first one, 214 participants would take 0.9 to 2.3 grams of oil per 1 pound of body weight. CBD successfully reduced seizures by a median of 36.5%. The second study focused on children who suffered from Dravet syndrome. Dravet syndrome is a type of epilepsy that happens in early infancy. Normally high temperatures and fevers trigger it. The results of the second study showed that CBD oil reduced seizures significantly.
Well, yes and no. "Most companies only search for the cannabinoid THC. That said, there are some testing facilities that check for a spectrum of cannabinoids, and therefore, THC-free CBD products could trigger a positive result," says Sheri Kasper, RDN, LDN. "By law, you are allowed to ask the facility what cannabinoids they test for. If you are uncomfortable with that, you can call and ask anonymously." These super-sensitive tests are rare, however. Most of the time, employers just want to know if you're smoking weed all day, not if you're taking CBD for your anxiety.
For ingested CBD, that fat solubility is a problem. “[Ingested] CBD has a very low bioavailability, something between 6 and 15 percent, which varies between people,” says Blessing. Because ingested CBD is so inefficient at actually getting to the brain to stimulate CB1 and other receptors, the doses shown to be effective have to be very high. “There’s no evidence that doses below 300 mg of CBD have any effect in any psychiatric measure,” says Blessing. “And in fact, dose-finding studies show that the lowest clinically effective dose of CBD for reducing anxiety is 300 mg.” Blessing is talking about induced anxiety in otherwise healthy patients, which is all we have studies on; studies of CBD’s efficacy in treating clinical anxiety, which would require regular doses, haven’t been published.
For anxiety, CBD products with a ratio of 20:1 or higher are recommended and administered as drops, capsules, or edibles. High-CBD cannabinoids can be very effective in reducing chronic anxiety, treating temporary stress, and protecting the body from the physiological effects of both. Varieties high in linalool, a terpene shared with lavender, are known to be effective for relieving anxiety. In particular the strain AC/DC is very effective.