Every decade has its drug. They are just as distinct as the music, fashion and cinema that we associate with different eras; often, they even come from the same roots. The 80s gave us Reaganomics, Izod shirts with the collars popped, and U2. It’s hard to imagine much of this wasn’t fueled by untold quantities of cocaine. The 90s gave us house and acid music, shiny neon tracksuits, and a concoction of acronyms such as MDMA, which made that all seem somehow acceptable. Today, it seems very few of us are raving. Given the rise of the gig economy, the decline of political discourse, and the unabashed embrace of flannel and check shirts, it’s no surprise that the signature drug of this decade is one that promises a good night’s sleep, an end to lower back pain and a little help controlling the existential angst that rises up for most of us every time we read the news.
Cannabidiol, or CBD, is the hip drug right now with sales poised to hit $1 billion by 2020. Chances are you’re either using it already, or you’ve heard of it online or from your friend at the gym who won’t shut up about the amazing healing powers of hemp. Sure, CBD is a cannabis-derived compound, but unlike the joints you sneaked into college dorms, it won’t get you high. What it claims to do is just about everything else. From anxiety to arthritis via insomnia and indigestion, CBD has become a go-to for athletes, aging people and just about anyone who finds themselves frustrated with chronic conditions. Cannabidiol is a non-psychoactive compound that is found in the hemp plant as well as the marijuana plant. When you consume marijuana as a whole plant, the CBD is accompanied by other cannabinoids and terpenes including its psychotropic cousin ?9-tetrahydrocannabinol, better known as THC — that’s the one that gets you high. When you use CBD alone, you don’t feel high. But if you believe what you read on the internet, you might feel and perform better.
For decades, people have been using weed as a way to treat conditions ranging from headaches to epilepsy. For many people, cannabis was a safer alternative to opiate pain relief or the only way to cope with a painful and distressing condition. It turns out that, in many cases, it was the CBD that was helping and the THC — and its associated high — wasn’t necessary. Ironically, it wasn’t really until recreational cannabis made leaps towards legalization in many states that the medicinal use of CBD really caught on.
Understandably, there is a lot of caution and confusion around what CBD is, how it can be used medically and if it can be used legally. Research is rushing to catch up with the way people use CBD as, for decades, studies on cannabis and its derivatives was virtually impossible due to the fact that the federal government considers it a schedule one drug — the same category as heroin and, bizarrely, one degree more illegal than meth. The Drug Enforcement Administration (DEA) defines schedule one drugs as “drugs with no currently accepted medical use and a high potential for abuse.” So CBD is illegal? Not exactly. The FDA approved Epidiolex, a CBD medication for epilepsy, in June. The DEA classified that product as schedule 5, meaning it had the lowest potential for abuse. Confused yet?
Things are about to get better. A farm bill passed by the Senate in December 2018 makes hemp and its derivatives legal federally, which means that CBD from hemp plants can be purchased, shipped and used anywhere in the US. CBD derived from the cannabis plant, or anything with above 0.3% THC, remains technically illegal federally but might be legal on a state level. With hemp freely available and more and more states moving towards legalization of recreational cannabis, CBD is poised to become the aspirin of the new millennium. Given how much hype there is around CBD, it seems about time to work out if it belongs in the gym bag, medicine cabinet or in that little box you keep hidden in your dresser drawer as if your mum is going to bust you for smoking weed — even though you don’t live with her anymore.
Photo: Flora Folium
What’s it for?
Joshua Kaplan, Ph.D. is an assistant professor at Western Washington University and specializes in neurophysiology and neuropharmacology. He’s not the sort of guy many people would associate with weed, but CBD is fast moving away from the stoner stereotype. Kaplan told us that, while some of the claims being made about CBD lack rigorous testing, there is plenty of hard science to show that CBD can help with pain and inflammation. We know that CBD interacts with the body’s endocannabinoid system, which regulates everything from mood to memory, but research on how we can use that interaction is just beginning. “Perhaps the most well-studied medicinal use of CBD is in treatment-resistant forms of epilepsy,” Kaplan told us. Studies have also shown benefits in patients with generalized anxiety and psychosis and evidence suggests it might even help in treating opioid addiction and breast cancer. The World Health Organization lists transplant acceptance and schizophrenia as other research-proven uses. CBD interacts with the brain’s serotonin and vanilloid receptors, the same receptors that are involved in the action of anti-depressants and pepper spray respectively. Beyond this, there is a lot of work to be done on the way CBD interacts with the body and how that can be used to treat a variety of conditions. There are at least 20 clinical trials underway in the US right now to determine CBD’s utility in treating everything from brain trauma to back pain.
Much of the use of CBD is not yet backed up by research. As with all crazes, some of this will melt away and some will stick around. Despite its rapid surge in popularity, it’s fair to say that CBD isn’t likely to be the Pokémon Go of medications. For one thing, its impact has been felt across a much broader range of society. Missy Bradley, co-founder and brand director of Stillwater Foods, a company making cannabis products in Colorado, told us that CBD products are used by representative samples of the population across age and gender. The AARP website confirms that aging baby-boomers aren’t as averse as previous generations to using the more natural approach to treating arthritis (there is promising evidence to support that CBD can treat arthritis in rats).
Kaplan counsels that not all of these benefits come from the same dosage or application of CBD. Does as high as 600mg are being used in trials with epilepsy while most over the counter doses range from 10-50mg. There’s also what Kaplan called a “u shaped curve” in some conditions, such as anxiety where some CBD helps the condition, but more might make it worse. There are also worries about the interaction of CBD with other medications, especially if users take it without informing their doctors. One Reddit user noted his hands shook when he combined Zoloft with CBD. This is where research comes in. For now, most users will be financially limited in the doses they can take as a 50mg dose of high-quality hemp CBD costs about $2.67, making that 600mg dose about $31. However, as supply increases, we can expect this price to drop.
How do I get it?
CBD is as popular now as Bitcoin was a year ago. It’s in everything from bath bombs to body rubs to (obviously) bongs. Indeed, the perceived medical benefits of CBD might soon outweigh the psychoactive effects of THC and claim the majority of the cannabis product market. This is a problem for growers as, up until the late 1990s, cannabis was grown more or less exclusively to get people high and thus the plant was selectively bred to obtain as much THC as possible. The difficulty of getting CBD in large quantities from marijuana plants, along with the new farm bill, means much of the current crop of CBD products are derived from hemp, making them legal in all 50 states. You can go online and order yourself a bottle right now.
But, unless that’s your only option, it might not be the best choice. The issue with hemp-derived CBD products is that there may be some benefit to consuming CBD in combination with THC and other terpenes. Kaplan called this the “entourage effect” and noted that there is a lot of theoretical evidence for it, but the complexity of regulation around cannabis studies involving THC has made it hard for clinical trials to take place. Although this is still an area that needs research, Kaplan notes that there may be other benefits to picking cannabis-derived CBD products where they are sold. “In states with legal cannabis, any product derived from the cannabis, such as cannabis-derived CBD, must be tested for content accuracy and pesticides. Since proper dosing is a critical element of effective CBD use, it’s important to know that you’re consuming how much you think you’re consuming.” Hemp-derived products are not regulated in this way. In fact, research in the Journal of the American Medical Association found that 69 percent of CBD products tested didn’t have the same amount of the active ingredient as stated on the label. There are also concerns about pesticide toxicity, as pesticide use is regulated in cannabis, not hemp. However, if you are not in a cannabis-legal state, don’t despair. Kaplan still believes that “the overwhelming therapeutic benefits stem from CBD itself” and there are several companies selling organic hemp-derived CBD which should alleviate pesticide concerns.
Most CBD products use CO2 extraction to produce pure CBD from hemp or cannabis. This CBD is then packaged for delivery as a tincture, vaporizer, capsule or salve. A few are growing high-CBD strains and making them into lower-THC joints, edibles, or whole-plant balms. Each of these products has benefits and, depending on the end use, each of them might be part of your medicine stash.
Topical applications, such as creams and salves, might lack a whole-body impact, but they allow users to target specific pain and benefit from the entourage effect of combining CBD and THC without the psychoactivity. Oral products such as tinctures and capsules take longer to work, but allow for a more precise dosing than creams, with capsules allowing for the highest degree of precision. The fastest acting method of delivery is vaping, which acts almost instantly and allows users to take CBD until they get the desired effect, but it can be less precise and it’s not something everyone wants to do, especially if they are taking CBD to boost their athletic performance.
Whatever you take, you’ll need to experiment a little with dosage to find what works for you. CBD isn’t a miracle cure, and it needs to concentrate over time, so lower dosages might seem to be doing nothing at first but over time could lead to a reduction in chronic symptoms.
Will it improve my fitness?
In 2018, the World Anti-Doping Association stopped considering CBD a prohibited substance, meaning that athletes could begin experimenting with its performance-enhancing potential. For athletes, the benefits of CBD are more subtle than in people living with a condition like epilepsy and there is a lot of research to be done before we can work out how, and how much, CBD can help. This doesn’t mean that many athletes have not embraced the trendy supplement in an attempt to get the edge on their competition before CBD becomes as common as caffeine in the athletes’ arsenal of ergogenic plant-derived substances. CBD seems to be the most effective cannabinoid in treating pain and inflammation, and it doesn’t take a Ph.D. neuroscientist to work out that those are both things athletes would like to get rid of.
Whether CBD actually will boost your performance is up for debate. Certainly, it’s not something that everyone should swallow a handful of before exercise, but if inflammation, pain or anxiety are limiting performance, then CBD can likely help in overcoming that bottleneck. CBD seems to be most promising as a supplement for athletes recovering from injury. What it won’t do is help you if you’re not inflamed or injured; the World Anti-Doping Association stated that “there is no direct evidence of performance-enhancing benefits.” Bradley, an athlete herself, sees CBD as a sort of natural alternative to over-the-counter pain and inflammation medications today, saying, “We really see the budding interest in CBD slotting in with the larger trend in consumer preferences toward natural, plant-based ingredients that help us feel better.” But she also notes that, as she is free of injury or chronic pain, she hasn’t used CBD that much herself.
Kaplan also told us that there’s also a suggestion that the same anti-inflammatory properties of CBD could help in reducing the severity of traumatic brain injuries, the kind that you’ve read about in NFL players. Just having the CBD on board at the time of injury might help reduce the severity of the injury. This idea is supported by a recent article in the Clinical Journal of Sport Medicine which suggested that whole-plant cannabis use was common in high-risk sports, and that it might have some benefit in pain and concussion treatment. Studies into this are ongoing, but it’s possible that in a few years athletes might be dosing up on CBD tinctures before a game or maybe following Nate Diaz’s lead and vaping after UFC fights.
In an informal Twitter poll, I found half a dozen professional and amateur athletes who are habitual CBD users. These weren’t your stereotypical stoner snowboard types who seem to be identified in the Clinical Journal of Sports Medicine article — they were mostly athletes in their 30s or older that tried CBD as a way to boost recovery. Only one of them used weed recreationally. All the athletes in my (admittedly biased) sample felt that CBD had helped with recovery from injury and training, and most used topical applications on problem areas. Several mentioned that it had helped them avoid opiate pain medications or that they had stopped using NSAIDs chronically after beginning with CBD. About 1/3 of people use NSAIDs and athletes tend to self-administer them in the belief that they enhance performance (they don’t). NSAIDs have side effects that include an increased risk of gastrointestinal and cardiovascular disease and so replacing these with CBD, which doesn’t seem to have the undesirable side effects, is a health benefit in itself.
Much like the athletes mistakenly throwing back the ibuprofen pills at the start of their events, people taking CBD under the impression that it is some kind of wonder drug that prevents pain entirely are going to be disappointed. CBD is not going to stop it hurting when you push your body, and you wouldn’t want it to anyway. Studies show that you need to feel pain to pace your efforts. I spoke to one CBD brand who had sent samples to a pro athlete (whom they asked me not to name) who said he had felt no difference when using the product. When they asked him what he took it for, he didn’t know.
Photo: Floyd’s of Leadville
Some brands, like Floyd’s of Leadville — owned by former Tour de France winner Floyd Landis — tout the benefits of CBD consumption during exercise, but there’s no research to support this yet. Kaplan suggested that there might be a benefit from anti-inflammatory properties in CBD during prolonged exercise, but the major benefits will come in treating injury and enhancing rest and recovery. This might sound minor, but recovering better means training more, and training more means getting faster, stronger, leaner and more skillful. Everything from protein shakes to HGH is, in short, a way to recover better. I’m not saying vaping is going to have the same effect as doping, or that you’ll be switching your protein shake with a CBD gummy, but as part of a recovery regimen, CBD could help achieve your exercise goals.
As more research is published, we’ll know more about how and when to use CBD. But, thanks to the incredibly convoluted legal issues around cannabis, the combination of CBD with THC and the promising potential of other cannabinoids such as tetrahydrocannabivarin (THCV), it is unlikely to be something we see much research on in the US for the foreseeable future. In the meantime, CBD isn’t that expensive or dangerous, so you’ll likely be hearing a lot more from your chatty friend at the gym.
In the spirit of n=1 experimentation, I tried a whole-leaf cannabis balm for my back (which has been making me pretty miserable the last few months). I figured the balm would let me target the back pain and combining CBD and THC with other terpenes would let me benefit from the entourage effect without getting baked. The balm I used, from Flora Folium in California, was derived from whole leaf cannabis and I certainly felt a little less after long bike rides once I had been using it for a few days. Despite using generous doses of the balm before bed and in the morning before workouts, I never felt high — I didn’t really feel much at all other than a slight tingle and, on reflection, several weeks without any flare-ups in my back pain.
I also tried a CBD tincture and a CBD-THC vape pen before bed. I used these as part of a general attempt to improve sleep hygiene and certainly felt more rested. It’s not the most scientific of trials, but during the 6 weeks that I was using CBD as a tincture, vape or balm I didn’t take a single Advil or have any trouble sleeping. It might be coincidental, but given the lack of side effects, it seems like there is little downside to trying your own CBD experiment with some of the products I found useful.
Kaplan recommended these pens as they contain a very precise dose of CBD in combination with a little THC and some accessory cannabinoids. The pen looks discreet and dispenses a lab-tested 2.25mg dose with each three-second hit. I used it before bed and did notice I slept well, but the first few hits from the pen were pretty acrid. Using the pen before bed helped me sleep, but I can’t see myself bringing one along on bike rides or hikes any time soon.
Dosist producets are currently only available in California and Florida.
Floyd’s of Leadville CBD Isolate Softgel
Former Pro cyclists Floyd Landis and Dave Zabriskie know a thing or two about pain. Landis was using cannabis to treat pain from a hip resurfacing in 2006 until he discovered CBD. These days, he The softgels are part of a product line that is hemp-derived and organic — this means it is 50-state legal and doesn’t have some of the pesticide concerns associated with non-organic hemp. At 50mg per pill, they pack a much more significant dose than many of the CBD products on the market. The isolate gels contain no THC, which means that even if your employer or WADA might drug test you, you’ll be safe. There’s also a full-spectrum line with trace amounts of THC for those of us who don’t have to worry about such things.
Flora Folium Balm
Made from whole-leaf CBD-rich cannabis that is grown and processed on an organic farm in California, this product sounds like something you might pick up from your local food co-op. But, thanks to rigorous testing demanded by the state of California and the combination of CBD, THC and other terpenes as well as herbal ingredients, there’s plenty of research-backed evidence for this topical rub. I used it every day for a month, and of all the products I tested, it was this one that I would turn to again to treat back pain and injury.