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Cannabidiol: Overview, Complexities, and Opportunities for Behavioral Health

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Cannabis in Psychiatric Practice

Part of the book series: Psychiatry Update ((PU,volume 3))

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Abstract

Cannabidiol (CBD) was first isolated from the cannabis plant in 1940, but it was not until 1963 that this cannabinoid compound’s molecular structure was identified—a foundational discovery for understanding its actions and how it might be used therapeutically. CBD is a non-intoxicating component of the cannabis plant, and its mechanisms of action are complex, involving a multiplicity of molecular targets, signaling systems, immune mechanisms, and more. CBD appears to be relatively safe (compared to other medications and drugs), which in part explains its vast proliferation in the U.S. and global markets purportedly to treat a wide array of symptoms and conditions. Epidiolex®, a plant-derived oral formulation of CBD, is the only FDA-approved medication, used for the treatment of several forms of severe epilepsy in children. Research is needed to evaluate the many other health claims made for CBD, including its potential therapeutic value in treating several conditions that currently have few or no safe alternative approaches. However, a complicated and evolving legal and regulatory framework has presented barriers to conducting research, including clinical trials; and most existing data on CBD have been collected in preclinical studies. Consumers are advised to exercise caution in the use of CBD products currently being marketed, since adequate oversight is lacking, which has resulted in inaccurate product labeling and inappropriate product claims. Moreover, important dosing and safety data are lacking, including effects of chronic use and among certain populations (e.g., pregnant women, older adults). And physicians should be cautious in making recommendations to their patients, ensuring that they are aware of the risks associated with purchasing unregulated products and using them in lieu of known effective treatments. This chapter will briefly review the history of CBD’s discovery; its current legal status; its mechanisms of action; unknowns and concerns about the efficacy, safety, and quality of CBD products; and its potential clinical applications in neurology and psychiatry.

The views and opinions expressed in this chapter are those of the authors only and do not necessarily represent the views, official policy, or position of the U.S. Department of Health and Human Services or any of its affiliated institutions or agencies.

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Authors and Affiliations

  1. Division of Extramural Research, National Institutes of Health, National Institute on Drug Abuse, Bethesda, MD, USA

    Susan R.B. Weiss & Katia Delrahim Howlett

Authors
  1. Susan R.B. Weiss
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  2. Katia Delrahim Howlett
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Correspondence to Susan R.B. Weiss .

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Editors and Affiliations

  1. Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA

    Paula Riggs

  2. Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA

    Thida Thant

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R.B. Weiss, S., Delrahim Howlett, K. (2022). Cannabidiol: Overview, Complexities, and Opportunities for Behavioral Health. In: Riggs, P., Thant, T. (eds) Cannabis in Psychiatric Practice. Psychiatry Update, vol 3. Springer, Cham. https://doi.org/10.1007/978-3-031-04874-6_3

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  • DOI: https://doi.org/10.1007/978-3-031-04874-6_3

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