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Cannabis oil: what is it and does it really work as medicine?

Cannabis is in the headlines for its potential medical benefits after the recent confiscation of cannabis oil medication from the mother of a 12-year-old British boy with severe epilepsy. The furore that ensued is shining a light on campaigns for cannabis oils to be made legal for medical reasons, and the UK government has now announced a review into the use of medicinal cannabis. Here’s what you need to know.

What is cannabis oil?

Cannabis oil is extracted from the cannabis plant Cannabis sativa. The plants medicinal properties have been touted for more than 3,000 years. It was described in the ancient Eygyptian Ebers papyrus around 1550BC, and it was likely used as a medicine in China before that. Some varieties of the plant contain high levels of the psychoactive substance tetrahydrocannabinol (THC), which is responsible for the “high” that comes from smoking or eating cannabis leaves or resin. The plant’s other major chemical component is cannabidiol, which has no psychoactive effect. Both act on the body’s natural cannabinoid receptors which are involved in many processes such as memory, pain and appetite. The cannabis plant also contains more than 100 other different cannabinoid compounds at lower concentrations.

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So can cannabis oil make you high?

It depends on the THC content. Some types of Cannabis sativa plant, known as hemp, contain very little THC. The extracts from these plants contain mainly cannabidiol, so will not get anyone stoned.

Is it legal?

That’s a complicated question. In the UK cannabidiol is legal. Cannabis plant extracts (known as hemp or CBD oils) are available in high-street stores but the THC content must be below 0.2 per cent. “THC is not psychoactive at this level,” says David Nutt, a neuropsychopharmacologist at Imperial College London. But cannabidiol is illegal in many other countries.

In the USA for example, cannabidiol is classed as a schedule 1 controlled substance, and can only be sold in states where cannabis use is legal.

However, the tide may turn in favour of cannabidiol after a recent World Health Organisation review. This concluded that cannabidiol “exhibits no effects indicative of any abuse or dependence potential” but “has been demonstrated as an effective treatment of epilepsy … and may be a useful treatment for a number of other medical conditions.”

What is the evidence that cannabis oils can help treat epilepsy?

Although there is some scientific evidence that THC has potential to control convulsions, its mind-altering effects mean that much of the focus has turned to cannabidiol – particularly for childhood epilepsies that conventional drugs fail to control.

Two recent high quality randomised and placebo controlled trials showed that cannabidiol is an effective treatment for Lennox-Gastaut syndrome and Dravet syndrome, severe forms of epilepsy. The mechanism of action is unknown, but it may be due to a combination of effects, such as inhibiting the activity of neurons and dampening inflammation in the brain.

The situation is less clear when it comes to the use of commercial cannabis oils to control seizures, where the evidence is mainly anecdotal, and the oils can contain differing concentrations of cannabidiol and THC.

The UK government announced on 19 June that it would review the use of medical cannabis.

Are there any cannabis-based epilepsy drugs on the market?

Not yet. In April the US Food and Drug Administration recommended the approval of a drug called Epidiolex for Lennox-Gastaut syndrome and Dravet syndrome. Its active ingredient is cannabidiol, and final approval is due at the end of this month.

However, it is possible the drug is not as effective as cannabis oil containing THC, says Nutt. For example, the cannabis oil used to treat Billy Caldwell, the boy at the centre of the recent cannabis oil confiscation furore, contained cannabidiol and a low dose of THC, because cannabidiol alone did not stop all his seizures.

This is one of the big unknowns. “It is important to remember that there is currently very little scientific evidence to support cannabis oil containing both THC and cannabidiol as a treatment for epilepsy,” said the charity Epilepsy Action, in a statement issued this month.

Are cannabis-based medications available for other conditions?

Yes. A synthetic version of THC called Nabilone has been used since the 1980s to treat nausea after chemotherapy and to help people put on weight. A drug called Sativex is also approved for the treatment of pain and spasms associated with multiple sclerosis. It contains an equal mix of THC and cannabidiol, but would not be suitable for the treatment of children with epilepsy such as Billy. “If you used that to treat epilepsy, the kids would be stoned off their heads,” says Nutt.

What is the aim of the UK government’s review of medical cannabis?

The first part of the review will look at the evidence for the therapeutic value of cannabis-based products. It can recommend any promising ones for the second part of the review. This will be carried out by the government’s Advisory Council for the Misuse of Drugs, which can recommend a change to the legal medical status of cannabis and cannabinoids.

This will hopefully lead to a relaxation of the rules surrounding research into cannabis-based medicines says Tom Freeman, a clinical psychopharmacologist at King’s College London.

In the UK cannabis currently has Schedule 1 status, the most restrictive category, which is for drugs which are not used medicinally such as LSD. “This creates a Catch 22 situation,” says Freeman. “You can’t show that cannabis and cannabis-based products have medicinal value because of restrictions on medical research.” If cannabis is moved to the Schedule 2 category, it will join substances such as morphine and diamorphine (heroin) which can be prescribed by doctors if there is a clinical need .

The UK government is reviewing medicinal cannabis after two boys with severe epilepsy were withheld cannabis oil treatments. Here's everything you need to know

Can You Get High from CBD or CBD Oil?

Cannabidiol (CBD) is a cannabinoid, a type of natural compound found in cannabis and hemp.

It’s one of hundreds of compounds in these plants, but it’s received more attention lately as changes to state and federal laws have led to a rise in the production of CBD-infused products.

Another well-known cannabinoid is tetrahydrocannabinol (THC). This compound is known for its psychoactive effects when consumed with cannabis, or marijuana.

THC produces what many consider a “high,” or an altered state characterized by euphoria, pleasure, or heightened sensory perception.

CBD doesn’t cause a high like THC.

CBD does have some positive health benefits, like helping people with anxiety and depression. If you’re seeking out CBD as a means to get high, you won’t experience that.

Both THC and CBD naturally occur in cannabis plants. CBD can be isolated from the cannabis plant and the THC compound. People infuse CBD into tinctures, oils, edibles, and other products without the high-inducing THC.

Still, many individuals might assume CBD causes the same effects as marijuana, because both can be found in the same plant. However, CBD alone is nonintoxicating. It won’t cause a high.

What’s more, CBD can also be derived from the hemp plant. Hemp has no psychoactive effects, either.

In fact, in many states only hemp-derived CBD is available legally. These products, by law, can have no more than 0.3 percent THC. This isn’t enough to create any psychoactive symptoms.

Once extracted from hemp or cannabis, CBD can be added to several products, including tinctures, lotions, and oils.

CBD oil is one of the more popular CBD products. You can take it sublingually (under the tongue) or add it to drinks, food, or vape pens.

Some of these products are promoted as a natural way to relax or lower anxiety. Indeed, research has found CBD can reduce some symptoms of anxiety and depression. This is still not equivalent to the high marijuana causes.

High concentrations of CBD (or taking more than recommended) could cause an uplifting effect. That’s not the same thing as a high.

What’s more, taking high doses of CBD could cause some side effects, including nausea and dizziness. In that case, you may not even experience the “uplifting” effect at all.

CBD and THC are two types of cannabinoids found in cannabis. They both have an impact on cannabinoid type 1 (CB1) receptors in the brain. However, the type of impact tells you a lot about why they produce such different results.

THC activates these receptors. This causes a euphoria or the high associated with marijuana.

CBD, on the other hand, is a CB1 antagonist. It blocks any intoxicating impact caused by the CB1 receptors. Taking CBD with THC may inhibit the effects of THC.

In other words, CBD may block the high effects.

CBD can have several positive effects. Some of these research-backed uses of CBD even suggest it may help you feel relaxed. That can feel a bit like a high, though it’s not intoxicating.

Research suggests CBD is beneficial for relieving symptoms of anxiety and depression. It might also ease inflammation and pain .

Some people with a history of epilepsy may find relief from seizures when using CBD. The Food and Drug Administration approved the first CBD-based drug, Epidiolex , for treating epileptic seizures in 2018.

What’s more, CBD has also shown promise as a way for doctors to help people with schizophrenia avoid side effects of antipsychotic medication.

People who use CBD-rich marijuana strains may also be able to prevent THC-induced psychosis , a potential side effect of the drug.

As research into cannabis- and hemp-derived CBD expands, doctors and healthcare providers will have a better understanding of how CBD works and who might benefit most from it.

The World Health Organization says CBD is safe. However, more research is still needed to understand the full spectrum of effects and possible uses.

Despite general acceptance, some people may experience some side effects when they take CBD, especially at high concentrations. These side effects can include:

  • diarrhea
  • mild nausea
  • dizziness
  • excessive fatigue
  • dry mouth

If you take any prescription medications, talk with your doctor before using CBD. Some medicines may be less beneficial because of CBD. They could also interact and cause unintended side effects.

U.S. federal law still classifies cannabis as a controlled substance. But in December 2018, Congress lifted the prohibition on hemp plants. That means hemp-derived CBD is legal in the United States unless outlawed at the state level.

By law, CBD products can have no more than 0.3 percent THC. In states where medical marijuana or recreational marijuana is legal, marijuana-derived CBD may also be available. CBD-to-THC ratios will vary by product.

CBD can be extracted from a cannabis plant, but it doesn’t have the same ability to create a “high” or state of euphoria as marijuana or THC.

CBD may help you feel relaxed or less anxious, but you won’t get high if you choose to use a CBD-infused oil, tincture, edible, or other product. In fact, if you use CBD with THC-rich cannabis products, the CBD may lessen how much of a high you get from the THC.

Before you begin using any CBD product, talk with your doctor.

Be sure to also source high-quality CBD products. Check for a label that confirms the product has received third-party testing for quality. If the brand you’re thinking of buying doesn’t have that, the product may not be legitimate.

Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level, but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and may be inaccurately labeled.

CBD may help you feel relaxed or less anxious, but you won’t get high if you choose to use a CBD-infused oil, tincture, edible, or other product. Here's why. ]]>