If there was any doubt that cannabidiol has officially gone mainstream, this should settle it.
A recent feature on the cannabis-derived chemical compound in the venerable New Yorkermagazine describes New York City’s sudden “CBD craze” as having “already reached Dadaesque levels of consumerism — hundred-dollar tinctures to treat anxiety in pet cats and dogs; CBD-laced room service at the NoMad location of the James Hotel, in Manhattan.”
But even The New Yorker, a publication known for fastidious fact-checking, got one thing wrong. The article describes cannabidiol as “a nonpsychoactive chemical,” and that’s simply not true.
The Oxford English Dictionary defines “psychoactive” as something, especially a drug, that affects the mind. There’s no doubt CBD meets that definition, but the misconception persists.
Longtime cannabis researcher Dr. Ethan Russo sees it everywhere. He’s been interested in CBD since the 1960s, when its chemical structure was first identified.
“The first misconception about cannabidiol was that it was inactive,” said Russo, a neurologist who serves as director of research and development for the International Cannabis and Cannabinoids Institute.
During early research on CBD and its euphoria-inducing cousin THC, Russo said, “all the hubbub was about THC, because of it being the, quote ‘active ingredient,’ unquote, but that’s a misconception, as well.”
“What people should think of, is that the primary intoxicating molecule in cannabis is THC,” he said.
Since CBD was non-intoxicating, many researchers initially lost interest in the the compound.
“During the ’70s, some people were working on it. It was noted to be an anti-inflammatory; there was some work done in Israel and Brazil about its anti-convulsant effects in the ’70s, and then things pretty much sat for the next 20 years.”
Research on CBD picked up again in the 1990s, Russo said, for which he largely credits Britain’s GW Pharmaceuticals. (Russo worked for GW first as a consultant and then as a senior medical adviser, from 1998 to 2014.)
“Very simply stated, what is clear about CBD is that it must be considered psychoactive because of its ability to act as an anti-anxiety agent and an anti-psychotic agent,” Russo said.
Recent clinical trials “have shown the safety and efficacy of cannabidiol in treating schizophrenia,” he added.
“So clearly, that’s got to be considered a psychoactive drug. But again, simply stated, it is not intoxicating in the way THC is, it does not produce a high, nor does it produce any craving or withdrawal effects. So it has no drug abuse liability that’s been observed.”
Perhaps the most straightforward way to describe CBD is that it “doesn’t create a euphoric high,” said UBC psychology professor Zach Walsh, who studies cannabis and mental health.
“It doesn’t create cognitive alterations that are obvious or overt,” he explained.
Walsh thinks the ongoing confusion over whether CBD is psychoactive has to do, in part, with “people struggling with the destigmatization of cannabis.”
“I see a lot of people come to me, usually cannabis-naive people, often people from a generation where cannabis was more highly stigmatized, and they’re like, ‘I heard there’s a new cannabis that doesn’t get you high, can I try some?'”
“Because they’re ambivalent, they want to partake in the potential benefits (that they’ve heard about), but at the same time they don’t want to go insane in a ‘reefer madness’ kind of a way, or they don’t want to be incapacitated or altered in a way that they’ve come to associate with moral failings, or just inappropriate behaviour,” said Walsh.
“They want to have the cake and eat it too…. If there’s a cannabis that’s not really cannabis, I think that’s pretty appealing to some people.”
Russo thinks educating the public about CBD requires an approach that’s both “top-down and bottom-up.”
“What I mean by that is, there’s a woefully inadequate treatment of not only cannabis and its pharmacology in medical schools, but also the endocannabinoid system that underlies a lot of its activity. So we need better-educated doctors that are going to understand this.”
The recent FDA approval of GW Pharmaceuticals’ CBD-based epilepsy medication Epidiolex could play a role in improving doctors’ knowledge, he said, as could ongoing efforts by medical cannabis users themselves to educate their health-care providers.
In the meantime, Russo continues to see CBD improperly described as “not psychoactive,” not only in the media, but also in scientific publications he peer-reviews.
“People like simple explanations, but anything about cannabis deserves paragraphs, not single phrases,” he said.
“So when you’re trying to distil the essence of these pharmacological concepts in single words, it’s easy to run afoul.”