Animal studies have shown that CBD has anti-inflammatory effects and works on the endocannabinoid and pain-sensing systems to relieve pain.
Animal studies showed that topical CBD applications relieve pain and inflammation associated with arthritis with few side effects. The topical application of CBD is beneficial because CBD is poorly absorbed when taken by mouth and can cause gastrointestinal side effects. 6
Conclusion: CBD may relieve anxiety before events such as public speaking but it is not known what the optimal dose is.
A laboratory study found that CBD prevented human sebocytes from creating too much sebum in addition to having an anti-inflammatory effect, preventing inflammatory cytokines from activating. Because excessive sebum and inflammation are characteristic of acne, topical CBD could be an effective treatment for acne and may prevent or reduce future breakouts. 12,13
CBD can interact with other medications used for epilepsy and some serious side effects have been reported, notably, a decrease in liver function when given to people already taking valproate.
Remember, because CBD oils are largely unregulated, there is no guarantee that a product is either safe or effective.
Potential drug-drug interactions with CBD include:
There have also been suggestions that CBD may aid in the treatment of cannabis and nicotine addiction. Further research is needed.
What to Look For
In an analysis of 14 published studies (nine involving animals and five involving humans), scientists with the University of Montreal concluded that CBD showed promise in treating people with opioid, cocaine, or psychostimulant addiction.
CBD is the short name for cannabidiol, one of the two chemicals—among the dozens in cannabis—that have the most health benefits. The other, tetrahydrocannabinol (THC), produces the psychoactive effects described as being “high.” CBD oil generally does not contain THC, although some trace amounts may be present in products sold in certain states.
There is currently no known “correct” dose of CBD oil. Depending on individual needs and what is being treated, the daily dose may range between 5 and 25 mg.
CBD oil contains CBD mixed with an inert carrier oil, such as coconut oil or hemp seed oil. The bottled oil, called a tincture, is sold in various concentrations. There are also CBD capsules, CBD gummies, and under-the-tongue CBD sprays.
“Our top therapies attempt to break the association between reminders of the trauma and the fear response,” said Mallory Loflin, an assistant adjunct professor at the University of California, San Diego and the study’s principal investigator. “We think that CBD, at least in animal models, can help that process happen a lot faster.” While large clinical trials are underway, psychologists say there isn’t compelling evidence yet as to whether this is a viable treatment.
The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays. More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm. Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby. The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too.
Just as hemp seedlings are sprouting up across the United States, so is the marketing. From oils and nasal sprays to lollipops and suppositories, it seems no place is too sacred for CBD. “It’s the monster that has taken over the room,” Dr. Brad Ingram, an associate professor of pediatrics at the University of Mississippi Medical Center, said about all the wild uses for CBD now. He is leading a clinical trial into administering CBD to children and teenagers with drug-resistant epilepsy.
Does CBD help anxiety and PTSD?
This year, 1,090 people have contacted poison control centers about CBD, according to the American Association of Poison Control Centers. Over a third are estimated to have received medical attention, and 46 were admitted into a critical care unit, possibly because of exposure to other products, or drug interactions. In addition, concern over 318 animals poured into the American Society for the Prevention of Cruelty to Animals’ Animal Poison Control Center.
Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”
Recently, the F.D.A. sent a warning letter to Curaleaf Inc. about its “unsubstantiated claims” that the plant extract treats a variety of conditions from pet anxiety and depression to cancer and opioid withdrawal. (In a statement, the company said that some of the products in question had been discontinued and that it was working with the F.D.A.)
Some CBD products may contain unwanted surprises. Forensic toxicologists at Virginia Commonwealth University examined nine e-liquids advertised as being 100 percent natural CBD extracts. They found one with dextromethorphan, or DXM, used in over-the counter cough medications and considered addictive when abused; and four with a synthetic cannabinoid, sometimes called Spice, that can cause anxiety, psychosis, tachycardia and death, according to a study last year in Forensic Science International.