While there is preliminary evidence that CBD may have therapeutic value for a number of conditions, we need to be careful to not get ahead of the evidence.

Ninety-five percent of drugs that move from promising preclinical findings to clinical research do not make it to market. The recently announced elimination of the PHS review of non-federally funded research protocols involving marijuana is an important first step to enhance conducting research on marijuana and its components such as CBD. Still, it is important to try to understand the reasons for the lack of well-controlled clinical trials of CBD including: the regulatory requirements associated with doing research with Schedule I substances, including a requirement to demonstrate institutional review board approval; and the lack of CBD that has been produced under the guidance of Current Good Manufacturing Processes (cGMP) – required for testing in human clinical trials – available for researchers. Furthermore, the opportunity to gather important information on clinical outcomes through practical (non-randomized) trials for patients using CBD products available in state marijuana dispensaries is complicated by the variable quality and purity of CBD from these sources. Ongoing CBD Research The NIH recognizes the need for additional research on the therapeutic effects of CBD and other cannabinoids, and supports ongoing efforts to reduce barriers to research in this area. 

NIH is currently supporting a number of Element X studies on the therapeutic effects as well as the health risks of cannabinoids. These include studies of the therapeutic value of CBD for: Treatment of substance use disorders (opioids, alcohol, cannabis, methamphetamine) Attenuation of the cognitive deficits caused by THC Neuropathic pain due to spinal cord injury Mitigating the impact of cannabis use on risk for schizophrenia Examination of the potential of CBD as an antiepileptic treatment It is important to note that NIDA’s mission is focused on drug abuse; studies related to the therapeutic effects of CBD in other areas would be funded by the Institute or Center responsible for that program area. For example, studies related to epilepsy will likely be funded by the National Institute of Neurological Disorders and Stroke or by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, while studies related to schizophrenia will likely be funded by the National Institute on Mental Health. Conclusion There is significant preliminary research supporting the potential therapeutic value of CBD, and while it is not yet sufficient to support drug approval, it highlights the need for rigorous clinical research in this area. There are barriers that should be addressed to facilitate more research in this area. 

We appreciate the opportunity to testify on the potential use of CBD for therapeutic purposes. Thank you again for inviting me here today, and I look forward to any questions you may have. CBD: Everything You Need To Know About Cannabidiol Cannabidiol (CBD) came out to the world in a big way after this simple plant chemical stopped an epileptic seizure in its tracks on U.S. national television. In the time since, many enthusiasts have realized that this miracle compound can stop spasms, calm anxiety, and soothe those in chronic pain. But, what is CBD and how does it work? How is it different from THC? To help you become more familiar with the cannabinoid here is everything you need to know about CBD. What is cannabidiol (CBD)? Cannabidiol (CBD) is one of the most prevalent chemical compounds in the cannabis plant. Unlike the more famous molecule, tetrahydrocannabinol (THC), CBD is completely nonpsychoactive. Don’t expect to get “high” off of this organic chemical, however. CBD is all relaxation without intoxication. While CBD still has an effect on your body, consuming CBD by itself isn’t going to send you on the cerebral adventure associated with THC. For decades, medical professionals and the general public overlooked CBD because psychoactive cannabis took center stage. Now, the medical potential of CBD has taken cannabis to mainstream audiences. Preclinical trials over the past four decades have found that the cannabinoid shows promise as an: anti-inflammatory antioxidant neuroprotectant anxiolytic antidepressant analgesic anti-tumoral agent anti-psychotic CBD is often used by patients in the form of an oil. 

Patients with more chronic conditions such as cancer and epilepsy often use medical cannabis oil extracted from high-CBD varieties of cannabis. How does CBD work? Most predominant inside the resin glands (trichomes) of the female cannabis plant, CBD is one of over 80 chemical compounds known as cannabinoids. Cannabinoids are agonists that bind to special receptors on your cells, called cannabinoid receptors. Certain receptors are heavily concentrated in the central nervous system while others are found in almost every organ of the body. Cannabinoid receptors are even found in the skin, digestive tract, and even in the reproductive organs. You can think of agonists as keys and cannabinoid receptors as locks. By consuming cannabis, you are taking in agonists that interact with different locks on cells in the body. Together, these cell receptors make up a larger endocannabinoid system (ECS). The ECS is a vast network of cell receptor proteins with many functions. Some describe the ECS as the greatest neurotransmitter system in the body. It lends a hand in seemingly just about everything, including: mood memory motor control immune function reproduction pain perception appetite sleep bone development Four primary purposes of the ECS include neuroprotection, stress recovery, immune balance, and homeostatic regulation. 

The last one is a fancy way of referring to a system that creates optimum energy balance in the body. Somehow, CBD seems to tap into this balancing system to produce its therapeutic effects. CBD is able to interact with cells in our bodies because the molecule has a similar composition to similar chemicals that the human body produces naturally, called endocannabinoids. Endo means inside and cannabinoid refers to action on cannabinoid receptors. In contrast, the cannabinoids in the cannabis plant are technically called phytocannabinoids. It’s not often that a plant compound can make headlines over and over again. However, CBD is a phytocannabinoid with some serious life-saving potential. In fact, CBD has only gained mainstream attention quite recently, after the family of one brave little girl decided to throw caution to the wind and speak out about medical cannabis. The beginning of the CBD movement Before she was five years old, Charlotte Figi stopped laughing. While the average child laughs around 300 times a day, Charlotte temporarily lost her ability to communicate due to a rare and severe form of epilepsy called Dravet syndrome. Dravet syndrome affects roughly 1 in 30,000 infants around the globe. Though most Dravet patients begin their lives as healthy children, development quickly begins to regress after the first few months. Intense seizures overtake children as young as three months old. 

These seizures cause them to lose consciousness and convulse for up to a few hours at a time. After years of rushed trips to the emergency room, the Figi’s were desperate. Between unexpected complications, experimental medications, being told that they’ve reached “the end of the line”, they had experienced it all. When there were seemingly out of options, the family finally made a life changing decision. What they didn’t know was that their choice would ultimately spur a social movement and, more importantly, bring their daughter back to life. The Figi’s decided to treat their daughter with cannabidiol (CBD), one of the primary compounds found in the marijuana plant. CBD: Underappreciated for too long When Paige and Matt Figi first began their search for nonpsychoactive cannabis in Colorado, they fell upon some tough luck. Since the 1980s, marijuana breeders have had one major goal: creating the most potent, psychoactive cannabis out there. The competition is tough. After nearly three decades of rising demands for psychoactive cannabis, it’s not uncommon to walk into a dispensary today and find cannabis with THC content over 20%. By comparison, cannabis in the 70s contained an average of 6 to 8%. Focusing on THC content alone meant growers overlooked CBD during the hybridization process, making access nearly impossible for anyone hoping to experiment with CBD as medicine. 

Fortunately for children like Charlotte, one Colorado family was ahead of the curve. The Stanley Brothers had been developing exactly the plant the Figi’s had been searching for: a strain high in CBD and low in THC. High-CBD/ low-THC strains have little, if any, psychoactive effect. Rather, anecdotal reports and preclinical studies suggest that high-CBD cannabis can calm excitability without causing cognitive impairment. Before making the final decision to try CBD as a treatment, Charlotte was having 300 grand mal seizures a week, one every 15 minutes. After adding CBD oil to her daily routine? CBD kept Charlotte’s seizures at bay for an entire week. The Figi’s were astonished. I didn’t hear her laugh for six months. I didn’t hear her voice at all, just her crying. I can’t imagine that I would be watching her making these gains that she’s making, doing the things that she’s doing (without the medical marijuana). I don’t take it for granted. Every day is a blessing. – Paige Figi CNN first aired Charlotte’s story in 2013. Since then, CBD has been making headlines all over the world.