The effectiveness of cannabidiol (CBD) as a treatment for a broad range of physical and mental conditions is the focus of ongoing research. Mountains of anecdotal evidence, as well as significant clinical studies, suggest this cannabinoid has significant potential to improve the quality of life for countless Americans and others worldwide.
No doubt you’re aware of CBD, since it’s been in the news a lot in recent years, and specialty stores sell it. An increasing number of commercial products contain CBD, ranging from beverages, cereals, and topicals to oils used in vaporizers. Many people swear by the relief CBD provides for a range of disorders, including epilepsy, autism, skin irritation (rashes), pain, anxiety, inflammation, and fibromyalgia.
In late 2018, President Trump signed the 2018 Farm Bill, which essentially made hemp once again legal in the United States—for the first time since 1937. The Marijuana Tax Act made the possession and use of marijuana and hemp illegal.
Hemp, which is the same plant species (Cannabis sativa) as some marijuana strains, is known to contain high levels of CBD and relatively low levels of THC. Passage of the Farm Bill opened the door for scientific research to determine the effectiveness of CBD for medical purposes. Prior to this change in its federal legal status, cannabis research was limited by federal regulations that largely prohibit it, as well as other Schedule 1 drugs, said to have no medicinal value—which many people strongly disagree with when it comes to cannabis.
Cannabis contains hundreds of compounds, including cannabinoids, terpenes, and amino acids. The cannabinoids and accompanying terpenes interact in complex ways. Terpenes are thought to bolster the effects of some cannabinoids, a phenomenon known as “the entourage effect.” Additional research is necessary to increase our understanding of this unique relationship. Now that CBD is legal, this cannabinoid undoubtedly will be the subject of future and ongoing research.
The two cannabinoids with the most applications for healing medical treatments are CBD and tetrahydrocannabinol (THC). Differentiating the two is important. THC is the psychoactive agent contained in marijuana, the effects from which make it desirable to marijuana enthusiasts. CBD does not have a psychoactive effect, although both cannabinoids are thought to have value as medicine. High-quality marijuana is high in THC and low in CBD, while the exact opposite is true for hemp. To be formally classified as “industrial hemp” fit for human consumption, the flowers must contain 0.3 percent CBD or less, which is a miniscule and negligible amount that will not produce a mind-altering effect. For now, marijuana remains illegal, as does research relating to it. Hemp, on the other hand, has been given federal approval and can be used nationwide, in either medicinal pharmaceutical form or as artisan hemp flower or the CBD concentrates extracted from it.
New CBD Drug for Epilepsy
One of the medical conditions for which CBD has shown promising effects is epilepsy. This debilitating disease impacts 1.2 percent of Americans (3.4 million people). More than 65 million people globally suffer from it, and about one in 26 people will develop epilepsy at some point during their lifetimes. Epilepsy strikes people of all ages and ethnic origins. Adults as well as children are deeply impacted by epilepsy in its various forms.
In 2018, the Food and Drug Administration (FDA) approved the first CBD drug, called Epidiolex, specifically for epilepsy. The most obvious symptoms of epilepsy, regardless of the type, are the seizures that accompany this disease and make the lives of those afflicted with it difficult and unpredictable. Many people are diagnosed with epilepsy after a seizure episode.
There are three main categories of seizures. One of the most common is convulsions, also known as “tonic clonic,” or “gran mal” seizures, which are characterized by stiffening of the body and jerking muscle movements. These uncontrollable muscle movements sometimes result in the person biting their own tongue, resulting in bleeding from the mouth. Other forms of seizures that do not appear to be as severe or dramatic may include shaking movements restricted to a region of the body, such as an arm or facial areas. People who experience seizures often have accompanying sensations felt only by them and that are not apparent to others. These sensations, sometimes referred to as “auras,” can include things like feelings of fear or stomach discomfort. The types of seizure auras can be recurring and are usually the same for those who experience them. These auras often will occur right before a seizure episode.
Several things can trigger a convulsive episode, although the number of those with epilepsy who experience specific triggers are in the minority. Seizure triggers can include bright light, loud music and noises, intense exercise, and emotional swings, which occur immediately before a seizure. Other things that can contribute to the occurrence of a seizure episode are fever, stress, menstrual cramps, and a lack of sleep.
People who experience gran mal seizure episodes often are not conscious for the episode. Immediately following the seizure, they experience a fairly brief condition known as a “postictal state,” during which they experience confusion as they slowly regain full consciousness. The postictal period typically lasts for a few minutes and can be accompanied by partial vision loss, the loss of full use of limbs, and the inability to speak clearly.
Not all seizures are caused by epilepsy, but it’s the main linking factor for many people. The hope is that Epidiolex will provide significant relief for those who experience chronic seizure episodes.
CBD for Specific Forms of Epilepsy
Currently, research is being conducted into the use of CBD—specifically Epidiolex—on two specific forms of epilepsy. The first of these types of childhood epilepsy are Dravet Syndrome, (aka Myoclonic Epilepsy), a form of epilepsy that occurs during the first year of life and impacts those affected by it throughout their lives. This epilepsy results in numerous prolonged seizures, as well as delayed speech and language issues. Nutritional and growth complications accompanied by sleeping disorders are a few of the other common symptoms of this disease. Those who suffer from Dravet Syndrome require constant care, and the disease results in a mortality rate as high as 20 percent.
The second form of epilepsy in the study is Lennox-Gastaut Syndrome, which often strikes between the ages of 3 and 5. Those who suffer from this condition have tonic seizures, during which their muscles contract uncontrollably. Many of the seizures that occur with Lennox-Gastaut Syndrome strike during sleep. Symptoms of this epilepsy include confusion, loss of alertness, delayed motor skills, intellectual disabilities, and other chronic conditions. Hopefully, the clinical trials of Epidiolex for these forms of epilepsy will provide positive results and a brighter future for those children who suffer from them, as well as hope for their families.
While Epidiolex will hopefully provide relief for many, some researchers believe whole-plant forms of CBD as a treatment for epilepsy and other conditions may be superior because of the manner in which this cannabinoid reacts and receives bolstered strength from other cannabis compounds—the mysterious entourage effect mentioned above. Whether drugs with isolated CBD are as effective as or more effective than CBD-rich artisan hemp flower and full-spectrum concentrates like oil remains to be seen and fully understood. For now, though, those with epilepsy can place their hopes in new forms of treatment for this serious disease.