Cannabidiol isn’t cannabis, so why is it suddenly so popular?

Cannabidiol can now be found as an ingredient in all sorts of over-the-counter products, including body lotion, face scrub, bath bombs, lip balm, bottled water, beer, vape oil, olive oil, gummy candies, coffee, jam, and even dog treats. But what is it? And why is it suddenly so popular?

Cannabidiol is not cannabis. But it is one of the many chemical components of the cannabis sativa plant, otherwise known as marijuana. The psychoactive compound in marijuana that causes a “high,” tetrahydrocannabinol (THC), is another chemical component of cannabis sativa, but there is no THC in cannabidiol. So, cannabidiol on its own doesn’t produce psychoactive euphoria.

In fact, most manufacturers that put cannabidiol as an ingredient in their products source it from the hemp plant, a botanical cousin to marijuana that yields cannabidiol but almost no THC. Even so, cannabidiol has been listed as a Schedule I controlled substance, on par with THC, despite being widely sold as a supplement. But recently, the US Drug Enforcement Administration relisted cannabidiol drugs approved by the Food and Drug Administration (FDA) as Schedule V substances—a classification of drugs with an approved medical use and low potential for abuse.

“In humans, cannabidiol exhibits no effects indicative of any abuse or dependence potential,” according to a report on cannabidiol by the World Health Organization. “To date, there is no evidence of public health related problems associated with the use of pure cannabidiol.”

Reviewing the research

So, if cannabidiol doesn’t cause a high, what does it do? Proponents of cannabidiol claim it has all sorts of benefits, such as lowering inflammation, reducing anxiety, relieving chronic pain, improving sleep, easing cravings for harmful drugs, and other benefits that are making it popular among patients. But many of these claims come from websites selling cannabidiol products. Let’s take a look at some of the scientific research on cannabidiol’s effects in different conditions.

• Epilepsy. The most research on cannabidiol’s effectiveness has focused on its use to treat epilepsy. Indeed, the FDA has approved an oral solution of cannabidiol (Epidiolex) for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, which typically begin in childhood and don’t respond to antiseizure medications. Notably, this is the first FDA-approved drug that contains a purified drug substance derived from marijuana. It’s also the first FDA-approved drug for the treatment of patients with Dravet syndrome.
  
  
• Chronic pain. Given the current opioid crisis, researchers are looking for newer therapies for chronic pain because so many of the current drugs produce unwanted side effects. In one trial in mice, researchers showed that cannabidiol lowered inflammatory and neuropathic pain without causing significant psychoactive side effects or analgesic tolerance. Clinical trials investigating cannabidiol’s effect on chronic pain in humans have just begun.
  
  
• Anxiety. Preclinical evidence “conclusively demonstrates” that cannabidiol effectively reduces symptoms of a variety of anxiety disorders—including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and social anxiety disorder—with “a notable lack of anxiogenic effects,” researchers concluded in one meta-analysis. They added that findings from trials in humans also indicated a lack of anxiogenic effects, minimal sedative effects, and an excellent safety profile. These studies, though, mostly involved acute dosing, so further research needs to determine whether chronic dosing of cannabidiol is similarly effective.
  
  
• Post-traumatic stress disorder (PTSD). “Human and animal studies suggest that cannabidiol may offer therapeutic benefits for disorders related to inappropriate responses to traumatic memories,” wrote authors in a recent review article on the therapeutic use of cannabidiol for PTSD. “The effects of cannabidiol on the different stages of aversive memory processing make this compound a candidate pharmacological adjunct to psychological therapies for PTSD.” They added that cannabidiol may have fewer side effects than standard pharmacological therapy currently used to treat the disorder.

Cannabidiol in a can?

As the research on cannabidiol expands, the public’s interest will likely continue to grow with it. Because it’s sold as a supplement and comes as ingredient in various items, be sure to specifically ask about it on your patient intake form and during the patient history. It may soon become an everyday household item—even Coca-Cola is considering a cannabidiol-infused beverage.