CBD Oil: explained

What is CBD oil?

CBD oil, also referred to as cannabis oil or medicinal cannabis oil, is derived from the cannabis plant. The ‘CBD’ in CBD oil stands for cannabidiol, which is a natural cannabinoid found in the plant.

Cannabinoids are the chemical compounds found in cannabis, alongside terpenes (plant compounds responsible for aromas and flavours), flavonoids (plant compounds associated with various health benefits), fatty acids, and other materials.

CBD oil contains high levels of CBD and can vary in levels of tetrahydrocannabinol (THC), which is the cannabinoid that produces a high because of its psychoactive properties, and other cannabinoids or compounds. There are 3 different types of CBD oil:

• CBD Isolate
• Full Spectrum CBD
• Broad Spectrum CBD

Often, the blanket term ‘CBD oil’ is used to refer to all of these products, regardless of their cannabinoid composition, which can make it hard to distinguish between the different types. 

What are the different types of CBD oils?

People tend to use the term CBD oil to refer to medical cannabis oils in general, which isn’t entirely accurate. It’s important to make a distinction between the different types of CBD oils, as they all serve different functions.

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CBD Isolate

CBD Isolate is the purest form of CBD. It doesn’t contain any of the other cannabinoids (such as THC) present in the cannabis plant, or terpenes, flavonoids, and fatty acids. As CBD Isolate only contains CBD, it can be well tolerated by most patients with very few adverse effects¹.

CBD Isolate is produced using the same extraction methods of other types of CBD oils, the only difference is that it goes through a final process called winterisation. During winterisation, the oil is dissolved in ethanol at sub-zero temperatures, which separates the compounds to allow them to be filtered off. What is left is pure CBD Isolate. 

Full Spectrum CBD

Full Spectrum CBD uses the entire plant extract and contains the complete range of cannabinoids, terpenes, and other compounds that are found naturally in the plant. This includes trace amounts of THC (less than 0.3%), which is unlikely to produce any psychoactive effects. This is important to note if you ever need to drive (learn more about driving and medicinal cannabis here.)

It has been found that the complete assortment of compounds found in Full Spectrum CBD may help achieve better medicinal and therapeutic outcomes than CBD alone in some patients – this is known as the entourage effect. 

Broad Spectrum CBD

Broad Spectrum CBD sits somewhere between Full Spectrum and CBD Isolate. It is essentially the same as Full Spectrum CBD, however, in the final stages of extraction, it has had trace amounts of THC removed. This means patients who are prescribed Broad Spectrum CBD can reap the benefits of having a range of cannabinoids, terpenes, and other compounds (aka the ‘entourage effect’) without feeling the psychoactive effects of THC and are able to drive (learn more about driving as a medical cannabis patient in Australia).   

Both Full Spectrum CBD and Broad Spectrum CBD contain cannabinoids other than just CBD. Technically speaking, this means they’re more than just 'CBD oils', however they still fall under this definition in the realm of medical cannabis.

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How is CBD oil different from medicinal cannabis flower?

Medicinal cannabis flower is the flower of the female cannabis plant that has been harvested. Unlike CBD oil, flower is unprocessed and less manufactured.

CBD oil is usually consumed either sublingually (under the tongue) or orally. Oral or sublingual medicinal cannabis products have been shown to be better for chronic conditions, and ongoing pain that needs to be treated over a longer period of time². This is because the cannabinoids may be absorbed by the body slower, with effects that last longer for some patients.   

The recommended method of administration for medicinal cannabis flower is inhalation using a TGA-approved medical vape. Inhalation allows the cannabinoids to absorb directly into the bloodstream from the lungs, meaning it may be more suitable for some patients who require  rapid relief².

CBD oil, hemp oil, and hemp seed oil: what’s the difference?

The terms CBD oil and hemp oil are sometimes used interchangeably, which can cause confusion.. Some people mistakenly buy hemp oil thinking it is high in CBD, but it is not.

Hemp oil is made from hemp plants that have very low concentrations of cannabinoids. CBD oil comes from cannabis plants that have large, cannabinoid-containing flowers³. The only way to get oil that is high in CBD is to get a prescription for CBD oil. 

Hemp seed oil is a different thing entirely from both hemp oil and CBD oil. Hemp seed oil is produced through cold pressing hemp seeds, is consumed for its vitamins and antioxidants, and contains no traceable amount of cannabinoids. 

How is CBD oil made?

CBD oil is made by extracting CBD from cannabis plants. The way that CBD oil is extracted can have an effect on the final product that is created, changing everything from its purity to its therapeutic and health benefits. 

There are a few ways that CBD is extracted from plants. These include:

• CO2 extraction - This method of extraction is one of the safest and commonly used ways to extract CBD. There are two types of CO2 extraction: supercritical and subcritical. Supercritical is the most popular and involves using heated and pressurised carbon dioxide to extract phytocompounds (like cannabinoids and terpenes) from the raw cannabis plant to create the oil.
• Liquid solvent extraction - This method of extraction uses a liquid solvent, like alcohol, to soak the plant and extract the cannabinoids. The resulting liquid is evaporated and then heated, creating an oil form of the cannabinoid concentrate. 
• Oil extraction - This method of extraction involves using a carrier oil – like olive oil, coconut oil, or melted butter – to absorb the cannabinoids from the plant. The plant is heated to a certain temperature to activate its compounds, where it’s then mixed with the oil and heated again for a number of hours. 

What are the potential therapeutic effects of using CBD oil?

Before going into detail about the potential therapeutic effects of  CBD oil (CBD Isolate, Broad Spectrum CBD, and Full Spectrum CBD), it’s important to understand how CBD oil works with our bodies.

One of the main systems for regulating processes and biological changes in our body is the endocannabinoid system (ECS). This system is made up of three key parts: endocannabinoids, receptors, and enzymes. 

Our bodies naturally create endocannabinoids, which travel and bind to the many receptors available to help regulate us when our natural state of being – called homeostasis – is disrupted. 

There are two main types of receptors in our bodies. CB1 receptors are found in the central nervous system, and CB2 receptors are found in the peripheral nervous system. After an endocannabinoid binds to a receptor and carries out its function, enzymes break it down.

The effect that occurs after an endocannabinoid binds to a receptor depends on the type of receptor, and which endocannabinoid it binds to. CBD is unique because it doesn’t interact directly with our receptors. Instead, experts believe⁴ it works by slowing down the decomposition of endocannabinoids, which means our bodies can feel their effects for longer. THC and other cannabinoids can bind to both CB1 and CB2 receptors, which produces a range of different outcomes when it comes to their potential therapeutic and health benefits⁵. 

Because of how they interact with our endocannabinoid system, CBD oils may be able to help our bodies manage inflammation and disruptions to our nervous system more efficiently. Because of this, some potential effects of medical cannabis that some patients may experience can include: :

Mood regulation

Various studies have found that CBD oil may help relieve symptoms of anxiety and other mood disorders in some patients, including panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder, when administered acutely⁶.

This 2020 study⁷ into the antidepressant and antipsychotic effects of CBD found that CBD oil may interact with serotonin receptors in the brain in such a way that it may  assist with regulating the mood of some patients and treating depression, though more research is needed in this space. 

Insomnia and sleep disorders

Given how CBD interacts with the central nervous system, it may help with improving sleep quality by helping relieve symptoms of anxiety disorders, which tend to be related⁹ in some patients. In a study¹⁰ of 24 participants over two weeks, participants reported an improvement in the time taken to fall asleep, time spent asleep, and feelings of being more rested and refreshed on waking.

Inflammatory pain

Although chronic pain is one of the top reasons for medical cannabis prescriptions in Australia, there is still a lot more research that needs to be done. A study led by the Australian Government Department of Health found that medical cannabis was more likely than a placebo to produce 30% and 50% reductions in pain scores in patients with chronic pain due to conditions like multiple sclerosis and fibromyalgia, and more likely than a placebo to produce a significantly greater reduction in pain intensity ratings¹¹. 

Though there have been studies conducted on the pain relieving effects of medicinal cannabis, more research needs to be conducted to reach a conclusive decision about the validity of it¹².

How do I administer CBD oil?

The recommended method of administration for  CBD oil is to drop the oil under your tongue (sublingually). This allows the oil to absorb faster into your bloodstream through your sublingual glands, which are found under your tongue. This is different to ingesting CBD oil, which goes through your gastrointestinal system and can take much longer to be absorbed by your body.

While CBD oil is typically used for long-term relief, cannabis flower may be used as an optional additional potential treatment for breakthrough pain or for patients who need more rapid relief.

When it comes to all types of medical cannabis treatment, it’s important to start low and go slow and always follow the appropriate dosing prescribed by your healthcare professional so you minimise any potential negative side effects.

Is CBD oil legal in Australia? 

At the time of writing this, CBD oil in Australia can only be legally accessed with a prescription from a qualified healthcare professional.

‍1. Special Access Scheme (SAS)

You can speak with your current doctor or healthcare professional who has a comprehensive understanding of your medical history. They will review your request and submit your diagnosis to the TGA, alongside a clinical justification for the prescription, any supporting evidence and details on how you will be monitored throughout your treatment. Unfortunately, many GPs aren’t well informed or prepared to go through this process with patients, so this pathway might not always be accessible. If you are unsure whether your current GP can help you access medical cannabis, we recommend making an appointment with a practitioner who has experience in prescribing medicinal cannabis treatments.

‍2. Authorised Prescriber

‍You can speak with an Authorised Prescriber (AP), who is a specialist doctor that has already received authority from the TGA to write prescriptions for medicinal cannabis. These practitioners don’t need to apply for approval from the TGA for individual patient prescriptions as they are pre-approved. One of the benefits of taking this pathway is that APs are experts in prescribing medicinal cannabis and can write prescriptions as soon as they have assessed your eligibility – this means you’ll experience none of the wait time associated with the SAS pathway.

You may have heard that CBD oil has been approved for over-the-counter (OTC) use, however, you can’t actually legally purchase CBD products without a prescription in Australia¹³. This is because so far no specific products have been approved for the Australian Register of Therapeutic Goods (ARTG), which is a requirement for OTC sales in Australia. 

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Can I purchase CBD oil online?

You may notice many online stores are now selling unregulated CBD oil products to ‘cash in’ on the rise in popularity of CBD oil. It’s important to understand that if you purchase nonprescription CBD products online that actually contain CBD, this is illegal in Australia, and comes with quite a large risk. The alternative is you’re buying CBD oil that doesn't actually contain CBD, which is just as bad. 

Because CBD oil and other medicinal cannabis products are prescription medicines, they need to follow strict protocols during manufacturing to make sure the end product is consistently produced. These same protocols aren’t implemented with black market products, and regulating them is practically impossible. There are limited quality control measures, and as a result, the end product could contain dangerous byproducts and contaminants. If you’re thinking of buying CBD oil online, it’s important to keep in mind that such a product has not been approved by the TGA. Learn more about legal vs. illegal cannabis in Australia here.

As with any treatment, the best way to ensure you’re getting what you need in terms of quality and effectiveness is to speak with a qualified specialist healthcare professional.