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Cannabidiol, Kids & Politics

A documentary from WTIU & WFIU

It’s estimated that 20,000 Hoosiers suffer from treatment resistant epilepsy.

A new state law allows seizure patients who sign up for a new registry to possess Cannabidiol, or CBD, without fear of being prosecuted for it.

CBD is an oil derived from the cannabis plant. It’s non-psychoactive; CBD comes from a part of the cannabis plant that is low in THC, so it can’t get people high.

A growing number of U.S. states allow people with specific forms of epilepsy to use CBD, despite the classification of cannabis as a schedule one drug – a high-risk substance with high abuse potential and no medical use.

Our half-hour documentary introduces listeners and viewers to the families who fought for years to legally use CBD oil and we examine the oil’s effectiveness and safety.

FAQ

What is CBD oil?

Cannabidiol (CBD) is one of the main neuroactive components of the marijuana plant and has many medicinal properties including anti-seizure, anti-inflammatory, and antioxidant activity. It is a lipophilic (fat-loving) molecule and therefore has to be extracted from the plant into a fat or oil. (References: 2, 4, 8)

What are the laws concerning CBD oil?

Laws governing the manufacture, sale and use of CBD vary from state to state.

Can you get high from using CBD oil?

No. CBD is structurally different than THC (the psychoactive component of marijuana) and binds different receptors in the brain and body. It is not psychoactive and does not produce the “high” commonly referred to when talking about marijuana. (References: 2, 4, 8) 

Are there side effects to taking CBD oil?

As with any medical treatment, there have been some side effects to CBD oil reported during clinical trials. The most common side effects of CBD oil are somnolence, decreased appetite, diarrhea and fatigue. Most often these side effects were reported to be mild and the majority of study participants opted to continue CBD oil because of the mild nature of their reactions. These side effects can be reduced or avoided all together by starting with a low dose of CBD oil and increasing the dose slowly. Most side effects do subside over time as the patient becomes acclimated to the medication. (References: 1, 2, 3, 4, 7, 8)

Can you take CBD oil with other medications?

Yes. CBD oil has been studied in a wide range of seizure types and in addition to a wide range of medications. It has been studied in addition to several different types of seizure medications and in combination with up to 7 different medications at one time. CBD is processed by the liver and, as such, there are potential interactions to be on the lookout for.

The most common seizure medication interactions are with Clobazam (increases the efficacy of clobazem by increasing the amount of circulating active metabolite, n-desmethylclobazem) and divalproex (can increase toxicity of divalproex, must be monitored closely). As with any other medication, CBD oil should only be used in addition to other medications under the supervision of a qualified medical professional. (References: 1, 3, 4, 7, 8) 

How Can CBD Oil Affect the Brain of Someone With Epilepsy?

The direct and exact effects of CBD oil on the epileptic brain are still being investigated, but we know that CBD is a multi-target molecule that works via several different, well-defined mechanisms to aid in seizure control. Many of these mechanisms are also targets of currently available prescription seizure medications. In addition, CBD has both anti-inflammatory and antioxidant properties.

There are over 100 naturally occurring chemicals found in the cannabis plant, but the two main active ones are delta-9-THC and cannabidiol (CBD). THC binds directly to CB-1 receptors, which are located in the brain and involved in bodily processes like appetite and pain-sensation. This binding is thought to be responsible for the mental and behavioral changes from cannabis use– the “high.” Purified cannabidiol does not bind to CB-1. In human studies, CBD has little or no such effects, because, according to current research, it does not bind to CB-1 receptors. Three recent human studies conclusively showed a positive effect of purified CBD on seizures but the precise mechanism of CBD’s anti-seizure effect is not fully understood. (References: 1, 2, 3, 4, 5, 6, 7, 9)

References:

  1. Devinsky et al. “Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial.” Lancet Neurol (2015)
  2. Devinksy et al. “Cannabidiol: Pharmacology and potential therapeutic role in epelipsy and other neuropsychiatric disorders.” Epilepsia, 55(6):791-802 (2014).
  3. Friedman D. et al. “Cannabinoids in the Treatment of Epilepsy. N Engl J Med 2015;373:1048-58.
  4. Epilepsy.com: epilepsy statistics 
  5. Epilepsy.com: refractory epilepsy
  6. Mead, A. The legal status of cannabis (marijuana) and cannabidiol (CBD) under U.S. law. Epilepsy Behav (2017)
  7. O’Connell BK, et al. Cannabinoids in treatment-resistant epilepsy: A review. Epilepsy Behav (2016)
  8. Tzadok, Michal, et al. “CBD-Enriched medical cannabis for intractable pediatric epilepsy.” Seizure, vol. 35 (2016), pp. 41-44. 
  9. Dr. Michael Privitera, former president of the American Epilepsy Society.