Sales of CBD products are increasing, highlighting “well-being” virtues. But scientifically, nothing has been proven about the possible therapeutic effects of cannabidiol.
An article to be found in the Magazine of theInserm n°56
On every street corner, CBD shops are popping up. Dedicated shelves are springing up in supermarkets and the Internet is not left out. If we trust the labels, cannabidiol does everything or almost: “pain reduction”, “anti-stress”, “anti-fatigue”, “stimulant”… What should we think of it? For now, science remains cautious. Clinical trials are lacking to confirm any therapeutic effects of CBD on anxiety, sleep or otherwise, or involve only too small cohorts of patients to be representative. ” CBD is not a patentable product as such, so few clinical trials are funded », indicates Tangui Barré, from the Economic and Social Sciences of Health and Medical Information Processing laboratory (Sesstim) in Marseille. Some avenues are still being researched, such as using CBD against addictions.
Substitute THC with CBD?
In mice, a meta-analysis carried out in 2019 by French teams from Inserm seems to indicate that the use of CBD induces a reduction in alcohol consumption and a very slight reduction in liver damage. It remains to be seen whether these effects are transposable to humans. Benjamin Rolland, from the Vinatier hospital center in Lyon, will launch the Caramel studya first clinical trial on the treatment of alcohol dependence with CBD, in the second half of 2023. At the same time, Clémence Casanova, post-doctoral researcher at Sesstim, is working on the acceptability of such a treatment.
On the cannabis addiction side, can the use of CBD alone, without THC, be a good substitution? Unlike THC, CBD does not cause addiction. A study conducted by Tangui Barré of 1,500 people showed that 11% of them used CBD to reduce their cannabis consumption, with success in just over half of the cases. ” CBD could reduce cannabis use. Mais impossible to substitute brutally and completely in case of dependencecar CBD does not bind to the same receptors as THC in the system endocannabinoïdeexplains Bruno Revol, from the Grenoble addiction monitoring center. On the other hand, it attaches to the receiver serotonergic 5‑HT1A, so we can expect an anxiolytic effect, which could alleviate withdrawal symptoms. He is not without interest “, he continues. A predictable effect but which remains to be demonstrated. ” Just because a molecule clings to a receptor does not result in a therapeutic effect.moderates Nicolas Authier, specialist in pharmacology and addictology in Clermont-Ferrand. That patients affirm to feel beneficial effects is not a problem, provided that there is no loss of chances compared to a possible other treatment. »
No more prohibition around CBD
Only one cannabidiol drug is currently authorized in France, Epidyolex. It is reserved for the treatment of epileptic seizures associated with Lennox Gastaut syndrome and Dravet syndrome. Although the precise mechanism of action of CBD as an anticonvulsant is not known, it appears to reduce the hyperexcitability of neurons.
This unique therapeutic indication of cannabidiol does not prevent the market from developing widely. As Nicolas Authier, author of the Little Book of CBD : « France is the leading hemp producer in Europe, and the market for hemp extracts, excluding flowers, represents 700 million euros there. At the end of 2022, the Council of State lifted the last ban on cannabidiol, canceling the decree which prevented the sale of flowers and leaves with a THC content of less than 0.3%. In terms of public health, Nicolas Authier recalls that “ the major problem is not that these now authorized flowers contain CBD, but that they are smoked, often in combination with tobacco. Combustion has been proven to cause serious damage to the respiratory tract, including cancer », warns the pharmacologist.
A lack of labeling and quality control
More than 10% of French people have already tried a product containing CBD, according to a survey conducted by Tangui Barré and Sesstim. And 5% consume it at least once a week. If CBD does not actually cause addiction, the substance is still psychotropic because it interacts with receptors of the central nervous system. « Cannabidiol has psychotropic effects, but that does not mean that it is an addictive or therapeutic substance. », Details Nicolas Authier. Before pointing out that the molecule is found ” classified as a poisonous substance in the case of Epidyolex and unregulated in CBD shops. »
For specialists, this vagueness endangers consumers. ” CBD is not subject to regulatory quality control or labeling, says Tangui Barré. However, the products can vary greatly depending on the plant, the culture, the drying, the extraction… » Some may contain heavy metals or residues of phytosanitary products. As for the legal threshold of less than 0.3% THC, it may be enough to affect driving. Not to mention the undesirable effects that may appear, such as drowsiness, fatigue, diarrhea, loss of appetite… A recent study conducted in mice by Olivier Manzoni and Pascale Chavis at the Mediterranean Neurobiology Institute in Marseille even shows cognitive and communication deficits during exposure to CBD in utero.
Finally, there are risks of drug interactions. ” Even at low doses, CBD can interact with many molecules in the body, such as thyroid hormones, antiepileptics, antidepressants, blood thinners and anti-inflammatories. “, describes Tangui Barré. ” Overall, all so-called narrow therapeutic margin drugs, those that have a very specific mechanism of action, with a delicate balance between efficacy and toxicity, should be the subject of attention because CBD can distort the situation. sums up Bruno Revol. Enough to remain cautious in the face of sometimes very aggressive marketing strategies.
THC vs. CBD
THC (delta 9 – tetrahydrocannabinol) and CBD (cannabidiol) are both cannabinoids, found in cannabis. THC is illegal in France. It has significant psychotropic effects, and causes strong dependence with withdrawal syndrome upon cessation. CBD is authorized in France and does not present a risk of addiction.
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Source: www.inserm.fr
