CBD Craze: Fact or Fiction
Claims about the therapeutic potential of CBD are ubiquitous online. The World Health Organization among others has confirmed CBD ‘s good safety profile with no potential for abuse. More and more people around the world are asking their physicians if CBD might be a useful treatment for them. From capsules and oils to topical ointments and sprays, the CBD craze has taken off.
A soon to be published two-year study from Santé Cannabis however suggests that CBD-rich medical cannabis treatments may on their own lead to only modest improvement of symptoms.
So does the clinical evidence for CBD’s therapeutic benefits support the hype?
LIMITED TO MODERATE EVIDENCE OF SYMPTOM RELIEF
Cannabidiol, or CBD, is the primary cannabinoid found in hemp, and is usually the second most common cannabinoid found in the cannabis plant. More recently, in Canada’s medical cannabis program, cannabis varieties and medical cannabis products have been developed to contain primarily CBD, though trace amounts of THC and other cannabinoids are present.
CBD is known for antiepileptic and anxiolytic effects supported by both clinical and pre-clinical evidence, with several studies also finding anti-inflammatory, immunomodulatory, antipsychotic and neuroprotective effects. Yet the mechanisms of CBD’s effects remain poorly understood and a lack of evidence supporting many of its potential therapeutic properties has proven to be a barrier to its clinical use.
Seizures associated with refractory epilepsy are the symptoms for which there is the most evidence supporting the use of CBD. Epidiolex®, the first CBD-based pharmaceutical product, was approved by the U.S. Food and Drug Administration (FDA) in 2018 as an anticonvulsant in the treatment of Lennox-Gastaut syndrome and Dravet syndrome. It was also approved by the European Medicines Agency in 2019 but remains unavailable in Canada for the moment.
Findings coming from 5 randomized controlled trials also suggest moderate evidence that CBD can help reduce symptoms of psychosis.
Although the evidence supporting CBD as an anxiolytic is limited, Santé Cannabis clinicians have observed good results using CBD-rich treatment to relieve symptoms of anxiety. A recent surge in long term, high-quality studies on CBD and anxiety could offer more conclusive findings over the next few years. All the same, mental health conditions like anxiety for the moment only account for about 6% of patient cases at Santé Cannabis.
There is also limited evidence that CBD might serve as a treatment for symptoms of withdrawal and cravings associated with Substance Use Disorder.
IF YOU WANT TO FIND OUT MORE ABOUT CBD AND THE USE OF MEDICAL CANNABIS TREATMENTS, SIGN UP TO OUR PRESCRIBER TRAINING PORTAL
CBD vs CBD & THC
CBD’s popularity has grown partially due to its good safety profile and the fact that it doesn’t impart the psychoactive effects typically associated with THC.
These characteristics have to some extent helped create the perception that CBD holds greater medical and therapeutic value than THC. In certain countries, regulators have even launched medical cannabis access programs that exclusively rely on CBD treatment plans.
The latest clinical study from Santé Cannabis however indicates CBD-rich treatments may in fact only produce limited improvements in symptom management, compared to treatment plans that combine both CBD and THC. In many contexts, the use of THC in might be necessary for patients to derive greater benefits from their medical cannabis treatment.
The Santé Cannabis study was set to be presented to the Annual Symposium of the International Cannabinoid Research Society and will be published later this year.
It was conducted with patients who initiated medical cannabis treatment at one of our four clinics in Quebec between 2017 and 2019. The study followed two groups during this period: a group of 715 patients who were prescribed CBD-rich treatments and a group of 380 patients who were prescribed both THC and CBD treatments.
The effectiveness of treatments was assessed using standardized medical questionnaire and validated assessment tools like the Edmonton Symptom Assessment Scale (ESAS), Brief Pain Inventory (BPI) and EQ5D at baseline (BL), as well as 3-month (FUP1) and 6-month (FUP2) follow-up.
The study found that patients with treatment plans that relied on CBD-only products reported fewer improvements and benefits than those who incorporated both THC and CBD into their treatment. The CBD and THC patient group showed a more important improvement for almost all assessed elements by a statistically and clinically significant margin.
Additional data and a deeper investigation are still required to further validate these findings and to address control for potential biases.
In the meantime, in the absence of results from further studies, it is probably best to approach the CBD craze with caution and perhaps a dose of scepticism. Santé Cannabis however remains eager to continue clinical research into the matter in cooperation with other participants in the scientific, pharmaceutical and medical cannabis fields.