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Multiple sclerosis (MS). A prescription-only nasal spray product (Sativex, GW Pharmaceuticals) containing both 9-delta-tetrahydrocannabinol (THC) and cannabidiol has been shown to be effective for improving pain, muscle-tightness, and urination frequency in people with MS. This product is used in over 25 countries outside of the United States. But there is inconsistent evidence on the effectiveness of cannabidiol for symptoms of multiple sclerosis when it is used alone. Some early research suggests that using a cannabidiol spray under the tongue might improve pain and muscle tightness, but not muscle spasms, tiredness, bladder control, mobility, or well-being and quality of life in patients with MS.
Laboratory evidence indicated that cannabidiol may reduce THC clearance, increasing plasma concentrations which may raise THC availability to receptors and enhance its effect in a dose-dependent manner. In vitro, cannabidiol inhibited receptors affecting the activity of voltage-dependent sodium and potassium channels, which may affect neural activity. A small clinical trial reported that CBD partially inhibited the CYP2C-catalyzed hydroxylation of THC to 11-OH-THC. Little is known about potential drug interactions, but CBD-mediates a decrease in clobazam metabolism.
Various strains of "medical marijuana" are found to have a significant variation in the ratios of CBD-to-THC, and are known to contain other non-psychotropic cannabinoids. Any psychoactive marijuana, regardless of its CBD content, is derived from the flower (or bud) of the genus Cannabis. As defined by U.S. federal law, non-psychoactive hemp (also commonly-termed industrial hemp), regardless of its CBD content, is any part of the cannabis plant, whether growing or not, containing a ∆-9 tetrahydrocannabinol concentration of no more than 0.3% on a dry-weight basis. Certain standards are required for legal growing, cultivating, and producing the hemp plant. The Colorado Industrial Hemp Program registers growers of industrial hemp and samples crops to verify that the dry-weight THC concentration does not exceed 0.3%. cbd oil
Hemp-producing cannabis has tall, fibrous stalks that are very strong and have very few flowering buds. On the other hand, marijuana strains are short, bushy, and have high amounts of THC. In fact, industrial hemp and medical marijuana are so distinctively different that most lay people wouldn’t be able to tell that they belong to the same genus of plants if they encountered them in the wild!
In September 2018, following its approval by the FDA for rare types of childhood epilepsy, Epidiolex was rescheduled (by the Drug Enforcement Administration) as a Schedule V drug to allow for its prescription use. This allows GW Pharmaceuticals to sell Epidiolex, but it does not apply broadly and all other CBD-containing products remain Schedule I drugs. Epidiolex still requires rescheduling in some states before it can be prescribed in those states.
State and local governments may also regulate CBD. For example, the Massachusetts Department of Agricultural Resources issued a rule in June 2019 aligning state CBD regulations with FDA regulations. This means that although recreational marijuana is legal in the state, CDB cannot legally be sold in food or as a dietary supplement under state law.
The two main receptors in the endocannabinoid system are CB1 and CB2. Where THC directly affects these receptors, CBD has a subtler, more indirect approach. Instead of attaching to these receptors, CBD affects how these receptors signal the body and its chemicals. Furthermore, CBD increases the production of the body’s own cannabinoids by blocking the enzymes that can break them down.
^ Jump up to: a b Hoch, Eva; Niemann, Dominik; von Keller, Rupert; Schneider, Miriam; Friemel, Chris M.; Preuss, Ulrich W.; Hasan, Alkomiet; Pogarell, Oliver (January 31, 2019). "How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review". European Archives of Psychiatry and Clinical Neuroscience. 269 (1): 87–105. doi:10.1007/s00406-019-00984-4. ISSN 0940-1334. PMC 6595000. PMID 30706168.
Statement from FDA Commissioner Scot Gottlieb, M.D., on signing of the Agriculture Improvement Act and the agency's regulation of products containing cannabis and cannabis-derived compounds. U.S. Food and Drug Administration Web site. Available at: https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-signing-agriculture-improvement-act-and-agencys. (Accessed May 7, 2019).