Genevieve Jacobs, DO
University of Louisville
As one of the hottest topics in medicine as of late, cannabidiol aka CBD oil has become one of the most popular remedies that claims to cure anything from dermatitis to cancer. But why is it shrouded in such confusion? To uncover the mystery of CBD oil, I started in my own backyard – Kentucky. As it turns out, Kentucky is the second largest producer of hemp in the country—second only to Colorado (1) and currently boasts 209 licensed hemp growers, 43 processing plants, and almost 13,000 acres of dedicated hemp farm land (2). In fact, with the help of the Kentucky Department of Agriculture who initiated a 2017 industrial hemp research pilot to drive even more cultivation and study of this plant, hemp is literally all around us here in Louisville(3). So what exactly is CBD? Cannabidiol is actually a non-psychoactive cannabinoid – one of more than 113 cannabinoids found in nature. THC or tetrahydrocannabinol is another well-known cannabinoid but with psychoactive properties that give a consumer a high. To understand the difference between these plants requires a bit of taxonomy: From the genus cannabis comes 3 plant species: Sativa, Indica, and Ruderalis. Hemp is a subspecies that only comes from the Sativa plant (marijuana can be derived from Sativa or Indica plants). Within the hemp plant lives cannabidiol and tetrahydrocannabinol. To be considered a legal hemp-derived “CBD oil” levels of the cannabinoid, THC, have to be <.3%. If there is more than .3% THC the substance is considered marijuana. It’s easy to see why lawmakers and consumers can be confused by CBD oil because for years hemp-derived CBD oil has been lumped in the same category as its psychoactive cousin, marijuana. In fact, marijuana and hemp could not be any more different. For example, hemp actually has a plethora of industrial uses that include production of textiles, paper, building materials, rope, and more (4). Hemp is a tall, sparse plant that reaches 20 feet in height and can grow readily in most climates requiring little care. Marijuana looks and grows much differently than hemp and is short and bushy with buds surrounding the plant’s body. It is very fickle with regards to growth and great care is needed to pollinate and cultivate the plant. Unlike hemp, marijuana does not have industrial uses and is only consumed recreationally or medicinally. CBD itself works by activating receptors in the endocannabinoid system which is endogenous to the human body. Cannabidiol activates many pathways and can augment cascades linked to anxiety, mood, the immune system, pain perceptions and sleep patterns. Currently, much of the research regarding CBD oil is focused around seizures in children specifically Dravet syndrome and Lenox Gasteaux syndrome as well as multiple sclerosis (5,6). Anecdotally there are reports that CBD oil aids in modification of a plethora of other disease but more research is needed to reveal what other uses CBD oil has on the human body and use in augmenting disease.