Before diving in on the research on CBD oil, we will start with the recent regulatory changes. The perspective of the United States’ government has shifted in the last 12 months due to new rulings and legislation.

NOTE: The following is a review of regulatory changes in the United States only. Always be sure of the legal status of any products you buy or use.

Is CBD oil legal to buy?

The United States Food and Drug Administration (FDA) approved the first-ever, marijuana-derived pharmaceutical drug on June 25, 2018. Epidiolex, derived from CBD, was approved for the treatment of two pediatric seizure disorders.

Following the announcement by the FDA, the United States Drug Enforcement Agency released their own statement which classified Epidiolex in schedule V of the Controlled Substance Act. Per the law, drugs are classified into 5 different categories (schedules) “depending upon the drug’s acceptable medical use and the drugs’ abuse or dependency potential.” Schedule I contains drugs considered to have no medical benefit (e.g., heroin, LSD, methaqualone, marijuana). In contrast, schedule V contains drugs with very low potential for abuse (e.g., cough syrups with low amounts of codeine, antidiarrheals).

Then, on December 20, 2018, The Agriculture Improvement Act of 2018 (Farm Bill 2018) was signed into law. A provision in the bill legalized “hemp, a species of cannabis that CBD can be extracted from but that isn’t psychoactive.”

The passage of the legislation resulted in a statement from Scott Gottlieb, M.D., the commissioner of the FDA. Gottlieb noted that the FDA still considers CBD a drug and, as such, it is illegal to put into foods/health products without approval from the FDA.

What does this all mean?

While there are pathways for approval now, most products currently on the shelves are not compliant with the regulations. A CBD oil product is de-scheduled so long as it was produced using legal hemp and does not make improper health claims. As pilot programs from the 2014 Farm Bill make it to market, and states adopt the changes of the 2018 Farm Bill, there will be an increase in these products.

Looking for more information? NORML provides information on the status of marijuana (both recreational and medical), hemp, and medical CBD for every state.

Okay… so what is CBD oil?

Cannabidiol, also known as CBD, is one of the extracts of the cannabis and hemp plants (Cannabis sativa) that is under research for its use in chronic diseases. Commonly taken from the hemp plant, CBD is a non-psychoactive chemical compound. CBD is different from Tetrahydrocannabinol (THC), the compound in cannabis associated with the “high.” Products can contain CBD alone or CBD with THC.

Because it does not cause a “high,” CBD extracts may provide relief without inhibiting a person.

CBD oil can come in a range of forms including:

• Ingestible
  • liquid drops or tinctures
  • pastes
  • pills
  • chewing gum
  • cooking oils
  • edibles (gummies, brownies)
• Smokable
  • eLiquid or vape cartridges
• Topical
  • patches
  • salves or balms
  • lotions

Dosage, time until onset, and duration of effects vary by method. Be sure to read labels closely!

Cannabinoids, the many chemical compounds that make up cannabis, are found naturally in the body. Through these body systems, medical cannabis may help regulate the sensations of pain and pleasure, the processes of thinking and memory, body movement, the awareness of time, and appetite regulations.

According to the World Health Organization (WHO) studies show that CBD has some antioxidant, anti-inflammatory, and immune-system regulating effects. CBD may also change how the brain responds to pain, making it feel less intense and reducing the need for pain medication. This gives it a lot of potential use for people with lupus.

CBD oil & lupus

Studies on cannabis have found potential for using CBD oil as a way to reduce lupus symptoms. Many of  these studies are conducted with small numbers of participants or rely on anecdotal reports. However, the research is beginning to paint a compelling picture regarding the efficacy of CBD.

A 2010 review published by the HHS government agency details the effects that cannabinoids have on the body. CBD goes directly to the immune cells and cause weak or damaged cells to die off. They also suppress T-cell responses, a major source of inflammation. This weakens the immune response, protecting cells from being attacked by the overactive immune systems of people with lupus. A 2015 report published in the Journal of the American Medical Association  (JAMA) that looks specifically at multiple sclerosis implies that  CBD may also directly protect nerve cells from autoimmune damage.

They interfere with a particular cytokine called IL-6, which is associated with inflammation-related tissue damage and joint pain. CBD has also been tested in experimental mouse models for many autoimmune disorders, and are being moved to testing in human models.

There are many clinical trials in the works on how CBD oil might help with inflammation. For now, though, we have a plant extract with a high potential to help and a low potential for habit formation and side effects. As interest – and funding — increases for using CBD oil to treat autoimmune diseases, this evidence will come.

Things to consider

Just like with medications, it is possible to have interaction effects between medications and CBD. Be sure to talk to your lupus treatment team about any potential interactions before starting any new treatments.

Also, any smokable products provide additional risks. The smoke can damage lung tissue, increase cancer risks, and contribute to inflammation. Only get your CBD oil from a reputable distributor.

If you do use CBD oil, you should also be vigilant and make sure that it doesn’t trigger a symptom flare. Though CBD has an immune system suppressing effect, you may have an allergy or be sensitive to the cannabinoid. In general, CBD is traditionally well tolerated with a good safety profile.

If you’re looking at products, be wary of overstated claims for health benefits. While the research is promising, individual products have likely not been validated via a clinical trial. And, keep your eyes out for new research.