CBD and Asthma: Part 1
The latest and greatest health-trend to sweep across communities, with marketing promoting it as a magic bullet medicine, is CBD oil. Many companies claim CBD can treat a variety of chronic conditions, like asthma, and will improve overall wellness. Is this true, though? What is CBD and where does it come from?
In this two-part article, we will explore the esoteric topic of cannabis, its legality, and make sense of why thousands of products are cashing in on this common cannabinoid. Part 1 will be about what CBD is and why its legality has been so questionable for so long and part 2 will be about its effects on our asthma.
A quick history of CBD
‘Cannabis’ is a genus of the family ‘cannabaceae’, it’s a cousin to the hops used to make beer. Cannabis is a plant genus with more history than most, and that history has lots of drama and agenda. The history of domesticated cannabis dates back thousands of years; from recreational substance use, to pharmacology, to industrial material; the plant was a very common commodity.
It wasn’t until the early 1900s, that alternative socio-economic motivations and privatized pseudo-science led to the prohibition of the genus ‘cannabis’ in 1936. This ‘cannabis’ ban included the three species under the umbrella genus; indica, sativa and ruderalis. What is so significant about the difference in species? Everything, really, but the propaganda behind the prohibition grouped them together for a reason.
The species of cannabis
The species of cannabis all look somewhat similar, but are very different in their uses and chemical properties. ‘Indica’ and ‘Sativa’ produce high amounts of ‘Tetrahydrocannabinol’ or (THC), a psychoactive chemical that affects our brain through cannabinoid receptors. They are commonly referred to as ‘marijuana’, a highly controversial substance, with legality and regulation differing by state. Marijuana was the focus of the prohibition’s propaganda, but not the only target.
‘Ruderalis’, on the other hand, looks and acts very different from it’s siblings and it’s commonly called ‘hemp’. Rather than being short and bushy, it grows tall like a tree. It is an excellent raw material for paper, building material and textiles; this was part of why it was an economic strategy to have its’ growth prohibited. It also differs significantly in chemical behavior; it has minuscule amounts of THC, and much higher amounts of a chemical called ‘Cannabidiol’ or (CBD). The important thing to know about hemp and CBD, is that it’s non-psychoactive and will not get the consumer intoxicated or “high”. In recent years, however, CBD has been studied as a treatment for a variety of chronic conditions, including asthma.
Although the species are all different, especially hemp, the United States federal prohibition covered the entire cannabis family; indica, sativa and ruderalis. That was the case, until 2018 when the ‘Farm Bill’ was passed.
The Farm Bill
Cannabis, more specifically, hemp, has been one of the largest cash crops that humanity has domesticated. There came a point recently, when keeping hemp under prohibition with the context that it is a narcotic, was both scientifically antiquated and economically illogical. Due to hemp having essentially no THC or intoxicating effects, but high amounts of valuable resources, it needed to be separated from the others. So, the law was changed with the introduction of the Farm Bill of 2018; legalizing cannabis with less than .03% THC by dry weight. This meant that for the first time in decades, hemp could be grown on U.S. soil again, and reaped of its benefits.
The CBD boom
It is because of the re-legalization of hemp, and CBD, that we have seen new products emerging constantly. The newest trendy health commodities are CBD oils, tinctures, and infused goods because it has been a long-awaited shift in policy.
The beneficial effects of CBD have been studied and known for years, showing promise with chronic pain experienced by cancer patients, but politics moves slower than science. The first major spotlight for CBD oil was its unparalleled effect on epileptic patients; outperforming many modern pharmaceuticals, with fewer and less-severe side effects. This led to the simple plant-oil medicine getting more serious looks from modern pharmacology researchers. That being said, science moves faster than politics, but marketing moves faster than science.
When the bill passed, it opened the floodgates to an untapped market that seemed like it was just starting to spring. Thus, we have CBD commodities in every health food store across the country; some products more legitimate than others and some are completely ineffective. Like many health trends, consumer ignorance is what many of these products are banking on.
Read on to CBD and Asthma: Part 2
In this first part we have discussed, briefly, where hemp and CBD have been and why CBD is making a bigger comeback than high-waisted jeans. We hear so much about how CBD will solve all our problems from the marketing. Is that really the case though? How does CBD work in our body and how does it interact with our asthma? Are all CBD products the same? Read on to part 2 so you can be an educated consumer.
CBD And Asthma
It has been known for many years that smoked Cannabis is a bronchodilator and can be useful in treating asthma. Usually, asthma is a problem with bronchospasm (wheezes) and increased mucous production in the smaller airways of our lungs. There is a large component of anxiety associated with asthma, as who would not be scared when it is difficult to breathe. More anxiety causes worsening bronchospasm, which causes more anxiety.
Typical inhalers contain adrenergic (adrenaline-like) stimulants, which work well but tend to heighten anxiety. It would be nice to have more alternatives to treat bronchospasm.
Since richer levels of THC can cause increased anxiety, using CBD seems like a reasonable thing to try. Last week a patient came into our office who had obtained some CBD-rich tincture at a local collective and said he felt it was helping his asthma. He was off of his Advair inhaler for a week and wanted to be “checked.”
We administered a baseline spirometry test and then repeated the test 15 minutes after the patient had taken three drops of his CBD-rich tincture. The graphic shows the result:
FEV1 is forced expiratory volume at one second (when the patient breathes out as hard as s/he can).
FVC is forced vital capacity (the amount of air you can blow out after taking a deep breath).
PEF is the peak expiratory flow rate at any point during the exhalation.
You can see that after a three-drop dose of the tincture taken sublingually, the patient’s FEV1 and PEF nearly doubled. This would generally be considered a great response to a typical bronchodilator!
It is well documented that CBD is a very potent bronchodilator and useful in the treatment of Asthma.
Taking CBD by any method does result in decreased airway resistance. So, how about taking it by inhalation without smoke?
Yes, how about that. So, now there are vape pens available that have CBD oil inside them. In general, a couple of puffs will give the patient 6-8 mg of whole plant CBD + some THC directly into their lungs.
We are looking into this for lung cancer as well.
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