By Ronni Shulman
In over 30 U.S. states that have legalized medical marijuana, cannabidiol (CBD) oil has become the hottest new product. The non-intoxicating marijuana extract is being credited with helping treat a host of medical problems from epileptic seizures to insomnia. Does medical marijuana help alleviate Raynaud’s symptoms? That’s a question we’re often asked. The answer, though, is unclear.
In online forums, many Raynaud’s sufferers claim they find relief. But scientific evidence is scarce, hampered by federal laws that still consider marijuana a Schedule 1 drug (in the same category as heroin). Only one purported use for cannabidiol, to treat epilepsy, has significant scientific evidence supporting it. CBD’s usefulness as an anti-inflammatory medication is promising, but those results come mostly from animal studies, experts said.
Cannabidiol is extracted from the flowers and buds of marijuana or hemp plants. It does not produce intoxication, Marijuana’s “high” is caused by the chemical tetrahydrocannabinol (THC).
In past decades, some research found that THC may help treat pain, nausea, loss of appetite and other problems, while CBD was thought to be biologically inactive in humans. But in the past 10 years, scientists have concluded that CBD may be quite useful.
It’s not clear how CBD works. This is partly because it stimulates multiple biochemical pathways, which may account for its wide range of effects. The compound is a powerful anti-inflammatory and antioxidant, and it increases levels of the neurotransmitter serotonin as well as another molecule, anandamide, which reduces pain and anxiety.
But studies have raised concerns about possible interactions with other drugs. Timothy Welty, chair of the department of clinical sciences at Drake University’s College of Pharmacy and Health Sciences, in Des Moines, Iowa, said epilepsy studies found that “there were very clearly increases in the blood levels of some other anti-epileptic drugs when people were on CBD.” There also is some indication that CBD might harm the liver, he noted.
States in which medical marijuana is legal offer a variety of strains that combine various ratios of CBD and THC. The formulas with a higher ratio of THC provide users with mild mind-altering effects commonly associated with marijuana. Patients report that the higher level of THC helps combat stress and insomnia, and may reduce or eliminate their reliance on other drugs used for those purposes.
“CBD oil is a really powerful compound,” says Mikhail Kogan, the medical director of the George Washington University Center for Integrative Medicine. “I’ve seen it work for a lot of my patients.” He prescribes high-CBD strains of cannabis regularly for such illnesses as epilepsy, post-traumatic stress disorder, anxiety, autoimmune disorders, autism and insomnia. Although CBD oil has not yet been studied for Raynaud’s patients, some speculate that a reduction in stress — if scientifically proven — can help patients whose Raynaud’s attacks are triggered by stress. Ingesting the drug by smoking it, however, would not be a recommended option because smoking reduces blood flow.
As more states are legalizing medical marijuana, acceptance by the public is growing. This has led some states to do an about-turn with their laws. In Florida, for example, voters approved the legalization of medical marijuana in 2018 after having rejected such a proposal two years before. To obtain the drug, patients must be approved by a specially trained medical marijuana-certifying physician and then must obtain a card from the Florida Health Department’s Office of Medical Marijuana Use.
There are more than a dozen “qualifying conditions” to meet, such as cancer, Crohn’s Disease, glaucoma and multiple sclerosis, but some conditions are broadly defined. For example, one on the list is defined as “chronic nonmalignant pain caused by a qualifying medical condition or that originates from a qualifying medical condition and persists beyond the usual course of that qualifying medical condition.” Scleroderma, lupus and other medical conditions that some secondary Raynaud’s patients have are included under that definition.
Unlike states where recreational marijuana is legal, Florida does not offer edible products like gummies and cookies that have been a concern in other states such as Colorado (because of the potential of appealing to children). The most popular choice for medical marijuana users is vaping pens. Other choices include tinctures, sprays, lotions and transdermal patches.
CBD is also known to interact with several medications. Before starting to use these products, discuss it with your doctor to ensure your safety and avoid potentially harmful interactions.
Even proponents of the drug agree that CBD medicine remains largely unexplored: Treatments are not systematized, many products are not standardized or tested, and patients are generally left to figure out dosing on their own. While some suppliers and dispensaries test the CBD and THC levels of their products, many do not.
The one conclusion on which most agree is that more research is needed.