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4. In June 2018, the Food and Drug Administration (FDA) approved a pharmaceutical CBD—an epilepsy medication named Epidiolex. Prior to that, all cannabis and its parts were considered an illegal Schedule 1 substance by the federal government. 5. The passage of the Farm Bill opened the door for hemp farming and CBD production, also creating opportunities for cannabis research. Now that the FDA has de-scheduled CBD, we see it everywhere. Are you ready to offer it in your practice? THE BENEFITS OF CBD CBD, the second most prevalent of the cannabis plant's active ingredients, must have a THC content of no more than 0.3 percent to maintain its hemp-derived CBD status, which is what is legally sold and used in most spas and massage clinics. Outside the over-the-top hype that has some CBD products "curing" everything that ails you, there are several anecdotal benefits to note about CBD. CBD is particularly well suited for: • Reducing pain and inflammation 7 • Reducing or eliminating seizures 8 • Fighting the growth of tumor and cancer cells 9 • Treating anxiety 10 • Managing mental illness as an antipsychotic agent 11 • Reducing muscle spasms and spasms of the small intestines 12 • Protecting the nervous system—managing dementia and Parkinson's disease 13 • Use with THC in autism and poststroke care 14 • Reducing the undesirable effects of THC, such as inebriation, sedation, and racing heart 15 CBD also appears to help maintain a healthy balance of calcium in nerve cells, which wards off the electrical overloads and damage that happen during seizures. The theory of using CBD is to support the endocannabinoid system and promote homeostasis. 16 Trista Okel, of Empower Bodycare in Oregon, says, "CBD is also an antinociceptive, which means it helps reduce the nervous system's response to painful stimuli." And pain reduction is certainly one of the main selling points for using CBD. In addition to reducing pain and inflammation, CBD has more subtle effects. CBD users may feel an increased sense of calm, diminished anxiety, improved mood, relaxation, and sometimes a mild "loosening" of the muscles. CBD SIDE EFFECTS AND CONTRAINDICATIONS Despite all its benefits, there are possible side effects, drug interactions, and cautions to be aware of when using CBD. For example, CBD can inhibit the activity of some liver enzymes that are responsible for metabolizing pharmaceutical drugs. High doses of CBD can temporarily neutralize these liver enzymes, which affects the way the drugs are used in the body; eating a grapefruit while taking certain statin drugs has a similar effect. To be safe, clients and therapists currently taking any pharmaceutical drugs should speak to their pharmacist or health- care provider to discuss any possible complications before using CBD. Potential side effects of CBD include: • Dry mouth • Temporarily lowered blood pressure • Lightheadedness or dizziness (caused by the change in blood pressure) • Nausea (some people have found that ingesting large amounts of CBD can cause GI discomfort; suspicions are that it's not the CBD causing the nausea, but other ingredients in the product being ingested) • Sleepiness or drowsiness The contraindications for using CBD would depend on whether a product is transdermal. If a topical CBD product does not have transdermal properties, the contraindications would be the same as with any topical product: avoid using on an open wound or rash. If a product is transdermal, Cannabinoids: The chemical compounds that act on the body's cannabinoid receptors as part of the endocannabinoid system. Endocannabinoids: Chemical compounds produced naturally in the body. Phytocannabinoids: Any of the 100-plus cannabinoids naturally derived from the cannabis plant. Synthetic cannabinoids: Cannabinoids that are artificially produced. Full-Spectrum CBD: In full- spectrum CBD products, cannabis plants are processed to retain all the elements of the plant—the cannabinoids, terpenes, flavonoids, and trace amounts of THC. If a product advertises itself as full spectrum, remember there is no such thing as THC-free full spectrum. Broad-Spectrum CBD: A product where the THC is eliminated from the spectrum, but everything else is left behind. CBD Isolate: This is what remains when all plant material except CBD is removed in the processing of cannabis. Considered the purest form of CBD, users like the isolate's quality control factor and lack of THC. CBD AND MASSAGE SPECIAL EDITION 50 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 9