TABLE OF CONTENTS
FOREWORD

It is a pleasure to introduce this practical guide for patients on cannabidiol (CBD). The topic is a complex one that requires discussion of myriad factors in various disciplines, including agriculture, medicine, pharmacology, and the law. Many differences of opinion compete for legitimacy in these realms, and the attendant rules that attach are in a constant state of flux. This publication serves admirably in clarifying the important factors that a patient or family should know when considering cannabidiol as a therapeutic modality.

A bit of background history is in order.1, 2 Cannabidiol is the primary cannabinoid encountered in European hemp chemovars (“chemical varieties,” Type III cannabis), but in low concentration. In ages past, in traditional hashish-growing areas such as Morocco, Lebanon, and Afghanistan, cannabidiol was present in equal measure with tetrahydrocannabinol (THC) (Type II cannabis). That situation has changed, however.

After the positive identification of the chemical structures of cannabidiol in 19633 and tetrahydrocannabinol the following year,4 THC became the subject of intense interest and research, with little attention devoted to CBD. Some even suggested that it was “inactive” merely because it lacked the intoxicating properties of THC. While a few stalwarts continued to investigate CBD, notably in Israel and Brazil,5-8 THC garnered the vast majority of funding dollars and became the clear target of cannabis breeding. Much of this focus was a by-product of prohibition: just as bathtub gin and moonshine were preferred clandestine products for alcohol, increasing THC concentrations over time have presented a desired result in increasing the value of cannabis commodities with the greatest potency per unit of weight.

5 INTRODUCTION

8 DEFINITIONS

9 CANNABIS SATIVA L.

11 AVAILABLE FORMS FOR USE

13 INDICATED USES

16 TALKINGTOYOURDOCTORABOUTCANNABINOIDS

18 FINDING THE RIGHT DOSE

19 WHAT TO KNOW ABOUT PACKAGING, LABELING, AND HANDLING 

22 THE SUPPLY CHAIN

30 CHEMICAL STRUCTURE AND ACTIVITY

34 UNDERSTANDING THE ENDOCANNABINOID SYSTEM

35 CANNABINOIDS, TERPENES, AND THE ENDOCANNABINOID SYSTEM

38 FULL-SPECTRUM MEDICINE AND THE ENTOURAGE EFFECT

38 CERTIFICATIONS AND THE NEED FOR STANDARDS 

40 CURRENT RESEARCH

41 CBD ON A GLOBAL SCALE

42 CONCLUSION

44 REFERENCES 

ABOUT ASA

Americans for Safe Access (ASA) is the largest national member-based organization of patients, medical professionals, scientists, and concerned citizens promoting safe and legal access to cannabis for therapeutic uses and research.

Since 2002, ASA has worked tirelessly to expand knowledge, dispel myths, and change laws regarding medical cannabis. We have played a key role in ensuring access to safe, legal medical cannabis in more than 30 U.S. states and territories. As a 501(c)(3) nonprofit organization, we would not be able to serve as agents of change or perform the meticulous work necessary to produce publications of this caliber were it not for the generous support of our members and donors.

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