You can rub CBD oil on your skin or drop it under your tongue; you can eat it as a sugarcoated gummy or drink it as a Goop-approved cocktail. There's evidence (some scientific, plenty anecdotal) that it helps with epileptic seizures, opioid addiction, PTSD, arthritis, anxiety, insomnia, nausea, chronic pain, and much more. If you believe the hype, CBD can do just about anything for your physical and mental health — and it won't get you high as a kite.
To make matters more confusing, nine states (including California, Washington, and Colorado) let residents buy cannabis-based products with or without THC. Nearly two dozen other “medical marijuana states” allow the sale of cannabis, including capsules, tinctures, and other items containing CBD or THC, at licensed dispensaries to people whose doctors have certified that they have an approved condition (the list varies by state but includes chronic pain, PTSD, cancer, autism, Crohn’s disease, and multiple sclerosis). Sixteen more states legalized CBD for certain diseases. But because all these products are illegal according to the federal government, cannabis advocates are cautious. “By and large, the federal government is looking the other way,” says Paul Armentano, deputy director of the Washington, DC–based National Organization for the Reform of Marijuana Laws (NORML), but until federal laws are changed, “this administration or a future one could crack down on people who produce, manufacture, or use CBD, and the law would be on its side.”
All CBD products start out the same way: as an extract from the leaves and flowers of cannabis plants. At Green Roads, we only extract CBD from hemp, defined as any variety of cannabis plant containing less than 0.3% THC by dry weight. Cannabinoids and terpenes are produced by tiny glands on the leaves and flowers of cannabis plants known as trichomes. The compounds produced by these trichomes give cannabis both its rich aroma and its nutraceutical effects.
Symptoms of fibromyalgia include chronic musculoskeletal pain. The use of cannabis oil for pain can also be a part of natural fibromyalgia treatment. A 2018 study published in the Journal of Clinical Rheumatology looked at the effects of medical cannabis on 26 fibromyalgia patients. The researchers found that after an average of about 11 months of medical cannabis use, all of the patients reported a significant improvement in every parameter on the questionnaire, and 13 patients (50 percent) stopped taking any other medications for fibromyalgia.
To access CBD oil, a solvent extraction process is required, which returns roughly 3-5 grams of oil per ounce of flower product used. Using grain or isopropyl alcohol as a solvent, you can strain the result of the mixture, leaving CBD oil behind. It is a lengthy process, and in countries where cannabis is legal, there are many places to access high-quality CBD oil.
Given CBD’s reputation as a popular, artisanal remedy, one would think that Epidiolex would command a lot of “off label” attention. After all, physicians often prescribe pharmaceuticals off label to treat conditions that were not the actual focus of clinical trials. But the costly price tag for Epidiolex (more than $30,000 annually) precludes off label prescribing as well as affordable access for tens of millions of Americans without health insurance.
While CBD can be extracted from non-hemp varieties of the plant, hemp-derived CBD is less restricted by the government because of its inherently low levels of THC. CBD from hemp is legal for sale in most US states, while CBD products derived from non-hemp varieties can contain noticeable amounts of THC, and are therefore subject to stricter laws and regulations.
Marijuana can produce acute psychotic episodes at high doses, and several studies have linked marijuana use to increased risk for chronic psychosis in individuals with specific genetic risk factors. Research suggests that these effects are mediated by THC, and it has been suggested that CBD may mitigate these effects.xxxi There have been a few small-scale clinical trials in which patients with psychotic symptoms were treated with CBD, including case reports of patients with schizophrenia that reported conflicting results; a small case study in patients with Parkinson’s disease with psychosis, which reported positive results; and one small randomized clinical trial reporting clinical improvement in patients with schizophrenia treated with CBD.xxxii Large randomized clinical trials would be needed to fully evaluate the therapeutic potential of CBD for patients with schizophrenia and other forms of psychosis.