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Health advice should always be taken with a healthy degree of skepticism. We are constantly presented with new products that are supposed to make us live longer, happier, and more beautiful lives. It's all very tempting – but at the same time, you know that if you fall for the hype about everything that comes onto the market, you'll end up spending your entire life (and income) ingesting industrial quantities of supplements.
However, in the last few years it has been impossible to ignore the chatter about the all-healing powers of CBD, or cannabidiol – often referred to as cannabis oil – a compound found in cannabis plants.
The range of medicinal benefits claimed for cannabis is vast, but includes: reducing epileptic seizures; lessening chronic pain and inflammation; overcoming insomnia and nausea; managing anxiety and stress; quitting smoking; reducing the effects of drug and alcohol withdrawal; combating the symptoms of Parkinson’s disease, and even helping stop the spread of certain cancers.
That makes cannabis sound like a miracle cure – but, inevitably, it's harder to substantiate claims than make them. For a start, the field is complicated by the fact that cannabis oil can be used to refer to products that contain CBD and/or tetrahydrocannabinol (THC), which is the chemical in the plant that gives users a feeling of euphoria – it gets you high, in other words. The latter compound is illegal in the UK, but as was demonstrated during the case of Billy Caldwell, whose mother fought a long campaign to get her son prescribed medicinal cannabis, oil containing both CBD and THC can reduce seizures in people who suffer from epilepsy.
CBD oil, meanwhile, is legal to buy – although it must be sold as a food supplement, which means companies are unable to use medical claims as part of their marketing (including on packaging). And as chemists are pointing out, this means the product exists in a regulatory grey area. It can be hard to know exactly what a bottle of CBD oil actually contains (although that looks set to change in the future).
Nonetheless, the numbers of people taking it for more everyday complaints like pain and anxiety are huge; it is clear that people believe in the medicinal effects of CBD enough to spend their hard-earned money on it. In the UK a conservative estimate values the market at £300 million a year. A recent study says that within five years, sales of CBD will hit $20 billion a year in the US alone.
As for CBD as a cure for cancer, there have been some very limited studies using both CBD and THC, but not enough to determine anything conclusive. As a relief from the effects of cancer treatment, however, trials have proved both CBD and THC to be effective as an appetite stimulant and an anti-nausea agent during chemotherapy.
The medicinal qualities of cannabis have been prized for thousands of years – there is disagreement over exactly how long, but it is beyond dispute that as a species we have been using cannabis far, far longer than we have been reading and writing.
The most common reason for taking CBD is for fighting pain. It works in three main ways: reducing inflammation by decreasing the production of inflammatory chemicals called cytokines; by binding to and blocking receptors in the central nervous system that are associated with pain; and reducing anxiety associated with pain by binding to serotonin receptors and giving a natural anti-depressant effect.
Certainly, painkilling properties are what brought me to CBD. I have suffered chronic pain for more than a decade, ever since a horrible double leg-break. CBD helped reduce the daily pain and stiffness to the point where I no longer had any need to take OxyContin – the highly addictive opioid known as “Hillbilly Heroin” because of the vast swathes of poor Americans who are addicted to it. I also used to regularly take ibuprofen, which was until very recently considered an entirely safe medicine, before its long term use was found to have devastating effects on your gut and your liver, and who knows what else.
For me, the painkilling choice is simple: pharmaceuticals that skirt the line between dangerous and deadly; or a plant that has been used for thousands of years and has never, as far as we know, killed anyone.
When you take CBD, it takes 30-60 minutes to work and the effects last somewhere between four and six hours. But the effect also builds up over a number of days, and crucially there is absolutely no withdrawal effect if you stop taking CBD, unlike with opioids.
As for side-effects, there's no giggly high or munchies or any of the other cliches associated with cannabis use, because there's no THC present. CBD oil reduces my pain and this has a fairly straightforward knock-on effect on my mood – less pain, less moody – but it doesn’t alter my state of mind in any other way. However, many people do report that it helps them with anxiety.
Whilst I find the 'pharmaceuticals vs plant' decision an easy one to make, knowing what to buy is not so simple. In December 2016 the UK Government designated CBD as a medicine, but so far prescriptions on the NHS have been almost non-existent, as even the most well-informed doctors on the matter are awaiting further trials.
That leaves the only realistic option of buying CBD privately. And with vast numbers of companies saturating the market, it is difficult to know which one to choose.
Over the past four years, while researching CBD as a painkilling option, I've spoken to numerous industry insiders. The main point to take away is this: CBD is expensive to source, so if you buy cheap CBD, you will be getting something that is most likely of inferior quality and almost certainly of an unrealistically low dose.
The main quality difference is in the way CBD is produced. Cannabis plants are grown in two principal varieties: hemp and marijuana. Hemp is naturally high in CBD, whereas marijuana is high in THC. The best-quality CBD is extracted organically from hemp plants, whereas the cheapest is produced as a waste product of marijuana plants that were grown principally for their THC. With a market that is largely unregulated, the processes of extracting CBD from the marijuana plants cannot be guaranteed, and often these products still contain THC, as well as potential contamination from the chemicals used during the extraction process.
How much CBD you should take can be difficult to determine, particularly because you'll find no discussion of medicinal dosage on the side of product packaging. The amount of CBD in a bottle is displayed on the label in milligrams, and it's up to you to work things out from here.
I use a standard 30ml size bottle of 1000mg oil and a dose is either a half or whole 1ml pipette. The important thing to look out for is the percentage CBD, which conveys the concentration – the strength – of the product you're buying. I use 10pc CBD, which tends to be quite expensive (about £70 for 30ml); but you can also buy 30ml bottles that contain only 100mg of CBD – that's 1pc. These are the entry-level CBD oils, often available for as little as £15. The concentration is so low that unless you neck half the bottle in one go, the amount of CBD you get will be homeopathically low.
I have tried a range of different products. I first bought a CBD vape pen after seeing MMA fighter Nate Diaz using one in the post-fight interview after his epic second encounter with Conor McGregor at UFC 202. Here was a man who knew a thing or two about pain, I thought. When I tried the vape pen for myself, I did get some relief from it, but I have serious misgivings about the potential long-term effects of all e-cigarette devices, so I looked for alternatives.
A lot of companies also sell muscle balms and oils for rubbing CBD into your skin, and some even stretch to CBD deodorants and CBD suppositories. I have tried a muscle rub, which does appear to ease pain, but it is hard to be sure how much of this is from other ingredients like eucalyptus oil. Dr. Weisinger said: “We see no reason to limit the means of taking CBD to tinctures and capsules. Our customers’ experience with topical CBD has been excellent, as the active ingredient is absorbed through the skin.”
Ultimately, to me, the concentration and source of the CBD are more important than the manner of application.
There is still a long way to go until we discover the full medical potential of CBD, with extensive double-blind placebo trials needed to understand exactly what the compound can do. In the meantime, millions of people are finding relief and it is just a matter of navigating the market.
You need to do a little bit of due diligence before buying. If a website doesn’t explain exactly how products are sourced and produced, you can assume the company has something to hide. Find a company you trust. Read their list of ingredients and understand that the raw materials cost a lot, so until the NHS starts writing CBD subscriptions, the stuff is expensive. If you find a bottle of CBD oil for a tenner, the concentration is going to be so low that your best hope is going to be the placebo effect.