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Researching Marijuana for Therapeutic Purposes: The Potential Promise of Cannabidiol (CBD)

July 20, 2015

Chemical structure of Cannabidiol over marijuana leaf background

Three weeks ago I had the opportunity to testify before the Senate on cannabidiol, or CBD—one of the main active ingredients in the marijuana plant, and a compound around which there is a growing amount of interest from the public as well as the scientific and medical communities. The intent of the hearing was to explore ways we can reduce obstacles to research on CBD, given that all chemicals in the marijuana plant are currently in the most restricted category of the Drug Enforcement Administration’s schedule of controlled substances—schedule I.  This category is reserved for substances that have a high potential for abuse and no scientifically supported medical use.  Medical research can and is being done with schedule I substances; however, there are strict regulations and administrative hurdles associated with this status.  

The chemical in marijuana that causes the high (and many of its other effects) is delta-9 tetrahydrocannabinol, or THC. But there are over 100 other cannabinoid chemicals in the plant; CBD is one of those. Different cannabinoids can have very different biological effects; CBD, for example, does not make people high and is not intoxicating. And, there is reason to believe it may have a range of uses in medicine, including in the treatment of seizures and other neurological disorders. In the impassioned, often emotional debates these days over medical marijuana, CBD is often cited as one of the main reasons restrictions on marijuana should be loosened.

A basic understanding of the way cannabinoids affect the body and the brain is helpful to making sense of some of the confusing and contradictory claims made by partisans on either side of those debates. Most cannabinoids (including THC) interact with specific targets on cells in the body, the CB1 and CB2 receptors. CB1 receptors are found mainly in the brain and are important for learning, coordination, sleep, pain, brain development, and other functions; CB2 receptors are found mostly in the immune system. The fact that chemicals in marijuana can speak the body’s chemical language (and cause both beneficial and harmful effects) is not surprising and does not make marijuana special. Many plants, including the opium poppy, tobacco, and coca are similar in that regard. Extracting and amplifying the medicinal benefits of such plants and minimizing their potential harms can lead the way to effective medications, but are also a major scientific challenge.

In marijuana’s case, future medicinal uses will most likely lie in drugs based on cannabinoid chemicals or extracts with defined concentrations that can be reliably produced.   There are very few precedents for a whole plant being approved as a drug (only two ”botanical drugs” are currently approved in the U.S.). This is because creating a standardized plant medicine poses major difficulties—especially in a case like marijuana where there are countless, widely varying strains and large numbers of chemical components about which little is yet known. Marijuana has over 500 chemicals in total, including the 100 or so cannabinoids, so we will still be learning about this plant for years to come. However, we are quickly learning a lot about THC and CBD, and because of its unique properties,  CBD, especially, may be poised to make great inroads into our pharmacopoeia.

CBD has very little effect on CB1 and CB2 receptors. This is probably why it does not make people high and is not mind-altering; in fact it may even blunt some of THC’s psychotropic effects. Most marijuana grown for recreational use is very low in CBD content (and high in THC). CBD’s actions in the body are not well understood, but they appear to involve several signaling systems besides the CB receptors, including a serotonin receptor.

Although CBD first rose to public prominence two years ago as a result of a CNN piece on medical marijuana, CBD has been considered as a potential therapeutic agent since the 1970s, when its anti-seizure properties were first examined in animal studies. A few very small randomized clinical trials were also conducted in adults with epilepsy, some showing positive results. But what has generated the renewed interest and excitement are the anecdotal reports that some children with otherwise untreatable severe epilepsies respond well to CBD extracts and oils. A followup to the CNN piece depicted the struggles of parents of children with a seizure condition called Dravet syndrome, who moved their families to Colorado in order to get CBD-rich marijuana legally. Several drug companies have recently developed CBD-based medications, and one of these, called Epidiolex, is now being tested in clinical trials. Epidiolex was developed by GW Pharmaceuticals and has been given to more than 400 children under the FDA’s expanded access (“compassionate use”) program.

While the existing data show promise, it is still too soon to tell whether and for whom CBD will be effective. Like most medical treatments, it doesn’t seem to work for everyone. Much more research needs to be done, but it should be done quickly. Parents can’t wait—their children are growing; their children’s brains are actively developing; and the repeated seizures may be damaging this growth. Parents currently must navigate states’ medical marijuana laws or defy the law to obtain CBD extracts—which, in the current unregulated market, may be of questionable quality and content.

Besides the trials of Epidiolex, there are already many studies of CBD for other disorders being conducted, including at NIH. Studies related to its possible use in the treatment of substance use disorders are being funded by NIDA, while other NIH Institutes are funding work on the potential of CBD and other cannabinoids in treating neurological and psychiatric disorders, disorders of the immune system and metabolism, and cancer.

In short, CBD appears to be a safe drug with no addictive effects, and the preliminary data suggest that it may have therapeutic value for a number of medical conditions. Addressing barriers that slow clinical research with CBD would accelerate progress. NIDA will do what we can to address such barriers and expedite the study of this potentially valuable compound, as well as other components of the marijuana plant.

This page was last updated July 2015


CBD Usage for insomnia

Hello and thank you for your informative blog. I have a 19 year old son. We are having pretty regular conversations about medical marijuana. The info that people tell him, the info he finds on the internet, and then there is the info that I have lived through with my husband, as an addict, first to marijuana and then to cocaine. My son has tried it, in its weed form, smoked it and been able to fall asleep. He has had bouts of insomnia his whole life, for one reason or another. We have agreed that he should see a doctor and get treatment for insomnia, not self medicate. I am wondering, should we see our family doc, if we are interested in discussing the possibilities of medical marijuana? Is there any sense in pursuing the subject of some form of it helping him to sleep?

Sorry to hear about your son

Sorry to hear about your son’s long term struggle with insomnia—that can be very disruptive to a person’s functioning. And while medical marijuana may seem like an option, I would caution you that there is no scientific evidence showing that prolonged use of marijuana is beneficial for treating sleep problems; and while it may induce sleep, its effects on sleep architecture and patterns are unknown. Moreover, daily use of marijuana in adolescents and young adults is unadvisable because it poses other risks, including dependence, and long-term cognitive impairment, possibly through effects on brain maturation. The best-studied and most successful treatment for sleep disorders is cognitive behavioral therapy (CBT). You might ask your family doctor for the name of a specialist who offers CBT for sleep disorders.

The very odd phenomenon of medical marijuana

How do we explain the general public's mostly lackadaisical disinterest with the myriads of new products continuously being offered to the world of medicine, yet for some crazy reason, interest in medical marijuana therapy currently steals the show!

Folks from all walks of life across the country- politicians, students, talk show hosts, etc.- are ebullient with the prospects of marijuana being the next medical marvel. At a local truck stop out in nowhere, one could hear two separate conversations about the wonders of marijuana. One trucker is commenting how he loves pot, but stopped smoking pot while driving since he found himself driving toward the median of the freeway too much. The other truck driver mentioned how there was nothing wrong with marijuana, how cannabis was truly the great cure all for so many ailments.

But yet, another astonishing curiosity: Those who tout marijuana as the ultimate panacea don't seem interested in just one chemical of cannabis,CBD, that may offer some benefits to the world of medicine. No instead, they prefer smoking the whole plant for "medicinal purposes."

The general populace seems to already have all the answers, so why are the scientists so slow at coming to the same conclusions? How can all these people appreciate marijuana's goodness while the world's top scientists, the best and brightest experts, don't quite get it?

The answer is simple. The mind of the marijuana smoker becomes re-wired favorably for cannabis. They love, cherish and practically worship marijuana. Their brains' redevelop neural structures that tell them to do whatever it takes to assure they have more access to the drug. If that means lying and deceiving, depleting the water table in drought-stricken California, for instance, or contributing to greenhouse gases from indoor growing operations, so be it. There are no morals or ethics. Even our thriving drug culture has engendered a virtual holocaust in Mexico, where crimes against humanity are being committed to supply OUR illegal drug habits. But shamefully, we simply turn our heads and ignore the crimes of humanity on our brethren to the south. Access to marijuana and other drugs is just that important to certain segment of our population. History will NOT judge our era (error!) favorably.

The general medical marijuana movement has zilch to do with medicine, and has everything to do with national legalization, so pot smokers everywhere can satisfy their drug habits. get high and indulge with impunity.

Why did NIDA wait until a cnn report to study cbd for benefits?

As Nora has said, the FDA and NIH have known about cbd's ability to stop seizures for some people since the 1970s. So why hasnt something been done in the FOUR decades since then?

Why only now? Why has this taken so long for such a safe non-toxic medication to be further researched?


check out US Patent 6630507 titled “Cannabinoids as antioxidants and neuroprotectants”. US govt owns patent at the same times tells people marijuana has no medical benefits. So contradictory ,unscientific. The bane of capitalistic world is money power wins over common sense. Thousands people die every year with prescription drug overdose. Thousands people get addicted to dangerous pain killer medicines. But govt continues to approve those drugs. Just look at any new drug approved by FDA - all of them have 4 pages of risks associated with those drugs. How can govt approve those drungs ? Marijuana is far safer than 90% of prescription junks on the market. But big pharma companies will never allow marijuana to be legal becuase they lose big profit. All the research papers claiming marijuana is bad is funded by propaganda. No one is interested in sciense or public safety.

Why now? You can thank the

Why now? You can thank the government and the pharmecutical companies. They have secrets about so many things...cancer and AIDS are the biggest secrets kept. Why not CBD?

Medical Marijuana

Thanks for the great article. I live in Washington state, where after years of questionable medical marijuana dispensaries, the drug is now legal for recreational use. I'm not a user myself, but I can assume that many (most?) of the prescription-holding medical marijuana users were actually using it for recreational purposes. Now that it's legal, several of my friends have told me that they do use it to fight insomnia, and one of my friends has reported its use in her work with end-of-life cancer patients. Thanks again for all the great detail in this article. Getting past the "Reefer Madness" attitude is surely the first step in understanding what legitimate uses marijuana might have.

Medical marijuana

Only time will tell,as when will be the optimum time for Cannibinoids to be re-regulated and given an expansive chance for entering the medical arena.Science is the only measure to work on,not biassness perceived or real.

There is still enough time,to properly re-intergrate social and individual interests with regard to patient`s rights and privileges to life.

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