What to know about vaping CBD

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Cannabidiol (CBD) is a compound derived from cannabis. Unlike tetrahydrocannabinol (THC), CBD does not produce a high. People use CBD in a wide variety of ways for its potential therapeutic effects, which may include:

• pain relief
• anti-inflammation
• anti-anxiety
• seizure and epilepsy treatment

CBD may also have antioxidant properties and may be toxic to some cells. Researchers are currently investigating the use of CBD in several disease states, including:

• neurodegenerative diseases
• anxiety disorder
• childhood diseases, such as tuberous sclerosis complex that has a prevalence lower than 5 in 10,000 individuals
• addiction

Approved uses and studies

Recently, the Food and Drug Administration (FDA) approved the use of Epidiolex, a CBD oral solution, indicated for use in Lennox-Gastaut or Dravet syndrome, which are rare forms of epilepsy.

In Canada and Europe, doctors can prescribe Sativex, which is a mouth spray that contains both CBD and THC to treat spasticity in multiple sclerosis.

According to the United States National Library of Medicine, there are currently 228 studies on CBD that are completed, active, or pending results.

People may also find CBD in commercial products, such as health and food supplements.

Challenges

One of the challenges that consumers and doctors face is the lack of standardized dosing and an understanding of what dose is therapeutic. Today, dosing recommendations for CBD are still unclear.

The challenge is extended further with the different routes of administration. People consume edibles, vape, and apply topical CBD to their skin.

Many people are now using e-cigarettes as a device for marijuana-based products, including CBD.

Studies on vaping CBD oil are lacking. Most clinical trials around CBD have focussed on oral capsules, sublingual sprays, or oral solutions.

People living with asthma and chronic obstructive pulmonary disease often use aerosolized therapies. This delivery system supplies the medication directly into the lungs, which results in a rapid clinical effect. Generally, people also need smaller doses compared with oral or subcutaneous injections.

The features of condensation aerosols can make vaping seem like a more effective method of taking CBD. However, since vaping is still a relatively new practice, researchers are unclear about its benefits and risks and need to conduct further investigations.

Learn more about vaping in general here.

In the United States, CBD extracted from the plant Cannabis sativa is still a Schedule I drug as the FDA have not approved its use for medicinal uses.

Also, the FDA do not regulate the manufacturing and labeling of CBD oil products in the U.S.

The condensation aerosols in vape pens can be useful delivery systems for drugs. However, an article in the Frontiers of Pharmacology warns that people must be aware that not all products contain the amount of CBD that the label suggests.

In one study, researchers analyzed two e-liquids, Cloud 9 Hemp Yellow Brick Road and Easy Rider. According to the label, each product consisted of 3.3 milligrams per milliliter (mg/mL) of CBD. However, researchers noted that Cloud 9 Hemp Yellow Brick Road had 7.6 mg/mL of CBD, and Easy Rider had 6.5 mg/mL. These deviations illustrate the consequences of a lack of regulation.

Without quality control, people have exposure to unknown doses of CBD, as well as other components that may carry risks.

According to an article in the International Journal of Environmental Research and Public Health, the oil may contain lower levels of CBD than the label lists.

This might occur because some oils may have been in storage for long periods under conditions that promote its instability. This can account for lower concentrations in the final purchased product.

Recently, doctors have reported several cases of severe lung injury in people who vape. According to a report from the CDC, as of February 2020, 2,807 people in the United States have received hospital treatment for e-cigarette, or vaping, product use-associated lung injury (EVALI). Of those people, 68 died.

The CDC recommends that people who wish to vape should:

• not use THC-containing e-cigarettes or vaping products from unreliable sources
• not use e-cigarettes or vaping products that contain vitamin E acetate
• not add additional ingredients to a vaping product

Vaping products and e-cigarettes are also not safe for youth, young adults, or anyone who is pregnant.

When selecting pens and formulations for vaping CBD, people should buy from reliable sources. All manufacturers make their products differently, and they lack the rigorous quality control that FDA-approved products undergo.

There are many pens and formulations available for purchase. Choosing an appropriate one is a challenging task, as there is a lack of evidence to support the use of vaping CBD for medicinal purposes.

Pain is the number one reason why people consume cannabis. However, at present, there are no studies that specifically evaluate the effect of vaping CBD on pain.

One review study evaluated the effect of cannabis-based medicines for chronic neuropathic pain in adults. The researchers suggest that the potential benefits of cannabis-based medicine may outweigh its potential harms.

This study did not focus primarily on CBD but explored the effects of herbal cannabis, plant-derived or synthetic THC, and THC and CBD oromucosal spray.

The researchers conclude that there is no high-quality evidence to support the efficacy of any cannabis-based product. At best, a few people with chronic nerve pain will benefit from long-term use of cannabis-based medicines.

Learn more about CBD use for pain management here.

Although some surveys show that people are using cannabis for pain, anxiety, and depression linked to insomnia, other studies do not demonstrate a consistent effect of CBD on depression.

However, researchers did find that formulations with high doses of THC may adversely affect mood.

Other studies show a greater level of depressive symptoms in chronic users of cannabis compared with light-users and non-users. One observational study demonstrated that over 50% of 1,400 study participants used cannabis for symptoms of depression, despite the lack of information on its efficacy.

Learn more about CBD and depression here.

Researchers have demonstrated that studies support the effects of CBD as a treatment for:

• generalized anxiety disorder
• panic disorder
• social anxiety disorder
• obsessive-compulsive disorder
• post-traumatic stress disorder

The effects were evident from acute dosing (short-term or a one-off dose). Researchers are unsure of the effects of chronic dosing (long-term, low-dose).

Although clinical data support the anti-anxiety effects of CBD, researchers need to carry out further studies to confirm these findings and determine appropriate dosing guidelines.

Still, many studies included oral dosing of CBD.

Those studies that used inhaled forms of CBD did not consistently show a positive effect on anxiety.

Learn more about CBD and anxiety here.

Each country, state, and province has its own laws and regulations surrounding the use of CBD.

CBD is still a Schedule I drug, as the FDA have not regulated it for general medicinal use. They have, however, approved the use of CBD to treat rare forms of epilepsy.

Despite many clinical trials and studies on the effects of CBD, researchers are still unclear on the exact medicinal purposes of CBD.

Most studies on CBD to date focus on oral forms of the compound, not vaping. Further studies are still needed to determine the specific benefits of vaping CBD.

People should be wary of the risks associated with vaping products, and researchers must continue to study the risks.

The Centers for Disease Control and Prevention (CDC) recommend against vaping, as the long-term effects are still unknown.