Last updated on: 1/10/2020 | Author:

Should Cannabidiol (CBD) Be a Medical Option?

General Reference (not clearly pro or con)

Amy Abernethy, MD, PhD, Principal Deputy Commissioner of the US Food & Drug Administration (FDA), said in a Nov. 25, 2019 statement titled “FDA Warns 15 Companies for Illegally Selling Various Products Containing Cannabidiol as Agency Details Safety Concerns,” available at

“In line with our mission to protect the public, foster innovation, and promote consumer confidence, this overarching approach regarding CBD is the same as the FDA would take for any other substance that we regulate…

We remain concerned that some people wrongly think that the myriad of CBD products on the market, many of which are illegal, have been evaluated by the FDA and determined to be safe, or that trying CBD ‘can’t hurt.’ Aside from one prescription drug approved to treat two pediatric epilepsy disorders, these products have not been approved by the FDA and we want to be clear that a number of questions remain regarding CBD’s safety – including reports of products containing contaminants, such as pesticides and heavy metals – and there are real risks that need to be considered.”

Harvard Women’s Health Watch wrote in an Aug. 2019 article titled “CBD Products Are Everywhere. But Do They Work?,” available a

“Cannabidiol is one of the two best-known active compounds derived from the marijuana plant. The other is tetrahydrocannabinol, or THC, which is the substance that that produces the ‘high’ from marijuana…

CBD does not get you high, but… some CBD products do contain small amounts of THC.

While CBD can come from marijuana, it can also be derived from hemp. Hemp is a related plant with 0.3% or less of THC. This plant is often used to make fabrics and ropes. As of 2018, Congress made hemp legal in all 50 states, and consequently CBD derived from hemp is also legal. The rules around marijuana-derived CBD, however, are far less clear…

The bottom line is that in order to understand whether CBD is legal where you live, you’ll need to consult your state health department website or professionals in your community.”

Laura Sanders, PhD, neuroscience writer at Science News, wrote in a Mar. 27, 2019 article titled “The CBD Boom Is Way ahead of the Science,” available at

“Produced by the cannabis plant, CBD is the straitlaced cousin of marijuana’s more famous component — the THC that delivers a mind-swirling high. CBD, or cannabidiol, has no such intoxicating effects on the mind. Yet the molecule has captured people’s attention in a profound way, sold as a remedy for pain, anxiety, insomnia and other ailments — all without the high…

Scientists still don’t know all of the targets CBD hits in the human body, nor what effects it may have, if any. With the exception of tests in people with rare forms of epilepsy, large studies that compare CBD with placebos in people are rare. Much of the existing research was done with cells in the lab or in lab animals, with results that don’t necessarily translate to people.”

Timothy Williams, New York Times writer, stated in May 6, 2019 article titled “CBD Is Wildly Popular. Disputes Over Its Legality Are a Growing Source of Tension.,” available at

“CBD, short for cannabidiol, is a chemical compound derived from the cannabis plant, but one that does not result in a high. It has become wildly popular during the last several months because of claims that it helps with a variety of ailments, from anxiety and diabetes to headaches and menstrual cramps…

Marijuana is rich in THC, or tetrahydrocannabinol, the psychoactive component; it can account for as much as 40 percent of the total cannabinoid content. Hemp, on the other hand, is richer in CBD, and generally contains only 0.3 percent THC or less. CBD oils, which are processed from the hemp plant, are legal to possess under the new federal law [2018 Farm Bill] as long as they, too, contain no more than 0.3 percent THC…

Most states, though, have yet to change their laws to match the new federal rules, leaving local police and prosecutors in a quandary over what is legal and what is not.”

Peter Grinspoon, MD, primary care physician and instructor at Harvard Medical School, wrote in his Aug. 24, 2018 article titled “Cannabidiol (CBD) — What We Know and What We Don’t,” available at

“CBD stands for cannabidiol. It is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, which is a cousin of the marijuana plant. While CBD is a component of marijuana (one of hundreds), by itself it does not cause a ‘high.’…

CBD is readily obtainable in most parts of the United States, though its exact legal status is in flux. All 50 states have laws legalizing CBD with varying degrees of restriction, and while the federal government still considers CBD in the same class as marijuana, it doesn’t habitually enforce against it. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials…

CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to antiseizure medications.”

Penn Medicine wrote in a Nov. 7, 2017 press release titled “Penn Study Shows Nearly 70 Percent of Cannabidiol Extracts Sold Online Are Mislabeled,” available at

“There is interest in CBD as a medicine because there is some evidence that it has medical benefits, but it does not make people feel ‘high’ and there is no indication that CBD, by itself, is abused. Recent research has shown potential therapeutic effects of CBD for young children with rare seizure disorders, and patients in states where cannabis or CBD have been legalized report using it for a variety of health conditions. Business experts estimate that the market for CBD products will grow to more than $2 billion in consumer sales within the next three years. While interest in this area continues to grow, little has been done to ensure regulation and oversight of the sale of products containing CBD.”, an informational website and search engine, wrote in its article “What Is Cannabidiol?” (accessed Sep. 26, 2011):

“Cannabidiol is a cannabinoid and a major component of the cannabis plant, or marijuana plant. By itself, cannabidiol lacks the psychoactive effects most commonly associated with marijuana use yet still retains many of the medicinal benefits, such as its anti-seizure and anti-inflammatory effects. The legal status of cannabidiol varies from country to country. In the United States, for instance, it and all other phytocannabinoids are classified as Schedule I controlled substances, making possession or ingestion illegal.”

Sep. 26, 2011

The International Association for Cannabinoid Medicines, an international non-profit cannabinoid association, wrote in its “Cannabidiol” page on the website (accessed Sep. 28, 2011):

“CBD, or cannabidiol, is the major non-psychotropic cannabinoid found in Cannabis. It has shown anti-epileptic, anti-inflammatory, anti-emetic, muscle relaxing, anxiolytic, neuroprotective and anti-psychotic activity and reduces the psychoactive effects of THC [D9-tetrahydrocannabinol, the primary psychoactive ingredient in marijuana]. The mode of action of cannabidiol is not fully understood and several mechanisms have been proposed…”

Sep. 28, 2011

Project CBD, a non-profit educational service dedicated to promoting and publicizing research into the medical utility of cannabidiol, wrote in its “About Cannabidiol” page on the website (accessed Sep. 28, 2011):

“Cannabidiol —CBD— is a compound in Cannabis that has medical effects but does not make people feel ‘stoned’ and actually counters some of the effects of THC…

Scientific and clinical studies indicate that CBD could be effective in easing symptoms of a wide range of difficult-to-control conditions, including: rheumatoid arthritis, diabetes, alcoholism, PTSD, epilepsy, antibiotic-resistant infections and neurological disorders. CBD has demonstrated neuroprotective effects, and its anti-cancer potential is currently being explored at several academic research centers in the U.S. and other countries.”

Sep. 28, 2011

PRO (yes)


Peter Grinspoon, MD, primary care physician and instructor at Harvard Medical School, wrote in his Aug. 24, 2018 article titled “Cannabidiol (CBD) — What We Know and What We Don’t,” available at

“CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to antiseizure medications. In numerous studies, CBD was able to reduce the number of seizures, and in some cases it was able to stop them altogether. Videos of the effects of CBD on these children and their seizures are readily available on the Internet for viewing, and they are quite striking. Recently the FDA approved the first ever cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.

CBD is commonly used to address anxiety, and for patients who suffer through the misery of insomnia, studies suggest that CBD may help with both falling asleep and staying asleep.

CBD may offer an option for treating different types of chronic pain. A study from the European Journal of Pain showed, using an animal model, CBD applied on the skin could help lower pain and inflammation due to arthritis.”


The US Department of Health and Human Services (HHS) wrote in its Oct. 7, 2003 United States Patent #6,630,507 “Cannabinoids as Antioxidants and Neuroprotectants” on the website

“Cannabinoids have been found to have antioxidant properties… This new found property makes cannabinoids useful in the treatment and prophylaxis of wide variety of oxidation associated diseases, such as ischemic, age-related, inflammatory and autoimmune diseases. The cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease and HIV dementia. Nonpsychoactive cannabinoids, such as cannabidiol, are particularly advantageous to use because they avoid toxicity that is encountered with psychoactive cannabinoids at high doses…”

Oct. 7, 2003


Raphael Mechoulam, PhD, Lionel Jacobson Professor of Medicinal Chemistry at the Hebrew University of Jerusalem, et al., wrote in their 2007 paper “Cannabidiol – Recent Advances” in Chemistry and Biodiversity:

“CBD… has been shown to produce a plethora of pharmacological effects, many of them associated with both central and peripheral actions… The plethora of positive pharmacological effects observed with Cannabidiol make this compound a highly attractive therapeutic entity in inflammation, diabetes, cancer and affective or neurodegenerative diseases.”



Teresa Iuvone, PhD, Professor of Experimental Pharmacology at the University of Naples Federico II, et al., wrote in their Feb. 13, 2009 paper “Cannabidiol: a Promising Drug for Neurodegenerative Disorders,” in CNS Neuroscience and Therapeutics:

“The great therapeutic value of CBD, either given alone or in association with THC, derives from the consideration that it represents a rare, if not unique, compound that is capable of affording neuroprotection by the combination of different types of properties (e.g., anti-glutamatergic effects, anti-inflammatory action, and anti-oxidant effects) that almost cover all spectra of neurotoxic mechanisms that operate in neurodegenerative disorders (excitotoxicity, inflammatory events, oxidative injury, etc.).

The reported data here, taken together with the evidence of the CBD’s almost absolute absence of side effects, including psychotropicity, suggest its great efficacy and open new horizons for the treatment of the main neurodegenerative disorders!”

Feb. 13, 2009


The Beckley Foundation, a charitable trust that promotes the scientific investigation of consciousness, wrote in its Oct. 6, 2010 page “Cannabidiol” on

“Cannabidiol (CBD), a constituent of herbal cannabis, has attracted much interest recently as a promising medicine. After being discovered in the early 1970s it was quickly established that CBD has anti-convulsant and anxiolytic properties in animal models and in humans… Work in the 1980s and early 1990s suggested CBD had anti-psychotic properties and could be an effective treatment for schizophrenia…

In the last decade or so many other properties of CBD have been characterised… CBD has potent anti-inflammatory properties and is a neuroprotectant… CBD appears to protect, not just neurons, but heart muscle from injury. Several groups in the US and UK are pursuing this line which has massive implications for clinical practice. Perhaps even more dramatic is recent work from Mechoulam’s lab which suggests that CBD can restore normal pancreatic functioning in models of type 1 diabetes. The list of putative indications for CBD include…


  1. anxiety
  2. temporal lobe epilepsy
  3. schizophrenia


  1. Rheumatoid arthritis
  2. Type 1 diabetes


  1. Stroke
  2. Head injury


  1. Acute myocardial infarction


  1. Glioma

CBD exhibits an impressive plethora of therapeutic uses, including anticonvulsive, sedative, hypnotic, antipsychotic, anti-inflammatory and neuroprotective properties. CBD is well tolerated in humans, with a profile of very low toxicity, and is devoid of psychoactive and cognitive effects.”

Oct. 6, 2010


Paul Armentano, Deputy Director of the National Organization for the Reform of Marijuana Laws (NORML), wrote in his Oct. 9, 2008 blog post “Is There Anything CBD Can’t Do? Then Why Is It Illegal?” on the website

“While the prohibition of cannabis is absurd, the ban on the plant’s non-psychoactive components is even more mind-boggling — particularly when it’s apparent that these compounds possess amazing therapeutic properties. Case in point: cannabidiol (CBD)…

Studies have suggested a wide range of possible therapeutic effects of cannabidiol on several conditions, including Parkinson’s disease, Alzheimer’s disease, cerebral ischemia, diabetes, rheumatoid arthritis, other inflammatory diseases, nausea and cancer…

[T]he past 45 years of scientific study on CBD has revealed the compound to be non-toxic, non-psychoactive, and to possess a multitude of therapeutic properties. Yet, to this day it remains illegal to possess or use (and nearly impossible to study in US clinical trials) simply because it is associated with marijuana.

What possible advancements in medical treatment may have been achieved over the past decades had US government officials chosen to advance — rather than inhibit — clinical research into CBD…? “

Oct. 9, 2008


Ruth Gallily, PhD, Berthan and Max Densen Professor Emerita of Immunology at the Hebrew University of Jersualem, et al., wrote in their July 20, 2010 approved patent application #7759526 “Pharmaceutical Compositions Comprising Cannabidiol Derivatives” available on the website

“The present invention relates to cannabidiol… and to pharmaceutical compositions comprising cannabidiol… being anti-inflammatory agents having analgesic, antianxiety, anticonvulsive, neuroprotective, antipsychotic andanticancer activity…

CBD… has been shown in in vitro assays, in animal tests, as well as in some human, preliminary trials, to produce numerous pharmacological effects… which are of potential therapeutic value… [R]ecent reports describe the in vitro effects of CBD on immune cells… These in vitro studies lend support to earlier reports on analgesic and anti-inflammatory effects in animals…

CBD has been found to produce several, potentially therapeutic, effects in animal models, as well as in patients with neurological diseases… in anxiety… and in psychosis… CBD is a neuroprotective antioxidant.”

July 20, 2010

CON (no)


Peter Grinspoon, MD, primary care physician and instructor at Harvard Medical School, wrote in his Aug. 24, 2018 article titled “Cannabidiol (CBD) — What We Know and What We Don’t,” available at

“Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.”


The US Department of Health and Human Services’ (HHS) Office of Public Affairs at the Food and Drug Administration (FDA) wrote in a Sep. 30, 2011 email to

“It is important to know that the statements in the patent document [United States Patent #6,630,507  Oct 7, 2003] about the purported medical benefits [of cannabidiol] are based on in vitro data (antioxidant properties of this class of molecules, neuroreceptor binding studies, neuronal cell cultures, etc.), and in vivo rat studies. In order to make a determination that these compounds have a role in medical treatments, clinical data would be needed.

‘Does this patent indicate the US government’s position that cannabidiol has medical value?’ ‘no,’ (since that would be done through the NDA [New Drug Application] process and not the patent application process)…

DEA is responsible for administration of the Controlled Substances Act (CSA). DEA has determined that cannabidiol is a Schedule I substance because it is derived from marijuana… which is also listed in Schedule I. Marijuana is defined under the CSA to mean all parts of the plant, as well as every compound and derivative and preparation, etc. of the plant.

Thus far, an [NDA] for cannabidiol has not been submitted to the FDA that shows that cannabidiol can be used therapeutically. Thus, cannabidiol has no accepted medical use in medical treatment in the United States. Having ‘accepted medical use in the United States’ of a drug is a necessary finding for drugs that are not in Schedule I, but listed in a less restrictive, Schedules II through V. Thus, currently Schedule I is the only possible CSA schedule where cannabidiol could be listed.

This is not to say that cannabidiol cannot be studied for development or to support rescheduling. Delta-9-tetrahydrocannabinol (THC, dronabinol) was developed as an antiemetic and treatment for AIDS wasting and approved for marketing under the trade name Marinol. Marinol is listed in Schedule III. All research on cannabidiol would need to be conducted under a Schedule I license issued by the DEA.

An investigator wishing to remove cannabidiol from Schedule I would have to demonstrate that cannabidiol has NO abuse potential in order for it to be decontrolled. This would probably necessitate conducting studies to demonstrate that its pharmacology differs from other substances that have high abuse potential and that cannabidiol is not being abused by individuals…

Consideration of rescheduling or decontrol could be initiated by petitioning the DEA and providing all available and relevant data in the petition.”

[Editor’s Note: also emailed two additional questions below to HHS on Oct. 6, 2011. As of May 29, 2012, we have not yet received a response.

“1. Has HHS allowed other government agencies or private parties to use its patent?

2. Has HHS filed other patents regarding substances between drug code #7350 and drug code #7380? If so, could you please provide a list or direct us to where we could obtain such a list?”]

Sep. 30, 2011


The Drug Enforcement Administration’s (DEA) Office of Congressional and Public Affairs wrote in a Sep. 27, 2011 email to

“Cannabidiol is currently controlled in schedule I under the drug code for marijuana, 7360. The drug code 7372 for cannabidiol is used by DEA only for internal record-keeping purposes. DEA is currently working on a Final Rule to establish the drug code for marihuana extract as 7350.

In July 2011, DEA published a Notice of Proposed Rulemaking (NPRM) in the Federal Register. The NPRM proposes the establishment of a new drug code for marijuana extract independent of the drug code for marijuana and tetrahydrocannabinols. Drug codes are linked to DEA registrations and provide specificity as to the substance/drug/or chemical each registrant canpossess under their registration. The codes are also used for internal tracking purposes.

The Single Convention on Narcotic Drugs, 1961, requires statistical reporting to the United Nations on the use and production of marijuana and marijuana extract for the medical and scientific needs of each party of the treaty. The statistical reports for marijuana and marijuana extract have to be reported separately for the U.S. to be in compliance with this treaty…

Cannabidiol has always been a schedule I controlled substance listed under marijuana…

The Department of Health and Human Services (DHHS) is the U.S. competent authority for determining whether a substance is safe and effective for medical use and for approving a drug product for marketing in the United States. DEA would therefore defer to DHHS for any related questions…

The Federal Register notice published in FR Vol 57 10499-10508, 1992, details the issues and criteria for determining accepted medical use…

DEA performed an outreach to the scientific community to obtain data on the current state of research and abuse potential of cannabidiol. DEA’s scientific review involving cannabidiol depends upon reliable and peer-reviewed scientific studies which are still being gathered as they become available.”

[Editor’s Note: also emailed five additional questions below to the DEA on Oct. 5, 2011 and received confirmation on Oct. 6, 2011 that they were forwarded to the appropriate DEA Section Chief for comment. As of May 29, 2012, we have not yet received a response.

“1. Since drug code 7372 is used by DEA only for internal record-keeping purposes, could you please provide all the internal drug codes between 7350 and 7380 along with which substance they correspond to? Since we had seen the drug code 7372 on DEA Form 225 on the DEA website we did not realize that internal codes existed.

2. When do you expect that DEA will complete its work on a Final Rule establishing the drug code for marijuana extract as 7350? A specific deadline would be ideal, but a ballpark estimate would also be useful.

3. Which substances would be classified under the new drug code 7350?

4. Will cannabidiol itself be classified under 7350 since it does not contain ‘cannabidinols AND cannabidiols’ as specified in the proposed drug code?

5. How will the new 7350 classification affect the DHHS patent [United States Patent #6,630,507 (185 KB) Oct 7, 2003] on cannabinoids and cannabidiol if at all?”]

Sep. 27, 2011