Science Vs - CBD: Weed Wonder Drug?

Episode Date: November 15, 2018

CBD mania is in full swing and people are using it for just about anything, but what is this chemical in cannabis? In this week’s episode, we tell you unlikely origin story of CBD and if the science backs up the hype. We speak to Paige Figi, neuroscientist Prof. Kent Hutchison, clinical researcher Dr. Mallory Loflin, and Josh and Joel Stanley. Check out the transcript right here: http://bit.ly/2OVCfub Selected references: Mallory’s study showing most CBD products are labeled inaccurately and 1 out of 5 has some THCReview discussing all the possible things CBD is binding to in the brainNational Academy of Sciences report on cannabis and cannabinoids Clinical trial showing CBD reduces seizures for treatment-resistant epilepsy  Credits: This episode was produced by Kaitlyn Sawrey with help from Wendy Zukerman, along with Rose Rimler, Meryl Horn and Odelia Rubin. We’re edited by Blythe Terrell, with help from Caitlin Kenny. Fact checking by Michelle Harris. Mix and sound design by Emma Munger. Music by Emma Munger and Bobby Lord. A huge thanks to Professor Elizabeth Thiele, Professor Cinnamon Bidwell, Professor Celia Morgan, Associate Professor Ziva Cooper, and Associate Professor Didier Jutras-Aswad, as well as Sindu Gnanasambandan, Mathilde Urfalino, Frank Lopez, Joseph Lavelle Wilson and the Zukerman Family. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman and you're listening to Science Versus from Gimlet Media. This is the show where we pit facts against 420. On today's show, CBD. CBD is a chemical that's extracted from cannabis and it's all the rage right now. So, I'm at a very bougie coffee shop in Brooklyn to try it out. We are in the heart of Williamsburg. There's lots of plants around and wicker furniture. The clientele is Brooklyn fancy.

They kind of look like bankers who at some point in their lives wanted to be screenwriters. And I'm here with senior producer Caitlin Sori, who at one point in her life wanted to do hard-hitting journalism. There's a lot of subtle geometry in the woodwork here, have you noticed? But she's now stuck with me, talking to our very friendly barista, Will, who walked us through this new CBD craze. Who tends to order CBD stuff?

I feel like the most open-minded people you'll ever meet here in Williamsburg, honestly. Will told us that most of his customers add CBD to take the edge off. If you feel stress on your shoulders, it kind of helps it drop a little bit because people think that you're going to go on this euphoric adventure having CBD. It's like, nah, it helps you just, like, feel a little bit more relaxed. It's like getting a 10-minute massage, like a nice quickie and you're in and you're out. But online, people claim this chemical

can do way more than a massage. They say it reduces pain, helps with sleep, makes you lose weight and can even clear up your acne. Here's how the menu at the coffee shop sold its benefits. This high-potency tincture reduces stress and anxiety, pain, inflammation and promotes balance of mind and body. And so, Will told us that he likes to add CBD to a bunch of stuff, including his coffee...

It's like you get your boost, but you also feel a bit more relaxed at the same time. ..and his smoothies... That's why I love it. It's just so good. And his little shots of juice. Look at Vitality shots. This all sounds very chill, but this is a cannabis extract. Is it legal? I believe so. I mean, we're selling it, so I think it is legal.

It's everywhere. You see everywhere in Williamsburg and New York City in general, so I'm assuming so. OK, so we looked into this and CBD isn't exactly legal. It's a Schedule 1 drug. The feds put it in the same category as heroin. But there is some grey area here and the Drug Enforcement Administration, the DEA, told us that they're

generally not going after people who are using CBD. So, all right, I'm going to do it in the coffee. All right, so I'd say do a latte with cashew milk and CBD. Done. Sold. That's my favourite. I got you. Okay, here goes. My first CBD. Initial thoughts? Oh, it tastes like... You know what?

Like, I am a massive nerd and I haven't had pot that often, but it does taste a bit like pot. Are we going to be very chilled out at work today? You're about to have the best day of your life. It all starts right here. OK, so it wasn't the best day of my life, but maybe I did feel a little less anxious. And this CBD taste test really got me thinking,

what exactly is CBD and how did we get here? Where a trendy barista is casually adding a cannabis extract to my morning coffee? Well, it turns out that the story about how this thing got so huge has nothing to do with Brooklyn hipsters. It was actually a matter of life and death. And that story is coming up just after the break. It's season three of The Joy of Why, and I still have a lot of questions. Like, what is this thing we call time? Why does altruism exist?

And where is Jan Eleven? I'm here, astrophysicist and co-host, ready for anything. That's right. I'm bringing in the A-team. So brace yourselves. Get ready to learn. I'm Jan Eleven. I'm Steve Strogatz. And this is Quantum Magazine's podcast, The Joy of Why. New episodes drop every other Thursday, starting February 1st. What does the AI revolution mean for jobs, for getting things done? Who are the people creating this technology? And what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI with the most human issues at the center.

Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. Welcome back. Today, we're tackling CBD, a substance found in pot, and we're starting with the unlikely tale of how it went from being virtually unknown to becoming the coolest chemical around. Sorry, hydrogen peroxide.

OK, and our story starts a long way from trendy Williamsburg coffee shops. It was 2006, and in a small town in Colorado, at the foothills of the Rocky Mountains, Paige Figge had just given birth to twin girls. Everything was perfect, they were born healthy, everything was awesome, and they were a joy. Paige was settling into life with her two little girls but then something happened to one of the twins, Charlotte, when she was only three months old. I was getting her dressed and my husband was changing her diaper, I believe, getting her dressed and she started shaking and she was blue and convulsing. It was terrifying. I mean,

it's absolutely terrifying to see a healthy child that way. Paige and her doctors hoped that this was just a one-off. Sometimes babies have seizures and they never happen again. But that wasn't what happened here. Charlotte started having seizures again and again. And sometimes they went for hours. I think her longest was four hours long. And so they just started coming.

Years went on and it wasn't getting better. Paige sometimes took videos of the seizures for her doctors. And you can see Charlotte's entire body shaking and her eyes rolling back in her head. It's OK, honey. Mommy's here. Shh. Doctors gave Charlotte all these meds to stop the seizures. Paige thinks it was about 15 different drugs.

And nothing worked. We tried everything. We tried everything by the time she was two and a half, three years old. Everything. And some of them multiple times. Charlotte was eventually diagnosed with a rare form of epilepsy called Dravet syndrome. It has no cure and it's really scary. A lot of kids with Dravet's die before they're 10 years old.

And Charlotte's case was bad. She was on oxygen. She was fed through a tube. She didn't make eye contact. And I just felt like we were keeping her body alive in between a seizure every 30 minutes. By the time Charlotte was five, doctors were already planning for the worst. Paige signed a do not resuscitate order for Charlotte, which meant the hospital wouldn't revive her if she stopped breathing. Paige said Charlotte was having so many seizures that she was hardly conscious,

and she told Caitlin Sorey, our senior producer, about one particularly terrible night. She never slept at that point in her life, and so her and I were in the kitchen, downstairs in the kitchen, and I was just holding her and rocking her, and she was screaming, and then she fell into a seizure. And this time the seizure, instead of going on and on for an hour or two, it just stopped and she went lifeless in my arms. And then I just started doing CPR right there. But that's rare that that works. So it was kind of, it wasn't like, come on, Charlotte,

you know, get through this. It was me saying goodbye. Were you almost feeling like perhaps at this point it's better if she does? Absolutely. It was, I wanted her to be at peace. I was saying it's okay. I love you and it's going to be okay. And just to let go. And just hoping she would. I mean, at that point it was just to let go, and just hoping she would.

I mean, at that point, it was just so bad. You're just hoping. Whatever happens after you die, go there, and it's okay. And I was giving her my blessing to die. Charlotte didn't die that night, but Paige knew she may only have a few weeks to live, and it was clear she was in pain. So Paige started hunting for something that could help her die as peacefully and painlessly as possible.

And Paige figured, well, we're in Colorado, medical marijuana was legal, and cancer patients were using it for their pain. So she thought maybe marijuana could help Charlotte. I know that sounds crazy, and I'm not this, you know, way-out-there hippie mom. It was just like, whatever. Whatever works. Paige started researching marijuana, trying to figure out what strains might be good for Charlotte's pain. And she found something unexpected.

Paige stumbled across some small studies from decades ago about a particular chemical in marijuana, CBD, or as it's known in the literature, cannabidiol. Now, this chemical didn't seem to get you high, but it could do something else, something potentially amazing for Charlotte. In these small studies, CBD looked like it could prevent seizures. So Paige dives into the research to find out everything she can about CBD.

She calls scientists from around the world. I called everybody all day, and they could hear her seizing in my arms on the phone. And it turned out that very few researchers knew anything at all about CBD and seizures. The science was kind of flimsy. But Paige had nothing to lose, so she decided to try it on Charlotte.

Her next step, finding marijuana with high levels of CBD. And this turned out to be harder than you might think. There wasn't a big market for that kind of weed. I went to every dispensary. I called every person. I remember my last dispensary I visited. I had called them. They said, we've got this stuff. It doesn't get you high. It doesn't get you high at all. And I said, that sounds really promising. So I went down there, cloud of smoke. You could see the smoke coming out of the back room. They had smoked it.

They had smoked the last little bit of this that they had. What? They wanted to see. They're like, yeah, you know, it really doesn't get you high. And I just felt like, I'm done. I'm done with this whole, I'm done with all of this. And I quit in that moment. Yeah. Thanks to these bozos at the dispensary, Paige's shot at getting CBD for Charlotte went up in smoke. And Paige thought, you know what?

I give up. This is never going to happen. But then the phone rang. One of those people I had called, called me and he said, I got this guy. I'm going to send him to your house. He's a pot grower and he knows some stuff that might interest you. I'm like, now I'm done. I quit today. Thank you so much. And the doorbell rings. The guy on the phone had given Paige's address to the pot grower. And now the pot guy was on her doorstep. And he was about to completely change Charlotte's life. That man that came to my door that day was Joel Stanley. Joel Stanley.

She was nice. But you could tell, you know, I was the pot guy. Here's another damn pot grower, right? But then we started talking and it quickly turned into her realizing that we had exactly what she was looking for. Joel, who kind of looks like a lost Winklevoss twin, had grown a strain of cannabis with tons of CBD in it. He did it for his small medical marijuana business that Joel had with his brothers. In fact, they all called this strain hippie's disappointment because it didn't get you high. So Joel starts telling Paige all of this. And then right in front of him, Charlotte has a seizure.

So violent, you know, just this uncontrollable shaking, eyes kind of roll back in the head. And these parents, like Paige Figge, they're so used to it. They'll continue the conversation while you're kind of sitting there in shock. You look over by the door and there's a bag packed for the hospital. That's how these folks live. Joel was a bit freaked out, though, and he wasn't sure about giving his pot to five-year-old Charlotte. So he talked to his brothers about it, since they all run the business together. I would say the brothers had a bit of a response like mine, like, wait a minute, wait a minute. You want to give some of our cannabis to a five-year-old who's about to die? Hold on a second.

Joel and his brother Josh told us how stressful making this decision was. Here's Josh. We had that conversation, do you remember? That was right, that was what we said. What if she were to pass on from a seizure? Right after taking, you know, this by coincidence, we talked about, you know, who would get more jail time, you or me, or Jesse or John. Jesse and John, they're more Stanley brothers.

There's seven in total. And yes, their names all begin with J. And now, these brothers had to decide if they were going to go out on a limb to help a mum they'd only just met. They did some serious thinking and even spoke to Charlotte's doctors who gave them the go-ahead. After all, these docs didn't have any good options left. So the brothers ultimately decided to help. They reduced the CBD pot down to an oil and then Paige gave it to her little girl.

And that was the moment she stopped seizing. She just stopped. Yep, she's having a seizure every half hour. She didn't seize for a week. At first, Paige thought, no, this can't be the CBD. I didn't believe it. I honestly didn't. I don't mean like I was astounded.

What I mean is I didn't believe it was working. But weeks, months went by, and while Charlotte's seizures didn't go away entirely, the difference was huge. Paige says Charlotte went from not talking and being fed via a feeding tube to running around with her siblings. She feeds herself now.

She's started school. She walks. She rides a now. She's started school. She walks. She rides a bike. She can talk. And so she's just a kid running around. You know, she's special needs, but she has a life again. It's just a total 180.

Charlotte, say, hi. Hi. Yes. Charlotte, they're mommy. Hi. Yes. Charlotte, they're mommy. Mommy. Oh. The Stanley brothers ended up naming their CBD after little Charlotte. Instead of hippies' disappointment, they called it Charlotte's Web.

And this is where things really started taking off for CBD and the Stanley Brothers. Once the epilepsy community got word of what CBD could do for Charlotte, desperate families with no other medical options wanted to get some. Before Charlotte's story went viral, the Stanley Brothers only had a supply for about 50 people. Soon, they had a waiting list of 15,000. We would have people that would find out where we lived, where I personally lived, and knock on the door to explain to me why their child needed to be moved up on the waiting list

and why they were worse than another. It was impossible to keep up with any of it. It was so heavy. Since Charlotte's story, scientists have run several clinical trials testing if CBD can help with some kinds of epilepsy. And it can. Not in all kids, but it has a big enough effect that the FDA approved a CBD-based drug this year,

and it just hit the shelves. And while the epilepsy community was getting very excited about CBD, the internet also got a hold of it. There were tales around the web of this great new chemical that didn't just cure epilepsy, but also aches and pains. Demand for this stuff was skyrocketing, and the Stanley Brothers fast became one of the biggest CBD suppliers in America.

I mean, there are millions of consumers now, right? Some portion of those are reporting experiencing amazing results for one reason or another. And people are buying it for all sorts of things, like anxiety. That's the number one reason we see people buying now. Then, number two, people are saying sleep. And then also some people are using that have cancer. Some people are using that have MS, Parkinson's.

Alzheimer's. Rheumatoid arthritis. Lupus. Before too long, Gwyneth Paltrow's goop started spiking cocktails with CBD, and Joe Rogan was using CBD lotion for his injuries. And these claims have really snowballed. Just last year, some websites were even suggesting that CBD could treat cancer. The Stanley brothers got in trouble with the FDA for linking to a website like this.

They're more careful now. But still, Josh is keen on the powers of CBD. He wants to see people taking it every day, like a vitamin. We'd like to see this in everyone's medicine cabinet as a therapeutic, a nutritional therapeutic. Okay, so CBD arrived on the scene as almost a miracle cure for some types of epilepsy. And now it's exploded into this phenomenon where people are using it to treat just about anything. So after the break, what can science tell us about this chemical? Will CBD live up to the hype?

That's coming up. . live up to the hype. That's coming up. Welcome back. Before the break, we heard the story of Charlotte Figge, the girl whose recovery from severe epilepsy whipped up a frenzy around CBD. And now people say that CBD can help with all kinds of things, from pain to depression and anxiety and even clearing up acne. And it seems kind of crazy that CBD could do all these things. But the industry and CBD fans say that they have science on their side. Hey, guys, Dr Josh Axe here along with... They say that this extract can do all this stuff because of a complicated system in the human body

that interacts with CBD, and it's called the endocannabinoid system. Endocannabinoid system. The endocannabinoid system is thought to play a role in a bunch of things like regulating our immune system and even influencing our emotions. And it does this through a network of receptor sites that are found throughout our brain and our body. Now, CBD advocates say that their chemical has this amazing ability to fit into these receptor sites like a key into a lock,

like Gwyneth Paltrow to a vagina egg. We have receptors in our physiology for CBD. This is a really big deal that we have these receptors in our body that directly bind the plant. They say that by interacting with this complex system, CBD can make you feel better, reduce your anxiety and dampen down inflammation. And speaking to the Stanley brothers,

they told us that CBD binds to these receptors. Here's Joel. So there's much more to understand. What we do know is that, let's say, CBD for the CB2 receptor site does fit like lock and key. All over the internet, you hear this basic idea, and it really adds scientific legitimacy to using CBD for all sorts of things. The only problem is this story, the lock and the key.

For CBD, it doesn't seem to be true. Yeah, scientists have looked at this all sorts of ways, and they're like, dude, CBD is not binding to those receptors in the endocannabinoid system. Or, as researchers put it in a review paper, this idea, quote, has now been largely dismissed, end quote. The truth is, we don't know what CBD is doing. We talked about this with Kent Hutchison, a professor and neuroscientist at the University of Colorado.

So, you know, we don't even know the mechanism yet in terms of how CBD works in the brain, right? I mean, there's maybe some hints in the literature in animals, but even that is pretty sparse. That is kind of crazy. We really don't know even, like, how it would be possible. Yeah, it's totally crazy. So it doesn't look like CBD is latching onto these receptors.

It could be affecting the endocannabinoid system in some other way, or maybe not. It's one of the many possibilities. There's just a lot science hasn't figured out yet. And while many scientists, including Kent, do think that CBD is doing something and shows promise, largely because it's helping kids like Charlotte. The research is so new that other than epilepsy, we've hardly got any clinical trials here. There's a few encouraging studies on pain, a little on mental health,

and here's what Kent said when Caitlin asked him about the research on anxiety. What's the most convincing study you've seen that CBD could help with anxiety? So, you know, I mean, honestly, there haven't been any convincing studies. This is the problem, right? This is where we're at. There haven't been any convincing studies yet. And I think we are waiting for that convincing evidence that actually does something helpful for people with anxiety. And it seems like people who want science on CBD will be waiting for a little while. And this isn't just because science takes time. In the case of CBD, it has another hoop to jump.

CBD is a Schedule I drug. And that means if Kent or any other scientist wants money from the U.S. government to study it, it's really tough. There's a bunch of rules here. They can't just buy CBD online and then study its effects. Yeah, so even though I just had some CBD in my morning coffee... As scientists, we can't touch the stuff, right? It doesn't matter how many dispensaries there are here in Boulder, Colorado. It doesn't matter that the state legalized it, you know, whatever, six years ago. That's kind of bonkers. Like, that must be so frustrating.

Oh, it's totally frustrating, right? Because, you know, even talking to you, I'm getting a little discouraged as I realize more and more how little we know, right? But at the end of the day, we're going to see, you know, again, maybe it works for some things. And the middle list is not, you know, too long after all. What all this means is that when people sing the praises of CBD for all sorts of conditions, we really don't know how this chemical is working. And we also don't know if it's working. Because some of what people are feeling could be due to an entirely different phenomenon. That's right.

Our old friend rhymes with placebo. Say it with me. Placebo. Even Joel Stanley, who made the original CBD concoction for Charlotte, acknowledges that placebo might be playing a role in the CBD mania. Is there some placebo? Because of all of the hype and the news stories coming out about CBD for this, that and the other reason, and the people talking on Facebook and Twitter and Instagram, is there some placebo going on out there? Absolutely. There is every time something good pops up. But that doesn't, we shouldn't detract from all the people that are receiving genuine benefit, whether it's drastic benefit or they just feel a little bit better. And that's a fair point. If you're using CBD and you're feeling better, that's great.

But before you start adding CBD to your morning coffee and evening cocktail, there's something you should think about. How do you know what is actually in these CBD products? Because nowadays, there's scores of them on the market. And it's not like birth control. I mean, this stuff isn't tightly regulated. And this is something that Mallory Loughlin, a clinical research scientist, has thought a lot about. You know, I have more faith in what's in a candy bar

than I have in something that people are using to treat medical conditions, primarily mental health and neurological conditions. That's insane. Mallory just did a study with her colleagues from the Institute for Research on Cannabinoids. They analysed what was inside over 80 CBD products. And so, what did they find? Oh, the overwhelming majority were not accurately labelled. 70% had labels that didn't match the stuff inside. Yeah, 70%. They either had too much or't match the stuff inside. Yeah, 70 percent. They either had too much or too little CBD in them. And while that's not great, what is perhaps more concerning is that

one in five of the products had some cheeky THC in them. This is the psychoactive chemical in weed that gets people high and gives them the munchies. It's probably not something you want in your coffee before work, unless you're running a billion-dollar electric car empire. But seriously, Mallory told us about this one report of a few kids who are acting funny after taking CBD for epilepsy. The doctors tested them and they were positive for THC, and so they were intoxicated. They were high?

They were high. Oh. And their parents thought they were positive for THC. And so they were intoxicated. They were high? They were high. Oh. And their parents thought they were giving them pure CBD. They thought they were treating them. They were giving them something non-intoxicating. So they weren't expecting their kid to get high. And yeah. Yeah.

THC in your CBD? It can happen. Now, one thing to note about Mallory's research is that her team got funding from the weed industry. But the findings do hold up. When the FDA did a similar analysis a few years ago, they also found a few products of CBD had some wacky tobacco snuck in. OK, so that's one risk, getting high when you'd rather not be. And what if you're just getting CBD?

Is that safe? Well, while we haven't followed people who use CBD in the long term, from the studies we do have, it doesn't have serious side effects. In the clinical trials, some people got diarrhoea, nausea or felt tired. When I took it, I did get sleepy. I had a nice nap. CBD? More like CBZ. Oh, jeez.

Anyway, there is also evidence that sometimes CBD can interact with other medications, things like antidepressants and some blood thinners. From what we're seeing clinically, we're not seeing anything too bad, I guess I'd say. But again, we don't know. There's not enough studies on this. Time will tell. But yeah, folks should definitely be aware. At the end of the day, CBD does seem pretty safe, but it's still early days, so it's tough to know for sure. So when it comes to CBD, does it stack up? Well, CBD can really help some people with epilepsy, which is pretty amazing.

So we know that this chemical is doing something to our brains. But we're waiting on hard data for a lot of the other claims about anxiety and sleep and pain and everything else that people are using CBD for. Here's my prediction, though. Like every other wonder drug before it, CBD will probably turn out to work for some people for some things. Maybe sleep, maybe anxiety,

maybe it'll just end up helping kids like Charlotte. Staring into the crystal ball a year from now, I don't reckon you'll be so jazzed about adding CBD to your coffee. There will be a new thing in town and, like always, we'll be here to rain on your parade. That's Science vs CBD. Hey, Caitlin. Sorry. Hey, Wendy. So how many citations in this week's episode?

Over 100. We cracked the centennial? Sure. It's been a long week. If people want to read these citations, where should they go? They can go to the show notes in your podcast app. You can just click on it and you'll see the transcript right there or you can go to the website

scienceversus.show Thanks Katie. Thanks Wendy. This episode was produced by Caitlin Sorey with help from me, Wendy Zuckerman along with Rose Rimler, Meryl Horn and Odelia Rubin. We're edited by Blythe Ter, with help from me, Wendy Zuckerman, along with Rose Rimler, Meryl Horn and Odelia Rubin. We're edited by Blythe Terrell, with help from Caitlin Kenny. Fact-checking by Michelle Harris.

Mix and sound design by Emma Munger. Music written by Emma Munger and Bobby Lord. A huge thanks to Professor Elizabeth Teal, Professor Cinnamon Bidwell, Professor Celia Morgan, Associate Professor Ziva Cooper and Associate Professor Didier Houtres-Azoard, as well as Frank Lopez, Joseph Lavelle-Wilson and the Zuckerman family.

Next week, the seven-minute workout. Can you work off that Thanksgiving turkey in just seven minutes? I'm not in the mood to work out. I'm in the mood to be a whinger. There's no whinging allowed in the seven-minute workout. There's simply no time. I'm Wendy-minute workout. There's simply no time. I'm Wendy Zuckerman. Back to you next time.