CBD or Cannabidiol is a chemical found in the cannabis plant. Unlike other chemicals in cannabis, CBD is not psychoactive and so does not produce the characteristic ‘high’ associated with cannabis consumption.
CBD is not a controlled substance meaning it can be purchased legally and without prescription within the UK as a food supplement or nutraceutical, as opposed to a pharmaceutical.
But what does it do?
Multiple studies of the effects of CBD have shown these include antiepileptic, anxiolytic and antipsychotic effects [1,2] as well as even; improve in muscle regeneration post work-out , improved cognition , and reduce substance abuse . This is not an exhaustive list and many claims of other potential benefits to CBD have been suggested and are currently being tested. Clinical-trials are currently underway investigating CBD as a potential prescription medication for the treatment of a wide range of disorders, from schizophrenia and anxiety to Parkinson’s, with CBD based medicines already in existence for the treatment of epilepsy. Prescriptions of CBD based medicines are predicted to be licensed for many other conditions once final trials are concluded.
But how does it work?
CBD binds to a wide range of receptors, not just the cannabinoid receptors of the endocannabinoid system where it has a modulatory action. It works on enzymes that break down the body’s natural cannabinoids (slowing them down); mechanisms involved in pain and pain perception; facilitation in some serotonin transmission; and has anti-inflammatory action- particularly in brain regions, where it may even promote brain growth and cell survival . This list is not extensive and the full extent of CBDs action is still being discovered.
How does cannabis work?
The cannabis plant contains a range of cannabinoids; most notably Tetrahydrocannabinol (THC) and cannabidiol (CBD). These cannabinoids attach to cannabinoid receptors mostly found in the brain. The reason these receptors exist is that they form part of a regulatory system in the body called the endocannabinoid system, for which the body makes its own chemicals with very similar structure to those found in the cannabis plant.
Consuming cannabis activates this regulatory system and dampens the brain's reaction in a way that can be beneficial if for instance parts of the brain are being hyper-active. The balance of cannabinoids in cannabis alters the overall effect of consumed cannabis. Cannabis with high CBD have been shown to be much more effective for reducing anxiety. Those who consume cannabis report feelings of relaxation, reduced hypervigilance and anxiety, improved sleep, and improved feelings of well-being.
Is cannabis safe?
There has never been a known case of anybody overdosing on cannabis. It is generally very well tolerated by people using medicinal cannabis and adverse side effects to cognitive performance are not seen in medicinal users as they are in recreational use.
Like many other substances cannabis can be an addictive substance and should be used responsibly. In comparison to many other substances used to treat PTSD and other veterans related conditions it may be a much safer alternative, particularly used in a short-term program.
Current status in the UK
Cannabis has been legal for medical purposes in the UK since November 2018. Despite the law change, insufficient prescribing guidelines for doctors mean that we have hardly seen any prescriptions issued through the NHS, forcing patients to seek out treatment via the private sector.
Currently, you can access medical cannabis (with 6,000+ prescriptions to date) at a range of specialist private clinics in the UK. Patients must pay for their own consultation and prescription costs, which are reducing as competition in the sector increases. Medical cannabis prescription costs are now on par with the illicit cannabis market.
Heroic Hearts Project UK supports Project Twenty21, the medical cannabis study run by the UK’s leading charity for evidence-based drug policy, Drug Science.
Based on the ever-growing evidence available, CBD may be highly useful to the veteran community in the management of symptoms related to stress, anxiety, PTSD, sleep, substance use and chronic pain.
CBD could be used as a complimentary or alternative treatment to current pharmaceutical treatments used to manage these symptoms. The benefits of this would reduce the harms and dangers of poly pharmaceutical use as well as avoiding some of the negative side effects of many of the commonly used medications by the veteran community.
Much progress is still to be made in fully understanding the potential of CBD, however from the evidence available to date, there are no major health concerns associated with its use and so far reported side-effects from its use are negligible. One point to note is that people taking high doses of CBD can show abnormalities in blood tests related to the liver – similarly with many other non-prescription drugs. Therefore you should inform your GP if you are using CBD regularly. One of the main considerations is due to CBD being sold as a supplement and not a medicine so there is less regulation on safety and purity. Make sure you obtain CBD from a reputable source and disclose your use of CBD with your doctor to assure it won’t affect any other medicines you are taking.
1. Kirkland, A.E.; Fadus, M.C.; Gruber, S.A.; Gray, K.M.; Wilens, T.E.; Squeglia, L.M. A scoping review of the use of cannabidiol in psychiatric disorders. Psychiatry Res 2021, 308, 114347, doi:10.1016/j.psychres.2021.114347.
2. Espinosa-Jovel, C. Cannabinoids in epilepsy: clinical efficacy and pharmacological considerations. Neurologia (Engl Ed) 2021, 10.1016/j.nrleng.2020.02.012, doi:10.1016/j.nrleng.2020.02.012.
3. Isenmann, E.; Veit, S.; Starke, L.; Flenker, U.; Diel, P. Effects of Cannabidiol Supplementation on Skeletal Muscle Regeneration after Intensive Resistance Training. Nutrients 2021, 13, doi:10.3390/nu13093028.
4. Razavi, Y.; Shabani, R.; Mehdizadeh, M.; Haghparast, A. Neuroprotective