Medical reviews published in 2017 and 2018 incorporating numerous clinical trials concluded that cannabidiol is an effective treatment for certain types of childhood epilepsy. An orally administered cannabidiol solution (brand name Epidiolex) was approved by the US Food and Drug Administration in June 2018 as a treatment for two rare forms of childhood epilepsy, Lennox-Gastaut syndrome and Dravet syndrome.
Some manufacturers ship CBD products nationally, an illegal action which the FDA has not enforced in 2018, with CBD remaining as the subject of an FDA investigational new drug evaluation and is not considered legal as a dietary supplement or food ingredient as of November 2018. CBD is openly sold in head shops and health food stores in some states where such sales have not been explicitly legalized.
An excellent example is the use of CBD (and also THC) products for the self-medicating of cancer, with the intention of fully curing it . This is based on an increasing body of preclinical evidence showing cannabinoids to be capable, under some conditions, of inhibiting the development of cancer cells in vitro or in vivo by various mechanisms of action, including induction of apoptosis, inhibition of angiogenesis, and arresting the cell cycle . This is certainly exciting news, and research is ongoing around the world, but there is no solid clinical evidence yet to support that cannabinoids – whether natural or synthetic – can effectively and safely treat cancer in actual humans . In fact, there are indications that certain types of cancer may even accelerate when exposed to cannabinoids . This becomes problematic when patients choose to refuse chemotherapy treatment because they firmly believe in the rumored curative properties of cannabinoids. As a result, recommendation of cannabinoids for treating cancer should be done with great care, and with distinction as to the type of cancer being treated .
In the United States, non-FDA approved CBD products are classified as Schedule I drugs under the Controlled Substances Act. This means that production, distribution, and possession of non-FDA approved CBD products is illegal under federal law. In addition, in 2016 the Drug Enforcement Administration added "marijuana extracts" to the list of Schedule I drugs, which it defined as "an extract containing one or more cannabinoids that has been derived from any plant of the genus Cannabis, other than the separated resin (whether crude or purified) obtained from the plant." Previously, CBD had simply been considered "marijuana", which is a Schedule I drug.
^ Hayakawa K, Mishima K, Nozako M, Ogata A, Hazekawa M, Liu AX, Fujioka M, Abe K, Hasebe N, Egashira N, Iwasaki K, Fujiwara M (March 2007). "Repeated treatment with cannabidiol but not Delta9-tetrahydrocannabinol has a neuroprotective effect without the development of tolerance". Neuropharmacology. 52 (4): 1079–87. doi:10.1016/j.neuropharm.2006.11.005. PMID 17320118.
For ingested CBD, that fat solubility is a problem. “[Ingested] CBD has a very low bioavailability, something between 6 and 15 percent, which varies between people,” says Blessing. Because ingested CBD is so inefficient at actually getting to the brain to stimulate CB1 and other receptors, the doses shown to be effective have to be very high. “There’s no evidence that doses below 300 mg of CBD have any effect in any psychiatric measure,” says Blessing. “And in fact, dose-finding studies show that the lowest clinically effective dose of CBD for reducing anxiety is 300 mg.” Blessing is talking about induced anxiety in otherwise healthy patients, which is all we have studies on; studies of CBD’s efficacy in treating clinical anxiety, which would require regular doses, haven’t been published.
Though a CBD latte might not do much for you — at least not beyond what caffeine and the placebo effect combined can do, which isn’t nothing — it’s also probably harmless in most cases, says Carson, and may even have positive benefits we aren’t yet aware of. “I suspect there’s probably some antioxidant benefit to CBD like there is with coffee,” says Carson. “There’s tons of good things in coffee that we still don’t fully understand, and I think the marijuana plant is much the same way.”