CBD is everywhere. From corner stores and bars to medical marijuana dispensaries, it's sold for its reputed ability to relieve pain and make people feel better.
CBD (officially known as cannabidiol) is extracted from marijuana or hemp, but it doesn't get you high because it doesn't contain THC, the psychoactive chemical found in marijuana.
Available in a variety of forms, including e-cigarettes, oils, lotions, cocktails, coffee, and gummies, CBD has been touted as a treatment for a wide range of conditions, including chronic pain, cancer, migraines, anxiety, and ADHD. Consumer Reports also publishes guides on how to buy CBD and tips for safe CBD use, showing that CBD is going mainstream.
Not only are adults trying CBD to help with their own concerns, but more and more parents are also turning to CBD to help their children with focus, sleep, calmness, and more.
However, the general use of CBD has exploded with little research into its safety or effectiveness, especially for children. Epidiolex, the first and only cannabis-derived drug approved by the Food and Drug Administration, is used to treat a rare and severe form of epilepsy in patients 2 years of age and older. And because cannabis is in its early stages of legalization and regulation, there is wide variation in product quality and dosage, and there are risks associated with using products that have not been reviewed by the FDA.
What do we know about CBD?
For thousands of years, hemp plants have been used for medicinal purposes around the world. In 1851, marijuana was classified by the United States Pharmacopoeia as a viable medical compound used to treat conditions such as epilepsy, migraines, and pain. However, research on marijuana and CBD has been lacking since marijuana and cannabis-related products became illegal in the United States in 1970. Its classification as a Schedule 1 drug has made it nearly impossible to obtain federal funding to study cannabis.
“The biggest problem is that there's still a lot to know, especially when it comes to children,” says Dr. Paul Mitrani, a child and adolescent psychiatrist at the Child Mind Institute. “There is a lack of evidence to support its use when it comes to treating mental health disorders in children and adolescents.”
Dr. Mitrani, a pediatrician and child and adolescent psychiatrist, says this is an area worth researching, but urges parents to wait until more research is done before giving CBD to their children.
Concerns about CBD
Although anecdotal evidence of the benefits of CBD is common, there are risks associated with using these products, especially in children. Some of the concerns:
You can't trust a product to provide a consistent amount of CBD. It may be less or more than advertised, and in most cases no independent verification of active content is provided. Analysis of the products on sale shows that many do not contain the advertised amount of CBD. “So you can't rely on the quality of what you get,” points out Dr. Mitrani. How much is absorbed? Little is known about how much CBD a particular product actually delivers to the brain. Different delivery systems, such as e-cigarettes, ingestion, and eating in baked goods, have different delivery speeds. Even oils with dissolved CBD can have a variety of effects. “Effects vary widely depending on the delivery system used, and the amount people are exposed to may be inconsistent,” Dr. Mitrani says. Products may contain things other than CBD and may be harmful. Lab tests that provide information about CBD levels, THC levels (if present), and contaminants in the product are not required for CBD products in all states. Without a CoA (Certificate of Analysis), it becomes very difficult to verify the safety of a product. Bootlegged CBD may be linked to recent lung illnesses and deaths attributed to vaping. The CDC and American Medical Association recommend completely avoiding e-cigarette use until the cause of these illnesses is determined. While CBD itself may be safe, it can interact with other medications your child is taking (which are also metabolized by the liver). Dr. Mitrani said that while it may be effective for sleep when used for sleep, he is concerned that “the child may develop a tolerance to it and the sleep disorder may worsen if it is discontinued.” Since the use of CBD, especially in children, is still new, it can be difficult to decide how much to give your child, as few people are familiar with dosages for children. Clinical doses and doses found in coffee shops can vary widely. The legality of cannabis products and CBD is still murky. While CBD derived from hemp is federally legal, CBD derived from the marijuana plant is subject to each state's legal status and remains illegal under federal law. Meanwhile, the FDA issued a statement claiming that products containing CBD, even those derived from legal commercial hemp, do not claim to have therapeutic benefits unless that use is approved by the FDA. The company clarified that it cannot be sold as a nutritional supplement.
Is CBD safe?
Last year, the World Health Organization acknowledged the proliferation of “unapproved” medical uses for CBD and reviewed the evidence regarding its safety and effectiveness. The WHO report concluded that “CBD is generally well tolerated and has a good safety profile.” The WHO noted that any adverse effects could be the result of an interaction between CBD and a patient's existing medications.
The report found no signs of potential abuse or dependence. “To date, there is no evidence of public health-related issues associated with the recreational use of CBD or the use of pure CBD.”
Regarding efficacy, the WHO points out that several clinical trials have shown efficacy in epilepsy, adding that there is “preliminary evidence that CBD may be a useful treatment for many other medical conditions.” There is evidence,” he added.
CBD oil for anxiety
In 2015, a group of researchers led by Dr. Esther Blessing at New York University investigated the potential of CBD in treating anxiety. A review of 49 studies found promising results and a need for further research.
“Pre-clinical” evidence (i.e., from animal studies) “conclusively demonstrates the effectiveness of CBD in reducing anxiety behaviors associated with multiple disorders,” Dr. Blessing wrote. These include generalized anxiety disorder, PTSD, panic disorder, social anxiety disorder, and OCD.
The review notes that the promising preclinical results are also supported by human trial results, which suggest “minimal sedation and an excellent safety profile.” However, these findings were based on placing healthy subjects in anxiety-provoking situations and measuring the effects of CBD on anxiety responses. Further research is needed to establish whether treatment with CBD has similar effects on people suffering from chronic anxiety and what effects long-term use of CBD has.
“Overall, current evidence indicates that CBD has considerable potential as a treatment for multiple anxiety disorders,” concludes Dr. Blessing. “Further research is needed on chronic treatment effects in relevant clinical populations.”
CBD and autism
A group of Israeli researchers has been studying the use of CBD to reduce behavioral problems in children on the autism spectrum. A feasibility study in 60 children found significant improvements in parent-reported behavioral outbreaks, anxiety, communication problems, and stress levels.
Researchers led by Dr. Adi Alan, director of pediatric neurology at Shaare Tzedek Medical Center, continued the double-blind, randomized, placebo-controlled trial with 150 participants with autism. In this trial, which has just been completed but has not yet been analyzed, patients were treated with CBD for three months.
research boom
In the United States, changes in guidelines and laws are facilitating research. In 2015, the DEA relaxed some of the regulatory requirements that had made it difficult to study CBD, a Schedule 1 substance. “CBD contains less than 1 percent THC and has been shown to have potential medicinal properties, making it of significant research interest for medical use,” the DEA said in announcing the changes. .
And last year, in approving the first CBD-based drug, Epidiolex, the FDA had harsh words for the flood of product marketers claiming unproven health benefits. He also expressed his enthusiasm for the research boom that is sure to come.
“We continue to support rigorous scientific research into the potential medical uses of marijuana-derived products and work with product developers interested in providing safe, effective and high-quality products to patients.” the FDA has promised. “But at the same time, if we see illegal sales of CBD-containing products with serious and unproven medical claims, we are ready to take action.”
FAQ
Is CBD safe for children?
The World Health Organization concludes that CBD is generally safe for children. However, there is not enough research on what doses are safe for children and how they interact with other medications. Experts recommend that parents refrain from giving CBD to children because there is still much we don't know.
