|Summary sheet: Cannabidiol|
|Common names||Cannabidiol, CBD, Epidiolex|
|Routes of Administration|
Cannabidiol (also known as CBD and Epidiolex®) is a naturally-occurring cannabinoid found in the cannabis plant. It is one of some 113 identified cannabinoids in cannabis plants, accounting for up to 40% of the plant's extract. It does not possess the same psychoactivity as tetrahydrocannabinol (THC), which is responsible for the euphoric and hallucinogenic aspects of cannabis, and is typically described as non-intoxicating.
Cannabidiol can be administered by multiple routes, including by inhalation of cannabis smoke or vapor, as an aerosol spray into the cheek, and by mouth. It may be supplied as CBD oil containing only CBD as the active ingredient (i.e. no added THC or terpenes), a full-plant CBD-dominant hemp extract oil, capsules, dried cannabis, or as a prescription liquid solution.
In the United States, the cannabidiol drug Epidiolex is approved by the Food and Drug Administration for the treatment of epilepsy disorders. The U.S. Drug Enforcement Administration has assigned Epidiolex a Schedule V classification, while non-Epidiolex CBD remains a Schedule I drug prohibited for any use. Cannabidiol is not scheduled under any United Nations drug control treaties.
Cannabidiol is generally well-tolerated with a good safety profile. However, it may have the potential to cause adverse drug-drug interactions. As a result, it is advised to use harm reduction practices if using this substance.
History and culture
This History and culture section is a stub.
As a result, it may contain incomplete or wrong information. You can help by expanding it.
Cannibidiol was first isolated from Mexican marijuana by Roger Adams and from Indian charas by Alexander Todd, both in 1940. On the basis of chemical degradation and correlation with cannabinol, a general structure was proposed. In 1963, Raphael Mechoulam isolated CBD from Lebanese hashish and established its structure and relative stereochemistry. Its absolute stereochemistry was determined in 1967.
At least 128 samples out of more than 350 tested by government labs in nine states, nearly all in the South, had 371 types of synthetic cannabinoids in products marketed as CBD. Half of the 28 tested CBD-vape products contained less than 0.3% CBD.
Cannabis contains more than 400 different chemical compounds, of which 61 are considered cannabinoids, a class of compounds that act upon endogenous cannabinoid receptors of the body. CBD accounts for up to 41% of the plant's extract.
Cannabis produces CBD-carboxylic acid through the same metabolic pathway as THC, until the next to last step, where CBDA synthase performs catalysis instead of THCA synthase.
The exact mechanism of action of CBD and THC is not currently fully understood. However, it is known that CBD acts on cannabinoid (CB) receptors of the endocannabinoid system, which are found in numerous areas of the body, including the peripheral and central nervous systems (such as the brain)). The endocannabinoid system regulates many physiological responses of the body including pain, memory, appetite, and mood.
More specifically, CB1 receptors can be found within the pain pathways of the brain and spinal cord where they may affect CBD-induced analgesia and anxiolysis, and CB2 receptors have an effect on immune cells, where they may affect CBD-induced anti-inflammatory processes. CBD has been shown to act as a negative allosteric modulator of the cannabinoid CB1 receptor, the most abundant G-Protein Coupled Receptor (GPCR) in the body. Allosteric modulators differ from receptor agonists in that they alter the activity of the receptor by binding to a functionally distinct binding site rather than directly to the receptor.
In addition to the well-known activity on CB1 and CB2 receptors, there is further evidence that CBD also activates 5-HT1A/2A/3A serotonergic and TRPV1–2 vanilloid receptors, antagonizes alpha-1 adrenergic and µ-opioid receptors, inhibits synaptosomal uptake of noradrenaline, dopamine, serotonin and gamma-aminobutyric acid (GABA), and cellular uptake of anandamide, acts on mitochondria Ca2+ stores, blocks low-voltage-activated (T-type) Ca2+ channels, stimulates activity of the inhibitory glycine-receptor, and inhibits activity of fatty amide hydrolase (FAAH).
Cannabidiol is metabolized in the liver and intestines by enzymes CYP2C19 and CYP3A4, and UGT1A7, UGT1A9, and UGT2B7 isoforms.
|This subjective effects section is a stub.|
As such, it is still in progress and may contain incomplete or wrong information.
You can help by expanding or correcting it.
Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWiki contributors. As a result, they should be viewed with a healthy degree of skepticism.
It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.
- Addiction suppression - There are some anecdotal reports that suggest CBD may have some addiction suppressing effects. However, this has not been subjected to rigorous clinical studies and more research is needed.
- Muscle relaxation - Some users report that CBD produces a mild to moderate degree of muscle relaxation that is weaker than that of benzodiazepines and muscle relaxants. However, other users do not experience this effect.
- Pain relief
- Seizure suppression
There are currently no anecdotal reports which describe the effects of this compound within our experience index. Additional experience reports can be found here:
Cannabidiol is currently approved in the United States under the name Epidiolex as a treatment for epilepsy disorders.
At lower doses, some studies have shown cannabidiol to have various antioxidative, anti-inflammatory, and neuroprotective properties. For instance, CBD is more effective than vitamin C and E as a neuroprotective antioxidant and can ameliorate skin conditions such as acne. It should be noted that cannabidiol has been the subject of sensational health claims in the popular media. A 2016 study found that there is only limited high-quality evidence for cannabidiol having any neurological effect in people.
Toxicity and harm potential
According to clinical studies, cannabidiol is well-tolerated and shows little to no toxicity.
In a 2011 literature review, CBD was found to not alter physiological parameters such as heart rate, blood pressure, and body temperature. Moreover, psychological and psychomotor functions are not adversely affected. Chronic use and high doses of up to 1500 mg per day have been repeatedly shown to be well tolerated by humans. As a result, it is considered to have a good safety profile. However, this information should be interpreted cautiously as cannabidiol has been subject to relatively few human studies; further research is needed to fully establish its safety profile.
Dependence and abuse potential
Cannabidiol is considered to have low abuse potential compared to THC and other recreational substances. Cannabidiol administration does not produce euphoria or other reinforcing effects and there is no evidence that use results in physical or psychological dependence.
This dangerous interactions section is a stub.
As such, it may contain incomplete or invalid information. You can help by expanding upon or correcting it.
Cannabidiol can be an inhibitor of CYP enzymes (including CYP3A4), which are involved in the metabolism of many psychoactive substances. As a result, it has the potential to cause dangerous interactions. Caution is advised when combining cannabidiol with other substances, particularly with higher doses.
Internationally, cannabidiol is not scheduled under the Convention on Psychotropic Substances or any other UN drug treaty.
- Australia: Cannabidiol (in preparations for therapeutic use containing 2 per cent or less of other cannabinoids found in cannabis) was placed in Schedule 4 as a "Prescription Only Medicine OR Prescription Animal Remedy" in 2015. It was previously listed in Schedule 9 as a prohibited substance.
- Canada: Cannabidiol is specifically listed in the Schedule II Controlled Drugs and Substances Act. However, in 2016 Canada’s "Access to Cannabis for Medical Purposes Regulations" came into effect. These regulations improve access to cannabis used for medicinal purposes, including CBD.
- New Zealand: Cannabidiol is a controlled substance in New Zealand. However, by passing the Misuse of Drugs Amendment Regulations 2017 in September 2017, many of the restrictions currently imposed by the regulations are removed since then. The changes will mean that CBD products, where the level of other naturally occurring cannabinoids is less than 2% of the cannabinoid content, will be easier to access for medical use.
- Switzerland: Cannabidiol is not subject to the Narcotics Act in Switzerland because it does not produce a psychoactive effect. It is still subject to standard Swiss legislation.
- United Kingdom: In 2016, the Medicines and Healthcare products Regulatory Agency (MHRA) issued a statement that products containing CBD used for medical purposes are considered as a medicine subject to standard licensing requirements.
- United States: Cannabidiol is one of many cannabinoids present in cannabis, and as such is in Schedule I of the Controlled Substances Act. FDA-approved drugs that contain CBD derived from cannabis and no more than 0.1% THC, such as Epidiolex, are Schedule V substances.
- Mechoulam, R., Peters, M., Murillo-Rodríguez, E., & Hanuš, L.O. (2007). Cannabidiol--recent advances. Chemistry & Biodiversity, 4 8, 1678-92.
- Mechoulam, R., Parker, L. A., & Gallily, R. (2002). Cannabidiol: an overview of some pharmacological aspects. The Journal of Clinical Pharmacology, 42(S1).
- Devinsky, O., Cilio, M. R., Cross, H., Fernandez‐Ruiz, J., French, J., Hill, C., ... & Martinez‐Orgado, J. (2014). Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia, 55(6), 791-802. https://doi.org/0.1111/epi.12631
- Campos, A. C., Moreira, F. A., Gomes, F. V., Del Bel, E. A., Guimarães, F. S. (5 December 2012). "Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders". Philosophical Transactions of the Royal Society B: Biological Sciences. 367 (1607): 3364–3378. doi:10.1098/rstb.2011.0389. ISSN 0962-8436.
- "Epidiolex (Cannabidiol) FDA Label" (PDF). fda.gov. Retrieved 28 June 2018. For label updates see FDA index page for NDA 210365
- FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy, 2018, retrieved 25 June 2018
- LaVito, A., DEA reschedules Epidiolex, marijuana-derived drug, paving the way for it to hit the market
- Angell, T. (2018), UN Launches First-Ever Full Review Of Marijuana’s Status Under International Law
- Iffland, Kerstin; Grotenhermen, Franjo (2017). "An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies". Cannabis and Cannabinoid Research. 2 (1): 139–154. doi:10.1089/can.2016.0034. ISSN 2378-8763.
- Mechoulam, R., Hanuš, L. (December 2002). "Cannabidiol: an overview of some chemical and pharmacological aspects. Part I: chemical aspects". Chemistry and Physics of Lipids. 121 (1–2): 35–43. doi:10.1016/S0009-3084(02)00144-5. ISSN 0009-3084.
- How the Associated Press collected information on CBD vapes, 2019
- Sharma, P., Murthy, P., Bharath, M. M. S. (2012). "Chemistry, metabolism, and toxicology of cannabis: clinical implications". Iranian Journal of Psychiatry. 7 (4): 149–156. ISSN 1735-4587.
- Marks, M. D., Tian, L., Wenger, J. P., Omburo, S. N., Soto-Fuentes, W., He, J., Gang, D. R., Weiblen, G. D., Dixon, R. A. (September 2009). "Identification of candidate genes affecting Δ9-tetrahydrocannabinol biosynthesis in Cannabis sativa". Journal of Experimental Botany. 60 (13): 3715–3726. doi:10.1093/jxb/erp210. ISSN 1460-2431.
- Jones, P. G., Falvello, L., Kennard, O., Sheldrick, G. M., Mechoulam, R. (1 October 1977). "Cannabidiol". Acta Crystallographica Section B Structural Crystallography and Crystal Chemistry. 33 (10): 3211–3214. doi:10.1107/S0567740877010577. ISSN 0567-7408.
- Cannabidiol, DrugBank
- Laprairie, R. B., Bagher, A. M., Kelly, M. E. M., Denovan-Wright, E. M. (October 2015). "Cannabidiol is a negative allosteric modulator of the cannabinoid CB 1 receptor: Negative allosteric modulation of CB 1 by cannabidiol". British Journal of Pharmacology. 172 (20): 4790–4805. doi:10.1111/bph.13250. ISSN 0007-1188.
- Ibeas Bih, C., Chen, T., Nunn, A. V. W., Bazelot, M., Dallas, M., Whalley, B. J. (October 2015). "Molecular Targets of Cannabidiol in Neurological Disorders". Neurotherapeutics. 12 (4): 699–730. doi:10.1007/s13311-015-0377-3. ISSN 1933-7213.
- Zhornitsky, S., Potvin, S. (21 May 2012). "Cannabidiol in Humans—The Quest for Therapeutic Targets". Pharmaceuticals. 5 (5): 529–552. doi:10.3390/ph5050529. ISSN 1424-8247.
- Scuderi, C., Filippis, D. D., Iuvone, T., Blasio, A., Steardo, A., Esposito, G. (May 2009). "Cannabidiol in medicine: a review of its therapeutic potential in CNS disorders: CANNABIDIOL IN CNS DISORDERS". Phytotherapy Research. 23 (5): 597–602. doi:10.1002/ptr.2625. ISSN 0951-418X.
- Mechoulam, R., Parker, L. A., Gallily, R. (November 2002). "Cannabidiol: An Overview of Some Pharmacological Aspects". The Journal of Clinical Pharmacology. 42 (S1): 11S–19S. doi:10.1002/j.1552-4604.2002.tb05998.x. ISSN 0091-2700.
- Devinsky, O., Cilio, M. R., Cross, H., Fernandez-Ruiz, J., French, J., Hill, C., Katz, R., Di Marzo, V., Jutras-Aswad, D., Notcutt, W. G., Martinez-Orgado, J., Robson, P. J., Rohrback, B. G., Thiele, E., Whalley, B., Friedman, D. (June 2014). "Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders". Epilepsia. 55 (6): 791–802. doi:10.1111/epi.12631. ISSN 0013-9580.
- "Epidiolex (Cannabidiol) FDA Label" (PDF). fda.gov. Retrieved 28 June 2018. For label updates see FDA index page for NDA 210365
- Hampson, A. J., Grimaldi, M., Axelrod, J., Wink, D. (7 July 1998). "Cannabidiol and (−)Δ 9 -tetrahydrocannabinol are neuroprotective antioxidants". Proceedings of the National Academy of Sciences. 95 (14): 8268–8273. doi:10.1073/pnas.95.14.8268. ISSN 0027-8424.
- Oláh, A., Tóth, B. I., Borbíró, I., Sugawara, K., Szöllõsi, A. G., Czifra, G., Pál, B., Ambrus, L., Kloepper, J., Camera, E., Ludovici, M., Picardo, M., Voets, T., Zouboulis, C. C., Paus, R., Bíró, T. (2 September 2014). "Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes". Journal of Clinical Investigation. 124 (9): 3713–3724. doi:10.1172/JCI64628. ISSN 0021-9738.
- Prud'homme M, Cata R, Jutras-Aswad D (2015). "Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence". Substance Abuse. 9: 33–8. doi:10.4137/SART.S25081. PMC . PMID 26056464.
- Cunha, J. M., Carlini, E. A., Pereira, A. E., Ramos, O. L., Pimentel, C., Gagliardi, R., Sanvito, W. L., Lander, N., Mechoulam, R. (1980). "Chronic Administration of Cannabidiol to Healthy Volunteers and Epileptic Patients". Pharmacology. 21 (3): 175–185. doi:10.1159/000137430. ISSN 1423-0313.
- Bergamaschi, M. M., Queiroz, R. H. C., Zuardi, A. W., Crippa, J. A. S. "Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent". Current Drug Safety. 6 (4): 237–249.
- Iffland, K., Grotenhermen, F. (January 2017). "An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies". Cannabis and Cannabinoid Research. 2 (1): 139–154. doi:10.1089/can.2016.0034. ISSN 2378-8763.
- Yamaori, Satoshi; Ebisawa, Juri; Okushima, Yoshimi; Yamamoto, Ikuo; Watanabe, Kazuhito (2011). "Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: Role of phenolic hydroxyl groups in the resorcinol moiety". Life Sciences. 88 (15-16): 730–736. doi:10.1016/j.lfs.2011.02.017. ISSN 0024-3205.
- Australian Government Department of Health Therapeutic Goods Administration. (2017, August 1). Retrieved from https://www.tga.gov.au/book/part-final-decisions-matters-referred-expert-advisory-committee-2
- Consolidated federal laws of Canada, Controlled Drugs and Substances Act
- Medicinal Cannabis Agency - Cannabidiol (CBD) products
- Swiss Agency for Therapeutic Products. (2017, August 1). Retrieved from https://www.swissmedic.ch/aktuell/00673/03778/index.html?lang=en
- MHRA statement on products containing Cannabidiol (CBD)