CBD Oil: Your Questions Answered – Part 1
There’s no doubt that cannabis derived supplements are hitting the headlines this year and that CBD (cannabidiol), a major component of cannabis plants, are causing a revolution in several areas of health. But are cannabis-derived oils legal? Do they help health or just get you ‘high’?
If you take an interest in the news or current health events then you will have heard the compelling story in the last few weeks about Billy Caldwell, the 12-year-old boy who had his epilepsy medication confiscated by UK Customs upon his return from receiving medical treatment for his condition in Canada. Within a few days of not receiving this treatment he had to be hospitalised as he was suffering once again, from severe fits which had been in remission since starting his Canadian medical treatment. Billy is now back on this medication, administered via hospital treatments in Belfast, and the epileptic seizures are back under control. And what is this so-called miracle treatment? You cannot have failed to have heard that it’s a type of cannabis oil.
This story, and others now coming to light, has firmly placed cannabis-based extracts and oils as one of the major health stories of 2018. But what are these all these different products? The cannabis-derived treatment young Billy is receiving was, up until July 26th 2018, classed as a Schedule 1 drug (though considering data, the Home Office has now changed this to Schedule 2 giving cannabis-derived medicines the green light to be prescribed by UK doctors1). But then you can also buy cannabis-derived CBD oil as a food supplement, which contains cannabidiol (CBD) extracts derived from the cannabis plant. So, what is CBD oil? If CBD oils are derived from cannabis plants are they legal in the UK? What is CBD good for in terms of health?
There are so many questions and mis-information surrounding cannabis-derived food supplements and CBD products that, as a nutritional neurologist, I want to take some time across a series of three Nutrigold blogs to answer the top questions that I commonly get asked about CBD oil… It’s time to bust some myths!
Can I get high from CBD oil?
Cannabis oils and CBD oils are both derived from cannabis plants, but the main difference is the strain of cannabis used, which underpins the levels and presence of different bioactive components, including the phytocannabinoid CBD.
Cannabis plants in general contain over 400 different types and classes of phytonutrients, including over 85 known cannabinoids. the most widely recognised and studied cannabinoid groups include tetrahydrocannabinol (THC) and CBD.2 THC is the primary psychoactive compound in cannabis and is associated with the natural cannabis ‘high’; this is the component that affects the legality of cannabis products, which we will discuss throughout this 3-part series of Nutrigold blogs on CBD oil. CBD, on the other hand, is an entirely non-intoxicating component, which has enormous therapeutic potential and the research about the health benefits of CBD is really stacking up!3
Medicinal cannabis oils derived from some strains of cannabis plants contain varying levels of THC and CBD, as well as other phytocannabinoids and phytonutrients. However, reputable products that are sold as food supplements are derived from the specially bred Cannabis Sativa L. plant, also commonly known as hemp. These CBD oils typically contain less than 0.05% THC (a negligible amount that does not confer any intoxicating effects, so CBD oils are not classed as Schedule 2 medical drugs) but are still rich in varying levels of CBD and other beneficial cannabis-derived phytocannabinoids and phytonutrients.
CBD OIL FACT:
You CANNOT get ‘high’ or intoxicated by consuming food supplement grade CBD oil made from Cannabis Sativa L. (Hemp).
Are CBD oils legal? Can I recommend them?
CBD products that are produced using Cannabis sativa L. (aka hemp) can be legally sold as food supplements in the UK. The Food Supplements Directive 2002/46/EC defines a food supplement as foodstuffs which supplement a normal diet and are concentrated sources of nutrients or other substances with a nutritional or physical effect.
Hemp (Cannabis sativa L.) has been used as a nutritionally rich ingredient for thousands of years. It’s also one of the oldest and most sustainable crops to be grown in the world. This means that it’s known to be safe and non-toxic and, as long as the CBD product is derived from Cannabis sativa L. with proven levels of <0.2% THC then it can be legally sold and recommended as a food supplement in the UK.
So, this leads us back to Billy’s case; he is taking medicinal cannabis oil from Canada where there are different laws surrounding THC content. The cannabis oil he is taking contains higher than UK permitted levels of THC therefore was, until recently, classed as a UK Schedule 1 drug. However, recent developments have led the Home Office to review this categorisation and now medical cannabis-derived products are classed as Schedule 2 drugs, meaning they can be prescribed by UK doctors and administered at home.
However, please do not get confused by this story; the current discussions around medical licensing of cannabis-derived products and food supplement CBD oil are about two distinct and different products. Food supplement CBD oils from Cannabis sativa L. with <0.2% THC remain legal in the UK, free to buy without prescription and to use in accordance with the dosing instructions and product guidelines to support many areas of health.
CBD OIL FACT:
oils from Cannabis sativa L. with <0.2% THC are legal in the UK.
They are classed as food supplements so can be recommended without
prescription. A reputable brand of CBD oil will have <0.05% THC.
Is CBD oil safe?
We’ve already discussed the negligible amount of THC in CBD oil. THC in itself is not harmful, but it does product psychoactive effects (i.e. the ‘high’ associated with cannabis) it is illegal to take and in higher doses may lead to side effects such as anxiety and diarrhoea through its direct actions on cannabinoid receptors throughout the body, discuss in “The latest research and health benefits of CBD oil” Nutrigold blog.
However, this is not the case with CBD, which has an excellent safety profile when found in the whole plant raw CBD oil. CBD is a very safe substance, but like other plant-derived nutrients, e.g. naringenin in grapefruit, CBD can interact with some common pharmaceuticals. At sufficient dosages, CBD will reduce activity of the cytochrome P450 enzymes, which metabolise around 60% of marketed medications, thereby altering how the liver metabolises painkillers, statins, blood thinners (e.g. warfarin) and insulin.4,5
If the dosage of CBD is low enough, it will have no noticeable effect on CYP activity, but CBD may still exert other health-promoting effects. There is no clearly established cut-off dose below that CBD does not interact with other drugs. A 2013 report on a clinical trial using Sativex, a whole plant CBD-rich sublingual spray, found no interactions with CYP enzymes when approximately 40-50mg of CBD was administered.6
What does this mean in practical terms when taking a CBD rich oil alongside prescription blood-thinner like warfarin, for example? Taking 8-10 drops of 500mg CBD oil (equating to 40 to 50mg CBD) is unlikely to cause increased enzymatic degradation of warfarin. However, as with all medications, regular reviews, including blood monitoring, with your medical practitioner is recommended. We discuss dosing and quality of CBD in the Nutrigold blog “How to source the best quality and dose CBD oil“.
CBD OIL FACT:
to 40-50mg CBD oil per day is safe and is not likely to interact with
commonly prescribed medications. Regular medicine reviews with a medical
practitioner is always recommended.
So, if CBD oil is derived from a cannabis plant, what’s the difference between cannabis, marijuana and hemp?
Cannabis is the name of the plant genus and marijuana and hemp are different forms derived from different parts of the plant and with different levels of phytocannabinoids; marijuana is the commonly used street term for illegal recreational cannabis (derived solely from female cannabis plants that contain high levels of THC in the flowers); hemp (derived from male cannabis plants and female plants but not the flowers) is a legal cannabis product including the oil, seeds and fibre that has been used for centuries in many different ways including in the food industry and in industrial manufacturing processes such as paper, carpeting and fabrics.
When trying to get your head around the differences between the types of cannabis it is important to begin with this simple concept: They all ultimately come from the same plant species, Cannabis sativa, just different parts. Whether you call something hemp or cannabis will depend on a variety of factors but despite this fact the terms hemp, cannabis and marijuana are often used interchangeably. It’s important to remember though that they do have separate connotations and it’s the THC content (<0.2%) that confers legality of cannabis-derived products like CBD oil in the UK.
CBD OIL FACT:
oil is derived from Cannabis sativa L. (hemp) so is a cannabis-derived
product but is NOT the same as marijuana, the common term for the
cannabis street drug.
So we hope that you now understand the legal position and excellent safety profile of CBD oil. I’m sure you still have many questions including the latest research into health benefits of CBD oil and its practical application so please read the other Nutrigold blogs on the subject; “The latest research and health benefits of CBD oil” and “How to source the best quality and dose CBD oil“.
Wishing you the best of health
- Marzo et al (2015) The endocannabinoid system and its modulation by phytocannabinoids. Neurotherapeutics 12:692-698
- Ligresti et al (2016) From phytocannabinoids to cannabis receptors and the endocannabinoids: Pleiotropic physiological and pathological roles through complex pharmacology. Physiol Rev 96:1593-1659
- Yamaori et al (2010) Characterization of major phytocannabinoids, cannabidiol and cannabinol, as isoform-selective and potent inhibitors of human CYP1 enzymes. Biochem Pharmacol 79:1691-1698
- Yamaori (2011) Cannabidiol, a major phytocannabinoid, as a potent atypical inhibitor for CYP2D6. Drug Metab Dispos 39:2049-2056
- Stott et al (2013). A phase I, open-label, randomized, crossover study in three parallel groups to evaluate the effect of Rifampicin, Ketoconazole, and Omeprazole on the phamacokinetics of THC/CBD oromucosal spray in healthy volunteers. SpringerPlus 2:236