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Cannabidiol (CBD) is a plant extract obtained from the Cannabis sativa plant, which is more commonly considered as an extremely common drug ‘marijuana’. The chemical compounds obtained from the extract of this plant are known as cannabinoids and include cannabigerol, cannabidiol, cannabichromene, and tetrahydrocannabinol (THC) along with some other chemicals. Among all the cannabinoids, tetrahydrocannabinol (THC) is the most known one and is psychoactive, and is used for addictive purposes. The next main constituent of the plant extract other than THC is cannabidiol (CBD), which constitutes about 40 percent of the total extract.
Recent research advancements in the regime of natural plants and herbs being an effective treatment for many of the disorders in humans have brought out some very fascinating results. People have been using cannabis for their recreation for centuries. Iranian people found cannabis high in the mountains, and have never stopped it using since then. The recent research conducted by scientists all around the world has shown that many of the natural herbs and plants that were considered to be harmful to the human body previously are very beneficial for certain disorders. Countless such pearls are hiding in our plain sight, and waiting to be discovered to be used for disorders that are thought to be incurable. Most of these disorders were considered to be uncurable previously, but certain advancements in scientific research have enabled us to discover their treatment in the natural herbs.
The cultivation of such natural herbs was for long considered to be illegal because of the potential use of the derivatives from these herbs as recreational drugs that manifest sense impairing symptoms. People have for long cultivated natural herbs such as cannabis and poppy in the drug black markets, such as Afghanistan. The cocaine trade from Columbia was also the result of large plantations of such plants. But due to their use as drugs and the harmful effects they have, if they are abused, the governments all over the world declared the cultivation of these crops illegal. But due to the advancements in the field of scientific and medical research that brought forward the case of Cannabis, it has become possible to give cannabidiol as a prescription drug to the patients suffering from specific nervous disorders such as Parkinson’s disease, Alzheimer’s disease, insomnia, and schizophrenia, etc.
Similar is the case for Cannabis sativa, more commonly known as marijuana or ‘weed’. Cannabis has been used as a recreational drug by people for centuries. Contrary to the conventional use of the cannabis plant to make marijuana for smoking, advancements in the field of medical research have found that some of the natural chemicals found in this plant such as cannabidiol (CBD) are very useful for certain medical disorders. The plant extracts, also known as the cannabinoids, have found immense medical importance that has been proven through immaculate medical research, which can be found online. The public sentiment towards the legalization of cannabidiol (CBD) and marijuana is increasing day by day, and more and more people are deciding to use cannabis derivatives to treat various nervous disorders of the brain and spinal cord. Physicians have researched the efficacy of cannabidiol in properly supervised clinical settings, and the results they have gained are satisfactory enough to enable doctors to prescribe medical marijuana as a therapeutic drug, the major component of which is cannabidiol (CBD).
The Natural Chemicals in Cannabis
The cannabinoids include cannabigerol, cannabidiol, cannabichromene, and tetrahydrocannabinol (THC) along with some other chemicals found in the extract from Cannabis sativa plant. Cannabidiol (CBD) differs from other chemicals found in cannabis, as it has a different mechanism of action and a different effect on the body as compared to other chemicals such as the tetrahydrocannabinol (THC). The main substance behind the ‘high’ that the person gets after consuming marijuana is THC, which messes with the neuronal circuits to give hallucinations and euphoric feelings to the person who consumes marijuana. The chemicals having such types of results in the body are called ‘psychoactive’ substances. The top example of a psychoactive substance found in marijuana is tetrahydrocannabinol (THC). CBD is emerging largely as a full body treatment nowadays. The effects of CBD are not only limited to treating localized pain and anxiety, but it also has found a vast range of uses in other medically related conditions such as inflammation, cancer, and nervous conditions such as Alzheimer’s disease, Parkinsonism, and multiple sclerosis. Owing to the neuroprotective and anti-psychotic effects of cannabidiol, this compound has found itself being used for many pharmaceutical purposes.
The Mechanism of Action of Cannabidiol
The derivatives of Cannabis all act by interacting with the neuronal circuits of the central nervous system. Their ability to interact with the sensitive nerve circuits of the brain and spinal cord enables them to exert pronounced effects on our nervous system. These effects produced depend mainly on the two chemicals that are found in abundance in Cannabis: one of them is tetrahydrocannabinol, the psychoactive substance that gets you the ‘high’ you experience after smoking cannabis. The other one that is responsible is cannabidiol (CBD) which is non-psychoactive and exerts similar effects on the body, the difference being that it does not give the ‘high’ effect, and grants a much more controlled effect to the body than tetrahydrocannabinol (THC).
Cannabidiol (CBD) acts by interacting with the endocannabinoid system of the body. The endocannabinoid system in our body is just another neurotransmitter system just like the acetylcholine system or adrenaline system. The neurotransmitter system of our bodies acts to pass on the nerve impulses on synaptic terminals. The nerve impulse gets passed on through the secretion of certain molecules at the synaptic junctions. These molecules are known as neurotransmitters. There are various types of neurotransmitters in the body. Each type of neurotransmitter molecule has a different effect on the body. Some of the neurotransmitters are long-acting while others have a significantly short course of action.
Similar to these neurotransmitter systems in the body, the endocannabinoid system (ECB system) is also a neurotransmitter release system. The receptors in the ECB system are known as the cannabinoid receptors. The endocannabinoid system is composed of neurotransmitters known as endocannabinoids. Endocannabinoids are one of the most widely known, potent, and versatile signaling molecules known up to now. The receptors in the endocannabinoid system are called the cannabinoid receptors. When these cannabinoids such as cannabidiol bind to these receptors, they affect the rates of metabolism and other factors such as transcription and translation of specific protein factors in the cells. These protein factors are then responsible to exert certain effects, which mainly include the inhibition of certain inflammatory cytokines such as interleukin factors. These mediators of inflammation cause several diseases in the central nervous system such as fibromyalgia and multiple sclerosis. These factors are also beneficial in the sense that they inhibit certain autoimmune responses in the body. These autoimmune responses are responsible for damaging the beneficial tissues in the body such as myelin sheath, causing nervous disorders such as multiple sclerosis. These receptors are present on the cells throughout the entirety of our central nervous system along with the brain and spinal cord, and they are specifically called CB1 and CB2 receptors. Such receptors are found predominantly in the brain in the hippocampus and cerebellum. Due to their specific location in these areas of the brain, the endocannabinoid system can affect certain behaviors and processes of the body such as immune responses of the immunocytes such as T cells, communication between cells such as signaling and chemotaxis, bodily processes such as appetite, metabolism, and digestion, and cognitive behaviors including memory, and more. Because these receptors directly affect the function of the cell they are on, the psychic effects experienced after consuming cannabinoids such as CBD and THC have a rapid onset. The psychoactive cannabinoids such as THC result in euphoria, enhancement of sensory perception, increased heart rate, decreased pain stimuli, and difficulties in concentrating on specific tasks. These effects are due to the relative abundance of CB1 and CB2 receptors in the hippocampus. The effects may also include short term impairment of memory. These effects are largely due to the psychoactive agents found in cannabis such as tetrahydrocannabinol (THC).
On the other hand, the effects of CBD are largely different than that of THC. This is because of the non-psychoactive nature of cannabidiol.
The therapeutic effects of CBD have carried it out to the field to be tested against various disorders related to the brain, and also against the congenital brain damage. However, the use of cannabinoids greatly needs to be cautious, as each illness the cannabis extracts are being used to treat requires a different combination of cannabinoids. If not used cautiously, the cannabinoids may even start showing negative effects.
The Advantage of Using CBD over THC
The main advantage of using CBD is that it is not psychoactive as is the case of THC. THC leads to a deranged state of mind for the user, where the user experiences euphoric thoughts without having control over his or her thoughts. The difference between CBD and THC lies in the site of action of both chemicals in the central nervous system. CBD has a largely opposite effect as compared to that of THC in the areas of the brain such as the striatum, hippocampus, and prefrontal cortex. This fact has been established after years of research that CBD is finally safe for medical use, as is the case for ‘medical marijuana’’. Many studies conducted by laboratories around the world, along with controlled clinical trials, have confirmed that CBD can be adopted as a well-tolerated, safe, and effective drug for antipsychotic purposes. The THC has an impairing effect on the body, while all the effects of CBD are non-impairing. But, CBD in cannabis has some effects on the body where it serves to release overall stress on the body. These effects are different from the euphoric or ‘high’ sensations induced in our bodies due to THC, and serve to alleviate the stress and anxiety. This makes CBD as the best alternate to marijuana to seek an escape from pain and anxiety. Contrary to THC, CBD is not psychoactive; it does not get a person high but grants an equal amount of cure against anxiety and nervousness.
Therapeutic Properties of CBD
Averts Brain Damage Due to Trauma
Traumatic brain injury, as visible from the word itself, means a traumatic shock to the fragile areas of the brain within the skull due to abrupt force that is exerted on the skull due to an accident or a fall. The injury might cause internal bleeding due to a hemorrhage, which in result might cause permanent brain damage in the areas of the brain that are affected. Traumatic brain injuries are heterogeneous in their clinical presentation. The signs and symptoms of a traumatic brain injury can be very vast. The onset of the symptoms may be as sudden as on the spot and time of the injury, or may not appear until weeks following the injury. The symptoms may not appear at all or maybe misleading as people may look fine even though they may act or feel differently. Headache and dizziness accompanied by confusion and fatigue may start immediately after an injury, but subsides over time. There might also be emotional symptoms, the victim might develop frustration and irritability in the general behavior later on after the injury.
Cannabidiol, due to its promising effects on the central nervous system of a person, has been extensively researched to judge its effects on reversing the brain damage caused due to traumatic brain injury. The primary mechanism due to which CBD can be used to avert brain damage due to the traumatic brain injury lies in the vast anti-inflammatory properties of the CBD. CBD averts inflammation due to various ways. One of the factors through which CBD can avoid inflammation is the dysfunction of the cytokines (chemical substances in the body which serve to mediate inflammation through promoting it). Endocannabinoids, particularly nonpsychoactive agents such as CBD, affect the cytokine structure and biology of various cell systems. Antiproliferative effects of endocannabinoids on cancer cells have been studied well, and their effect on stopping the inflammation is large. As inflammation particularly spreads vastly after a tissue injury due to contusion or other contact causes, so the rate of inflammation surrounding the brain injury can be particularly dangerous, as it causes necrotic cell death in the tissue on a large scale. This cell death proves fatal to certain brain areas that are hit directly by the injury. So, in the case, if traumatic brain injury, stopping the inflammation gains prime importance, as it reduces the chance of the damage spread. The microglia, or the macrophages that exist in the brain tissue, have a very important role in inflammation. Moreover, there are cells in the brain tissue called astrocytes. The astrocytes serve to nourish the brain tissue under normal circumstances, providing vital nutrients to the neurons thus playing an important role in tissue growth. However, under traumatic brain injury where the brain tissue becomes necrotic, the astrocytes have been found secreting certain cytokines along with other chemicals such as nitric oxide that mediate inflammation.
At What Time to Take CBD to Cope with These Symptoms:
CBD can be taken at virtually any time of the day, as long as the patient prevents an overdose. The most common symptoms of brain damage are pain and persistent insomnia. So, in theory, CBD can help you enjoy a good night’s sleep if the patient is administered CBD before sleeping. But, this administration requires that the CBD must be used in controlled quantities, otherwise the side effects of CBD, which include dizziness, nausea, and vomiting may prevail over the next day for the patient.
The patient can also be administered CBD in the morning. When CBD is taken in the morning to avert pain, the whole day of the patient will be almost free of the pain that is elicited due to trauma, and the patient will also feel relaxed throughout the day because of the calming effects CBD has over one’s mind. Other nervous symptoms due to the traumatically damaged brain such as periodic attacks can also be averted due to the use of CBD, which may also help the administration of such attacks by the caregivers by lessening the frequency of such attacks in the patient. This also improves the lifestyle of the patient suffering from these attacks.
CBD and Pain
The use of Cannabis for therapeutic and analgesic purposes is not new and dates back to as far as 2900 BC. A common form for administering CBD is SATIVEX, which is an oral mixture consisting of THC and CBD. This drug is one of the very few that are approved for use and is used for treating pain in multiple sclerosis. The drug SATIVEX is approved for use in many countries but is not currently recognized by the FDA as an analgesic.
However, analgesics that are currently being used to treat chronic pain in the patients include opioids and steroids. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are used to treat the pain which occurs due to inflammatory causes. For the chronic pain that occurs due to causes other than inflammation, such as mechanical pain, one needs an effective analgesic that not only relieves the pain but also prevents it from coming back. In this case, cannabidiol (CBD) is a potential candidate to be used as a drug for relieving chronic pain.
A review was conducted in 2018 to examine the potential of CBD for curing pain. This review consisted of 47 studies, in which many different groups of people were studied who were using cannabidiol as an analgesic for chronic pains other than cancer pains. These studies examined various types of pain, including pain due to multiple sclerosis, fibromyalgia, rheumatoid arthritis, and visceral pain. The studies involved administering cannabidiol to people as an analgesic and also involved people who were administered placebos. The conclusion was: cannabinoids reduced the pain by 29.0 percent, as compared to 25.9 percent for the placebo. Moreover, because cannabidiol has no psychotic effects, there was no change observed in the psychological, emotional, or physical functioning of the subjects. As a result of a reduced sense of pain, the subjects also experienced improved quality of sleep as compared to the sleep they were having before taking cannabinoids. The National Center for Complementary and Integrative Health (NCCIH) based in the United States is funding new research into cannabinoids to examine their potential in pain management for chronic malignancies. According to this, about three million dollars’ worth of research will be conducted to produce nine papers that comprehensively explore the potential of using CBD oils as an analgesic.
When to Take CBD in Chronic Pain Conditions
Just like taking CBD in the management of conditions like traumatic brain injuries, pain management also requires taking precisely controlled quantities of CBD throughout the day in order to curb the long-lasting effects of the pain. Chronic pain conditions such as arthritis, osteomalacia, and chronic back pain usually kick in late in the day, due to fatigue. This translates into the overall sleep disturbance in the patient, which reduces the overall lifestyle of the patient suffering from the symptoms of chronic pain conditions.
Analyzing these conditions, the physicians can determine the dose, as well as the time at which the dose should be taken in order to curb the pain conditions. Most of the time, it includes the administration of CBD at various times throughout the day in small quantities. The dosage is determined according to the severity of the symptoms. Although CBD can be taken throughout the day, the most efficient time to take CBD to curb chronic pain is at night before going to bed, because this not only helps relieve the pain but also grants a good night’s sleep to the subject because of the sedative properties of CBD.
CBD for Alzheimer’s and Parkinsonism
Alzheimer’s Disease is a disorder caused due to the gradual degeneration and the resultant death of cerebral cortical cells, and the effect of the death of these cells is visible in the form of dementia in the patient. The most common symptom of AD is memory loss, which may be so severe that personal neglect occurs in some of the patients. This disease may also lead to impaired cognitive abilities of a person. Acquired cognitive disabilities caused by this disease have a diverse effect on the social life, overall behavior, and day to day activity of the patients. Alzheimer's disease is neurodegenerative: it worsens over time and as the person ages.
The ability of cannabinoids such as CBD to fine-tune various vital brain circuits in the nervous system has found bright prospects in the treatment of various forms of dementia including Alzheimer’s. CBD is an effective drug to check the progression of Alzheimer’s disease. A medical team researched the properties of CBD that could be useful in treating Alzheimer’s disease. This study found out that CBD activated the peroxisome proliferator-activated receptor through the beta-catenin pathway to protect PC12 cells from neurotoxicity and oxidation stress that leads ultimately to cell death, thereby indirectly increasing the rate of cell survival along with reducing ROS production. CBD also indirectly reduced lipid peroxidation in the areas of the central nervous system. Lipid peroxidation is found to be the main culprit behind the uncontrolled tumor production through dangerous free radicals. Decreased lipid peroxidation, therefore, inhibited the hyperphosphorylation of the tau protein, which in turn inhibits acetylcholestrinase (the enzyme responsible for the breakdown of acetylcholine at neuromuscular junctions). All of this leads to an increased rate of neurogenesis in the hippocampus, which is a vital part of the brain involved in the formation of long-term memories.
Parkinsonism is a neurodegenerative disorder characterized by involuntary tremors throughout the body, stiffness, and rigidity. The disease gradually progresses over time like Alzheimer’s, and the symptoms get greater over time. Parkinson’s disease is caused due to degeneration in the areas of the brain that produce dopamine: a neurotransmitter involved in executive functions of the brain such as coordinating the motor control of muscles, as well as lower-level functions including lactation, sexual function, and nausea. The exact cause of cell death in the areas that produce dopamine in the brain is still not understood to the scientists and continues to be the hotspot of Parkinsonism research.
Cannabis extracts, particularly CBD, have found to be useful in Parkinsonism. The pain-reducing properties of CBD help reduce pain. Research has also found that administering oral doses of CBD to patients having Parkinsonism helped relieved the tremors and muscle instability. The dose-related improvement due to the administration of CBD in dystonia was observed in all patients, and the collective effect of CBD ranged from relieving pain to getting rid of tremors throughout the body. Another complication that might occur in Parkinson’s disease is psychosis, and the symptoms of psychosis gradually aggravate over time. A small study conducted in 2009 found CBD to have particularly canceling effects on the symptoms of psychosis, thereby improving the sleep and general lifestyle of the patients having Parkinson’s disease. A study conducted at the University of Louisville, Kentucky shows that CBD acts as an inverse agonist on the CPR6 receptors that are found in the brainstem and are responsible for controlling movement, emotions, and learning - all of which are affected by Parkinsonism. This means that CBD responds to these receptors, and can act as a therapeutic agent in relieving the symptoms of this disease. Studies also show a promising effect of CBD in treating psychosis and resulting in insomnia due to Parkinsonism’s Disease Dementia (PDD).
CBD Therapy in Neurodegenerative Disorders
Seeing the potential of CBD in neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease, it can be used for the symptomatic treatment of the patients quite efficiently. CBD has shown to be of particular importance in relieving the symptoms of dementia. Due to these properties, the potential of CBD in treating the ‘sundowning syndrome’ in the patients is also particularly impressive. Sundowning usually happens late in the day due to the aggravation of the neurodegenerative disorders, so the administration of CBD at the start of the day proves to be particularly useful in such patients. Administering CBD in this way not only helps curb the psychiatric symptoms but also helps to treat pain that might occur in peripheral limbs due to rigidity.
CBD and Anxiety
Anxiety is an emotion that is characterized by feelings of tension accompanied by worried thoughts and physical changes like increased blood pressure and heart rate. Anxiety is not always a medical condition requiring immediate attention, it is completely normal to have anxious feelings about something daily. It is very important to judge the situation when will a person having anxious feelings require medical attention before experiencing aggravated symptoms such as panic attacks due to increased anxiety.
The anxiolytic properties on CBD oil have also been studied extensively through research. Particularly, the results of using CBD to relieve Social Anxiety Disorder (SAD) are fascinating. In 2011, a study examined the effect of CBD given to patients with a control group which was given a placebo. The administration involved giving 400 milligrams (mg) of CBD or placebo to the subjects. The results of the study were largely in favor of CBD treating anxiety. The subjects who were given CBD reported a considerable decrease in their anxiety levels. This study reports that administering CBD to patients reduces anxiety in SAD, particularly due to the effects of CBD on activity in limbic and paralimbic brain areas and related circuits involving the amygdala that control mood and emotions.
The best time to use CBD for its anxiolytic properties is determined by the time in the day when the patient is most susceptible to these attacks. This helps in the efficient management of anxiety in the patients. Generally, it is known that taking CBD before going to bed not only relieves anxiety but also helps to curb the harmful effects that anxiety might have on one's sleep.
- Schurman, Lesley D., and Aron H. Lichtman. "Endocannabinoids: A Promising Impact For Traumatic Brain Injury". Frontiers In Pharmacology, vol 8, 2017. Frontiers Media SA, doi:10.3389/fphar.2017.00069. Accessed 1 Sept 2020.
- Fakhoury, Marc. "Could Cannabidiol Be Used As An Alternative To Antipsychotics?". Journal Of Psychiatric Research, vol 80, 2016, pp. 14-21. Elsevier BV, DOI:10.1016/j.jpsychires.2016.05.013. Accessed 26 July 2020
- 2020, https://royalcbd.com/best-time-of-day-to-take-cbd-oil. Accessed 27 Sept 2020.