The Effectiveness and Safety of Cannabidiol in Non-seizure-related Indications: A Systematic Review of Published Randomized Clinical Trials

Tang, Yuni; Tonkovich, Kolbi L.; Rudisill, Toni Marie

doi:10.1007/s40290-022-00446-8

Cited by 4 publications

(6 citation statements)

References 97 publications

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“…The age of the participants in this study was normally distributed, and the 65:35 ratio of females to males is consistent with other studies of the usage of CBD in general populations [11][12][13]. Similar to other studies, the most common conditions for which CBD are being taken are pain, mental health (primarily anxiety/stress), general health and wellness, and sleep, while digestive health and central nervous system conditions are cited as reasons for its use by significantly fewer individuals [12][13][14][15][16]. As in the Moltke study [12], individuals taking CBD for chronic pain were significantly older, whereas those taking CBD for mental health (primarily anxiety and stress) were significantly younger than those taking CBD for other reasons.…”

Section: Discussionsupporting

confidence: 90%

“…Using data from another study where self-dosing CBD users were asked to estimate their daily dose, the average daily dose was 61 mg/day and with a range from 0 to 200+ [12]. Since orally administered non-prescription products typically recommend daily doses well below 150 [14,23], it is not surprising that the vast majority of self-dosing CBD users were ingesting CBD daily doses in this range [14,23]. In the present study, individuals reported that their GHS and SS significantly improved each day after ingesting CBD.…”

Section: Daily Cbd Dosementioning

confidence: 99%

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Long-Term, Self-Dosing CBD Users: Indications, Dosage, and Self-Perceptions on General Health/Symptoms and Drug Use

Kaufmann,

Harris Bozer,

Jotte

et al. 2023

Med Cannabis Cannabinoids

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Introduction: Self-dosing of off-the-shelf cannabidiol (CBD) for a myriad of health conditions is common in the USA. These CBD products are often mislabeled, suggesting that much less or much more CBD is being consumed than indicated on the label. This study examined the relationship between long-term self-dosing of CBD and (a) indications and, when a verified concentration of CBD is being consumed, (b) the daily CBD dosage, (c) the impact on general health and symptoms, and (d) over-the-counter (OTC) and prescription (Rx) drug usage. Methods: US adults 18–75 years of age who had used unverified CBD products for >1 month were recruited to participate in this decentralized, observational, IRB-approved study and provided a concentration-verified CBD product of their choice from 15 different vendors for 4 weeks. Prior to receiving product, they were queried on their primary reason for use (PRfU), primary symptom for use (PSfU), general health score (GHS), symptom score (SS), OTC and Rx drug use, and daily CBD dose. Individuals were queried daily on OTC and Rx drug use and CBD dose and weekly on SS and GHS prior to (pre-CBD) and after (post-CBD) ingestion of CBD on that day. Results: The PRfU included chronic pain, mental health, general health and wellness, sleep disorders, the central nervous system, digestive health, and others, while the PSfU included anxiety, back and/or joint pain, sleep, inflammation, and others. The mean daily dose was normally distributed, with a mean, median, and range of 53.1, 40.8, 8–390 mg/day, respectively. For both GHS and SS, the post-CBD was significantly higher than the pre-CBD score for each category of PRfU. The GHS scores did not change over the study, but pre- and post-CBD SS improved over time, with pre-improving more than post-CBD SS. The percentage of individuals decreasing or completely stopping OTC drugs or Rx drugs over the 4 weeks was 31.2% and 19.2%, respectively, with those taking CBD for chronic pain, decreasing drug use the most. OTC and Rx drug usage decreased when the CBD dose was changed and when GHS and SS improved. Conclusion: Pain, mental health (primarily anxiety/stress), and sleep are the most common reasons for CBD use. Self-administration of CBD reduced OTC and Rx drug usage at daily doses less than those reported in controlled studies. CBD self-administration significantly improves self-perception of general health and decreases symptom severity, and as these improve, fewer OTC and Rx drugs are used.

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Section: Discussionsupporting

confidence: 90%

Section: Daily Cbd Dosementioning

confidence: 99%

Long-Term, Self-Dosing CBD Users: Indications, Dosage, and Self-Perceptions on General Health/Symptoms and Drug Use

Kaufmann,

Harris Bozer,

Jotte

et al. 2023

Med Cannabis Cannabinoids

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“…Of the included studies, there were 3 RCTs reported across 5 (18.52%) studies, 29 , 34 , 36 , 37 , 41 1 (3.7%) pilot clinical trial, 28 1 (3.7%) open-label pilot study, 47 1 (3.7%) cross-sectional survey study, 48 1 (3.7%) qualitative study, 45 2 (8.33%) case reports, 35 , 42 and 16 (59.26%) reviews. 9 , 24 - 27 , 30 - 33 , 38 - 40 , 43 , 44 , 46 , 49 Evidence was primarily available for the use of CBD adjunctively to opioids and cocaine. Two studies focused on polydrug-using samples.…”

Section: Resultsmentioning

confidence: 99%

“…The 2 case reports, 2 pilot studies, 1 cross-sectional survey study, and 1 qualitative study were considered to also have a high risk of bias due to study design. 28,35,42,45,47,48 The 4 systematic reviews assessed with AMSTAR-2 were rated critically low 25,40 or low 33,49 quality primarily due to no predefined protocols, no discussion on the funding source included studies, and no bias assessment (Table 2). For the remaining narrative reviews, 11/12 were assessed with SANRA as being moderate or high quality (Table 3).…”

Section: Quality Of Evidencementioning

confidence: 99%

Cannabidiol as a Harm Reduction Strategy for People Who Use Drugs: A Rapid Review

Lo,

MacCallum,

Nanson

et al. 2023

Can J Psychiatry

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Objective The drug poisoning crisis throughout North America necessitates novel harm reduction approaches. Emerging evidence suggests that cannabidiol (CBD) may have some utility as a harm reduction modality for those with problematic substance use. This rapid review aimed to synthesize available evidence on CBD as a potential harm reduction tool for people who use drugs while providing clinical and research insights. Method A systematic search in EMBASE, MEDLINE, CENTRAL, and CINAHL was completed in July 2022. For inclusion, studies had to meet the following criteria: (1) drawn from an adult population of people who use drugs; (2) investigates CBD as an intervention for problematic substance use or harm reduction–related outcomes; (3) be published after the year 2000 and in English; and (4) be primary research or a review article. A narrative synthesis was used to group outcomes relevant to harm reduction and provide clinical and research insights. Results We screened 3,134 records, of which 27 studies (5 randomized trials) were included. The evidence remains limited, but available studies support the potential utility of CBD to reduce drug-induced craving and anxiety in opioid use disorder. There were low-quality studies suggesting that CBD may improve mood and general well-being of people who use drugs. Evidence suggests that CBD monotherapy may not be an adequate harm reduction strategy for problematic substance use but rather an adjunct to the standard of care. Conclusion Low-quality evidence suggests that CBD may reduce drug cravings and other addiction-related symptoms and that CBD may have utility as an adjunct harm reduction strategy for people who use drugs. However, there is a significant need for more research that accurately reflects CBD dosing and administration regimens used in a real-world context.

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“…Interestingly, some effects of CBD may be gender-dependent (Franzen et al, 2023 ). Analysis of clinical trials suggests that while CBD seems to be effective as an anxiolytic, its efficacy for other non-seizure-related conditions is much more variable (Tang et al, 2022 ). 5-HT3AR, 5-HT1AR, and the two closely related G-protein coupled receptors, GPR3 and GPR6, are considered as main molecular targets mediating the antidepressive effects of CBD (Vitale et al, 2021 ).…”

Section: Therapeutic Potential Of Cannabidiol In Neurological Diseasesmentioning

confidence: 99%

Cannabidiol: potential in treatment of neurological diseases, flax as a possible natural source of cannabidiol

Storozhuk

2023

Front. Cell. Neurosci.

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The Effectiveness and Safety of Cannabidiol in Non-seizure-related Indications: A Systematic Review of Published Randomized Clinical Trials

Cited by 4 publications

References 97 publications

Long-Term, Self-Dosing CBD Users: Indications, Dosage, and Self-Perceptions on General Health/Symptoms and Drug Use

Long-Term, Self-Dosing CBD Users: Indications, Dosage, and Self-Perceptions on General Health/Symptoms and Drug Use

Cannabidiol as a Harm Reduction Strategy for People Who Use Drugs: A Rapid Review

Cannabidiol: potential in treatment of neurological diseases, flax as a possible natural source of cannabidiol

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