The search for safer alternatives to the highly addictive opioids for pain management has led to the emergence and the explosion of plant-derived CBD oil. In the rapidly growing but unregulated industry, CBD oil’s suggested uses go beyond just addressing pain, including everything from helping with anxiety and depression, arthritis and insomnia, to seizures and even acne. Understanding more about CBD may help shed light on its potential applications, limitations and the role it can play in addressing aspects of certain health conditions.
What Is CBD Oil?
CBD, or cannabidiol, oil is one of the most abundant naturally occurring components of the cannabis plant species. It is one of at least 85 cannabinoid compounds found in cannabis plants. It is typically derived from the hemp plant, which is not the same as the marijuana plant, though in the same genus family.
Commercial hemp plants naturally have much higher CBD concentrations, with negligible THC concentrations, unlike their sister marijuana plants. As such, CBD oil that is hemp-derived does not induce the psychoactive effect or “high” that is associated with THC in marijuana. While hemp products like hemp seeds, hemp protein and hemp milk are viewed as nutritional supplements—containing things like essential fatty acids, minerals, amino acids and fiber—CBD oil should not be viewed in the same light. It is more a pharmacological agent in the body.
What Are Its Uses?
Currently, the FDA only recognizes CBD oil in the treatment of two rare forms of childhood epilepsy, with strong evidence of its efficacy. There are a number of studies showing CBD oil may reduce chronic pain, as well as pain associated with some chronic conditions, and reduce anxiety, depression and cancer-related symptoms. However, few of these trials were studied in humans and were done using small sample sizes. Many of the health claims still lack evidence and should be understood as such.
Local Perspective
Dr. Mikael Brucker, a naturopathic doctor and acupuncturist with Grace Acupuncture in Bethlehem, and Dr. Susan Mattes Bostian, integrative health and nutritional specialist at Dr. Susan’s pH, both utilize CBD oil in their practices when it is deemed appropriate. They see its most prevalent application in addressing pain management, but they recognize its limitations.
“I see it as a more short-term management strategy than as a long-term therapy—especially in instances of pain, where it can take over your life and prevent you from daily activities, sleep and getting through your workday,” Brucker says. “At that level, looking for something to make daily living bearable, I have seen positive and rapid change in patients utilizing CBD oil.” As a naturopathic doctor, he is trained to look at all the systems of the body, optimizing their function and creating balance for optimal health. While CBD oil can be a temporary stopgap, helping investigate and address the underlying imbalances is his goal in helping to create more long-term health and vibrancy.
The Misconceptions
CBD oil is a much safer option than opioid medications; however, as with most pharmacological agents, there are potential interactions, along with a potential for liver toxicity. Bostian notes that it is vitally important to know the sourcing, as the industry is unregulated. “Especially if you have a major health challenge, you should know what exactly is in it and where it is coming from,” she says. Bostian recommends getting a copy of the certificate of analysis to ensure you know exactly what is in the product.
Bostian shares her concern that individuals and the companies making the health claims are not qualified in understanding interactions and contraindications of CBD oil, so it makes it appear to be a cure-all for everyone. Bostian says that she has had some clients with rheumatoid arthritis, seizures and cancer that do well, but others do not respond well and in fact feel worse. “It is important to understand not everything works the same in every body, and knowing your body and paying attention to it is critical.”
Uses & Forms
CBD oil has many forms—it can be taken orally, used topically with creams or eaten in food products like chocolates. The quality and concentration levels can vary greatly. Bostian has a powder form available and she teaches her clients how to make their own topical cream. “It is important to know what you are putting in and on your body,” she says. “Teaching my clients how to make their own cream allows them to have full control of the quality of the ingredients.”
Bostian is also careful in guiding their usage so it is appropriate for their body. Brucker recommends patients titrate up, starting with a low dose, and pay attention to how it affects them. Then they can increase the dose until they get the desired effects. “The right amount, you should feel sharp to go to work,” he says. “Too much, you may feel body heaviness and lethargy.”
Both Bostian and Brucker agree that education with patients is key to ensuring that the appropriate dosages are utilized. Brucker says, “Tolerance to CBD oil develops quite easily, so your health professional may suggest taking breaks so as not to require increasing amounts.”
If considering CBD oil, Bostian says, “It is good to check with your integrative practitioner to make sure you are doing what’s appropriate for you and your body.” CBD oil shows promise of being a safer alternative in pain management and may provide relief in some other conditions as more research continues. It is important to understand it is only a part of the solution and, depending on one’s body, it may not be any part at all.
