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But is it miraculous — or just a mirage?

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The extract from the cannabis plant is the hot new treatment for all kinds of ailments, but don’t buy into it just yet.

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Cannabidiol (CBD), extracted from the cannabis or hemp plant, has been promoted as the latest miracle cure for everything from aches and pains to anxiety and sleep disorders. There is a good chance you’ve heard a friend share his or her story about the wonders of CBD.

“CBD is being used over the counter in a range of ways that is not supported by the science,” says Dr. Jordan Tishler, instructor of medicine at Harvard Medical School and president of the Association of Cannabis Specialists. “There is still much we don’t know. But aggressive marketing, hype, and word of mouth have made CBD like a drug version of the emperor’s new clothes. Everyone says it works, but lab studies suggest that it’s really not what people think.”

The study concluded that whole-plant, CBD-rich extract had a superior therapeutic value to single-molecule CBD extract. Though there may be cases, depending on an individual patient’s condition and physical restrictions, where a CBD isolate is a more appropriate prescription, a whole-plant, high-CBD product has the advantage of working in tandem with other potentially therapeutic cannabinoids and terpenes. This synergistic relationship is commonly referred to as the entourage effect. For instance, some studies have demonstrated CBD’s ability to minimize the undesirable effects of THC, including paranoia and cognitive impairment.

One major explanation for CBD’s wide range of potential benefits is the complex way it interacts with our bodies, particularly through the endocannabinoid system (ECS), an internal system made up of endogenous cannabinoids, or endocannabinoids, the receptors that these cannabinoids bind to, and the enzymes that break them down. CBD and other phytocannabinoids, or cannabinoids produced by the cannabis plant, bind to cannabinoid receptors when they enter the body, and elicit a wide range of effects, depending on which receptors they activate.

To anyone unfamiliar with CBD, it may seem strange to see something that comes from cannabis garner such widespread attention and acceptance across the U.S.. Following the passage of the 2018 Farm Bill, CBD derived from industrial hemp, defined as cannabis with less than 0.3% THC, is not a controlled substance under federal law. CBD from marijuana or hemp with more than 0.3% THC is still considered illegal federally, but legal in states where medical and adult-use cannabis is permitted. The laws vary significantly from state to state, however, so it’s best to double check. For example, Idaho and South Dakota still consider CBD illegal.

5. Not all CBD oil is the same

Although the most effective CBD dosing can be difficult to pin down, mounting research is starting to give us a better idea of how to best use this non-intoxicating cannabinoid. For example, a study published in the February 2019 issue of “Brazilian Journal of Psychiatry” found that CBD may be useful for treating social anxiety associated with public speaking. The research team gave subjects doses of CBD ranging from 150 to 600 milligrams, as well as a placebo, prior to a public speaking challenge. The study seemed to indicate that 300 milligrams helped alleviate anxiety-related symptoms.

A 2015 study from The Hebrew University of Israel documented the medicinal potency of single-molecule CBD extract versus that of a whole-plant, CBD-rich extract. Single molecule extract is an isolated extract of a single compound, such as CBD. A whole-plant extract essentially preserves the full cannabinoid and terpene profile of the original plant.

So, if we’re unable to figure out what dose is most effective for treating most ailments, where does that leave the user who doesn’t have experience with CBD? Fortunately, it’s easy to simply start with small doses and slowly work toward higher ones. Why? Because a 2011 study and a 2017 update show that CBD has what clinicians call a ‘favorable safety profile,’ due to the fact that it doesn’t change major factors like heart rate, blood pressure, or body temperature and it doesn’t affect psychological functions. It’s also been proven that doses of up to 1,500 milligrams per day are well tolerated, even over long periods of time. However, some subjects from several CBD-related studies have reported side effects of CBD use, including extreme sleepiness, decreased appetite, diarrhea, fatigue, convulsions, and vomiting. There is also evidence that CBD can interfere with certain prescription medications so it’s best to check with a doctor or pharmacist before mixing oral CBD and prescription drugs.

According to a 2019 survey from Gallup, 1 in 7 Americans, or 14%, use some form of CBD, mostly for medicinal purposes. As CBD’s presence continues to grow, consumers and patients are becoming more curious about the ins and outs of this therapeutic cannabis derivative.