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CBD: What is it and what are its' long-term implications?

What is CBD?

Cannabidiol, or CBD, is one of the two major compounds found in the Cannabis plant. While the other major compound, Δ9-tetrahydrocannabinol, or THC, is widely known for its psychoactive properties, CBD has been at the forefront of recent cannabinoid research for its pharmaceutical potential without the antagonizing adverse psychoactive effects of THC [1,2]. Emerging research studies and clinical trials hold promise for CBD as an effective antipsychotic, anxiolytic (anti-anxiety), antiepileptic, and anti-inflammatory medication [2].

How does CBD work in the body?

Your body’s endocannabinoid system contains many cannabis receptors - the two main ones being the CB1 and CB2 receptors. These receptors are very important in determining how cannabis affects the body and the brain. CB1 receptors are expressed mostly in the brain, which means they’re responsible for the psychotropic effects of THC. CB2 receptors are expressed mostly in immune cells, making them an interesting point of study in the field of autoimmune and rheumatic diseases. CBD can bind to CB1 receptors, blocking THC from binding to it, and thus preventing the psychoactive and adverse effects of THC [2,3].

CBD can also bind to and activate other receptors in the body including serotonin and adenosine receptors. Upon activation, serotonin receptors help to stabilize mood while adenosine receptors act as a CNS depressant, slowing down neural activity and promoting sleep. This explains CBD’s observed antipsychotic and antianxiety properties [3]. 

How is/can CBD be used for the treatment of various diseases?

CBD can also function as an immunosuppressant and anti-inflammatory drug by blocking CB2 receptors. This inhibits the function of immune cells which can be beneficial to those with autoimmune disorders and chronic inflammation such as arthritis and inflammatory bowel disease [3]. As such diseases are commonly treated with both steroidal and non-steroidal anti-inflammatory drugs with often unfavourable side effects, CBD offers new treatment options with comparative side effects. Benefits have also been shown in the treatment of cardiovascular and neurodegenerative diseases, diabetes, cancer, and asthma [3]. 

CBD can be administered both orally and transdermally. However, oral administration allows for the most convenient and accurate dosing. Oral dosing, such as through oils, tinctures and solid tablets, contain pharmaceutical-grade compounds and standardized concentrations. CBD oil has been used for treatment in Dravet syndrome, Lennox-Gastaut syndrome and severe myoclonic epilepsy in infancy [3]. 

However, because CBD is a fat-soluble molecule, it is prone to destruction by digestive acids and enzymes. This significantly reduces the actual absorption of CBD when consumed orally. Methods such as transdermal delivery (i.e. topical anti-inflammatory lotion, butter etc.), nasal/inhaled-pulmonary delivery (i.e. smoked or vaporized cannabis flower), and oral transmucosal delivery (i.e. sublingual tablets or oils held under the tongue) enable CBD uptake directly into the blood, thus, increasing its absorption [3].

Long-term Implications

As biotechnology advances, so do the pharmaceutical potential of Cannabinoids, THC and CBD included. Nanotechnology, for example, has worked well in several therapeutic fields in recent years, with numerous drugs reaching the market and cannabinoids recognized as a suitable candidate due to their fat-soluble properties [3]. In addition, Dronabinol, a synthetic THC, has recently been approved by the FDA for the treatment of anorexia in patients suffering from AIDS and nausea/vomiting induced by cancer chemotherapies [2]. 

The variety of CBD-based products for therapeutic use, such as oils, tinctures, and vapours, have expanded significantly in recent years. With this, it’s important to note the potential increase of health risks for patients/consumers that comes along with such a rapid expansion [3]. CBD, unlike THC, is not considered an abused drug. Several industries are involved in the production of CBD as an active pharmaceutical ingredient with the highest quality standard [3]. Safe and controlled access to CBD is pivotal for the advancement of CBD’s therapeutic use and future research. With cannabis becoming more prevalent in society and the pharmaceutical industry, it's interesting to see what medical advances and future studies are in store for both CBD and THC.

Written by Vanessa Ramasammy on behalf of Supriya Lal, RD 


[1] Mechoulam, R., Peters, M., Murillo‐Rodriguez, E. and Hanuš, L. (2007), Cannabidiol – Recent Advances. Chemistry & Biodiversity, 4: 1678-1692. DOI:10.1002/cbdv.200790147

[2] Lafaye, G., Karila, L., Blecha, L., & Benyamina, A. (2017). Cannabis, cannabinoids, and health. Dialogues in clinical neuroscience, 19(3), 309–316.

[3] Bruni, N., Della Pepa, C., Oliaro-Bosso, S., Pessione, E., Gastaldi, D., & Dosio, F. (2018). Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules (Basel, Switzerland), 23(10), 2478.

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