Since it started becoming popular roughly two years or so ago, the general consensus has always been that since CBD oil from top brands does not contain the psychoactive properties of THC, it is therefore legal. Unfortunately, its legality is much more nuanced because of conflicting federal laws and new court cases. What is clear is that in one of the most recent court decisions on the topic, Hemp Industries Assoc. v. DEA, which came out on April 30, 2018, the US Court of Appeals for the Ninth Circuit found that Section 7606 of the 2014 US Farm Bill (the “Farm Bill”) preempts the Controlled Substances Act (CSA), the federal law which designates marijuana as a Schedule I substance (along with heroin and cocaine) making it illegal to possess or use. This means that when there is conflict between the CSA and the Farm Bill, the Farm Bill wins out.
A number of difficulties exist in evaluating published data on CBD or marijuana use for epilepsy. The extremely limited published studies were small, poorly described, and not well designed. Contributing to the difficulty of interpreting published studies, CBD products are not produced under the guidance of good manufacturing practices (GMP) and are not subject to regulations governing labeling, purity, and reliability. In other words, currently, there is no guarantee of consistency between products, or even differing lots produced by the same manufacturer. Without independent testing (e.g. USP certification) of CBD products for content and purity, as well as bioavailability testing of specific products, uncertainty surrounds the use of available CBD products in routine clinical settings.
It is thought that by applying the correct amount of cannabis, the cannabinoids can help with the promotion of lipids which help fight chronic skin conditions including acne and psoriasis. Some also claim that cannabis oil has the power to remove wrinkles and skin spots. While we wouldn’t bank on it being the “anti-aging” miracle, it is helping millions of people worldwide deal with a variety of skin diseases including eczema and rosacea.
Other targets for CBD include transient receptor potential (TRP) channels that are involved with the modulation of intracellular calcium (1, 6). Cannabinoids are highly lipophilic, allowing access to intracellular sites of action, resulting in increases in calcium in a variety of cell types including hippocampal neurons. CBD actions on calcium homeostasis may provide a basis for CBD neuroprotective properties.
There’s a growing consensus that cannabis is a highly effective treatment for many kinds of neuropathic pain. A 2015 study published in Neurotherapeutics states, “Clinical studies largely affirm that neuropathic pain patients derive benefits from cannabinoid treatment.” But much of the human-based research (like this study) on CBD and nerve pain has centered around the efficacy of the FDA-approved medication Sativex, which includes both THC and CBD. Research on the best CBD for pain isolated from THC is still limited when it comes to neuropathic pain. There are exceptions, though:
Like we said, once you start using CBD oil more frequently and are able to gauge how much you need to find relief or therapy, then you can jump up to the more high-potency products as needed. For reference, doses will typically range anywhere from 5 mg to 100+ mg in a single day. And for epilepsy patients, they may take anywhere between 300 mg to an entire gram (1,000 mg) per dose — or more!
A survey of patients seen in a tertiary epilepsy center found that 21% of patients admitted to using marijuana in the last year, and 24% of patients believed marijuana to be effective for their seizures (10). While interesting, this anecdotal observation does not rise to the level of evidence needed to evaluate a potential new therapeutic modality.
And then I woke up on the concrete, a worried crowd gathered around me. “You had a seizure,” my friend said gently as I blinked my eyes, trying to process this new information. I remember it was warm that night because I was wearing a sundress, and when I finally regained consciousness my first worry was that my dress flew up and everyone could see my underwear.