Cannabis oil, CBD oil, cannabidiol - what is it and does it work?

CBD is one of the hundreds of so-called cannabinoids in the cannabis plant and unlike the intoxicating and more known substance THC, CBD is not psychoactive and does not in itself cause any intoxication.

However, both THC and CBD are pharmacologically interesting and there is a great potential for medical use - both individually and partly in different combinations between them.

Historically, the medicinal properties of the cannabis plant have been used for a variety of ailments in much of the world. For example, to reduce pain or to relieve symptoms of rheumatism and epilepsy.

Today, this range of disease states, which cannabis is said to alleviate and cure, has been expanded even more, although the scientific support for its medical effect is often weak or non-existent.

A major problem, however, has been that research on cannabis's medical potential has been hampered by the drug being classified as a heavy drug with no medical potential, which has resulted in, among other things, few large and well-made studies on people.

The fact that it is difficult to take patents on natural substances is also a reason why pharmaceutical companies have not invested in studies on cannabis's medical effects.

But a lot has happened in recent years and today we can see a more relaxed view of CBD.

For example, the anti-doping organization Wada will remove cannabidiol from its list of banned substances in 2018 - while cannabis and THC are still on the list.

We can also see that sales of CBD products, often in the form of oils, have grown sharply in recent years.

The CBD industry in the US is both large and profitable and has sales of just under SEK 3 billion a year. It is also expected to grow and be worth around SEK 10 billion by 2020.

But criticism from the authorities has long been harsh on the industry.

The US FDA recently sent out a number of letters to a number of major CBD retailers in the United States. The message: Stop marketing your products with medical claims that are not backed by science.

The authority is also critical that CBD oil is marketed as a dietary supplement despite the fact that according to the FDA it is obvious that the products are pharmaceuticals.

A new study of CBD content in products on the US market also showed that 70 percent of the tested products contained more or less CBD than the list of contents stated.

In Sweden, it is difficult to get figures on how large the industry around CBD products is today, but that it has grown sharply in recent years.

The Swedish sellers have long worked in a legal gray zone and marketed their products as food and supplements.

This has meant that you have been in a more or less lawless country where you do not have to follow the drug laws and it is up to the manufacturers themselves to be responsible for the products being safe.

Specifically, it means that buyers cannot possibly know if the amount of CBD in the product is actually what is claimed or whether it contains heavy metals, other drugs or toxic substances. Nor is there any responsibility to collect any side effects.

Sales are also driven by personal testimonials published on vendor sites or in Facebook groups, where people testify that CBD helps in virtually all symptoms and illnesses that exist - a tactic often used to sell supplements without making any direct medical claims. from the sellers' side.

This has also been criticized by the Swedish Medicines Agency, which is currently investigating whether CBD should be classified as a drug.

In the United States, CBD broke through on a broad front following an attention-grabbed CNN report in 2013, which met five-year-old girl Charlotte Figi, who suffers from a very severe and unusual form of childhood epilepsy, Dravets syndrome.

Charlotte was plagued by up to 300 severe epileptic seizures a week and after existing drugs failed to work, her parents tested her medication with a CBD-rich cannabis oil, which drastically reduced epileptic seizures.

And it is precisely around relieving and reducing seizures in difficult-to-treat and unusual epilepsy that CBD has shown the most promising results.

In a 2016 review article, a number of researchers went through a series of studies on the medical effects of cannabidiol and pointed out a number of areas where CBD drugs may be particularly interesting.

Here, both early clinical data and anecdotal evidence point to the fact that CBD can be effective against epilepsy and then specifically difficult-to-treat forms that affect children, such as Dravets syndrome and Lennox-Gastauts syndrome.

A British pharmaceutical company , GW Pharmaceuticals, is also in the final phase of a CBD-based drug that many hope will soon be prescribed to children suffering from severe epilepsy.

A 2017 study of 120 children and young adults with Dravet's syndrome also gives additional weight to CBD treatment in epilepsy. A statistically significant reduction in severe epilepsy attacks in the group receiving cannabidiol was then demonstrated. However, the CBD group also had more side effects than the placebo group.

Today, we know that cannabis use is one of several risk factors for suffering from schizophrenia and other psychotic disorders. And being able to relieve and treat this with substances from the cannabis plant may sound strange, but the cannabidiol's antipsychotic properties are being studied closely.

In the review article for the researchers, various studies have shown that it is possible to relieve symptoms of schizophrenia with CBD. And among the over 100 studies on cannabidiol that are currently registered, there are several whose future results can clarify CBD's potential in psychosis disease.

The same British drug companies that develop the CBD-based epilepsy drug have also, in a recently published and well-conducted study, shown that CBD can provide symptom relief in schizophrenia.

Another interesting area where CBD is predicted to have a medical use area is addictive disease. Currently, studies are underway on the treatment of problematic use of alcohol, cocaine and opioids.

There are also studies suggesting that CBD can reduce withdrawal problems in people trying to quit cannabis.

If you try to summarize the scientific state of cannabidiol's medical potential, you could say that a lot is happening right now, but we still know too little.

It can also be stated that in this uncertain situation, many people make money selling CBD with promises that cannot be backed up with evidence. And that CBD has just received a reputation as a miracle drug can make the placebo effect of those using the oil extra strong.

One problem that is also raised around the self-medication with CBD oil is the dose itself. The amount sold in expensive small bottles online is often far from the dose given in clinical trials.

For example, a bottle of 50 milliliters sold in a Swedish online store for 700 SEK contains as much CBD as in some studies is given as a daily dose.

One area where CBD is particularly interesting is about its levels of cannabis consumed around the world.

Today, most things point to the fact that more CBD-rich cannabis can reduce the drug's negative effects and that the relationship between CBD and the intoxicating substance THC is important if you want to reduce the damage with cannabis.

Large parts of the cannabis consumed today contain high levels of THC and lower levels of CBD, which an increasing number of researchers and experts point to as a problem.

- In our research we have seen that CBD-rich cannabis does not pose the same risk for, for example, psychosis, addiction and memory problems, says Swedish researcher Amir Englund at Kings Collage in London.

Last spring, he and colleagues published an article in Lancet Psychiatry on how to reduce the risks of cannabis - and now they have just launched a new research project to investigate the optimal relationship between THC and CBD to reduce the adverse effects during the drug itself.

Forty subjects will receive different doses of THC and CBD at different times to investigate how these affect memory and paranoia.

- We hope to gain a better understanding of how we can make cannabis safer, which in turn can be helpful in countries that legalize cannabis.

Amir Englund also believes that more knowledge about how CBD levels in cannabis affect the drug's harmful effects may be helpful even in countries where cannabis is illegal.

- Even a black market can be affected and, for example, one can imagine that the punishment of cannabis with high THC and low CBD content can be harsher than the punishment of cannabis with lower THC content and higher CBD content.