Should Climbers Take CBDs?

This article originally appeared on Climbing

CBD is all the rage these days. Sold in everything from tinctures to bath bombs to dog treats, it's widely touted as the cure-all of the decade. Like Starbucks or AirPods, CBD is everywhere, and with such a cult-following, it's hard not to get caught up in the hype.

"I love using the CBD salve after training on my muscles and fingers that really need it!" stated pro climber Alex Puccio on Instagram.

"As a climber, I use the salve on my finger joints/tendons after brutal days climbing and finger training to reduce some of the stress ...," wrote former USA Team boulderer Lisa Chulich on her blog. "I also used daily on my recent MCL tear to help reduce pain at night and inflammation. Beginning four days after the injury, I was very thankful to have access to the salve."

The claims are doctrine-like. If you believe them all, CBD can do everything from eliminate anxiety, help heal your tendons and sore muscles, get rid of acne, improve hair shine and more. But what even is CBD, and, more importantly, can climbers really benefit from it?

What is CBD?

Dr. Andrew Abeleira PhD, former Research and Development Analytical Chemist in the cannabis industry, explained: "CBD, like THC, is derived from Cannabis L. Sativa plants (a.k.a. Marijuana, weed or hemp), but has substantially different biochemical and pharmacological effects in the human body. THC is well known for the euphoria-inducing psychotropic properties of marijuana, i.e. getting 'high' or 'stoned.' CBD, while being psychoactive, is non-intoxicaticating and acts much more subtly."

Consumer CBD products (e.g. tinctures, balms, or beverages) can contain raw CBD in different forms. These forms are typically referred to as CBD isolate and full or broad spectrum distillates. Isolate, as one might guess, often contains 98+% CBD. Both full and broad spectrum CBD distillates typically contain 70 to 90% CBD, along with other naturally occurring cannabinoids and phytochemicals. The important distinction between full and broad spectrum distillates is that full spectrum distillates contain trace amounts of THC (less than 0.3% by law). CBD consumer products contain varying amounts of raw CBD from these different forms - often at wildly different dosages. A consumer should be aware of the types of raw CBD that is used in a product, as there are major purported differences in the effects of full spectrum, broad spectrum and isolated raw CBD.

"There is substantial anecdotal and some preclinical evidence that the presence of these other compounds in full and broad-spectrum products promotes a 'synergistic' effect that enhances the efficacy of the CBD product for various treatments," notes Abeleira. But further research is needed to confirm the efficacy of the "synergistic effects."

Theoretically speaking, the gobs of CBD-related health claims are plausible. The body already produces internal cannabinoids (a.k.a. endocannabinoids) through the Endocannabinoid System (ECS), which helps maintain homeostasis throughout the human body. According to Dr. Abeleira, the ECS is self-regulated in the body, and a myriad of factors can cause down-regulation of endocannabinoids, which can lead to chronic inflammation, an out of sync immune system, anxiety, migraines, depression, etc. Exogenous phytocannabinoids (cannabinoids taken into the body), such as CBD, can positively modulate the ECS.

But from there, the scientific details are blurry. Most CBD studies are either based on animal models or are preclinical human trials. "While animal models are essential for guiding further research endeavours for human application, they do not always translate to positive outcomes for treating human issues," says Abeleira.

Pal Pacher, an investigator at the National Institutes of Health and president of the International Cannabinoid Research Society, summed it up to Newsweek: "Consumers are participating in one of the largest uncontrolled clinical trials in history, and no one really knows what it is they're taking."

Methods of Consumption and Dosage

The CBD market offerings are endless. There's everything from the traditional CBD supplements to CBD-infused toilet paper (yes, you read that right), suppositories, mascara and even workout gear. So what's actually the best form of CBD and at what dose?

Ingestion is the most common method of taking CBD, and most studies focus on that method of consumption. CBD, however, is rapidly metabolized by the stomach and liver and most of it doesn't have a chance to enter the bloodstream. "[Ingested] CBD has a very low bioavailability, something between six and 15 percent, which varies between people," said Esther Blessing, a professor at New York University, to Vox. Blessing has performed clinical trials on CBD's effect on post-traumatic stress, anxiety and other conditions and has published several papers on the topic. Because of CBD's low bioavailability, high doses may be needed, particularly when taken orally.

"There's no evidence that doses below 300 milligrams of CBD have any effect in any psychiatric measure," said Blessing. "And in fact, dose-finding studies show that the lowest clinically effective dose of CBD for reducing anxiety is 300 milligrams."

Jordan Tishler, MD, a cannabis therapeutics specialist and the CEO/CMO at InhaleMD, echoed Blessing's assessment. "CBD at the tiny doses that people are taking (10 to 40 milligrams) is simply not effective," he told Popsugar.

Based on the price of one popular brand of CBD, consuming 300 milligrams per day would cost upwards of $250 a month, or $3,000 a year.

The good news is that, despite the myriad of unknowns when it comes to CBD, studies do show that overdosing seems near to impossible. A 2011 study published in Current Drug Safety found that a toxic dose of CBD is in the realm of 20,000 milligrams, taken almost all at once.

While more scientific studies on CBD are generally needed, CBD has shown promise in treating some of the most historically untreatable conditions--such as Alzheimer's disease, arthritis and the side effects of cancer chemotherapy--without any troublesome side effects. For Vitamin I (ibuprofen)-reliant climbers, it could be the healthiest way to reduce systemic inflammation.

Disclaimers

For those that want to give it a go, here are a few disclaimers. The 2018 Farm Bill made hemp-derived CBD legal in all 50 states, and most CBD is in fact derived from hemp. However each state has their own Controlled Substances Acts (CSA), and a few have made hemp-derived CBD illegal.

Consumers should also be aware the Food and Drug Administration typically only regulates how CBD companies market their products. "So long as the company isn't claiming their CBD product will cure cancer or other serious illnesses, the FDA typically won't get involved," says Abeleira. And since the FDA doesn't police product quality, CBD companies can get away saying their product has as much CBD as they want.

A 2016 study published in the Journal of the American Medical Association tested 84 CBD products sold online from 31 companies. Of the 84 products, 26% contained less CBD than labeled. In 2019, the FDA published a similar statement:

"Over the past several years, FDA has issued several warning letters to firms that market unapproved new drugs that allegedly contain cannabidiol (CBD). As part of these actions, FDA has tested the chemical content of cannabinoid compounds in some of the products, and many were found to not contain the levels of CBD they claimed to contain."

Luckily, there are honest companies out there that publish data about their products. "Respectable and responsible companies will typically have QR codes on their products that can be scanned to direct the consumer to the products' certificate of analysis (COA)," says Abeleira. The COA will not only give test results of cannabinoid content, but also heavy metals and pesticides--which brings up another concern. Abeleira continued:

"CBD products are derived from plants, which can accumulate pollutants such as heavy metals and pesticides that can be harmful to humans."

One last precaution: While CBD has been found to be safe, with little to no side effects, CBD may interact with other drugs, including SSRIs (antidepressants including Zoloft and Prozac), opioids and blood-thinning medications such as Warfarin and Coumadin. The research on those interactions is new, but it indicates that CBD plus certain prescription drugs could be potentially detrimental to your health. Like with alcohol, do your research before mixing.

Final Thoughts

Ultimately, most researchers are excited about CBD. It may not be for everyone, but it's worth exploration, especially for those with chronic pain or illness.

"My experience with CBD has been very positive," says Dr. Abeleira. "I am a first-hand account of some of the benefits that CBD products can have for pain reduction and opiate withdrawals."

About four years ago, Abeleira took a 35-foot ground fall in a gym. Despite three subsequent surgeries, his ankle will never be the same. "During that time, [while recovering] I was taking moderate to high dosages of oxycodone daily. I needed to wean off of the pain medication, and I found that taking CBD throughout the day reduced the negative effects of opiate withdrawals while also helping to reduce some of the pain I was experiencing." Now, Abeleira takes 60-120 milligrams of CBD daily in the form of a "full-spectrum" oil-based tincture.

Dr. Abeleira offered this final thought: "I think that CBD and other cannabinoids have great potential for improving human health and wellbeing, but I also believe that the research and science in that regard is in its infancy. The mainstream CBD industry is very young. Currently, the burden lies on the consumer to be informed as to the origins and quality of CBD products that they consume. And stay away from gimmicky products like bath bombs and weird CBD infused products like CBD pillows and clothes!"

Note: Outside of the FDA approved use of Epidiolex to treat intractable epilepsy syndromes, there are no other current FDA approvals for clinical treatment of disorders, diseases, cancers, etc. Take CBD products at your own risk.

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