from the world's big
What is CBD really good for?
There is a lot of hope in the healing powers of CBD. Unfortunately there's way more hype.
- Cannabidiol (CBD) is the most well-known of the 113 cannabinoids found in the cannabis plant.
- There is strong evidence that CBD might help in an array of problems, including anxiety and pain management.
- But numerous companies are marketing low doses of CBD with no proven efficacy and charging a premium.
I began noticing a new beverage in Los Angeles. The first thing you notice is the cheap wrapping, as if directly printed at home and pasted onto the bottle. The sparse print leaves room for plenty of white space. The first six ingredients of one particular flavor are all juice or sugar: blackberry, ginger, blueberry, and lemon juices, along with erythritol (sugar alcohol) and agave. Stevia is featured later on. The final ingredient is the selling point: Hemp CBD.
Each bottle retails for $8.99. Effectively, glorified vitamin water.
Or CBD water, which makes it this year's additive du jour. I've seen this drink sold in the same case as a sugar-rich CBD-infused coffee drink that sells for a dollar less and six fewer ounces. CBD is as trendy as its forebears, antioxidants, keto supplements, and açaí rolled into one, the superfood of superfoods. And you will pay a premium for it.
I've been a marijuana smoker for 25 years, well before I knew about the endocannabinoid system. I was clueless that our central and peripheral nervous systems—and by "our," I mean mammals—were tailor-made to accept cannabinoids (including the most famous, cannabidiol, aka CBD), and that these systems play an essential role in immune system functioning, pain management, and regulation of appetite. I didn't know it for a long time, but I've certainly felt it.
Point being, I'm a fan. Cannabis helped me deal with cancer and chemotherapy, pain management through multiple surgeries, and chronic anxiety disorder. Marijuana helped keep me off Xanax and opioids. Despite that fact that I was among those who nodded and winked when getting my California medical license, I'm skeptical of the hype. The collapsing dominoes that led to legalization have brought with them a gold rush of CBD-infused products and all the ridiculous claims that come along with it.
When Coca Cola is jumping aboard, you know it's going to get weird.
I'm not the only one who's suspicious. As Dan Nosowitz writes at Vox, this trend is the result of two collisions: widespread marijuana legalization and the growing anxiety economy. By 2020, CBD products could reach a billion dollars in sales, making it a potential goldmine for speculators.
There are benefits to CBD, at least according to some reports. As I wrote last month:
Recent research shows a wide range of therapeutic applications, including helping opioid addicts manage pain, helping everyone deal with chronic pain, deal with stress (at low doses), ease pain associated with multiple sclerosis, and may even, somewhat counterintuitively, help combat the obesity epidemic.
Yet CBD is enforced as a supplement, as unregulated by the FDA as most homeopathic products and "natural remedies" that make up a lion's share of the $49 billion herbal supplement industry. According to Nosowitz, the FDA actually regulates CBD as an active ingredient, meaning you shouldn't be able to just throw it into a cup of coffee and double the price, but what sort of regulations are any federal agency even enforcing these days? Nosowitz continues:
CBD is about as poorly regulated and understood as a product this popular can possibly be. It's not accurate to say that CBD, as a whole, is bullshit. From a medical perspective, it's promising; recreationally, it's interesting. But that doesn't mean the stuff you're buying works.
Photo: Alexandre Chambon / Unsplash
The burgeoning CBD oil industry, for example, faces a serious problem: science. Not that that stops any holistic company. Topical application or ingestion of CBD are much less effective means than inhaling. Sipping it from your hyped-up vitamin water means most of the CBD will just bind to other fat in your body and never reach your brain. Smoking, as Nosowitz writes, "bypasses the digestive system."
Even then, he was only able to discover one study detailing the bioavailability of inhaled CBD and none on topical lotions. Even more problematic is dosage. One study discovered that the only amount of CBD that made a noticeable difference in anxiety levels was 300 mg. The standard dose in most products is 20 mg. One coffee shop Nosowitz highlights adds 5 mg to their $9 coffee. So really, you just paid $9 for… coffee.
More studies are being conducted on CBD and, hopefully, the 112 other cannabinoids found in the marijuana plant. Legalization and destigmatization will hasten that process. We should welcome this progress so that we can separate the wheat from the chaff—the flower from the stem—and make smart decisions about how to apply this plant medicine. Then we can stand on firmer ground when denouncing market manipulators bucking a trend and put our money into products that work as intended.
In my refrigerator sits a $42 bottle of CBD oil we bought for our cats when we were integrating our newest member with our overly territorial Maine Coon. At 300 mg per bottle, it would have taken the lion's share to quell any anxiety—cats being smaller than humans would likely not require the same dose. Still, the recommended dose did nothing to stop their anxiety.
Something else did: Prozac. It's not a long-term strategy (as such anti-anxiety medications were never designed to be). Over a three-month period it's worked wonders; we're now tapering them off. That's the thing about clinical studies: sometimes they're effective. It's a message I hope CBD hucksters take the time to learn.
Innovation in manufacturing has crawled since the 1950s. That's about to speed up.
Health officials in China reported that a man was infected with bubonic plague, the infectious disease that caused the Black Death.
- The case was reported in the city of Bayannur, which has issued a level-three plague prevention warning.
- Modern antibiotics can effectively treat bubonic plague, which spreads mainly by fleas.
- Chinese health officials are also monitoring a newly discovered type of swine flu that has the potential to develop into a pandemic virus.
Bacteria under microscope
needpix.com<p>Today, bubonic plague can be treated effectively with antibiotics.</p><p style="margin-left: 20px;">"Unlike in the 14th century, we now have an understanding of how this disease is transmitted," Dr. Shanthi Kappagoda, an infectious disease physician at Stanford Health Care, told <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">Healthline</a>. "We know how to prevent it — avoid handling sick or dead animals in areas where there is transmission. We are also able to treat patients who are infected with effective antibiotics, and can give antibiotics to people who may have been exposed to the bacteria [and] prevent them [from] getting sick."</p>
This plague patient is displaying a swollen, ruptured inguinal lymph node, or buboe.
Centers for Disease Control and Prevention<p>Still, hundreds of people develop bubonic plague every year. In the U.S., a handful of cases occur annually, particularly in New Mexico, Arizona and Colorado, <a href="https://www.cdc.gov/plague/faq/index.html" target="_blank">where habitats allow the bacteria to spread more easily among wild rodent populations</a>. But these cases are very rare, mainly because you need to be in close contact with rodents in order to get infected. And though plague can spread from human to human, this <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">only occurs with pneumonic plague</a>, and transmission is also rare.</p>
A new swine flu in China<p>Last week, researchers in China also reported another public health concern: a new virus that has "all the essential hallmarks" of a pandemic virus.<br></p><p>In a paper published in the <a href="https://www.pnas.org/content/early/2020/06/23/1921186117" target="_blank">Proceedings of the National Academy of Sciences</a>, researchers say the virus was discovered in pigs in China, and it descended from the H1N1 virus, commonly called "swine flu." That virus was able to transmit from human to human, and it killed an estimated 151,700 to 575,400 people worldwide from 2009 to 2010, according to the Centers for Disease Control and Prevention.</p>There's no evidence showing that the new virus can spread from person to person. But the researchers did find that 10 percent of swine workers had been infected by the virus, called G4 reassortant EA H1N1. This level of infectivity raises concerns, because it "greatly enhances the opportunity for virus adaptation in humans and raises concerns for the possible generation of pandemic viruses," the researchers wrote.
So far, 30 student teams have entered the Indy Autonomous Challenge, scheduled for October 2021.
- The Indy Autonomous Challenge will task student teams with developing self-driving software for race cars.
- The competition requires cars to complete 20 laps within 25 minutes, meaning cars would need to average about 110 mph.
- The organizers say they hope to advance the field of driverless cars and "inspire the next generation of STEM talent."
Indy Autonomous Challenge<p>Completing the race in 25 minutes means the cars will need to average about 110 miles per hour. So, while the race may end up being a bit slower than a typical Indy 500 competition, in which winners average speeds of over 160 mph, it's still set to be the fastest autonomous race featuring full-size cars.</p><p style="margin-left: 20px;">"There is no human redundancy there," Matt Peak, managing director for Energy Systems Network, a nonprofit that develops technology for the automation and energy sectors, told the <a href="https://www.post-gazette.com/business/tech-news/2020/06/01/Indy-Autonomous-Challenge-Indy-500-Indianapolis-Motor-Speedway-Ansys-Aptiv-self-driving-cars/stories/202005280137" target="_blank">Pittsburgh Post-Gazette</a>. "Either your car makes this happen or smash into the wall you go."</p>
Illustration of the Indy Autonomous Challenge
Indy Autonomous Challenge<p>The Indy Autonomous Challenge <a href="https://www.indyautonomouschallenge.com/rules" target="_blank">describes</a> itself as a "past-the-post" competition, which "refers to a binary, objective, measurable performance rather than a subjective evaluation, judgement, or recognition."</p><p>This competition design was inspired by the 2004 DARPA Grand Challenge, which tasked teams with developing driverless cars and sending them along a 150-mile route in Southern California for a chance to win $1 million. But that prize went unclaimed, because within a few hours after starting, all the vehicles had suffered some kind of critical failure.</p>
Indianapolis Motor Speedway
Indy Autonomous Challenge<p>One factor that could prevent a similar outcome in the upcoming race is the ability to test-run cars on a virtual racetrack. The simulation software company Ansys Inc. has already developed a model of the Indianapolis Motor Speedway on which teams will test their algorithms as part of a series of qualifying rounds.</p><p style="margin-left: 20px;">"We can create, with physics, multiple real-life scenarios that are reflective of the real world," Ansys President Ajei Gopal told <a href="https://www.wsj.com/articles/autonomous-vehicles-to-race-at-indianapolis-motor-speedway-11595237401?mod=e2tw" target="_blank">The Wall Street Journal</a>. "We can use that to train the AI, so it starts to come up to speed."</p><p>Still, the race could reveal that self-driving cars aren't quite ready to race at speeds of over 110 mph. After all, regular self-driving cars already face enough logistical and technical roadblocks, including <a href="https://www.bbc.com/news/technology-53349313#:~:text=Tesla%20will%20be%20able%20to,no%20driver%20input%2C%20he%20said." target="_blank">crumbling infrastructure, communication issues</a> and the <a href="https://bigthink.com/paul-ratner/would-you-ride-in-a-car-thats-programmed-to-kill-you" target="_self">fateful moral decisions driverless cars will have to make in split seconds</a>.</p>But the Indy Autonomous Challenge <a href="https://static1.squarespace.com/static/5da73021d0636f4ec706fa0a/t/5dc0680c41954d4ef41ec2b2/1572890638793/Indy+Autonomous+Challenge+Ruleset+-+v5NOV2019+%282%29.pdf" target="_blank">says</a> its main goal is to advance the industry, by challenging "students around the world to imagine, invent, and prove a new generation of automated vehicle (AV) software and inspire the next generation of STEM talent."
A new Harvard study finds that the language you use affects patient outcome.
- A study at Harvard's McLean Hospital claims that using the language of chemical imbalances worsens patient outcomes.
- Though psychiatry has largely abandoned DSM categories, professor Joseph E Davis writes that the field continues to strive for a "brain-based diagnostic system."
- Chemical explanations of mental health appear to benefit pharmaceutical companies far more than patients.
Challenging the Chemical Imbalance Theory of Mental Disorders: Robert Whitaker, Journalist<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="41699c8c2cb2aee9271a36646e0bee7d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/-8BDC7i8Yyw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>This is a far cry from Howard Rusk's 1947 NY Times editorial calling for mental healt</p><p>h disorders to be treated similarly to physical disease (such as diabetes and cancer). This mindset—not attributable to Rusk alone; he was merely relaying the psychiatric currency of the time—has dominated the field for decades: mental anguish is a genetic and/or chemical-deficiency disorder that must be treated pharmacologically.</p><p>Even as psychiatry untethered from DSM categories, the field still used chemistry to validate its existence. Psychotherapy, arguably the most efficient means for managing much of our anxiety and depression, is time- and labor-intensive. Counseling requires an empathetic and wizened ear to guide the patient to do the work. Ingesting a pill to do that work for you is more seductive, and easier. As Davis writes, even though the industry abandoned the DSM, it continues to strive for a "brain-based diagnostic system." </p><p>That language has infiltrated public consciousness. The team at McLean surveyed 279 patients seeking acute treatment for depression. As they note, the causes of psychological distress have constantly shifted over the millennia: humoral imbalance in the ancient world; spiritual possession in medieval times; early childhood experiences around the time of Freud; maladaptive thought patterns dominant in the latter half of last century. While the team found that psychosocial explanations remain popular, biogenetic explanations (such as the chemical imbalance theory) are becoming more prominent. </p><p>Interestingly, the 80 people Davis interviewed for his book predominantly relied on biogenetic explanations. Instead of doctors diagnosing patients, as you might expect, they increasingly serve to confirm what patients come in suspecting. Patients arrive at medical offices confident in their self-diagnoses. They believe a pill is the best course of treatment, largely because they saw an advertisement or listened to a friend. Doctors too often oblige without further curiosity as to the reasons for their distress. </p>
Image: Illustration Forest / Shutterstock<p>While medicalizing mental health softens the stigma of depression—if a disorder is inheritable, it was never really your fault—it also disempowers the patient. The team at McLean writes,</p><p style="margin-left: 20px;">"More recent studies indicate that participants who are told that their depression is caused by a chemical imbalance or genetic abnormality expect to have depression for a longer period, report more depressive symptoms, and feel they have less control over their negative emotions."</p><p>Davis points out the language used by direct-to-consumer advertising prevalent in America. Doctors, media, and advertising agencies converge around common messages, such as everyday blues is a "real medical condition," everyone is susceptible to clinical depression, and drugs correct underlying somatic conditions that you never consciously control. He continues,</p><p style="margin-left: 20px;">"Your inner life and evaluative stance are of marginal, if any, relevance; counseling or psychotherapy aimed at self-insight would serve little purpose." </p><p>The McLean team discovered a similar phenomenon: patients expect little from psychotherapy and a lot from pills. When depression is treated as the result of an internal and immutable essence instead of environmental conditions, behavioral changes are not expected to make much difference. Chemistry rules the popular imagination.</p>