Does CBD Have Any Value as a Treatment?

last time we covered the research on cbd and specific mental health ailments but there are many claims about the ability of cbd to improve other health conditions as well what does the research look like for these that's the topic of this week's healthcare chat [Music] the data in this realm much like in our last episode are scant and not of the highest quality there is one cbd drug approved in the united states and it is effective at alleviating certain types of seizures but beyond that we have limited evidence of cbd helping out with other human ailments what we do have focuses mainly on pain management addiction and sleep there are lots of cbd claims out there for lots of other problems but the evidence for any of those is so sorely lacking that beyond one trial on parkinson's disease we had no reason to cover them in this episode the cbd drug approved for use in the united states is called epidiolex and it is effective at treating seizures associated with specific types of epilepsy in these cases an oral dose ranging between 5 and 20 milligrams per day significantly reduces seizure frequency the evidence for this is pretty good but from here on out it gets murky let's start with pain it's difficult to find evidence examining the relationship between cbd and pain management particularly because most studies examine its effects when administered in combination with thc a 2019 review of cbd studies in humans did identify three studies examining pain relief and spasticity though the strength of evidence from the first two are pretty low in the first a maximum sublingual dose of 150 milligrams of cbd and hemp oil did reduce pain in young women experiencing adverse effects after hpv vaccination but the study was observational and included only 12 people with no placebo for comparison it's impossible to say if there was any cbd specific effect the second study assessed oral cbd between 50 and 150 milligrams twice daily for three weeks in seven kidney transplant patients two patients reported total pain improvement and four reported partial improvement and one reported no change again seven patients is too low to determine anything and lack of placebo makes it impossible to form any real conclusions for all we know these improvements would have simply occurred with the passage of time third study was a randomized placebo-controlled trial in 24 patients with pain and spasticity issues due to various conditions they were given either cbd thc a combination of cbd and thc or placebo administered sublingually between 2.5 and 120 milligrams every 24 hours when compared to placebo reported pain was significantly lower in all groups including those given only cbd this is encouraging but still hard to make any big conclusions with so few participants another study examining opioid use and quality of life among 97 chronic pain patients found that over half were able to reduce or stop using opioids within an eight week period wherein they took an average of 30 milligrams of cbd per day this is also pretty great but still a small study and still very limited by a lack of a placebo group and looking more at the data on cbd and drug use a 2019 rct found that when compared to a placebo group both 400 and 800 milligram doses of cbd significantly reduced q-induced cravings in abstinent individuals with heroin use disorder a 2018 study found that 800 milligrams of cbd reduced tensional bias to cigarette use independent cigarette smokers when compared to a placebo group though it did not reduce reports of cravings and withdrawal while both of these studies suggest that cbd could be helpful in the realm of addiction the very small trial sizes approximately 50 and 30 people respectively mean we still don't know for sure just how helpful moving on to sleep a review of clinical trials found that work on cbd and sleep suffers from many of the same limitations we found in the rest of the cbd literature including small sample sizes and lack of control group they also mostly examine sleep in the context of other illnesses making it hard to say anything definitive about cbd and sleep by itself one study from the 1980s did find that 160 milligram dose of cbd increased self-reported sleep among insomniacs when compared to placebo but this was only in 15 subjects somewhat to the contrary a 2018 study reported that the sleep cycle of 27 healthy subjects given 300 milligrams of cbd was no different from a placebo control a 2019 review of cbd studies we mentioned earlier also examined the data on cbd and parkinson's disease finding one trial where a 300 milligram daily dose of cbd did not improve coarse symptoms of the disease but did appear to lead to some improvements in quality of life measures like emotional well-being it's also worth repeating some of the cautions from our last episode the amount of cbd required to maybe have an effect and that's a big maybe it's hard to come by in commercial products without spending a lot of money what you're getting in those commercial products isn't very likely to match what the label says you're getting and it's important to talk to your doctor first because cbd may have an effect on liver enzymes that could translate to some bad interactions with other medications the bottom line here is that while some evidence suggests that cbd could be useful it's a very small amount of evidence at the moment mostly from animal studies and or in combination with thc and the cbd specific human data that we have aren't really high quality and overall experts on the subject are currently skeptical as one researcher put it in a vox interview this is the main scam snake oil thing going on out there now after doing the research for these two episodes the best thing we can say about it here at healthcare triage is that the bold claims being made about cbd and health are definitely not yet confirmed by reliable scientific trials hey to enjoy this week's episode you might enjoy last week's episode on cbd and mental health we'd appreciate it if you'd like the video consider subscribing to the channel down below and going on over to patreon.com healthcare triage where you can help make the show bigger and better even during a global pandemic we'd like to thank our research associates james glasgow joe sevitz josh kister and michael chin and of course our surgeon admiral sam