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In February, the Ministry of Health announced that it had begun ordering all the city's restaurants and bars to stop selling products containing CBD, citing a December FDA decision stating that 39, it is "illegal to add CBD to food or drink". The embargo has been postponed until this summer, and the city council member (and chair of the health committee), Mark Levine, told Gothamist that he was working on a bill to prevent corruption. # 39; ban. But it is unclear when it will be ready by the June 30 deadline and local business owners are still wondering if their CBD-based products are governed by the new rules and how they can be made. Adapt to the changing landscape of the CBD.
It's not as if things were much clearer for CBD users. CBD, for example cannabidiol, is one of the 80 naturally occurring active compounds found in cannabis plants. But he misses the psychoactive tetrahydrocannabinol, the THC, the compound that gives the weed its extra courage. As this does not elevate you, CBD applications seem to have no limits.
Two years ago, you probably would not have found many people who had even heard of the CBD; now, it's an ubiquitous product available in corner bodegas. Even now, you would still have trouble finding someone who could explain exactly what the CBD does.
People claim that it can help with a wide variety of illnesses, from insomnia and anxiety to Crohn's disease and fibromyalgia. It has become the ultimate link between the well-being industry, the flourishing legal cannabis industry and the alternative medicine community. This has also been the subject of much media hype and skepticism, particularly because very little research has been done and there has been even less surveillance of any kind – Recent study evaluating dozens of CBD-based products ordered online revealed that nearly 70% were not labeled accurately.
In the hope of trying to separate facts from fiction, we spoke to Dr. Orrin Devinsky, director of NYU Langone's Comprehensive Epilepsy Center, who has been closely studying the CBD since 2013. He led the studies which led the FDA to approve the first drug containing CBD, Epidiolex, which is used to reduce seizures associated with severe forms of epilepsy.
What scientific conclusions have you gathered about the use and benefits of the CBD? CBD is a unique molecule. It works on a variety of receptors in the brain, some of which are relatively unique to CBD, and the combination of working on more than six different receptors in this way is quite unique for CBD. We proved [its effect], and this has led to the approval of the CBD by the FDA to treat several rare syndromes of epilepsy in this form of CBD. Epidiolex is now on the market and available for patients with these disorders.
However, there are many additional data from animal studies and small human studies that suggest that CBD could have beneficial effects on a variety of other disorders, including: anxiety to autism, via sleep induction in people with insomnia, sleep disorders and inflammatory disorders. it has a very wide range of potential uses. However, apart from the small number of epileptic disorders that I have described, everything else is largely anecdotal, although sometimes supported by animal data. We are really at the stage where we have to get a lot more information.
Do you think people have taken the lead in asserting that they could be used to treat a wide variety of diseases? Its popularity has exploded over the past year. Yes, I think there is no doubt that in the progress of medicine and science, we try to do it through carefully designed and executed tests in which the doctor or the doctors investigators, as well as the patients or children of the parents who are studying. , none of them knows what drug it is, because everyone is biased. And with the CBD, there is so much hype and religion – and I'm talking about religion in that there's a large amount of belief without a significant amount – and in some cases without any data – at that time. # 39; support.
And keep in mind that CBD is a medicine. Yes, that's natural, but our double-blind studies have taught us that in some cases, some very serious side effects have caused some people to quickly leave some of the clinical trials they've been involved with, [like] significant weight loss, diarrhea, elevated liver enzymes. It is therefore a drug that interacts with other drugs and is something that, although natural, has potential benefits and risks, like all medicines.
"… for those who consume CBD, if you take it alone or after a high carbohydrate meal, you absorb about 4 to 6% of the CBD.If you take it after a high fat meal, you can absorb 16 at 20% – it's a huge difference. "
What do you recommend to people who are interested in CBD, and who see it in their restaurant or local bodega and want to try to buy it and take it? I think they should ideally be educated about it. They should read about it. They should try to go to websites or other sources from reputable organizations. One solution is to access a site such as PubMed, the National Library of Medicine. And if you type cannabidiol, you will probably have several thousand items, [especially] if you are interested in using it to treat anxiety, autism or insomnia. You can add this keyword and at least start to see what is the scientific data.
It is also important to know what dose you are taking, as with any medication. For example, many people, such as an adult with anxiety, could take 300 to 600 milligrams a day in studies that have shown benefits. And yet, it's a dose, if you get it from one of Colorado's or California's renowned online sources that will send a hemp-derived CBD to locals. " New York State, this can cost you between three and four hundred dollars a month. So many people will use a much lower dose, but the effectiveness of these low doses has not been demonstrated. So, I think everyone does not think that it is the next panacea that will cure all the ailments they suffer, and whose data are far from sufficient.
And this is particularly difficult, because I understood that there was no way to recommend a dosage to patients: everyone reacted differently to doses. And what we've said, it's that we have to do some tests and mistakes, which seems very imprecise from the point of view of a layperson. Yes, and I think one of the problems you mentioned is that of a bodega. Now, if you go to a bodega, even if they have the same supplier who gives them the "CBD", you do not know who the mix is, how much the lots of what they contain are consistent, how they make their muffins or whatever you do. are consuming. So, the dose can vary a lot, even going to the same place and thinking that you get exactly the same dose, there could be a variation of two, three, or four.
How much is considered inconsequential then? I think it varies from person to person, as with any medication or medication. Some people are extremely sensitive and others are remarkably insensitive. In general, I think that 30 milligrams for an adult would be a very low dose of CBD, although some people may experience some beneficial effects or side effects. Many others take between 100 and 600 milligrams or more a day.
On top of that, very few lay people are aware of it, but I think it's a critical point: for anyone who consumes CBD, whether it's taken alone or after a high carbohydrate meal, you do not have to. Only absorb four to six percent of the CBD. While if you take it after a meal high in fat, you can absorb up to 16 to 20%. It's a huge difference. So as it is expensive for people who use it as a medical agent to treat different disorders, even if it's a 30 milligram capsule coming from A reliable supplier, you must take it with a meal or a snack with high fat content. And that could be something from olive oil to guacamole avocado to a few bites of a ribeye steak. But something with fat in it will greatly improve the absorption and value of your dollar.
It's fascinating because there has been an explosion among people who create CBD-infused food and sugar, as well as drinks containing caffeine and alcohol. And I asked myself a lot of questions about whether this actually increased the use of this product or whether it mitigated the effects. So it's complicated. I think if you add these things, most of these things like caffeine or alcohol just have not been studied, and I think when they have not been studied, scientists and doctors have tend to be humble and say, "I do not know what happens."
There is an interesting interaction between CBD and THC that has been very well characterized. THC stimulates a receptor in the brain, which leads to the psychoactive activity of THC, called CB1 receptor or cannabinoid one. It turns out that the CBD blocks this receiver – not very loud, but blocks it. So for people who consume a small amount of THC with a large amount of CBD, you eliminate considerably, if not completely, a lot of THC effects. So it's something to keep in mind because many people consume both together.
Yes, and there are CBD versions sold in some states that combine THC / CBD. Absolutely, including the state of New York. I am therefore a doctor in the states of New York and New Jersey and participate in the marijuana program for medical purposes of the state. And it's quite true. Most of the drugs you can prescribe, if we want to call them drugs from these medical dispensary programs, are a combination of CBD and THC. And then certainly for people who go to dispensaries in other states where it's legal or recreational, like California and Colorado, most of the things these clinics have are combinations. Although they may contain pure THC and pure CBD, most preparations have been combined.
Let me assure you that I understand, because it seems counterintuitive: do THC / CBD hybrid products really erase the effects of THC? Say, for example, that it is 20 milligrams of CBD and half a milligram of THC, which gives a much higher ratio than THC. There is enough CBD to dramatically reduce the effect of half a milligram of THC taken alone. So, the CBD will actually curb the psycho activity of THC. As far as we know, THC does not really affect what CBD does in many places where it acts in the brain, and in some places it actually seems to act in the same way on these other receptors. But on the CB1 receptor, the one that gives THC its highly productive or psychoactive properties, CBD is actually a light blocker of this receptor while THC stimulates the receptor.
You have examined the effects of CAD on convulsive patients. Now that Epidiolex is on the market, what is your research about? I have participated in other trials on CBD and CBDV, another related cannabinoid in the treatment of people with autism. And I am also interested in anxiety disorders.
Have you had any preliminary findings or ideas about the effect of CBD on anxiety? Because I know that is one reason why many people cite why they are interested in taking it. I think there is some evidence that CBD can help some people with anxiety. I found it in my practice as a prescriber in New York and New Jersey. However, this is anecdotal and I think we desperately need more rigorous science, which many of us are trying to do right now.
Have you ever used CBD for yourself? I do not have it. No, thankfully, I have no medical condition going for which I need it, so I have not taken it.
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