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CBD For Sleep, Anxiety, and Pain Management

Ghost Written Content / Original Text

In 2019 26% of Americans used Cannabidiol (CBD). Now legal in the United States, hemp-derived CBD is available in a wide range of products. With CBD sales expected to exceed $20 billion in the U.S. alone by 2024, it's no wonder we all know someone who uses it. There are many opinions and anecdotal claims that CBD can cure everything from symptoms of a restless night, anxiety, and pain. With misinformation running rampant, people wonder if CBD is the cure-all others claim it to be.

CBD may seem like a relatively modern addition to our lifestyles; however, industrial hemp was once required by law to grow in the

U.S. in the 17th century. Industrial hemp was used much for the same reasons we cultivate today: clothes, ropes, sponges, and medicinal uses. The passing of the Farm Bill in 2018 has made hemp legal once again to grow in the United States, which allows for access to products otherwise exclusive to states with a medical cannabis program. The Farm Bill allowed industrial hemp to be produced but must remain below 0.03% THC for qualification. This bill has opened up CBD products to the United States, becoming accessible in all 50 states.

CBD was discovered in the 1940s and is a non-psychoactive phytocannabinoid found in cannabis. More than 50 years later, the discovery of our endocannabinoid system (ECS) was made along with the CB1 and CB2 receptors, which are most common in humans and other mammals. Scientists also discovered "endocannabinoids", which are naturally occurring molecules that interact with our ECS. The main endogenous cannabinoids are anandamide and 2-arachidonoylglycerol (2-AG), which form in our immune system, brain, organs, and glands. CBD also stimulates the serotonergic receptors, 5-HT1A, along with the TRP-V. They are released when our body's endocannabinoid system is unbalanced.

Phytocannabinoids are synthesized molecules found in plants and interact with our ECS, imitating that of endogenous cannabinoids. Phytocannabinoids can be in hemp, echinacea, black pepper, among other plant life. When we consume CBD, it triggers similar responses that our body would naturally use to bring the ECS to homeostasis organically. It is hypothesized by Dr. Ethan Russo, in a 2008 study that many treatment-resistant conditions are linked to an unbalanced ECS.

The ECS's primary function is to keep the body in a state of homeostasis regulating your mood, movement,

sleep, metabolism, and more. Endocannabinoid receptors exist throughout the body, brain, spinal cord, and peripheral nerves. Receptors are located mainly at the cortex, cerebellum, basal ganglia, hippocampus, spinal cord, and peripheral nerves are where the CB1 and CB2 receptors are located. The CB1 receptor, which lives in much of our peripheral tissues and cells, primarily within the central nervous system. CB2 receptors have more influence on the immune system and the gastro tract.

Scientists have looked into what that potentially means for anxiety and sleep disorders with CBD's ability to interact and effectively modulate our ECS. Cannabis, Cannabinoids, and Sleep: A Review of the Literature analyzed data from 2014-2017, which found that CBD may be beneficial for people who have insomnia by regulating the body's circadian rhythm. In a 2019 large case series, researchers observed that of the patients studied, 66.7% reported better night's sleep within the first month. The same study also showed the potentiality to provide relief for people affected by REM sleep behavior disorder and nightmares as a symptom of PTSD.

Anxiety disorders affect roughly 18% of the U.S. population, estimating around 40 million adults. CBD has been hypothesized that it could be a potential anxiolytic due to the physiological response. The aforementioned large case ser

ies conducted in 2019 found that, alongside improved sleep, almost 80% of the patients reported a decrease in anxiety within the first month. In another 2019 study, researchers sought to determine if CBD works as an alternative treatment for people suffering from social anxiety disorder (SAD). In a double-blind study performed on teenagers ages 18-19 that CBD for treatment of SAD can decrease anxiety considerably. Cannabidiol as a Potential Treatment for Anxiety Disorders had similar results finding that in human studies, CBD can reduce anxiety and fear, along with assisting in fear extinction training. These findings showed that CBD could potentially be beneficial in other anxiety disorders.

Evidences for the Anti-panic Actions of Cannabidiol performed a standard test used to specifically target panic disorders, known as the simulated public speaking (SPS) test. Researchers asked individuals suffering from an anxiety disorder to speak publicly, finding that those who orally ingested CBD had "significant reduction in anxiety-related measures obtained during their speech performance". With CBD becoming readily available, it could provide immense benefits for people who don't have access, or have adverse to traditional pharmaceuticals.

Opioids are one of the most over-prescribed medications in the U.S., accounting for more than 20,000 deaths in 2017. With roughly 38 million people with chronic pain, there is an increasing interest in identifying safe alternatives to opioid prescriptions. A 2008 review by Dr. Russo shows that CBD has potent anti-inflammatory properties that can relieve pain associated with cancer, and central neuropathic pain associated with multiple sclerosis (M.S.). CBD is a TRPV1 agonist and furthers the notion that CBD is very powerful in the ECS modulation, further noting the anti-inflammatory properties.

A 2000 study points out that presented data shows due to CBD's immunosuppressive and anti-inflammatory abilities, it can reduce pain in the autoimmune disease, collagen-induced arthritis. These are promising for individuals that suffer from chronic pain. The same 2000 study showed that in rodent studies, CBD introduced early in treatment can block the continuation of arthritis by helping induce apoptosis (cell death). In a 2017 study released in the journal Pain, researchers showed that CBD could prevent pain associated with osteoarthritis along with joint neuropathy.

CBD has neuroprotective properties, meaning that it can assist with neuropathic pain. Studies are showing

that by using CBD, which is an antioxidant, it possesses the ability to lessen glutamate toxicity. This happens due to glutamate being an excitatory neurotransmitter. The excitatory neuronal pathway can increase the chance that neurons will begin to fire and can eventually flood inflammatory properties to cells. It is located in our central nervous system within our nerve terminals. Research on the glutamate receptors shows that it plays a large part in chronic pain as neuropathic pain is largely created and sustained due to the glutamenergic system, which is the main transmitter in our body. Left unbalanced, it can lead to chronic pain conditions, including migraines, fibromyalgia, and IBS. This shows promise that CBD can intervene by providing the ability to resolve issues by bringing the ECS back into a state of homeostasis.

CBD can be found in numerous legal market items, with over half of the sales coming from legal hemp products. Most common are CBD tinctures, topicals, infused edibles, patches, smokeable products, alongside hundreds of others. One of the benefits of having these various options is that experimentation is key with CBD.

CBD is used for a wide range of reasons as it's shown to be helpful not just with pain management and anxiety, but for treating Parkinson's Disease, epilepsy, eating disorders, and for reducing symptoms of psychosis. In a 2018 paper titled A Cross-Sectional Study of Cannabidiol Users, the study shows that most people using CBD do so for medicinal reasons. Nearly 61.56% of users reported using CBD for a medical issue, with 36% of surveyed users saying it effectively aids their medical problem, with the main three ailments reported to be chronic pain, joint/arthritis, and anxiety. According to a 2018 report published by the World Health Organization (WHO), currently there is no evidence CBD has any public health-related problems. WHO also states: "The potential toxic effects of CBD have been extensively reviewed...with a recent update of the literature… In general, CBD has been found to have relatively low toxicity, although not all potential effects have been explored."

When people begin to start using CBD, dosing is essential, but unfortunately, with a lack of available research, it can be inconsistent. One study found that a 300 mg dose of CBD decreased anxiety before the subjects performed a simulated public speaking (SPS) test allowing for improved performance. Another study conducted in 2015 found that as high as 1500mgs of CBD taken orally was tolerated well across the board of recipients, with no adverse mood effects or issues with motor skills. In A Systematic Review of Cannabidiol Dosing in Clinical Populations, researchers compared thirty-five studies finding that the medium dose is 15 mg. Despite the medium dose, researchers point out that CBD shows the ability to produce the largest therapeutic window between 1 and 50 mg. Researchers also make note that studies with better outcomes were using higher doses of CBD. One drawback to using CBD for treatment of anxiety, pain, or other uses will often be that dosages are a relative experience making it difficult to know exactly what will work for what condition. More research is needed to conclusively determine what the exact number will undoubtedly provide consistent relief.





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