CBD oil is the new “it” trend in the wellness world, and it’s being touted for its anti-anxiety, anti-inflammatory and pain canceling health benefits. And while CBD can be found in the cannabis plant, let’s cut to the chase – it does not get you high.

“There is a lot of social stigma surrounding CBD – less so with younger generations – but I have a lot of elderly patients who have been diagnosed with Alzheimer’s or Parkinson’s disease, and this is a subject that comes up often,” said Matt Robertson, MD, a neurologist affiliated with Portsmouth Regional Hospital in Portsmouth, N.H., a state that fully legalizes the medical use of CBD products derived from marijuana. “They struggle more with the social implications of using CBD. They’ll say, ‘I’ve never used drugs in my life.’”

The social stigma is not stopping companies from cashing in on the latest beauty and wellness obsession. From topical creams to smoothies to gummies to cannabis-infused products for pets, CBD is a bit of the “wild wild west,” says Dr. Robertson, who practices at Appledore Neurology Associates in Portsmouth.

“CBD is understudied,” he says. “There are a lot of things it may be helpful for, but we just don’t know enough about it. We need to do more research and treat it the same way we treat other pharmaceuticals so that we have a regimented approach.”

HCA Today, with help from Dr. Robertson, discussed the what, why and how of the hottest ingredient on the market – CBD.

What is CBD oil?

Cannabidiol, more commonly known as CBD, is a sub-group of one of the chemicals found in the marijuana plant. CBD has been purported to help with many pain-related symptoms. What it is not is tetrahydrocannabinol, or THC, which is the psychoactive or, intoxicating, substance found in marijuana. CBD and THC are two different compounds found in marijuana but each has distinctly different effects on the brain and the body.

Is CBD oil considered marijuana?

No, CBD oil does not make people “high”, give them that feeling of euphoria, impact their ability to drive, get the “munchies” or any of those things we all associate with marijuana.  Marijuana contains THC, which is not in CBD oil. That’s where the CBD versus the THC comes into play. The THC creates the euphoric feeling in the person ingesting or smoking the substance.

How does CBD work?

The receptors that are activated and how it impacts the central nervous system is up for debate. However, the primary effects of CBD are around the perception of pain. There are two aspects of pain – whatever caused the instigating injury and the suffering associated with that painful sensory input. CBD doesn’t change the sensory input. In other words, someone can still feel a sunburn but the perception is the person doesn’t suffer from the pain associated with the sunburn. So, many people use it either for the reduction of cancer-related pain, neuropathic pain due to a condition such as diabetes; and spasticity-related pain from cerebral palsy or multiple sclerosis, for example.

What are some of the purported benefits of CBD?

It’s been used for many different things. The question is, what does it actually work for? Some of the areas where it has proven success are anxiety, insomnia and, more recently, epilepsy. The U.S. Food and Drug Administration (FDA) approved the first medication that is a derivative of cannabis and is specific for seizures or epilepsy. There will probably be more drugs that come to market in the future, but this was a groundbreaker.

This is the only CBD-derived medication that has gone through the rigorous trials through the FDA to demonstrate that 1.) it is not harmful and 2.) that it does what it’s supposed to do.

Is it safe?

In New Hampshire, there are state-approved and state-run dispensaries that are highly regulated. Individuals will know the percentage of CBD versus THC in any particular strain of medical cannabis that is purchased from the dispensary. And a person has to have certification to purchase it. On the other hand, the CBD oil that people purchase from farmer’s markets or natural food stores isn’t really regulated. It’s regulated by the same people that grade beef and say, “hey, is this an accurate representation of what you’re saying on the bottle?” If the company says this oil has 100 units of CBD per vial, for example, the “regulators” take their word for it, place a label on the container and a disclaimer saying it has not been evaluated by the FDA. This process isn’t unique to CBD oil. It’s the same for any supplements we take like melatonin or St. John’s Wort. There’s nothing that inherently regulates that system. My recommendation to patients is to be careful. People should be aware of potential variations from one vial to the next.  If an individual notices changes in how the oil works for them, it’s probably because there’s more or less substance in there compared to the last bottle.

What are the side effects?

The over-the-counter CBD oil has minimal side effects. People have said that it makes them relaxed or sleepy. My mantra is that any medication, CBD oil included, can cause any side effect. I always tell patients to look for cause and effect. If someone notices something’s a little off after taking a medicine, quit taking it and contact your physician.

What should people know before purchasing CBD oil?

If people are going to try over-the-counter CBD oil, do it in a controlled environment. And make sure they don’t have any obligations in the first two hours to see if there are any side effects that will prevent them from wanting to use it in the future. Also:

  • Recognize there is variability. Take that as a calculated risk. Even if an individual does their research and knows where it’s sourced, there still could very well be variability from what the label says and what the person is getting.
  • Do your research anyway. The company should bend over backward to tell buyers how pure or reliable they test their products. Many companies will go so far as to have another lab test the security or quality of their oil.
  • Know where it’s sourced. If online shopping, be careful about where the CBD oil is sourced. There are a lot of knockoffs with CBD oil – and other products – that look nice and shiny on the surface, but it’s from a backwater wholesaler looking to make extra money.

Portsmouth Regional Hospital, an affiliate of HCA Healthcare and a member of HCA’s Capital Division, is located in Portsmouth, N.H.