We have been hearing news about FDA approving some CBD drugs for epilepsy. It has been shocking because all this time most of us thought CBD was something addictive and disastrous and now FDA is recommending it as a medicine?
This makes us question what CBD is? What is the definition of CBD, what does it mean and what is the legal status of CBD? This article will describe in detail about CBD, its properties, its medicinal uses, and discuss its legality.
What does CBD stand for and how do we define it?
CBD stands for Cannabidiol that is a phytocannabinoid extracted from Cannabis plant, but devoid of psychoactive activity with analgesic, anti-inflammatory, and chemopreventive properties.
When taken into the body, it exerts anti-angiogenic, anti-proliferative and pro-apoptotic effects through various signaling pathways.
How does CBD work?
Unlike other Cannabis compounds, it doesn’t mainly interact with cannabinoid receptor 1 (CB1), CB2 or receptors like vanilloid receptor 1. CBD activates autophagy and promotes apoptosis by stimulating the endoplasmic reticulum stress and inhibiting the AKT/mTOR signaling.
CBD is also known for the upregulation of ICAM-1 or intercellular adhesion molecule and TIMP-1, tissue inhibitor of matrix metalloproteinases-1.
This prevents cancer from becoming invasive and producing the Mets. It promotes the uptake of cytotoxic agents by activating the vanilloid type 2 (TRPV2) and decreasing the inhibitor of DNA binding 1 (ID-1)
CBD mediates the analgesic effect by interacting with the CB1 receptors. The binding of CBD with CB1 and CB2 receptors is mediated in a way that it doesn’t produce the effects THC does when it binds with these cannabinoid receptors.
CBD acts as an inverse agonist, while THC shows agonist behavior at CB1 receptors. CBD interacts with many other receptors in the endocannabinoid system that include GPR6, GPR3, TRPV1, and TRPV2.
The anti-inflammatory and analgesic action of CBD may be a possibility due to the interaction of CBD with these receptors.
CBD counteracts depression and anxiety by activating the serotonin receptors, i.e., 5-HT1A. It has a likely effect in the treatment of Alzheimer’s disease as CBD interacts with PPAR (gamma) or peroxisome proliferator-activated receptors.
These receptors respond to CBD by conveying cardio-protection and neuroprotection.
What are the effects and medicinal uses of CBD?
CBD is known for reducing inflammation, acting as an analgesic, anxiolytic, antipsychotic, anti-seizure, anti-spasmodic substance, without causing euphoric or producing a psychoactive state.
The government and scientists are investing in CBD and doing various research studies to figure out the medicinal benefits of CBD.
These research studies are incorporating the use of CBD in the treatment regimen of diabetes, multiple sclerosis, arthritis, depression, schizophrenia, epilepsy, and cancer.
Recently the U.S. Food and Drug Administration approved the use of Epidiolex (CBD) oral solution in the treatment regimen of two severe forms of epilepsy, i.e., Lennox-Gastaut syndrome and Dravet syndrome, in patients above two years old.
This is the first time that the FDA has approved a drug containing a derivative of Marijuana for a disease.
Currently, around 40 clinical trials are enrolled in which the effects of CBD are under study on patients with varying diseases like:
- post-traumatic stress disorder
- anxiety
- depression
- substance use disorder
- chronic pain
- inflammatory conditions like Crohn’s disease
- cancer and many more
CBD is not just for adults; it is safe for children as well in a dose of 20 milligrams per kilogram of body weight.
CBD has pain-relieving properties; therefore, it is given to patients with chronic pain. CBD helps in the prevention of absorbing a substance known as anandamide that regulates pain.
Anandamide is a natural cannabinoid in the body that tends to reduce pain, but when it is absorbed back quickly into cells, the action of Anandamide is reduced.
CBD prevents this absorption, and thus anandamide is shunted into the system where it regulates pain. CBD also targets alpha-3 glycine receptors that are known for processing pain.
Doctors are also finding the use of CBD in the treatment of various types of addiction. CBD indeed has therapeutic effects on cocaine, opioid, tobacco, and other psychostimulant dependence. The anxiolytic effect of CBD helps in reducing cravings for these addictive substances.
What is the stance of the FDA about CBD?
The FDA is an agency within the U.S. Department of Health and Human Services that assures the safety of the public and protects the health of the public by ensuring the proper regulation of food and drug substances as well as vaccines.
After the recent approval of the FDA of the use of CBD for epilepsy, it is noticeable that they are more open to the use of CBD for medicinal purposes.
FDA Commissioner Scott Gottlieb, M.D. stated that at FDA we believe in rigorous research to find out the medicinal properties of different substances.
The use of active ingredients of Marijuana in medical therapies still requires a lot of scientific research which the FDA is ready to support.
FDA statesman was inviting product developers to come up with scientific research to get the approval of CBD and other substances for the use in the treatment of various ailments.
Considering this statement by FDA, we can see a future where CBD will be used for the treatment of ailments and this approval from the FDA will improve the regulation of CBD and put a stop to the black marketing of this substance.
Is CBD legal?
CBD is not legal at the federal level in the United States, but its legality varies in different states. It is classified as Schedule I drug. are substances with no medical benefits and a high potential for abuse and addiction.
This makes CBD a mysterious substance as recently it has been approved in the treatment course of complex Epilepsy. The drugs included in Schedule I are Marijuana, heroin, LSD, and ecstasy.
Despite being placed in the Schedule I category, CBD is bought as a dietary supplement countrywide through the FDA also disapproves of it.
According to the FDA, under section 301 (II) of the FD&C Act, it is strictly prohibited to add CBD (which comes in drugs approved under 21 U.S.C. & 355, section 505 of the Act) to any food (including animal food).
Earlier this year when the FDA approved Epidiolex for Epilepsy, the DEA was given a 90 days window to adjust or change its stance about CBD. In September, however, to the surprise of many CBD advocates, the DEA announced that CBD would remain Schedule I drug, and Epidiolex is now in Schedule 5 of the Controlled Substances Act.
The DEA administrator Uttam Dhillon supported the statement of FDA by encouraging scientific research for approving the therapeutic uses of Cannabis origin substances.
He emphasized the commitment of DEA to partner with the FDA to ensure that all research that is undertaken is effective. People are still hoping that DEA and FDA will soon approve the use of CBD for the treatment of various medical issues.
In different states of America, the regulations for CBD are different. Some states allow CBD infused products while others approve of products containing less THC and more CBD. The laws are very confusing, but overall it is not legal.
Internationally, the CBD legality is as confusing as it is in the States. Some countries approve of CBD that has been derived from industrial hemp and not from whole plant Marijuana.
Resources;
- https://www.cancer.gov/publications/dictionaries/cancer-drug/def/cannabidiol
- https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm611046.htm
- https://www.fda.gov/newsevents/publichealthfocus/ucm421168.htm
- https://www.ncbi.nlm.nih.gov/pubmed/26724101
- https://www.ncbi.nlm.nih.gov/pubmed/30100226
- https://www.ncbi.nlm.nih.gov/pubmed/19896326
- https://www.ncbi.nlm.nih.gov/pubmed/23180178
- https://www.ncbi.nlm.nih.gov/pubmed/23602129