CBD (cannabidiol) and THC Oil: Health Benefits and Risks

CBD (cannabidiol) and THC (tetrahydrocannabinol) Oil Use in COPD

Dear Dr. Mahler: My father is 81 yrs old and suffers terribly with advanced COPD. A few
Bottle of CBD (cannabidiol) and THC (tetrahydro cannabinol) used by the father

Bottle of CBD (cannabidiol) and THC (tetrahydro cannabinol) oil used by father of person submitting question

months ago he agreed to try cbd oil and has been making some progress in his condition.  I was wondering if when he has a flare up and is coughing terribly would a tincture of cbd oil help stop the coughing? He has been making great progress on the low thc cbd oil. Should he have a stronger dose of thc is my other question? Here is a photo of the bottle of oil that he is taking. Many thanks. Bridgett from Squamish, British Columbia Dear Bridgett: The photo of the bottle shows that the oil contains both CBD and delta-9 tetrahydro-cannabinol (THC). THC is the most well known compound in cannabis; it is psychoactive and gives the “high.” CBD is not psychoactive, but appears to produce changes in the body that may have medical benefits. Where Do CBD and THC Come From? Both are obtained from the plant cannabis sativa, which is also known as marijuana, grass, pot, dope, and Mary Jane along with many other names. However, there are varieties of cannabis sativa.
CBD (cannabidiol) is derived from the cannabis plant

Cannabis sativa plant

CBD (cannabidiol) comes from two main sources – medical marijuana plants and industrially grown hemp plants.  The medical marijuana plants are grown to be high in CBD, but also contain various amounts of THC. I don’t know the legal status in Canada. In the United States, they are sold to licensed dispensaries and prescribed by physicians for specific conditions depending on the state where you live. Medical marijuana is legal in 29 states and in the District of Columbia. CBD that comes from industrial hemp plants is totally different. In the United States, the Food and Drug Agency considers hemp oil to be a dietary supplement not a medication. It contains virtually no THC, and does not give a “high” feeling. For those readers who live in the US, you don’t need a prescription and can legally purchase CBD oil in any state.
Hemp oil contains CBD (cannabidiol)

Hemp oil in bowl and in syringe

How Does CBD and THC Work? All cannabinoids, including CBD and THC, attach themselves to certain receptors in the body. The two main cannabinoid receptors are called CB1 and CB2. CB1 receptors are found in brain and deal with coordination, movement, pain, mood, thinking, appetite, and memory. THC attaches to these receptors. CB2 receptors are more common in the immune system that deals with inflammation and pain. Potential Health Benefits of CBD CBD oil is taken by mouth, rubbed on the skin, or may be inhaled. One of the main uses is to relieve pain and stiffness. In one study involving rats and mice, CBD significantly reduced chronic inflammation and pain. CBD is already in use for humans who have multiple sclerosis and fibromyalgia – both of which can cause chronic pain. There is also promising evidence that CBD (cannabidiol) may help people quit smoking. It is also being studied as a treatment for anxiety, mood symptoms, epilepsy. difficulty sleeping, cancer, type 1 diabetes, acne, and Alzheimer’s disease. In one report of four individuals with COPD there was no difference in ratings of breathlessness when breathing a gas mixture of carbon dioxide (causes more breathing) with 10 mg of cannabidiol and a placebo (published in Chronic Respiratory Disease; year 2011; volume 8; pages 109-118). Potential Side Effects and Health Risks Small scale studies have found that CBD is well tolerated in adults. The most common side effect noted is tiredness, while some have noticed diarrhea and changes in appetite. Bridgett – I am glad that your father “has been making some progress.”   Although I am not aware of any studies evaluating whether CBD/THC affects coughing frequency, a search on the internet reveals that there are anecdotal reports (stories by individuals) that THC taken by mouth (not inhaled) reduced coughing fits. One report suggested that THC “latches onto the nerve cells in the upper airways of mammals and short-circuits the signals that cause coughing spasms.” My suggestion: it seems reasonable to continue the oil as it is working and not causing side effects. Any higher dose will require you and your father to “experiment” if you believe/consider that there is a reasonable likelihood that the benefit (less coughing) outweighs possible side effects. Thanks for such an interesting and challenging question. Donald A. Mahler, M.D.    

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.