The Rise of Cannabidiol: A New Health Craze
By Mashal Ahmed
Cannabidiol! The new magic elixir, the miracle drug, cure to every possible ailment you can think of. Whether you suffer from depression, anxiety, psychosis, epilepsy, arthritis, migraines, dry skin, insomnia, an opiate addiction or the unrelenting pain from high heels – this wonder drug can heal all, adherents claim. Over the past two years cannabidiol products have exploded into mainstream markets, with certain health enthusiasts and social media influencers treating the compound as the new “cure-all”.
Cannabidiol, or CBD, is a major cannabinoid constituent of Cannabis plants. However, unlike THC (tetrahydrocannabinol)–the primary psychoactive compound in many cannabis products–CBD does not produce any psychoactive or mind-altering symptoms.1 Whereas THC often induces anxiety and psychosis-like effects, CBD tends to reverse them. In fact, research suggests that CBD has the potential for multiple beneficial health improvements, including neuroprotective, anti-inflammatory, antiepileptic, antianxiety and antipsychotic effects.1
In 2018, the high-profile case of Billy Caldwell drew CBD into the media spotlight. Thirteen-year old Caldwell of Northern Ireland suffers from treatment-resistant epilepsy and relies on a CBD-based medication to control his seizures. He made headlines last year when his imported medication was confiscated at a London airport; medicinal cannabis was illegal in the UK at the time. This case resulted in a fierce public debate on medicinal cannabis use and its health benefits.2 In November 2018, prescribed medicinal cannabis was finally legalized in the UK for patients with exceptional clinical needs. Caldwell’s medicine, Epidolex, is a purified CBD extract made specifically to treat individuals with severe forms of epilepsy. Two recent clinical trials showed that epileptic patients treated with Epidolex had significantly greater reduction in the frequency of atonic seizures compared to patients treated with placebo.3,4
CBD has also become a major drug of interest in the field of mental health, with studies suggesting mild to moderate improvements in anxiety and psychotic disorders1. Dr. Philip McGuire, professor of psychiatry at King’s College London, has been studying CBD for over 15 years. His recent clinical trial investigated the effects of CBD on patients with schizophrenia.5 Results of this randomized, placebo-controlled, double-blinded study showed that patients treated with CBD showed significant improvement in psychotic symptoms compared to those treated with placebo. The CBD-treated group also demonstrated a trend for cognitive improvement, with no major side effects from the drug.5 In an interview with The Guardian he called CBD “the hottest new medicine in mental health”.6 Although optimistic, Dr. McGuire is still cautious about the current findings, noting that larger scale and longer-term clinical trials are needed before CBD can be introduced as a formal antipsychotic.
Despite the need for further clinical investigation, CBD products have exploded beyond the clinical realm into the larger over-the-counter marketspace in the past two years. “CBD” and “hemp-based” have become buzzwords, especially amongst upscale beauty brands. Product sales are now projected to reach $22 billion USD by 2022.7 This projected growth is largely due to CBD’s status as a health and wellness product; a quality highly desired by the growing body of health-conscious modern-day consumers looking for the “organic” option.
Latching on to shifting consumer trends, hemp-based health boutiques are popping up everywhere, offering a line-up of oils, lotions, and pastes to please the CBD craze. Danielle Blair, owner of Toronto-based Calyx Wellness, offers an array of CBD products in addition to other holistic remedies such as crystal healing and reiki. Her business aims to create open, informative dialogue about CBD therapies and make such natural remedies more accessible in the Canadian health and wellness market.8 However, the CBD frenzy has expanded beyond small businesses to the mainstream market. You can now find CBD-infused into just about anything. Products range from CBD soaps, toothpastes, and chewing-gum to truffles, spring water, alcoholic beverages, and even CBD-infused pillowcases. While some companies claim their products provide a sense of calmness, others say their products help individuals become more focused and grounded.
Big name celebrities like Kim Kardashian West have also hopped on the bandwagon. West regularly endorses CBD products through her social media platforms, showing off her CBD-themed parties and meditation sessions to her 150 million+ followers. In a recent interview with People, she talked about how CBD helps her stay relaxed and focused and how her use of CBD gummies has helped regulate her sleep.9 Businesswoman and lifestyle expert Martha Stewart has also become a strong CBD advocate. In March 2019, she announced her new partnership with Canopy Growth, through which she aims to produce a new line of CBD lifestyle products for consumers and their pets.10
The CBD hype only continues to grow; however, company and consumer claims all lack one important detail: empirical evidence. Since CBD is marketed as a nutraceutical rather than a pharmaceutical product, it is not subject to regulated randomized-controlled clinical trials. Without such assessments there is no way to determine whether the effects of such products are due to CBD or placebo. In his interview with The Guardian, Dr. McGuire also notes that during the psychosis and epilepsy trials, patients were given about 1,000 to 2,000 mg of pure CBD tablets each day for a certain number of weeks.6 In comparison, a single CBD-infused coffee or pastry may only contain 5 mg of the compound. Thus, individuals must also consider how much of that compound is actually metabolized by their body. “Of that 5 mg, you might absorb 1 mg or less”, says Dr. McGuire. “A lot of what people may be taking in good faith may [have] absolutely no effect at all, other than a placebo effect”.6
Another concern with the current trend is that consumers may try an advertised CBD product and find that it does not have any effect. Or perhaps they experience side-effects from other ingredients in the mixture. Dr. McGuire worries this confusion may lead consumers to believe that CBD has no health benefits at all. In the long-run, these misconceptions could “damage the therapeutic potential of what could be a very useful new medicine”, Dr. McGuire explains.6
So, what is the bottom line? Clinical trials assessing the treatment potential of CBD show promising results in the area of neurological disorders and mental illness, although further investigation is warranted for more conclusive evidence. However, the expansion of CBD into mainstream markets has given rise to products with unreliable and unmeasured health effects. Moreover, viral marketing fueled by health enthusiast and social media support has propagated exaggerated and sometimes false claims about the effects of CBD-based products. Thus, many ill-informed consumers may be indulging in products that produce little to no health benefits at all. Overall, conflicting consumer experiences may serve to damage the therapeutic potential of CBD, which is still being clinically investigated.
In order to mitigate the spread of false information and provide consumers with a more educated background on their product purchases, the CBD market requires urgent regulation. Setting standards for CBD product purity and dosing would help ensure safety and efficacy, clarify associated risks and benefits, and streamline processes for labelling and marketing. Most importantly, CBD regulation would allow us to hold companies accountable for the promises they make to their consumers.
IMS writer Mashal Ahmed is a 2nd year MSc student at IMS, studying under the supervision of Dr. Stefan Kloiber and Dr. Isabelle Boileau. Her research employs neuroimaging techniques to learn more about the neurobiological mechanisms associated with anxiety-spectrum disorders. Mashal is double-jointed and can twist her arm by 540 degrees!
- Mandolini GM, Lazzaretti M, Pigoni A, et al. Pharmacological properties of cannabidiol in the treatment of psychiatric disorders: a critical overview. Epidemiology and psychiatric 2018 Aug;27(4):327-35.
- Busby M. Billy Caldwell licensed for cannabis oil use in Northern Ireland. The Guardian [Interenet]. 2018 [cited 2019 Nov 3]. Available from: https://www.theguardian.com/society/2018/jul/05/billy-caldwell-heads-home-amid doubts-over-cannabis-oil-access-northern-irleand-medication-epilepsy
- Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. New England Journal of Medicine. 2017 May 25;376(21):2011-20.
- Devinsky O, Patel AD, Cross JH, et al. Effect of cannabidiol on drop seizures in the Lennox Gastaut syndrome. New England Journal of Medicine. 2018 May 17;378(20):1888-97.
- McGuire P, Robson P, Cubala WJ, et al. Cannabidiol (CBD) as an adjunctive therapy in schizophrenia: a multicenter randomized controlled trial. American Journal of Psychiatry. 2017 Dec 15;175(3):225-31.
- Lewis T. CBD: a marijuana miracle or just another health fad?. The Guardian [Internet]. 2019 [cited 2019 Nov 3]. Available from: https://www.theguardian.com/society/2019/may/05/cbd-a-marijuana-miracle-or-another health-fad-cannabidiol-anxiety-epilepsy
- CBD worth $22 billion by 2022? That’s crazy, right? [Internet]. Brightfield Group. 2018 [cited 2019 Nov 3]. Available from: https://www.brightfieldgroup.com/post/cbd-worth 22-billion-by-2022
- Scriver A. Meet Danielle Blair of Canada’s First CBD Boutique Calyx Wellness. Edit Seven [Internet]. 2018 [cited 2019 Nov 3]. Available from: https://editseven.ca/danielle-blair canada-cbd-boutique-calyx-wellness/
- Frey K. Kim Kardashian Uses CBD to Help Her Fall Asleep, Says She Wouldn’t Take ‘Xanax or Ambien Again’. People [Internet]. 2019 [cited 2019 Nov 3]. Available from: https://people.com/style/kim-kardashian-uses-cbd-for-sleep/
- Owram K. Martha Stewart Developing Cannabis Pet Care, Cosmetics and Food. Bloomberg [Internet]. 2019 [cited 2019Nov3]. Available from: https://www.bloomberg.com/news/articles/2019-06-18/martha-stewart-developing cannabis-pet-care-cosmetics-and-food