The hows and whys of cannabidiol and hemp
If you don’t have patients who already are using hemp oil or cannabidiol supplements it would be a surprise, as they have become very popular. Perhaps you’ve been recommending them for a while now, or, like many others, have been trying to do a crash course on the virtues and pitfalls of cannabis-based supplementation.
If you have questions, imagine the world for your patients. They may wonder if hemp supplements will make them feel drowsy or make them “high,” or put them in danger of failing drug tests, which may discourage them from even bothering to try it. As their practitioner, you can reassure them and steer them in the right direction. First, you can assure them that supplemental hemp and marijuana are not the same thing.
The difference between THC and CBD
While Cannabis sativa is the source plant for both, differences between them are key. Cannabis is known for two phytocannabinoids; delta-9-tetrahydrocannabinol (THC), and cannabidiol (CBD). Each compound has very different medicinal properties.
THC is the compound in marijuana that provides the high people experience when they smoke it. And, in specialized applications, it absolutely has medicinal value. But THC is not part of a tested, quality hemp supplement. In fact, by law, hemp supplements only can have 0.3 percent THC. Instead, the compound patients are responding to is cannabidiol (CBD).
Cannabidiol doesn’t cause cognitive impairment. It simply calms nerves and relieves pain by interacting with the receptors and signaling compounds in the body known collectively as the endocannabinoid system.
Our scientific understanding of the endocannabinoid system really only has become established in the last 25 years or so. It encompasses cannabinoid receptors that receive signals and our own fat-soluble, naturally-occurring compounds that carry them.
The cannabinoid receptors, primarily CB1 and CB2, are involved with inflammation, pain, stress, immune responses, bone and joint health, and a host of other neurological and physical concerns.1
The endocannabinoid system
The endocannabinoid system—the body’s own cannabinoids—have a variety of signal carriers, but at this point, two of the most studied are anandamide (AEA) and 2-arachidonoylglycerol (2-AG). These ligands are lipid compounds that interact with receptors in the mind and body to keep overall health in a state of homeostasis. Endocannabinoids can be metabolized by enzymes, however, and be in short supply for many reasons.2-4
For starters, the endocannabinoid system requires a sizeable intake of omega-3 and other healthy fats. Of course, omega-3s provide their own anti-inflammatory power, but if a patient doesn’t get enough of them, their own endocannabinoid system also won’t readily respond to inflammation or stress. The entire process of fighting inflammation and pain is highly synergistic and connected—and it requires all of its elements working in top form. Beyond nutrient deficiency, aging and acute injuries can deplete the body’s own natural balance of cannabinoids, too.
Hemp can protect endocannabinoids
Cannabidiol and other phytocannabinoids from hemp appear to preserve and protect the body’s own endocannabinoids, with pretty dramatic results. That’s why, no doubt, you have patients who are interested in it. All at once, the scientific, public, and legal environments (for the most part) seem perfectly in-tune for an awakening about the benefits of nutrients from cannabis as well.5,6
Hemp oil cannabinoids appear to be natural pain fighters due to their ability to reduce inflammation. In fact, it is one of the major reasons people become interested in hemp oil. The reasons why the compounds from hemp oil fight pain still are under investigation. Clinical research of patients with osteoarthritis (OA) and rheumatoid arthritis (RA) may provide some insight.
British researchers found that the synovial tissue between the joints of these patients had elevated levels of endocannabinoids compared to those without either form of joint disease. In the cases of those with OA and RA, the body seemed to flood joint tissue with endocannabinoids to reduce inflammatory damage. In this case, the side effect of that also may be the body’s attempt to relieve pain.7
But over time, any chronic condition can wear down a person’s supply of endogenous cannabinoids. Since hemp helps preserve endocannabinoid levels, it makes sense that it would have a pain-relieving effect.
CBD can help alleviate stress
Further research showed that changes in the endocannabinoid levels might also relate to the way we perceive pain, including feelings of anxiety and depression that often accompany joint conditions and a sense of immobility.3,7
Here again, CBD can help. It, along with other non-THC phytocannabinoids from hemp, can alleviate stress in general.
Clinical work investigating the effects of CBD and specific regions of the brain confirm the compound’s ability to change the blood flow in those sections associated with social anxiety disorder (SAD). This preliminary work led to a clinical trial in Brazil that compared CBD to a placebo in volunteers diagnosed with SAD along with healthy volunteers as a control group.8,9
This study featured a simulated public speaking test, as people with social anxiety tend to feel overwhelmed with a sense of negative self-evaluation and public speaking is one of the most feared events for just about everyone. The researchers wanted to see how quickly a supplemental dose of CBD (a large dose in this case, 600 mg) would work to alleviate anxiety symptoms.
CBD from hemp virtually eliminated the anxiety, cognitive impairment (the feeling of losing your place in the speech), and overall discomfort for those in the test group. Although this was a limited trial, given the side effects of conventional medications prescribed for anxiety and stress, the fact that CBD worked so dramatically well in such a short time, and for such an overwhelming fear for so many people, is very impressive.9
Hemp phytocannabinoids have amazing potential. You can clear up your patients’ questions—and treat the physical and emotional aspects of pain—by recommending a hemp supplement with a full spectrum of cannabinoids, including CBD. It is a perfectly complementary approach that can safely, easily, and effectively fit into a treatment protocol.
HOLLY LUCILLE, ND, RN, is a nationally recognized licensed naturopathic physician, author, educator, and consultant. She is a graduate of the Southwest College of Naturopathic Medicine in Tempe, Arizona, where she received the prestigious Daphne Blayden Award. She has a private practice in Los Angeles called Healing from Within Healthcare and volunteers at the L.A. Free Clinic. Lucille lectures throughout the nation, has appeared on national media programs, and is the author of Creating and Maintaining Balance: A Woman’s Guide to Safe, Natural Hormone Health. She can be reached at www.integrativepro.com/Medical-Advisory-Board/Holly-Lucille.
1 Welty TE, Luebke A, Gidal BE. Cannabidiol: promise and pitfalls. Epilepsy Curr. 2014 Sep;14(5):250-2.
2.Rabinski, G. “Understanding Cannabinoid Receptors: Why Cannabis Affects Humans,” November 19, 2015. Available at: https://www.massroots.com/learn/what-are-cannabinoid-receptors
3.La Porta C, Bura SA, Llorente-Onaindia J, et al. Role of the endocannabinoid system in the emotional manifestations of osteoarthritis pain. Pain. 2015 Oct;156(10):2001-12.
4.Biernacki M, Skrzydlewska E. Metabolism of endocannabinoids. Postepy Hig Med Dosw (Online). 2016 Aug 11;70(0):830-43.
5.Lafourcade M, Larrieu T, Mato S, et al. Nutritional omega-3 deficiency abolishes endocannabinoid-mediated neuronal functions. Nat Neurosci. 2011 Mar;14(3):345-50.
6.Freitas HR, Isaac AR, Malcher-Lopes R, Diaz BL, Trevenzoli IH, De Melo Reis RA. Polyunsaturated fatty acids and endocannabinoids in health and disease. Nutr Neurosci. 2017 Jul 7:1-20.
7.Richardson D, Pearson RG, Kurian N, et al. Characterisation of the cannabinoid receptor system in synovial tissue and fluid in patients with osteoarthritis and rheumatoid arthritis. Arthritis Res Ther. 2008;10(2):R43.
8.Crippa JA, Derenusson GN, Ferrari TB, et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: A preliminary report. J. Psychopharmacol. 2011;25:121–130.
9.Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naive social phobia patients. Neuropsychopharmacology. 2011;36:1219–1226