New CBD Integrated Treatments Based on Recent Scientific Literature and Clinical Practice

The statements mentioned in this content have not been evaluated by the FDA, and are not intended to prevent, diagnosis, or treat any disease. Always work with your personal healthcare provider.

By Chris D. Meletis, N.D.

One of the biggest developments we have recently witnessed in the CBD arena is FDA’s approval of GW Pharmaceuticals CBD drug Epidiolex as a treatment for three forms of epilepsy. In 2018, the FDA approved Epidiolex® for Lennox-Gastaut syndrome and Dravet syndrome, the first and only FDA approved uses of CBD. Most recently, in July, 2020, the FDA approved the use of Epidiolex® for seizures linked to tuberous sclerosis complex (TSC), a genetic disorder thought to affect one in 6,000 people.

This approval was a very strong positive for the CBD industry as a whole, as it helped legitimize CBD applications in epilepsy. However, it also sets a standard and raises the bar on expectations of the quality of product that consumers should expect from their healthcare providers. For example, it is important to offer patients trusted CBD-hemp products that have less than 0.3 percent THC. Anything above 0.3 percent THC is not hemp, it is legally considered marijuana. You never want to be in the position of having to explain to your medical board why your CBD products are high in THC. Therefore, when ordering CBD products for your patients it is critical to ask for a Certificate of Analysis from a source you can trust. Your license depends on it.    

A Nod To CBD’s Other Uses

I believe another development in the future will be the legitimization of CBD’s utility in many other applications in addition to epilepsy. Recently, we have seen papers published on CBD’s potential beneficial use in:

• Age-associated neurological disorders, including Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis and multiple sclerosis.1-3

• Mood4

• Peripheral vascular disease5

• Pain (chronic pain patients were able to reduce or eliminate their opioid dosage and 

   had an improved quality of life).6

Admittedly, some of this research is based on animal and in vitro results as well as justification for CBD’s use based on its mechanism of action. However, there have been a number of human studies investigating various applications. I suspect that we will soon be seeing more human trials studying CBD’s various beneficial uses that have also been confirmed in clinical practice.

Familiarization with Dosing 

Another development we’ll be seeing in regards to CBD is a greater appreciation for the nuances of dosing and what the proper amounts are for sustaining blood levels. We now recognize that dosing of CBD should begin at lower doses and progressively raised to clinical levels.7 

New Ways To Improve Absorption

Finally, I believe that improving the absorption of CBD will become a priority. For example, we have already seen this with the invention of the VESIsorb® SEDDS delivery system technology, which significantly improves the bioavailability of CBD-rich hemp extracts by mimicking a physiological absorption pathway.8  

References:

1. de Faria SM, de Morais Fabrício D, Tumas V, et al. Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson’s disease. J Psychopharmacol. 2020;34(2):189-196.

2. Hao F, Feng Y. Cannabidiol (CBD) enhanced the hippocampal immune response and autophagy of APP/PS1 Alzheimer’s mice uncovered by RNA-seq. Life Sci. 2021;264:118624.

3. Dash R, Ali MC, Jahan I, et al. Emerging potential of cannabidiol in reversing proteinopathies. Ageing Res Rev. 2021;65:101209.

4. Bartoli F, Bachi B, Calabrese A, Moretti F, Crocamo C, Carrà G. Cannabidiol for Mood Disorders: A Call for More Research. Can J Psychiatry. 2021;66(2):182-183.

5. Mazeh AC, Angus JA, Wright CE. Cannabidiol selectively inhibits the contraction of rat small resistance arteries: Possible role for CGRP and voltage-gated calcium channels. Eur J Pharmacol. 2021;891:173767.

6. Capano A, Weaver R, Burkman E. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgrad Med. 2020;132(1):56-61.

7. Meissner H, Cascella M. Cannabidiol (CBD). In: StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC.; 2020; Updated January 2021.

8. Knaub K, Sartorius T, Dharsono T, Wacker R, Wilhelm M, Schön C. A Novel Self-Emulsifying Drug Delivery System (SEDDS) Based on VESIsorb(®) Formulation Technology Improving the Oral Bioavailability of Cannabidiol in Healthy Subjects. Molecules. 2019;24(16).