Cannabidiol (CBD)

I first came across CBD when looking into alternatives to NSAIDs and opiate based painkillers.

Cannabidiol (CBD) works on pain by affecting the Endocannabinoid System (ECS). Here are some articles that describe the ECS in more detail: Endocannabinoid system and the ECS in relation to pain.

 

This article describes the benefits of CBD for sports training and recovery

For a more detailed description of the different types of cannabinoid, you can check the link  here.

 

The following chart summarizes the different categories of cannabinoid and their comparative medicinal effects.

One can see from this chart that CBD has a much wider range of possible applications than just inflammatory pain. While paracetamol or other NSAIDs have a more direct influence on inflammatory processes, CBD exerts its effects more indirectly through the ECS. This is what gives CBD its wider therapeutic potential.


 

The following articles describe CBD action in relation to the ECS. They refer to functional differences between the various receptors in the ECS, principly CB1 and CB2, and their different locations throughout the body. This accounts for the different psychotropic and medicinal effects of each cannabinoid type:

What is the Endocannabinoid System - part 1, part 2, part 3

and its role in homeostasis.

 

These articles discuss a hypothetical clinical condition -CECD (clinical endocannabinoid deficiency) It may be a stretch to say this is caused by an under consumption of external cannabinoids (due to prohibition and an agricultural move away from hemp products) but some biochemical deficiency of the ECS could account for certain conditions.

 

There are several receptors in addition to CB1 and CB2 that form part of this neurotransmitter system, and no doubt more will be discovered. But at this point there seems to be an abundance of evidence to show that cannabinoid compounds are a valuable supplement/medication for certain conditions. And may be the treatment of choice in some cases.

 

It should be noted that CBD can also inhibit the enzyme that breaks down a range of medications (enzyme cytochrome P450). This is similar to the effects of grapefruit, which is cautioned against when using certain medications because it can increase their potency or length of time in the system. This is a dose response effect, so that minimal doses e.g. 10-20mg will have a minimal effect, but this will increase proportionately with higher doses.

 

There are plenty of CBD products on Amazon and elsewhere, but the labeling can be ambiguous - ‘CBD hemp oil’, ’ ‘raw organic hemp oil extract’, ‘high potency full spectrum’ etc.

I haven't felt i could recommend anything because of this uncertainty, so instead I thought I would try and acquire the raw materials myself, (CBD isolate) and make up my own solution using MCT oil. This oil is 'Medium Chain Triglyeride' - derived from coconut oil.

There are some products which claim to use a spectrum of related compounds e.g. CBC and CBG but as most of the current evidence seems to be associated with CBD, I thought I'd simply use a pure product, which is easier to measure and standardise. I therefore use 99% CBD isolate.

 

I am aware of the use of a spectrum of other cannabinoids of the THC family. This makes use of the so called ‘entourage effect’, which does have clinical efficacy. However, these would also lie on a ‘spectrum of illegality’ because THC does have the intoxicant effects. By contrast, CBD does not cause this (won't get you high) so there’s no problem legally. This is not to say that CBD is not psychoactive - some of its beneficial properties include being an anxiolytic, a mood enhancer, and a sleep tonic.

 

I have made up a sublingual tincture with spray mechanism (for under the tongue), allowing for an accurate metering of the dose. So I can now provide this to patients who may benefit.

Please give the practice a call or email if you'd like to discuss this further.