Cannabidiol, often referred to as CBD, is one of the over 100 compounds that exist naturally in the Cannabis plant.
Often consumed in the form of an oil or capsule, CBD is generally contrasted to THC (the compound that gets you “high”) by being characterized as having minimal or no psychotropic effects.
My overwhelming sense is that, especially if you are here in Ontario where it is fully legal, that you or someone you know has tried or uses CBD in some form.
It’s popularity as a non-prescription compound with the potential to support mental health, combined with the extremely challenging context of the pandemic, has led me to re-visit this topic on my own 1.5 years after I wrote an article discussing the safety of CBD and its potential use for sleep & anxiety as part of a collaboration
Let’s take a look at what I found.
Part I – Why Do People Use CBD?
A 2021 survey out of the Journal Of Cannabis Research identified the top 4 self-reported reasons for CBD use in a UK-based sample to be;
- Self-perceived Anxiety
- Sleep Problems
- General Health
This makes sense anecdotally, but does not necessarily speak to the available evidence as to CBD’s role in any of these domains.
The unfortunate reality as it relates to high quality scientific evidence around CBD is that randomized controlled trials (the gold standard) measuring its effects are few and far between.
More on this later, but I did indeed come across a very intriguing and recently published randomized controlled trial out of JAMA.
Part II – CBD And Burnout In Healthcare Workers
The study in question looked at the effects of 300 mg of daily CBD + standard burnout treatment vs standard burnout treatment alone in healthcare workers and found that the inclusion of CBD had a significant positive effect on reducing burnout (as measured by the Maslach Burnout Inventory which measures emotional exhaustion).
Although studies have largely suggested CBD is generally well-tolerated with few to no adverse effects, it should be noted that a small % ( 5 of 61) of participants in the CBD group experienced adverse effects related to elevated liver enzyme scores.
It’s reasonable to say that, despite the excitement around CBD, we still have more to learn about navigating the cost/benefit of use in the general population.
Part III – Recent Review Papers On CBD And Mental Health
CBD has garnered interest, in part, for having potentially anti-inflammatory effects at the cellular level.
From the mental health perspective this is an intriguing physiological characteristic as neuroinflammation (a fancy way to say inflammation in the brain cells) has become a target of increasing interest related to depression risk and severity.
But scientific coincidence is not enough to make strong claims about CBD use, so let’s take a look at some notable quotes/findings from CBD studies published in the last two years.
I’m going to give you a hint – they all more or less conclude that the current body of evidence is promising but incomplete.
Case in point;
Journal Of The American Pharmacists Association 2020
“CBD has a promising role as alternative therapy in the management of anxiety disorders. However, more studies with standardized approaches to dosing and clinical outcome measurements are needed to determine the appropriate dosing strategy for CBD and its place in therapy.”
“All of the presented results show that CBD plays a significant role in the regulation of anxiety- and depressive-related behaviors…[H]owever, it is necessary to develop additional, larger animal and human studies to definitively characterize the usefulness, safety, and efficacy of CBD for these psychiatric disorders.”
It’s my responsibility to assess CBD with the same scientific rigour as any other topic of inquiry and an honest review of the best available data makes it hard to make definitive conclusions at this point in time.
CBD has been described by a 2017 World Health Organization report as exhibiting no potential for abuse/dependence and being generally safe/well-tolerated with some potential for interactions with medications and rare adverse effects (as discussed earlier).
I will you leave you with that until such a time I can re-visit this topic armed with better quality evidence to fuel the discussion.
Andy De Santis RD MPH