Although difficult to have envisioned only a few years ago, cannabidiol (CBD) is quickly eclipsing tetrahydrocannabinol (THC) as the most popular phytocannabinoid derived from the cannabis/hemp plant in terms of market share, media coverage, and interest from the patient community.

In Understanding CBD – Part 1, readers learned that cannabidiol, better known as CBD, is one of more than 113 special medicinal molecules produced by the cannabis herb called cannabinoids. In Understanding CBD – Part 2, readers learned how CBD binds with other molecules.

Like THC, CBD offers a multitude of medicinal efficacies, including analgesia (pain reduction), decreased anxiety, and even anti-psychotic properties. Perhaps its greatest power is derived from its anti-inflammatory properties, making it effective for literally hundreds of conditions in which inflammation* is a root cause—including Alzheimer’s, arthritis, cancer, coronary artery disease, and diabetes (according to Harvard Medical School’s April 2006 Harvard Health Letter).

CBD in More Detail

However, the chemistry of cannabis is rife with complexity. Major media outlets often script and promote messages regarding cannabis medicine that reflect the best interests of advertisers, not necessarily patients and consumers. This has resulted in a confusing cacophony of content marketing that sometimes preys on the ignorance of patients and primary care physicians, all of whom are new to the integration of cannabinoids and terpenes in the treatment of particular diseases and conditions.

More than 80 years of prohibition has created a culture in which THC is noted for its psychoactive effects and ability to provide users with euphoria, but CBD has gained a modern reputation as the “non-psychoactive cousin” of THC. While a convenient binary framing of the situation, this mental model lacks accuracy and detail.

CBD’s psychoactivity is arguably milder and qualitatively different than that of THC, reducing anxiety and never resulting in the potential disorientation, confusion, or panic conveyed by some strains of THC (especially those labeled sativa). In addition to its power to reduce pain and act as an anti-inflammatory agent, CBD is a powerful anticonvulsant, making it of special interest to those suffering from diseases involving seizures, including Dravet Syndrome, epilepsy, lupus, meningitis, and some types of brain tumors.

“CBD as an anticonvulsant has a broad spectrum of activity,” said pioneering cannabis researcher Dr. Ethan Russo during a January 2019 interview with Project CBD. “In other words, it works on many different kinds of seizures and has the possibility, again, of doing this without any of the liability that THC might produce,” he said.

Complex Medicinal Molecule

CBD is a “pleiotropic drug,” meaning it produces several beneficial effects through multiple molecular pathways and intricate feedback mechanisms. In fact, according to Project CBD, “The scientific literature has identified more than 65 molecular targets of CBD.”

Understanding the efficacy of plant-based (“phyto”) molecules such as cannabinoids or terpenes as they interact with the human body necessarily involves a basic comprehension of the endocannabinoid system (ECS). The ECS is a complex system of microscopic receptor sites and pathways strewn throughout the brain, central nervous system (CNS), and every organ and tissue of the immune system.

The two primary receptor types are CB1 (found in the brain and CNS) and CB2 (distributed mostly in the organs and tissues of the immune system). Several other receptor types are theorized to exist and assert important influence over the ECS.

Interestingly, the ECS is a feature of the physiology of all mammals, not just humans. Because of this, the popularity of products containing CBD extends to the multi-billion dollar market for pet health and wellness in North America. According to Ashlee Nolan, when writing for media outlet The Fresh Toast, “This past year you’ve probably noticed an uptick in CBD products for pets being sold everywhere from high-end smoke shops to gas stations. Forecasts predict this trend to continue into 2019.”

More than 113 cannabinoids and 200 terpenes exist in the cannabis genome. Each of these molecules has a different binding affinity for the various receptor types found within the ECS. To the surprise of many patients and medical professionals alike, CBD has little binding affinity with either CB1 or CB2 receptors.

Instead, CBD asserts its influence through more indirect pathways and modifies the ECS by affecting the efficacy of other cannabinoids and terpenes. Recent research is beginning to reveal that CBD acts as a balancing agent, both buffering and amplifying the effects of other molecules such as THC, THCA, ands CBG. In this respect, CBD can be considered a “smart drug” in that it targets the very subjective needs of a subject in an effort to achieve homeostasis (balance) within the ECS.

Synergistic + Isolate Benefits

An example of CBD’s indirect influence over the ECS is exemplified by how this special molecule can increase the ability of THC to reduce pain. In terms of its anti-inflammatory properties, CBD has been shown to exhibit considerable benefits as an isolate (when administered as a solitary molecule). It is also an anti-anxiety and anti-psychotic agent—labels that can’t be applied to THC.

Perhaps the greatest appeal of CBD, however, is precisely that it isn’t THC. It delivers none of the least desirable potential symptoms of THC, including anxiety (sometimes resulting in panic attacks), paranoia, and rapid heart rate.

Natural 1:1 CBD:THC Ratio?

It is theorized by some medical researchers, including Russo, that the landrace strains of cannabis that evolved naturally, sans human interference in the form of breeding and cultivation, produced considerably lower volumes of THC and greater quantities of CBD. Russo believes that most landrace strains offered more of a balance of CBD and THC, perhaps in the territory of a 1:1 ratio.

“Unfortunately, a lot of that is a by-production of prohibition,” said Russo during an interview with Project CBD in January 2019, when referring to the THC-rich strains of modern cannabis cultivars.

“The market was driven by people in the recreational sphere that were looking for escape or sometimes medical use,” said Russo. “In the process, a lot of the benefit of cannabis was lost genetically because customarily, in many parts of the world where cannabis was grown, it was typically a plant that had equal amounts of tetrahydrocannabinol—the main psychoactive ingredient in cannabis—and cannabidiol,” he added.

Stay tuned to the Strainprint Community’s Understanding CBD series as we explore this intricate molecule and its myriad medical benefits in the treatment of a wide range of diseases and conditions within the patient community.

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*“Although there may never be such a single path, mounting evidence suggests a common underlying cause of major degenerative diseases. The four horsemen of the medical apocalypse—coronary artery disease, diabetes, cancer, and Alzheimer’s—may be riding the same steed: inflammation.”