Getting Real With CBD

The low-down on the new popularity of a natural (and misunderstood) cure-all.
CBD-based products are the new shining star of the natural health industry. Proponents sing its virtues in the treatment of a wide range of ailments, from chronic pain to anxiety; ADHD to seizure disorders. But how does CBD work, and are these claims rooted in research?
A little-known fact about the human body is that we all have an endocannabinoid system. This system regulates a variety of processes, including appetite, pain sensation, mood, and memory. Similar to neurotransmitters like dopamine and serotonin, endocannabinoids serve as messengers of the nervous system and are produced throughout your body (the runner’s high has been traced to the release of an endocannabinoid, Anandamine). But there’s still much of their function that remains a mystery.
Within the endocannabinoid system, there are two different receptors, CB1 and CB2. CB1 receptors are essential for a healthy, functioning brain and are one of the most common receptors in the entire nervous system. They play a critical role in pregnancy, hormone production, cardiovascular health, digestion, and more. CB2 receptors are mainly found in the cells of our immune system. They help moderate inflammation and our immune response to pathogens. These are the receptors that CBD influences — but not binds to — in the way that it’s phytocannabinoid cousin THC does. CBD doesn’t directly trigger either receptor; instead, it modifies the receptor’s ability to bind to cannabinoids.
The exact modification that CBD has on these receptors, however, seems to be hard to nail down. Because CB receptors control so many aspects of the nervous and immune systems — and because of genetic variation in enzymes — it’s difficult to pinpoint exactly what modification the CBD exerts on the receptor. Genetic variations in individuals, paired with variations in plants from which the CBD is derived, creates challenges for baseline, cross-product testing. It also raises challenges in determining a direct, causal relationship between any individual effect and the CBD itself, particularly on specific conditions.
This lack of clear scientific evidence, however, hasn’t deterred people from trying it. Many CBD converts have turned to it as a more natural solution to a plethora of health conditions, with the largest number of users extolling its benefits for pain management. Recent research shows that — of the 62 percent of people who use CBD to treat a medical condition — most use it to manage chronic pain, arthritis, and joint pain.
Support for claims about the benefits of CBD largely rely on animal studies. Although CBD demonstrates some anti-inflammatory and analgesic effects in these subjects, these results haven’t yet been translated to clinical studies in humans. In order to credibly assess the effectiveness of CBD, future studies will have to isolate it from THC to determine how it works in the body. A solid research base in support of CBD will depend on longitudinal studies, in which CBD is administered for extended periods of time. It will also demand that researchers check the specific pain phenotype (neurotrophic, acute, or centralized), and draw tested samples from the pool of cannabis products in use today.
Despite the underwhelming results — and the equally underwhelming testing process — many experts remain hopeful about CBD’s ability to treat and manage pain, especially chronic pain such as that caused by arthritis. While the science doesn’t yet reveal exactly how this molecule works, anecdotal evidence shows a strong correlation between CBD usage and pain management. Bear in mind that it carries its own out-of-pocket costs, and that it is always best to consult with your physician before adding new supplements to your daily regimen.