Updated: Feb 23, 2021
This article was first posted a year ago. However when clients ask us about using CBD, or even when we bring it up, we refer them to this essay. Thus we have pinned it so that they may access it more easily.
Please note that once again this represents our personal views, in a language which we hope clients will find useful. We are not saying it is correct, some of it may be simply wrong, but it is our current level of understanding in a very fluid field of study. I’m sure there are those who will jump in to correct me, (there is a very vocal pro-cannabis lobby), and that is welcomed. Even if much of what is said here isn’t quite correct, hopefully clients will know more about the situation after reading it than they did coming in.
So last year I was attending CE at the RIVMA meeting and there was a lecture by the pre-eminent feline behaviorist in the country. (Better her than me…) She was discussing anxiety treatments, and when it came time for questions naturally query #1 was ‘You didn’t mention CBD oil. What do you think?’ In the haughty manner that tends to predominate in the ivory tower of academics and top rated specialists she replied ‘No idea, no data. Next question.’ Now, as we shall see, that is actually probably a very accurate scientific statement, however it simply isn’t good enough for us GP grunts in the trenches trying to help our clients to understand what the heck is going on.
So last month I attended seven hours of CE on CBD at the NEVMA meeting in Maine. (The VMA part of these associations means Veterinary Medical Association, Rhode Island and New England respectively). We were hoping to get some good objective information, though all the lectures were sponsored by CBD manufacturers. That is the way of medicine these days. Some quotes from the introduction ‘The Endocannabinoid system is the greatest breakthrough in medicine since vaccinations.’ ‘The endocannabinoid system’s ability to modulate and modify the nervous system will allow interplanetary space travel’. Yes, that is a quote. (Rough translation - ‘It’s gonna be a LONGGG day.’) Yes, I am purposely avoiding using the lecturers’ names, despite using a couple of their short quotes, lest I be get into trouble for misrepresenting them.
So what is this wonder drug, what does it do and why does it cure everything? First a little basic background. The hemp plant is of the genus Cannabis, so the substances it produces are called cannabinoids, (cannabis drugs). There are two main ones - CBD, the fairly benign one we will be discussing here, and THC, the psychotropic (mind altering) drug we most definitely will NOT be discussing here. By definition, if it contains less then .3% THC it is hemp, if it contains more then .3% THC it is marijuana.
So what does it do?
Well to answer that we have to review a little high school biology. (Yes, I know. Sorry.) Nerves communicate across gaps called synapses, which control the amount of nervous activity produced. The pre-synaptic neuron, (the one before the synapse) , when firing off sends chemicals called neuro-transmitters to the post- synaptic neuron which causes it to then fire off as well. (In our visual aid below think of God as the pre-synaptic neuron and Adam as the post-synaptic). So these chemicals are produced in the pre-synaptic neuron and attach to receptors in the post-synaptic. The endo-cannabinoid system runs the other way - chemicals produced in the post-synaptic neuron travel backwards to the pre-synaptic, providing feedback and helping to control how much the post synaptic neuron will fire. (It’s kinda like those students traveling from New England to Long Island to go to college and seeing everyone else going the other way.) This is actually quite similar, it would seem, to the action of drugs like Prozac, which blocks the neurotransmitters. We suppose you could look at Prozac as a sledgehammer and cannabis as a scalpel .Both modify the transmitters, but Prozac merely blocks them while cannabis can more subtly adjust them.
What does this mean? Well, suppose you are traveling down Rte 95 and someone cuts you off and gives you the finger. So you start fuming ‘Man when I catch up to him you know what I’m going to do? I am SO going to do this and that to him!!!’ In essence there is an electrical cascade in your brain responding to adrenaline and over reacting. And Prozac, by calming down the activity , works to block that cascade and get matters back under control. Think of separation anxiety in the dog who grows increasingly panicky when he hears the car start in the driveway, and starts tearing the paneling off the wall. A similar cascade to our highway situation. And if anxiety is nothing more than an over reaction in your nervous system to a non- threat then this buffering action can be very useful.
This, then explains the wide variety of potential uses for CBD. In essence, it can be useful whenever there is a harmful effect caused by overstimulated nerves, which can mean anything from the pain caused by inflammation to anxiety. While most talk of veterinary CBD use is about behavior, a study from the Cornell Veterinary school suggested it was quite useful for the pain of osteoarthritis, such as hip dysplasia. One condition where I, though a pronounced sceptic, would seriously consider it is the ‘acral lick granuloma’. This is an ‘OCD’ type condition where a dog will self mutilate his skin to the point of an ulcerated sore on his wrist due to anxiety, boredom etc. - similar to the person who habitually chews their nails until they bleed. For example, an active Labrador boarded in a kennel for a week might well develop such a habit, and it might continue and worsen when they get home. Because CBD might have a benefit against both the triggers to the continuation of this problem - the mental component and the pruritus (itchiness) caused by the inflamed area, this is an area where we might suggest it’s use.
Make no mistake, there is a lot of gobbledygook going around about CBD. Lectures are full of ‘emerging science’, ‘work in progress’ ,’mechanism poorly understood’ , which are all major ‘yellow flags’ for this supposedly miracle drug full of mysterious wonderful effects which transcend actual science. For example, to quote from the lecture I attended, ‘Cannabis dosing guidelines must incorporate an understanding of the product’s molecular profile, the influence of the individual molecules on multiple body systems, the synergistic effect of and between these molecules, and the individualized response of each patient.’ Sorry, when that dog comes in who has been chewing at his foot and I suggest we try CBD I’m just not going to do all that to choose a dose.
There is a LOT of money changing hands here, and there are fanatic adherents shouting down any suggestion of objective skepticism. We indeed did get some in, as of this writing I have not sold any . (Trust me, this is NOT a promotional infomercial. If you suspect that it is I suggest you reread it. ) However the potential beneficial effects should not be written off, nor should our impressions and reactions to the drug, positive or negative, be impacted by absurd notions like ‘its weed,’ or its cool because its a little naughty.
Hopefully this helps our clients to understand. At the very least it will save my long suffering staff from having to listen to a ‘What do you think about CBD oil?’ lecture a dozen times a day.