CBD 101: What Can CBD Be Used For? How To Use CBD? CBD Evidence.

Most of what you have read about CBD is either not scientific or it’s just plain marketing tactics. Read on as Dr Sam explains the real science behind CBD and safe usage.

CBD oil hemp oil medicinal cannabis

So you have thought about trying CBD for a particular health problem, that’s great you are wanting to try alternatives. This short article will guide you with all the information you need to know.

Legal status in NZ

Firstly, it is important to note that CBD is currently a prescription only medication. This means that sourcing it online or from other sources without a script is illegal.

What is CBD and what is it used for?

If you are unsure what CBD is and the difference between Cannabis, Hemp and Marijuana, please read here first.

People use CBD for a wide variety of different purposes and many find support and benefit from it. To give you an idea, in a recent poll study of 2400 CBD users, the main reasons for use were:

  • chronic pain

  • anxiety

  • insomnia

  • joint pain

  • depression

  • muscle tension

  • migraines

How does CBD work?

CBD is a type of chemical called a cannabinoid. The body has its own cannabinoid chemicals, these are called endocannabinoids. The main 2 are called: 2-AG and anandamide (there are others also but these are the most studied). The body also has many receptors in most major organs (including the brain, liver, skin etc) that respond to these cannabinoids. There are many functions of this system, including effects on pain, mood, anxiety and inflammation. In the human body, there are 2 types of CBD receptors, CB1 and CB2. These receptors were only discovered as recently as 1995! It is thought that CBD interacts with these receptors throughout the body to cause its effect.

The cannabinoid system in the body, termed the endocannabinoid system. Reproduced from  Terravida .

The cannabinoid system in the body, termed the endocannabinoid system. Reproduced from Terravida.

What evidence is there for using CBD?

Is this all hocus-pocus or is there real scientific basis to it? Good question! As a Doctor, I am biased naturally and all about the science! Here we go:

Short answer: research is not conclusive but there definitely does appear to be a positive benefit when it comes to pain and seizures.

Long answer: Most of the research out there supports the use of CBD for seizures and pain. Because CBD is not a pharmaceutical drug, the research currently present is limited in terms of proving clearly a benefit from using it. There certainly is research out there, and a lot of it, but to make conclusive statements needs a lot of high quality evidence. To get technical, there needs to be some double blind placebo controlled trials to prove that CBD has therapeutic value. The evidence out there suggests benefits but we can’t say for sure. If you are interested in the nitty gritty details of what evidence is out there, we suggest you read this study. This however does not mean that CBD is of no value and given its natural origin and very good safety profile, we have found very promising results from those using it. There is no doubt that CBD, and medicinal cannabis in general, has a role in modern medicine.

When pure and administered carefully, (cannabis) is one of the most valuable medicines we
possess
— Sir John Russell Reynold, published in Lancet 1890, Neurologist and personal physician to Queen Elizabeth

How can I get access to CBD?

CBD is a prescription-only medication in NZ. This means you need to talk to your GP about having it prescribed. However, chances are that your GP does not know anything about it and so expect to do some explaining (or let us do the explaining on your behalf). You can also see one of our own medicinal cannabis specialists to discuss your health concerns with them if you prefer.

Medicines in NZ are approved for particular therapeutic purposes. For example, paracetamol is approved to be used for a headache. This is because there has been high quality scientific evidence of paracetamol’s benefit. However for CBD, apart from some rare forms of childhood epilepsy, it is not an approved medicine for any health condition. This means that it should be used on a case by case basis.

The Cannabis Clinic is here help guide you through this process of talking to your GP and educating them about CBD. If you log on to our application page, you can provide us simple details about your self and your medical history and we will prepare a CBD pack for you to take to your GP to help guide them through the CBD prescription process. Alternatively, can make a direct booking with one of our medicinal cannabis specialists.

469 GP’s Surveyed

89% had no knowledge of the endocannabinoid system

Is CBD Safe? What are the possible side effects?

Yes it is very safe. As a matter of fact, there have not been any known deaths worldwide from CBD exposure.

Every medicine has potential side effects, but those associated with CBD are known to be mild and include:

  • somnolence

  • reduced appetite

  • diarrhoea

  • fatigue

  • asthenia (i.e. weakness)

When used in higher doses (i.e. >10mg/kg/day, so more than 700mg for an average 70kg adult), there is a risk of elevating a liver enzyme called transaminase. This threshold is lower for people using other medications that are metabolised by the liver, such as anti-epileptics. I suggest that people using such doses of CBD have liver function testing (LFT) done prior to commencing CBD and during treatment. Initially, this should be done after 1 month, 3 months and 6 months of treatment.

You may also be wondering if it is possible to get addicted to CBD? The short answer is no. In a recent report published by the WHO on CBD, the specialist panel were all in agreement that CBD is non-addictive and has no potential for abuse if taken in larger quantities. It also cannot be used to manufacture other compounds that have psychoactive or addictive properties.

What dose should I take?

This is a difficult question to answer precisely because it is not black and white and there are no formal dose recommendations. I usually recommend people start by using a low dose first, 10-20mg per day and gauge the effect after 1 week. Depending on the result (if any), this dose can then be doubled. This process is repeated until the desired effect takes place. The exact dosage will vary from person to person but I have found good response at the 25 - 50mg once daily range. Some people find quite high doses (e.g. 200 - 300mg daily) are needed to get a benefit.

See below for a helpful guide in treating chronic pain:

Suggested doses of CBD for pain

Suggested doses of CBD for pain

What’s next?

Every person is unique and different. From treating many patients with different health problems, I am quite happy to suggest CBD as an option and I encourage you to also have that discussion with your GP. If you find yourself stuck or need support, please contact us and we will be happy to be of assistance.

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