Beginner’s Guide: Cannabidiol 101
If you are just discovering medical Cannabis or you are a little puzzled by all of the information regarding its therapeutic benefits, then this Cannabidiol 101 guide is for you. Cannabidiol (CBD) is just one of the many cannabinoids that are produced within the Cannabis plant that have taken the scientific world by storm. There are several startup companies touting its benefits, some even presenting it as the next “miracle drug.” While it is definitely not a panacea, it does provide many beneficial therapeutic potentials that are unique solely unto Cannabis alone. This guide will introduce the reader to the basics of cannabinoids, cannabidiol, the endocannabinoid system, and any potential side-effects or adverse herb-drug interactions to be aware of. While this beginner’s guide is not exhaustive, hopefully it will bring you up-to-speed on the basics and prepare you for more advance inquiry.
What is a cannabinoid?
Cannabinoids are a class of molecules that act upon certain receptors within the body and alter the production of various neurotransmitters, thus augmenting physiological and pathophysiological processes. The Cannabis sativa et indica plant produces more than 420 chemical compounds, of these just over 80 are referred to as phytocannabinoids, which are classified as terpeno-phenol compounds, not found in any other known botanical. The most well known cannabinoid is called delta9-tetrahydrocannabinol (THC), primarily due to its potent psychoactive effects. Cannabinoids act upon receptors within the Endocannabinoid System, discussed below. It was discovered that exogenous phytocannabinoids interact with the same receptors as two endogenous cannabinoids. The cannabinoids produced within the body are called anandamide, referred to as the “bliss molecule,” and 2-arachidonoylglycerol, both of which function to maintain a balanced physical and psychological homeostasis.
What is the Endocannabinoid System?
The Endocannabinoid System refers to a network of receptors within the central and peripheral nervous system responsible for orchestrating a coordinated response to physical and psychological stress. It has been deemed to be a strong potential therapeutic target for drugs because it is capable of releasing various neurotransmitters that alter physiological and pathophysiological function. More specifically, it has been observed to affect the immune, cardiovascular, gastrointestinal systems, liver function, pain perception, stress, and psychological resiliency, to name a few. Primary receptors within the system are CB1 and CB2, of which CB1 receptors are responsible for inducing psychoactive effects. Although there are many phytocannabinoids, as well some synthetic cannabinoids recently developed, the most promising is Cannabidiol due to its broad spectrum effects and non-psychoactive effects.
What is Cannabidiol (CBD)?
Cannabidiol (CBD) is a major phytocannabinoid produced with Cannabis. It was first isolated and described in 1940 by Adams and coworkers, but its detailed classification and physiological mechanisms were not published until 1963 by Mechoulam and Shvo. CBD has become very popular within the scientific and medical community due to to its low affinity for CB1 receptors, which renders it non-psychoactive, in addition to acting upon several receptors outside of the traditional Endocannabinoid System. The result produces broad spectrum effects coordinated by several mechanisms and physiological pathways. This accounts for a plethora of pharmacological effects and conditions capable of being treated, such as anxiety, psychosis, addiction, neuropathic pain, movement disorders, and much more. Its presence counteracts the psychoactive properties of THC, allowing for extracts containing both cannabinoids to have greater systemic effects without producing as great of a “high” effect associated with THC alone.
What is the difference between CBD and THC?
General differences between CBD and THC have been alluded to above. THC binds to CB1 and CB2 receptors and is the primary cannabinoid responsible for Cannabis’ psychoactive properties. It is a powerful appetite stimulant for HIV/AIDS and cancer patients. When combined with CBD, usually in a 1:1 ratio, such as in the synthetic drug Sativex, it is capable of treating neuropathic pain, multiple sclerosis, and act as an adjunctive analgesic for patients with advanced cancer.
What is the correct dosage of CBD?
Unlike many other drugs we are familiar with, there is not a “one dose fits all” when it comes to CBD. Every person’s metabolism and physiology is unique and will respond differently to varying amounts of CBD. Another factor that plays into CBD’s effects is the environment one is in as well as perceived stress levels. In general, researchers have observed an inverted U-shaped dose response curve for optimal CBD dosing. This means that at relatively low and high doses there are no physiological effects, while a middle range dose is most efficacious. When determining an effective dose, it is important to start out small and gradually increase the dose until a desired effect is achieved. This means starting out at a dose of around 2-5mg/kg or 200mg-300mg and slowly increasing from there. CBD is safe and has been well tolerated at doses up to 1,500mg/day. For slightly more specific dosing info refer to the CBD dosing article on this site.
Is there a proper ratio of CBD to THC for specific conditions?
The beauty of cannabinoids is that they represent a personalized approach to an individual’s health and wellbeing. This means that there is no specific ratio or dose that works best. It is up to an individual and her/his healthcare team to determine the best efficacy. With that said, some individuals do not like the psychoactive effects produced by THC and thus may do better with ratios of higher CBD and very low THC. Others may do better with a 1:1 ratio, which actually provides the broadest range of actions. Additionally, depending on state laws, certain extracts may not be available for an individual. In summary, it is best to focus on getting a precise and consistent dose of CBD with as high of THC ratio as is comfortable and tolerable.
What is the difference between Cannabis and Hemp?
Both Cannabis and hemp are the same plant. The primary difference between the two is that Cannabis has been selectively bred for its flower-buds and most notably for higher concentrations of THC. Hemp has been bred for its stalk to produce fibers for ropes, paper, oil, and other building materials. Because hemp was not selectively bred for high THC, it has been discovered that many strains contained higher concentrations of CBD. However, CBD concentration is highest within the flower-buds and secondarily in the leaves, with small amounts in the stalk and practically absent in seeds.
Are there any adverse side-effects or herb-drug interactions associated with CBD?
CBD has been documented as being generally safe and well tolerated at doses up to 1,500mg per day. At higher doses, which may be different for each individual, CBD does interact with the cytochrome P450 metabolic pathway of the liver. This pathway metabolizes the majority of pharmaceuticals and drugs consumed by humans, including THC. Patients who are taking prescription medications are advised to consult their healthcare provider to ensure their medications are at safe and therapeutic levels in the presence of their desire for CBD consumption.
For additional reading:
- Non-psychotropic plant cannabinoids: new therapeutic opportunities from an ancient herb
- The Endocannabinoid System as a target for novel anxiolytic and antidepressant drugs
- Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action
- Review on clinical studies with cannabis and cannabinoids 2005-2009
- Review on clinical studies with cannabis and cannabinoids 2010-2014
- O’Shaughnessy’s Publication Online