Cannabidiol in Anxiety and Sleep: A Large Case Series
Cannabidiol (CBD) is one of many cannabinoid compounds found in cannabis. It does not appear to alter consciousness or trigger a “high.” A recent surge in scientific publications has found preclinical and clinical evidence documenting value for CBD in some neuropsychiatric disorders, including epilepsy, anxiety, and schizophrenia. Evidence points toward a calming effect for CBD in the central nervous system. Interest in CBD as a treatment of a wide range of disorders has exploded, yet few clinical studies of CBD exist in the psychiatric literature.
To determine whether CBD helps improve sleep and/or anxiety in a clinical population.
A large retrospective case series at a psychiatric clinic involving clinical application of CBD for anxiety and sleep complaints as an adjunct to usual treatment. The retrospective chart review included monthly documentation of anxiety and sleep quality in 103 adult patients.
Main Outcome Measures
Sleep and anxiety scores, using validated instruments, at baseline and after CBD treatment.
The final sample consisted of 72 adults presenting with primary concerns of anxiety (n = 47) or poor sleep (n = 25). Anxiety scores decreased within the first month in 57 patients (79.2%) and remained decreased during the study duration. Sleep scores improved within the first month in 48 patients (66.7%) but fluctuated over time. In this chart review, CBD was well tolerated in all but 3 patients.
Cannabidiol may hold benefit for anxiety-related disorders. Controlled clinical studies are needed.
The Cannabis plant has been cultivated and used for its medicinal and industrial benefits dating back to ancient times. Cannabis sativa and Cannabis indica are the 2 main species.1 The Cannabis plant contains more than 80 different chemicals known as cannabinoids. The most abundant cannabinoid, tetrahydrocannabinol (THC), is well known for its psychoactive properties, whereas cannabidiol (CBD) is the second-most abundant and is nonpsychoactive. Different strains of the plant are grown containing varying amounts of THC and CBD. Hemp plants are grown for their fibers and high levels of CBD that can be extracted to make oil, but marijuana plants grown for recreational use have higher concentrations of THC compared with CBD.2 Industrial hemp must contain less than 0.3% THC to be considered legal, and it is from this plant that CBD oil is extracted.3
Many different cultures have used the Cannabis plant to treat a plethora of ailments. Practitioners in ancient China targeted malaria, menstrual symptoms, gout, and constipation. During medieval times, cannabis was used for pain, epilepsy, nausea, and vomiting, and in Western medicine it was commonly used as an analgesic.4,5 In the US, physicians prescribed Cannabis sativa for a multitude of illnesses until restrictions were put in place in the 1930s and then finally stopped using it in 1970 when the federal government listed marijuana as a Schedule I substance, claiming it an illegal substance with no medical value. California was the first state to go against the federal ban and legalize medical marijuana in 1996.6 As of June 2018, 9 states and Washington, DC, have legalized recreational marijuana, and 30 states and Washington, DC, allow for use of medical marijuana.7 The purpose of the present study is to describe the effects of CBD on anxiety and sleep among patients in a clinic presenting with anxiety or sleep as a primary concern.
CBD has demonstrated preliminary efficacy for a range of physical and mental health care problems. In the decade before 2012, there were only 9 published studies on the use of cannabinoids for medicinal treatment of pain; since then, 30 articles have been published on this topic, according to a PubMed search conducted in December 2017. Most notable was a study conducted at the University of California, San Diego’s Center for Medicinal Cannabis Research that showed cannabis cigarettes reduced pain by 34% to 40% compared with placebo (17% to 20% decrease in pain).8 In particular, CBD appears to hold benefits for a wide range of neurologic disorders, including decreasing major seizures. A recent large, well-controlled study of pediatric epilepsy documented a beneficial effect of CBD in reducing seizure frequency by more than 50%.9 In addition to endorphin release, the “runner’s high” experience after exercise has been shown to be induced in part by anandamide acting on CB1 receptors, eliciting anxiolytic effects on the body.10 The activity of CBD at 5-HT1A receptors may drive its neuroprotective, antidepressive, and anxiolytic benefits, although the mechanism of action by which CBD decreases anxiety is still unclear.11 CBD was shown to be helpful for decreasing anxiety through a simulated public speaking test at doses of 300 mg to 600 mg in single-dose studies.12–14 Other studies suggest lower doses of 10 mg/kg having a more anxiolytic effect than higher doses of 100 mg/kg in rats.15 A crossover study comparing CBD with nitrazepam found that high-dose CBD at 160 mg increased the duration of sleep.16 Another crossover study showed that plasma cortisol levels decreased more significantly when given oral CBD, 300 to 600 mg, but these patients experienced a sedative effect.17 The higher doses of CBD that studies suggest are therapeutic for anxiety, insomnia, and epilepsy may also increase mental sedation.16 Administration of CBD via different routes and long-term use of 10 mg/d to 400 mg/d did not create a toxic effect on patients. Doses up to 1500 mg/d have been well tolerated in the literature.18 Most of the research done has been in animal models and has shown potential benefit, but clinical data from randomized controlled experiments remain limited.
Finally, the most notable benefit of cannabis as a form of treatment is safety. There have been no reports of lethal overdose with either of the cannabinoids and, outside of concerns over abuse, major complications are very limited.19 Current research indicates that cannabis has a low overall risk with short-term use, but more research is needed to clarify possible long-term risks and harms.
Given the promising biochemical, physiologic, and preclinical data on CBD, a remarkable lack of randomized clinical trials and other formal clinical studies exist in the psychiatric arena. The present study describes a series of patients using CBD for treatment of anxiety or sleep disturbances in a clinical practice setting. Given the paucity of data in this area, clinical observations can be quite useful to advance the knowledge base and to offer questions for further investigation. This study aimed to determine whether CBD is helpful for improving sleep and/or anxiety in a clinical population. Given the novel nature of this treatment, our study also focused on tolerability and safety concerns. As a part of the evolving legal status of cannabis, our investigation also looked at patient acceptance.
Design and Procedures
A retrospective chart review was conducted of adult psychiatric patients treated with CBD for anxiety or sleep as an adjunct to treatment as usual at a large psychiatric outpatient clinic. Any current psychiatric patient with a diagnosis by a mental health professional (psychiatrist, psychiatric nurse practitioner, or physician assistant) of a sleep or anxiety disorder was considered. Diagnosis was made by clinical evaluation followed by baseline psychologic measures. These measures were repeated monthly. Comorbid psychiatric illnesses were not a basis for exclusion. Accordingly, other psychiatric medications were administered as per routine patient care. Selection for the case series was contingent on informed consent to be treated with CBD for 1 of these 2 disorders and at least 1 month of active treatment with CBD. Patients treated with CBD were provided with psychiatric care and medications as usual. Most patients continued to receive their psychiatric medications. The patient population mirrored the clinic population at large with the exception that it was younger.
Nearly all patients were given CBD 25 mg/d in capsule form. If anxiety complaints predominated, the dosing was every morning, after breakfast. If sleep complaints predominated, the dosing was every evening, after dinner. A handful of patients were given CBD 50 mg/d or 75 mg/d. One patient with a trauma history and schizoaffective disorder received a CBD dosage that was gradually increased to 175 mg/d.
Often CBD was employed as a method to avoid or to reduce psychiatric medications. The CBD selection and dosing reflected the individual practitioner’s clinical preference. Informed consent was obtained for each patient who was treated and considered for this study. Monthly visits included clinical evaluation and documentation of patients’ anxiety and sleep status using validated measures. CBD was added to care, dropped from care, or refused as per individual patient and practitioner preference. The Western Institutional Review Board, Puyallup, WA, approved this retrospective chart review.
Setting and Sample
Wholeness Center is a large mental health clinic in Fort Collins, CO, that focuses on integrative medicine and psychiatry. Practitioners from a range of disciplines (psychiatry, naturopathy, acupuncture, neurofeedback, yoga, etc) work together in a collaborative and cross-disciplinary environment. CBD had been widely incorporated into clinical care at Wholeness Center a few years before this study, on the basis of existing research and patient experience.
The sampling frame consisted of 103 adult patients who were consecutively treated with CBD at our psychiatric outpatient clinic. Eighty-two (79.6%) of the 103 adult patients had a documented anxiety or sleep disorder diagnosis. Patients with sole or primary diagnoses of schizophrenia, posttraumatic stress disorder, and agitated depression were excluded. Ten patients were further excluded because they had only 1 documented visit, with no follow-up assessment. The final sample consisted of 72 adult patients presenting with primary concerns of anxiety (65.3%; n = 47) or poor sleep (34.7%; n = 25) and who had at least 1 follow-up visit after CBD was prescribed.
Main Outcome Measures
Sleep and anxiety were the targets of this descriptive report. Sleep concerns were tracked at monthly visits using the Pittsburg Sleep Quality Index. Anxiety levels were monitored at monthly visits using the Hamilton Anxiety Rating Scale. Both scales are nonproprietary. The Hamilton Anxiety Rating Scale is a widely used and validated anxiety measure with 14 individual questions. It was first used in 1959 and covers a wide range of anxiety-related concerns. The score ranges from 0 to 56. A score under 17 indicates mild anxiety, and a score above 25 indicates severe anxiety. The Pittsburg Sleep Quality Index is a self-report measure that assesses the quality of sleep during a 1-month period. It consists of 19 items that have been found to be reliable and valid in the assessment of a range of sleep-related problems. Each item is rated 0 to 3 and yields a total score from 0 to 21. A higher number indicates more sleep-related concerns. A score of 5 or greater indicates a “poor sleeper.”
Side effects and tolerability of CBD treatment were assessed through spontaneous patient self-reports and were documented in case records. Any other spontaneous comments or complaints of patients were also documented in case records and included in this analysis.
Deidentified patient data were evaluated using descriptive statistics and plotted graphically for visual analysis and interpretation of trends.
The average age for patients with anxiety was 34 years (range = 18–70 years) and age 36.5 years for patients with sleep disorders (range = 18–72 years). Most patients with an anxiety diagnosis were men (59.6%, 28/47), whereas more sleep-disordered patients were women (64.0%, 16/25). All 72 patients completed sleep and anxiety assessments at the onset of CBD treatment and at the first monthly follow-up. By the second monthly follow-up, 41 patients (56.9%) remained on CBD treatment and completed assessments; 27 patients (37.5%) remained on CBD treatment at the third monthly assessment.
Table 1 provides means and standard deviations for sleep and anxiety scores at baseline and during the follow-up period for adults taking CBD. Figure 1 graphically displays the trend in anxiety and sleep scores over the study period. On average, anxiety and sleep improved for most patients, and these improvements were sustained over time. At the first monthly assessment after the start of CBD treatment, 79.2% (57/72) and 66.7% (48/72) of all patients experienced an improvement in anxiety and sleep, respectively; 15.3% (11/72) and 25.0% (18/72) experienced worsening symptoms in anxiety and sleep, respectively. Two months after the start of CBD treatment, 78.1% (32/41) and 56.1% (23/41) of patients reported improvement in anxiety and sleep, respectively, compared with the prior monthly visit; again, 19.5% (8/41) and 26.8% (11/41), respectively, reported worsening problems as compared with the prior month.
CBD oil is having a moment. What’s it for and what’s behind all the hype?
If you believe all of its apparent virtues, CBD oil can fix just about anything. It stimulates the same response as social contact, chocolate and exercise. But what does the science say, and is it legal in Australia?
By Sarah Berry
If you believed all the hype extolling its apparent virtues, CBD oil just might be the elixir of life. The cannabinoid compound is having a moment, with its global market projected to grow from $US1.4 billion in 2020 to $US12.9 billion by 2027, according to one market research group.
A 2020 analysis that looked at social media posts to better understand why people used the plant extract found reasons ranging from mental health issues, including anxiety and depression, to musculoskeletal problems as well as for gut issues, autism, addiction, heart problems, skin problems, eye problems, sleep and sexual health issues.
This was despite a lack of evidence behind many of the claims about CBD oil’s benefits and, in many cases, a lack of access to the real thing. A separate analysis found that only one-third of extracts sold online contained the amount of cannabidiol (CBD) that the label claimed – if they contained any at all. University of Newcastle clinical pharmacologist Professor Jennifer Martin recalls a patient who was “really pissed off” because he spent $90 on what he believed was CBD oil only to discover it was olive oil.
Whether the products or claims are real or not, the hype surrounding CBD oil certainly is. So, what is it? Where does it come from? And does it do anything?
Illustration: Jo Gay Credit:
What exactly is CBD oil (and will it make me high)?
There are about 100 different cannabis-like (cannabinoids) compounds in hemp and cannabis plants. The two main ones are tetrahydrocannabinol (THC, found mostly in cannabis), which will make you high; and cannabidiol (CBD, found mostly in hemp), which will not make you high nor have psychotic effects. As the World Health Organisation states, “in humans, CBD exhibits no effects indicative of any abuse or dependence potential.”
Both THC and CBD fall under the umbrella of “medicinal cannabis”, which can contain THC only, CBD only, or various ratios of the two.
Although hemp has a higher CBD content, hemp oil is very different to CBD oil. Hemp oil is made by cold-pressing hemp seeds. CBD oil is made by extracting the compound from the hemp plant and then mixing it with a carrier oil. You can buy hemp seed oil at the supermarket to drizzle on your salad but it contains a negligible amount of actual CBD.
In CBD oils, the amount of cannabidiol varies from product to product. There is “purified” CBD, typically at least 98 per cent pure, and “full spectrum”, which contains other compounds from the plant, not just CBD.
“The purified preparation is the one that has been approved by the TGA [for epilepsy],” says associate professor Jonathon Arnold, the deputy academic director of the Lambert Initiative for Cannabinoid Therapeutics, a research centre at the University of Sydney set up with an investment by Barry and Joy Lambert, whose granddaughter suffered from debilitating paediatric epilepsy. Arnold adds that the full-spectrum preparations may be beneficial in their own right but need further research.
People have been using cannabis and its compounds for millennia, first documented in the case of Emperor Shen Nung in 2800BC.
In the 1800s, cannabis extracts, including CBD, were being used in Western medicine, but prohibition put a stop to that (Australian federal laws banned cannabis importation and use in 1926). People continued smoking marijuana and extracts were made and sold illegally. So, why the sudden interest in these compounds now?
The “father of cannabis”, Israeli researcher Raphael Mechoulam, discovered THC in the 1960s and then made other groundbreaking discoveries in the ’80s and ’90s, identifying the various cannabinoids in cannabis as well as the endocannabinoid system (ECS). The ECS is the naturally occurring cannabis in our bodies – made up of molecules, receptors and enzymes – that plays a role in regulating mood, motivation, pleasure, sleep, appetite and metabolism.
It wasn’t until 2015, that Australia’s Therapeutic Goods Administration (TGA) approved CBD as a prescription medicine.
Unless it is prescribed by a doctor, people who want CBD have to obtain it elsewhere, including buying unregulated products online from overseas suppliers.
Is it legal in Australia, and where is it sold?
In recent years, there has been a proliferation in research and a corresponding surge in supply and demand for the product. Low-dose CBD has since been approved as a Schedule 3 (pharmacist-only) medicine, and in 2021 Australia’s largest pharmacy chain, Chemist Warehouse, signed a deal to supply the products over the counter. But you won’t see them in any pharmacy yet. This is because no CBD product has been approved by the Australian Register of Therapeutic Goods (ARTG), which is a requirement of pharmacist sale. When, and if, ARTG gives its approval, “low-dose” CBD products (less than 150 mg per day), from companies that also have TGA approval, will become available over the counter in pharmacies.
Until then, doctors can prescribe it for a range of issues including epilepsy, chronic pain, anxiety and insomnia. Otherwise, people who want CBD have to obtain it elsewhere, including buying unregulated products online from overseas suppliers. Mail-order and online cannabis products are illegal in Australia.
It is, Arnold admits, “all quite complex”.
In many countries, CBD is available as an over-the-counter “nutraceutical”. These contain very low doses (just a fraction of the therapeutic dose range) for which there is little evidence of health benefits. The lack of therapeutic effect with such low-dose products is not the only issue, says Professor Stephen Myers, a complementary medicine expert from the NICM Health Research Institute.
“Obtaining your CBD oil other than through a medical prescriber is fraught with a number of problems,” Myers says. “The preparation is unlikely to have been manufactured under pharmaceutical-grade quality.”
And what you might think is pure CBD oil could have contaminants including, but not limited to, THC. “A lot of people don’t want the psychoactive effect of cannabis, they’re more after the anxiolytic effect – the reducing anxiety effect.“
OK, so why are people so excited about CBD?
CBD is what pharmacologists like to call a “promiscuous drug”, explains Arnold.
It is referred to as a “promiscuous drug” partly because the endocannabinoid system (ECS) is widespread in the body and CBD seems to interact with a variety of its target receptors and enzymes.
“CBD is a really interesting compound because there have been more than 65 different potential mechanisms of action that it has,” Arnold says. “CBD doesn’t directly activate the cannabinoid receptors. It might be boosting your endocannabinoids.”
Our endocannabinoids interact with cannabinoid receptors to influence biological function. When we boost our levels of endocannabinoids (endo means “within”), this may result in less inflammation and pain in the body, an enhanced sense of wellbeing and support the body to regulate its functions.
“Ananda is the Sanksrit word for bliss – and it increases levels of anandamide clearly in the body.”
“[The ECS] is all through the brain and in the immune system and in most parts of the body,” says pharmacologist and cannabinoid researcher Mark Connor from Macquarie University. “It has a zillion functions. It’s in parts of the brain that are important in anxiety, it’s in parts of the brain that are important in mediating reward, it’s in parts of the brain that are important in modulating pain.” He adds: “Any drug that interacts with that system has, potentially, a wide range of effects.”
By taking CBD oil, we boost our blood levels of endocannabinoids, Arnold says. “One of them is called anandamide – ananda is the Sanksrit word for bliss – and it increases levels of anandamide in the body,” he explains. “The idea then is that you’re toning up these levels of naturally occurring endocannabinoids and that could be exerting its beneficial effects.”
Social contact, chocolate and exercise can also stimulate anandamide.
CBD also has anti-inflammatory properties and, Arnold adds, inflammation can be common to a range of different health conditions.
He says CBD also behaves similarly to Valium “but it’s not as potent, and it acts on this inhibitory receptor called the GABA receptor, and it’s able to tone up the actions of that receptor.” GABA receptors help to inhibit or reduce nerve impulses and have a natural calming effect.
(Alcohol ultimately depletes GABA stores, and because these stores have a calming function, this results in anxiety.)
But does it work?
There is good evidence that CBD does help with epilepsy by reducing seizures, and this is what it is approved for medically.
Australian Medical Association president Dr Omar Khorshid points out that only two medicinal cannabis products have been approved by the TGA and registered on the ARTG: “Nabiximols (for patients with moderate to severe spasticity due to multiple sclerosis) and Epidyolex (for seizures associated with Lennox-Gastaut syndrome or Dravet syndrome).”
All other medicinal cannabis products available in Australia are unregistered medicines. Still, legal access to medicinal cannabis is increasing and GPs can prescribe a range of CBD oils via the Special Access Scheme or Authorised Prescriber Schemes for different conditions, including neuropathic pain, chronic pain, anxiety and insomnia.
As far as the evidence for these uses goes, there is emerging data suggesting it may help with anxiety, it has been approved in several countries for the treatment of pain caused by inflammation, and one review found it “could improve” sleep quality, but, this is based on the limited research and too early to say for sure.
Researchers continue to explore its use in other areas.
“It’s interesting because it seems to have so many benefits for symptoms that are troubling people – weight, sleep, appetite, mood,” Martin says. However, none of the evidence for this is solid yet.
Nor is the research that has explored its use for Parkinson’s disease (“interesting evidence” but currently insufficient, according to a 2020 review paper); burnout (it can help, according to one small new study); and as a treatment for addiction (one randomised, controlled trial found it was safe and more effective than a placebo).
“A lot of the things people would like to think it’s effective for, the evidence is very slim and a lot of it is just not there at all. The evidence for and against the usefulness is coming.”
Despite the lack of good evidence, some people take CBD oil daily as a prophylactic, for sleep and reducing anxiety: the reason more than 60 per cent of CBD users took it, according to a survey of 5000 people – by a cannabis market research group – reported in The New York Times.
For now, Khorshid is unconvinced of its benefits. “Currently, there is insufficient evidence to use medicinal cannabis products more broadly and the evidence base varies across conditions. This is why there are not more medicinal cannabis products registered on the Australian Register of Therapeutic Goods,” he says.
“The TGA states that medicinal cannabis is not appropriate for individuals with an anxiety disorder. The TGA also states that there is no evidence on its effects on sleep.”
Connor says, “A lot of the things people would like to think it’s effective for, the evidence is very slim and a lot of it is just not there at all. The evidence for and against the usefulness is coming. In a few year’s time we will have a much better idea about what benefits it might have.”
Are there side effects?
A landmark study on how cannabis affects driving ability has shown that CBD does not impair driving. People who are taking CBD-only products are legally allowed to drive, although Martin urges caution given that it’s used to help people with sleep issues, and seizures. It is illegal to drive while being treated with products containing THC.
“It is quite a safe drug,” says Arnold, noting that meta-analyses have found the main problems are that it can cause diarrhoea – and that it can interact with other drugs. “That needs to be better documented, so clinicians have good guidance on how to manage those interactions.”
Martin agrees: “It does seem to have a lot of potential benefits but there’s a need to understand it more as well.”
And while CBD seems to be “generally reasonably safe in healthy people at low doses”, according to Connor, “the fact that it’s probably harmless probably means it’s not doing very much either.”
He points out that the doses to treat a condition, such as epilepsy, are much higher than people are likely to take daily.
“It’s like any drug, if you take a little, it’s probably fine … taken at higher doses it could be problematic.”
If you think CBD may benefit you, speak with your GP.
“What’s a good combination for epilepsy may not be a good combination for pain,” Connor says, and doses and combinations my differ, depending on why it’s being used. “It’s a very complex space.”
“Even if it does turn out to be effective, it’s never going to be: ‘Here, take 100 milligrams of cannabidiol and that’ll fix what ails you’.“
Fascinating answers to perplexing questions delivered to your inbox every week. Sign up to get our new Explainer newsletter here.
11 Benefits of CBD Oil (Cannabidiol) & Why It’s Not What You Think
This post contains affiliate links.
Click here to read my affiliate policy.
I love remedies that have many uses (like emu oil), and cannabidiol oil (or CBD or hemp oil) is gaining popularity for this reason. This oil extracted from the hemp plant has come under a lot of legal and moral questions. Opinions may differ but what can’t be ignored is the incredible healing power CBD oil seems to possess and how versatile it is as a supplement and natural remedy.
CBD Hemp Oil: What Is It & What Does It Do?
CBD oil claims many benefits that seem to include every imaginable ailment. It’s a good idea to look a little deeper whenever something seems to be a cure-all… so I dug in.
The medical use of marijuana has brought some attention to the subject of using cannabis-derived products for health, but it’s important to understand how CBD oil differs. We’ll get into this more in a bit, but the key difference lies in the parts of the plant being used to make the product. For example, CBD oil is also different from hemp seed oil, since it is extracted not from the seed but from the flowers, leaves, and stalks of hemp.
Surprisingly, research shows that CBD products are actually helpful at reducing many ailments. Such diverse ailments that they seem to be unrelated, in fact… but they are not. Emerging research shows that each of these ailments may be related to dysregulation of the endocannabinoid system, or ECS for short.
Haven’t heard of it? You’re not alone! It’s not as familiar to us as the cardiovascular or immune system, but is a critical component of the human body.
Understanding the Endocannabinoid System
The endocannabinoid system is possibly one of the most fascinating systems in the body. It was discovered through researching the effects of cannabis on the body. In fact, this amazing system that regulates the body’s internal balance got its name from the cannabis plant that made its discovery possible.
The endocannabinoid system is made up of endocannabinoids and their receptors. These are found everywhere in the body from the brain and other organs to glands and immune cells. The endocannabinoid system works differently in different parts of the body but the end goal is homeostasis (internal balance).
Ever heard of a “runner’s high”? Research reported in the Scientific American found endocannabinoids are largely responsible for this natural “hit” of euphoria that increases feelings of well-being and decreases the perception of pain.
Cannabidiol (CBD oil) is another way to affect this powerful body system … but am I really saying “getting high” is a good thing?
It turns out there’s a very important distinction still to be made …
Does CBD Oil Create a High?
The short answer is: No. (Though oils with THC can also contain CBD).
There are two different types of CBD oil products — hemp-based CBD oil (the one I’m talking about in this article) and marijuana-based CBD (which is what someone would buy at the dispensary). Both contain CBD, and they’re both derived from the cannabis plant, but hemp and medical marijuana are are different varieties of the plant.
Marijuana-based CBD is generally going to have more THC and other cannabinoids. CBD oil does not contain THC (the compound that causes a “high” feeling). This is an important distinction that many people don’t understand.
The variety that is typically (and legally) used to make CBD oil is hemp. How is hemp oil different? A plant can only be legally considered hemp if it contains .3% per dry unit (or less) of the compound THC.
In a nutshell, CBD oil or hemp oil contains the benefits of the cannabis plant without the potential drawbacks of psychoactive compounds typically found from inhalation or other methods of consumption.
Cannabidiol (CBD) Benefits & Uses for Pain, Inflammation, Epilepsy & More
CBD oil is a great remedy for a lot of different ailments. Here are some of the amazing uses people (and medical research) report for CBD oil:
1. Relief for Chronic Pain
Those suffering from chronic pain from diseases like fibromyalgia are finding relief with CBD. Taking CBD can offer pain relief and can even prevent nervous system degeneration. In fact, it has been approved in Canada for multiple sclerosis and cancer pain.
What’s really amazing is that CBD doesn’t cause dependence or tolerance, so it’s a great choice for those trying to stay away from opioids.
Other Remedies to Consider: Not into CBD? Research also shows that turmeric consumption and heat therapy (like sauna use) may be helpful as well. A low inflammation diet also seems to be helpful for some people.
2. Calms Childhood Epilepsy
CBD has anti-seizure properties that have been shown to successfully treat drug-resistant children who have neurological disorders like epilepsy (with no side effects!). In one study published in the New England Journal of Medicine, CBD decreased frequency of seizures by 23 percentage points more than those taking a placebo.
While I much prefer a natural remedy as a first course of action, but even the Food and Drug Administration seems to agree that cannabis-derived drugs may have something to offer. In April 2018 FDA advisers cleared the very first cannabis-derived drug for approval, one that promises to help control seizures.
Other Remedies to Consider: Childhood epilepsy is a serious condition and it is important to work with a qualified practitioner with a specialty in this area. Emerging research also shows that a ketogenic diet can be very helpful for drug resistant epilepsy, especially in children.
3. Reduces Anxiety and Depression
According to the Anxiety and Depression Association of America, depression affects 6% and anxiety affects 18% of the U.S. population each year. Research shows that CBD oil can help with both.
CBD has been shown to reduce levels of stress and anxiety in those suffering from conditions such as PTSD, social anxiety disorder, and obsessive compulsive disorder. CBD even reduced the stress and discomfort surrounding public speaking.
Though a B12 deficiency may also be to blame, CBD has been shown to reduce depression by enhancing both serotonergic and glutamate cortical signaling (both are lacking in those with depression).
Other Remedies to Consider: Dr Kelly Brogan provides a lot of helpful information for anxiety and depression in this podcast episode. Vitamin B12 is also linked to mental health and it may be helpful to work with someone experienced in optimizing levels of B12.
4. Fights Multi-Drug Resistant Bacteria
Researchers discovered that cannabinoids (including CBD) have an unusual ability to destroy bacteria (especially drug-resistant strains). More research is needed to find out how and why it works.
A 2011 study found that CBD can also slow the progression of tuberculosis in rats. Researchers concluded that CBD likely does this by inhibiting T-cell proliferation, rather than possessing antibacterial properties.
Whatever the mechanism is for destroying bacteria, CBD seems to be a potent weapon against the antibiotic resistant “superbugs” that are becoming more and more of a problem today.
Other Remedies to Consider: Don’t want to try cannabidiol? There is also research on using garlic, honey and oregano oil for drug resistant strains, but work with a practitioner experienced in infectious disease.
5. Reduces Inflammation
Chronic inflammation is a huge problem in our society that contributes to many non-infectious diseases including heart disease, cancer, Alzheimer’s, autoimmune disease, and more, according to the National Center for Biotechnology Information.
Diet and lifestyle play a huge part in chronic inflammation but when folks are already eating a healthy, nutrient-dense diet and optimizing their lifestyle (getting enough sleep and exercise for example), CBD oil can help. Research also shows that CBD oil can reduce chronic inflammation that leads to disease.
Other Remedies to Consider: Research agrees that it is important to address gut health to manage inflammation. Removing refined sugar from the diet has also been shown to reduce inflammation in as little as a week.
6. Reduces Oxidative Stress
Oxidative stress is responsible for many ailments today. Oxidative stress is when the body has too many free radicals and can’t keep up with neutralizing them (with antioxidants). This is more of a problem now than in the past because our environment is so much more toxic than it once was. A 2010 study shows that CBD oil acts as an antioxidant and another study found CBD has neuroprotective qualities. So CBD can reduce neurological damage caused by free radicals.
7. Help for Schizophrenia
Schizophrenia is a complicated and serious disease that is typically managed through therapy and pharmaceutical drugs (that carry hefty side effects). Anecdotally, many folks have found that CBD oil has helped reduce hallucinations. Research is beginning to catch up too. A March 2015 review of available research found that CBD was a safe, effective, and well tolerated treatment for psychosis. But more research is needed to bring CBD into clinical practice.
It should be mentioned that THC, the psychoactive compound in marijuana, may actually increase psychosis for those at risk. CBD oil, on the other hand, only helps reduce psychosis and may even counteract psychosis brought on by marijuana use.
8. Promotes Healthy Weight
Cannabidiol can help maintain healthy blood sugar, stimulates genes and proteins that helps break down fat, and increase mitochondria that helps burn calories.
CBD also encourages the body to convert white fat to brown fat. White fat is the kind of fat we typically think of when we think about body fat. Brown fat is fat that is in small deposits that behaves differently than white fat. Brown fat is said to improve health by enhancing the bodies ability to burn white fat, create heat, and even regulate blood sugar.
9. Improves Heart Health
Heart disease is a growing problem today. In fact, it’s the leading cause of death in the U.S. A healthy diet and lifestyle is a top priority for heart health, but CBD oil can also help. According to research cannabidiol reduces artery blockage, reduces stress induced cardiovascular response, and can reduce blood pressure. It may also reduce cholesterol.
As mentioned earlier, CBD oil is helpful in preventing oxidative stress and inflammation. Both of these are often precursors to heart disease.
10. Improves Skin Conditions
CBD oil can be used topically to treat skin conditions. Studies show CBD oil has a high potential for treating skin conditions like eczema by encouraging abnormal cell death. It can also help regulate the skin’s oil production, reducing acne. CBD also contains many nutrients like vitamin E that help improve and protect the skin.
Other Remedies to Consider: Diet is vitally important for skin health. Many people find that removing foods like sugar, dairy or grains (if sensitive) improves skin. I also personally use a skin probiotic spray that has made a huge difference for my acne prone skin.
11. Fights Cancer
CBD oil’s role in cancer treatment still needs more research, but what is available is looking promising. According to the American Cancer Society, CBD oil can slow growth and spread of some kinds of cancer (in animals). Because it fights oxidative stress and inflammation (and both are linked to cancer) it makes sense that CBD oil could help fight cancer cells.
CBD vs. Hemp Oil
This is a common question and misconception. As mentioned above, while they come from the same plant, they are different strains and CBD is harvested from the plants that contain no THC (or negligible levels). CBD is completely legal and is not considered a drug. Because of the often confused history of these plants, many manufacturers use “hemp oil” instead of the more controversial “CBD oil” in their marketing. CBD levels can vary drastically based on manufacturing, so it is important to find a high quality manufacturer with verified levels.
From a sustainability standpoint, it is a shame that hemp has gotten so much negative press because it comes from a similar strain of plant. Aside from the CBD benefits, hemp is one of the strongest, longest, and most durable natural fibers and it can be grown without any type of pesticides or herbicides! It also:
- makes up to four times as much fiber per acre as pine trees
- can be recycled many more times than pine-based pulp products
- is easy to grow without chemicals and is actually good for the soil
- produces a seed and seed oil rich in protein, essential fatty acids and amino acids
How to Use CBD Oil
CBD oil is most often used internally (through ingestion). Because CBD oil is a relatively new supplement, exact dosing isn’t well established. While more long-term studies are needed, there is no established CBD “overdose” and there are very few if any side effects at any dosage.
When trying to find the right dosage, consider these things:
- Start by purchasing a high quality oil from a reputable company. A higher quality oil will be more bioavailable, so a lower dose can be enough.
- Begin with the recommended dosage on the bottle (especially if using preventatively).
- Some notice a change immediately, while others don’t notice any improvement for several weeks. If after several weeks there is still no change, increase the dosage.
- As with most herbal supplements, a small dosage 3-4 times a day is usually more therapeutic than one large dose.
Important note: Though CBD oil on its own is very safe, it may interact with medications, particularly opioids. Speak with your doctor if you’re concerned about interactions or are unsure about using hemp oil for your conditions. I know it’s tough to find a primary care doctor who understands alternative practices, but there are options like this service that pair you with a doctor who fits your lifestyle.
CBD Oil for Pets
Sidenote for our furrier friends: All mammals have an endocannabinoid system, CBD oil can have some of the same benefits for pets as it does for humans.
For cats and dogs in particular, CBD oil may help with:
- excessive barking or crying
- pets getting along with other pets
- relaxing pets before a trip to the vet
- lack of appetite
- separation anxiety
How to Use CBD Oil for Pets
There may be some trial and error in finding the right dosage for pets. Start with a low dose of 1 milligrams per 10 pounds of body weight and go up to 5 milligrams per 10 pounds of body weight if needed. A higher dose may be necessary for some ailments. A low dose 3-4 times a day is usually more therapeutic than one large dose.
Because I got so many questions on this, I dug into the research on CBD for dogs for you.
CBD: What I’ve Tried (& What I Will)
There are lots of benefits to using CBD oil as a supplement. A healthy diet and lifestyle should always be the first step to improved health, but CBD oil can help build on that foundation.
I have tried CBD oil supplements before and did notice a calming effect almost immediately. Since I have the MAO-A gene and am very type A, I’ve always struggled with sleep and getting my brain to turn off. I found CBD oil very helpful for this. I’ve also used it to reduce inflammation after injuries with good results.
- I don’t use CBD oil all the time but keep it around for injuries or nights when it’s difficult to sleep. It is important to use pure CBD oil from a reputable company. Personally, I like this brand. offers CBD infused therapeutic bodycare that is a great option. Check out my review here.
For more on CBD oil for health, hop over to this podcast interview to hear how a certified Bulletproof wellness coach uses it with life-transforming results.
This article was medically reviewed by Dr. Scott Soerries, MD, Family Physician and Medical Director of SteadyMD. As always, this is not personal medical advice and we recommend that you talk with your doctor.
What are your thoughts on CBD oil? Would you try it or think it’s too controversial still? I’d love to hear your thoughts!