If you follow the headlines, you know that many states have legalized the medical use of cannabis, the plant more commonly known as marijuana or hemp.

Recent development: An increasing body of scientific evidence shows comparable medical benefits from an extract of the marijuana/hemp plant that does not contain the psychoactive compound tetrahydrocannabinol (THC), which causes that signature high.

Known as cannabidiol, or CBD, it most often is taken in a formula that combines other related plant compounds (cannabinoids and terpenes) for much greater efficacy. CBD has been the focus of more than 8,000 published studies showing that it can help with a variety of common health problems.

To learn how CBD is being used, Bottom Line Health spoke with Hyla Cass, MD, a leading integrative physician who has recommended it for many of her patients.


CBD’s therapeutic effects are tied to the body’s endocannabinoid system (ECS), a complex “communication system” that was discovered by Israeli scientist Raphael Mechoulam, PhD. The ECS is comprised of cannabinoid receptors found throughout the body to balance vital functions, including the central nervous system and the cardiovascular, hormonal and immune systems.

When there’s an imbalance in the ECS, conditions such as anxiety and pain develop. CBD helps rebalance this messenger system. Here’s how CBD can help with…


Widely used antianxiety medications, such as alprazolam (Xanax), lorazepam (Ativan) and clonazepam (Klonopin), to mention a few, are highly addictive and commonly cause side effects, including drowsiness, dizziness, fatigue, headaches and blurred vision. CBD, on the other hand, is equally effective, much safer and rarely produces side effects (see below).

Scientific evidence: A review article published in Neurotherapeutics looked at a variety of experimental and clinical data and concluded that the evidence “strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder.”


Staggering numbers of people who suffer from chronic pain become addicted to opioid pain medications or, worse, die of an overdose. But CBD can often relieve chronic pain—without the risk for addiction.

Scientific evidence: In both human and animal studies, CBD is increasingly being studied for a variety of pain-relieving effects. For example, a study published in British Journal of Pharmacology found that CBD was “safe and effective” in the prevention and reduction of neuropathic pain due to the chemotherapy drug paclitaxel.


CBD can prevent seizures in patients with epilepsy. It also has been miraculous for children with Dravet’s syndrome, a condition that can cause hundreds of seizures a day and has not been effectively treated with medication.

Studies are also under way to determine whether CBD can help slow the progression of Alzheimer’s disease and Parkinson’s disease. In addition, I often advise patients in my integrative medical practice, where I treat various conditions, to try CBD for painful health problems such as fibromyalgia, Crohn’s disease, irritable bowel syndrome and migraine…to help relieve depression and improve sleep…and to help wean off prescription drugs, such as narcotics, antidepressants, antipsychotics and antianxiety drugs.


Based on my clinical experience, CBD can be used effectively and safely for the conditions described earlier. Side effects are rare—generally sleepiness, diarrhea and weight gain (or weight loss).

Important: Even though CBD has a good safety profile, you should check with your doctor before trying it if you are taking medication. Certain medications, including chemotherapy agents, anti-epilepsy drugs and the blood thinner warfarin (Coumadin), may be affected. For a list of potential drugs that may interact with CBD, go to MedLinePlus.gov and search “cannabidiol.”


Even though hemp-derived CBD oil is legal in many states, the federal Drug Enforcement Agency still classifies CBD as an illegal narcotic due to its association with the marijuana plant. To avoid any issues related to the federal regulations, which are being sorted out in the courts, CBD products often are labeled “hemp oil.”

When using this type of CBD product, follow label instructions for dosing, starting low and gradually increasing the dose until you get the desired result. Response to CBD is very individualized. If you have questions, you can consult a health-care professional who has experience prescribing CBD. More and more integrative medicine practitioners are learning about and prescribing CBD in their practices. CBD is available for oral use in tincture and capsules. There also are lotions, creams and other topicals that are useful for arthritis, migraines and other painful conditions and skin ailments such as acne and psoriasis.

To ensure purity and quality: Look for a non-GMO hemp oil product that has a certificate of analysis (check the company’s website), stating the amount of the various cannabinoids and terpenes, and that it does not contain chemical solvents, pesticides, mold or bacteria. Most important, look for a reputable manufacturer, some of which are listed here: CV Sciences (CVSciences.com)…Charlotte’s Web (CWHemp.com)…and Elixinol (Elixinol.com). You also can purchase the CBD that I prescribe to my patients at CassMD.com/hempoil.

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