The ABC's of CBD: What you want and need to know

It would be a rare person, these days, who hasn't heard about the medical benefits of marijuana and the growing use of cannabis in treating patients with disorders ranging from anxiety and depression, to epilepsy, cancer, and Parkinson's disease. Increased awareness of the human endocannabinoid system along with scientific research into the compounds active in cannabis, have allowed doctors, nurses and patients to develop highly effective treatments.

The information can be overwhelming, and sifting through it can be confusing. Sometimes articles contradict each other, and it can be difficult to determine opinions vs facts. While the information here is the basic stuff you need to understand to get started, there is wisdom in having conversations with people who are knowledgeable about both marijuana and specific conditions. Unfortunately, finding medical practitioners who specialize in treatments that include marijuana and its components are few. Once you do find that doctor, nurse, or holistic practitioner, don't merely use them to gain access to a “green” card – ask them questions about where they get their information, and become an educated patient. Sites like Leafly.com or Projectcbd.org are wonderful places to follow conversations about medical marijuana, yet few people know that in most states dispensaries are legally obligated to have bud-tenders who are certified to talk about medical marijuana. Not every bud-tender holds medical certification, so be sure to ask.

CBD is the shorthand for Cannabidiol, the active component in marijuana that has no psychotropic effects, like its closely related THC (tetrahydrocannabinol) and it is one of at least 85 different cannabinoids found in marijuana. Attaching to receptors throughout the body, rather than in the brain, CBD is a key component in treating pain, inflammation, seizures, spasticity, nausea, sleep disorders, and anxiety. Conditions like epilepsy, Crohn's disease, multiple sclerosis, post-traumatic stress disorder (PTSD), Parkinson's disease, and Dravet's syndrome have all been treated using CBD with varying degrees of success. CBD is used in concentrates, tinctures, edibles, topically, and by smoking or vaping the whole herb.

CBD in isolation is effective, however there is a growing body of research that suggests whole plant medicine is more effective in treatments for disease. As scientific study catches up on the how and why, patients who are finding relief using marijuana with high levels of CBD are gratefully experimenting with strains and preparations that work for them. While long-term effects of marijuana are debatable, there is no known toxicity for cannabinoids, including CBD and THC, making this experimentation safe for most individuals. In both cases, CBD and THC need to be decarboxylated (heated for a period of time at a low temperature) to “activate” these cannabinoids. Vaporization and smoking do this nicely. When manufacturing tinctures, edibles, and topicals, decarboxylation must be achieved as a step in the production process.

Certain drug interactions can occur with the presence of THC in some of the strains, so be honest with your pharmacist and medical providers if you are on medications like Viagra, Prozac, or certain medications for diabetes, as the production of enzymes in the liver can affect the breakdown of medications and cannabinoids, causing different elevations of medications in the bloodstream, which can be dangerous if too high or low. Luckily, some of the highest CBD strains average 20-24:1 CBD to THC ratios. High CBD is not all the same, and some strains that are high in CBD contain much more THC than others, so look at labels in dispensaries, and ask for help understanding them. Research in drug interactions with marijuana and cannabinoids is slim and more studies are definitely needed in this area.

Part of the issue in treating patients is the availability of strains that are high in CBD. Not every strain has the same cannabinoid profile, nor is every strain completely consistent in its cannabinoid makeup.

Just like humans, each plant is unique, and if you are not buying from a dispensary getting every plant tested in a lab is generally cost prohibitive. What we do know is that growers are working hard to develop strains that have distinct and consistent profiles, and as the work progresses, more and better CBD-rich strains are reaching the market. With the help of websites like Leafly.com and Projectcbd.org, patients are only a few clicks away from identifying and finding access to medication that improves their lives.

So for those of you wanting to take the plunge and find some High CBD herb to begin experiencing the effects for yourself, high CBD strains are reviewed frequently, and new ones added to the list as they come to market. Describing the strains requires a new vocabulary as the cannabinoid and terpene profiles create different effects. Leafly.com has a wonderful page that outlines strains, and has filters for searching them by their effects. Some of the top high CBD strains are outlined in an article here (https://www.leafly.com/news/strains-products/what-cannabis-strains-are-high-in-cbd). Do note, when going out and finding strains in the real world, that a benefit of purchasing from a dispensary is that each plant is laboratory tested for its CBD and THC cannabinoid levels.

Finally, CBD may be found in Hybrid, Indica and Sativa strains. The strains listed below are all good to know:

High CBD/Low THC Strains:

• ACDC (Hybrid)

• Canna-tsu (Hybrid)

• Cannatonic (Hybrid)

• Harle-tsu (Hybrid)

• Ringo's Gift (Hybrid)

• CBD Shark (Indica)

• Remedy (Indica)

  Mixed CBD/THC Strains:

• CBD Mango Haze (sativa)

• Harlequin (sativa)

• Hawaian Dream (sativa)

• MediHaze (Sativa)

• Sour Tsunami (Hybrid)

• Pennywise (Indica)

• Sweet and Sour Widow (Indica)