Natural alternatives to traditional medicine are becoming more and more accessible for people suffering the effects of Parkinson’s disease. Studies show that cannabidiol, also referred to as CBD, may relieve tremors and other debilitating symptoms of Parkinson’s. CBD is a compound found in cannabis sativa plants but is free of the “high” effect from THC in marijuana. And while traditional medications may become less effective over time, CBD users are finding long-lasting benefits, with many giving up their pharmaceuticals for good.
CBD is also gaining momentum as a treatment for Alzheimer’s disease, epilepsy, anxiety, and chronic pain. Studies are ongoing, but data indicates CBD is an exciting alternative to traditional medications.
Parkinson’s disease (PD) is a disorder that affects the nervous system, with the average age of onset at 60. Simply stated, brain cells that produce the neurotransmitter dopamine, responsible for sending messages to the body in relation to movement, become damaged and die. This results in a variety of movement issues including tremors, lack of facial expression, difficulty balancing, and stiff muscles. In addition, PD may develop into Parkinson’s disease dementia (PDD), which impacts one’s cognitive functioning, such as the ability to remember things, make good decisions, and pay attention.
A difference between PDD and Alzheimer’s disease (beyond the physical impact) is that while Alzheimer’s more directly targets a person’s memory and ability to communicate, PDD is often associated with deteriorating problem-solving skills and thinking speed. Another rare form of dementia is Lewy-body dementia, which has symptoms closer to PDD. (More on PDD.)
Initial symptoms of PD may be nearly unnoticeable and include:
– Difficulty standing
– Lack of facial emotion
– Tremors (shakiness of one’s hands)
– Bradykinesia (slow movement)
– Balance issues
Problems walking are so commonly seen that this symptom has its own name: Parkinson’s (or Parkinsonian) gait. This is often characterized by a stooped posture, short steps that are more like shuffling of the feet (as if the individual is dragging them), and reduced arm movement or arms that do not swing when one is walking. Persons with PD may experience other issues over time, including:
– Loss of smell
– Trouble swallowing
– Slurred speech
– Visual hallucinations
– Lack of judgment
– Difficulty concentrating
– Memory loss
People with PD may also suffer additionally from depression, anxiety, apathy, irritability, pain, and difficulty sleeping. This transitions for many patients with Parkinson’s disease to develop Parkinson’s disease dementia.
People with PD and PDD often seek treatment via prescription medications to alleviate the symptoms. Frequently this causes dizziness, drowsiness, blurred vision, nausea, diarrhea, vomiting, dry mouth, loss of appetite, heartburn, and more.
Many therapeutic benefits have been found as more research of CBD is done. CBD has anti-inflammatory and antioxidant properties that make it a neuroprotective agent, meaning it can help with specifically neurological disorders like Parkinson’s disease. When nerve cells in the brain and body are protected, problems with movement and thinking problems are less pronounced and get worse at a slower rate.
CBD can help alleviate anxiety symptoms tied to tremors. A published study from Brazilian researchers showed that CBD reduced anxiety and tremors that occurred during a public speaking test for people over 60 with PD. Subjects who took 300 milligrams of CBD before giving a speech (public speaking is a classic anxiety-inducer) had less symptoms than a control group who were given a placebo.
This has led to researchers studying how PD affects the brain’s ability to produce dopamine. They made an important discovery linking CBD to increased dopamine levels, which counteract the decrease of dopaminergic nerve cells that happens with PD.
Cannabinoid receptors run throughout our body as part of the endocannabinoid system regulating hunger, pain sensitivity, temperament, memory, and more. These natural receptors are affected in patients with PD. As research continues, CDB is showing relief for tremors, psychosis, and problems sleeping. CBD may also reduce depression, anxiety, and relieve pain. Studies have shown relief from tremors, difficulty sleeping and treating psychosis that comes with PDD (Parkinson’s disease dementia). Patients were using low doses of CBD oil and showed positive effects.
Numerous other studies echo CBD’s benefits:
– Researchers in Brazil had previously noted “Our findings point to a possible effect of CBD in improving quality of life measure in PD patients.” (Study)
– Researchers with the Department of Neuroscience and Behavior there concluded “preliminary data suggest that CBD may be effective, safe, and well tolerated for the treatment of the psychosis in PD” (Study)
– And a different Colorado study concluded: “Cannabis was rarely used in our population but users reported high efficacy, mainly for nonmotor symptoms.”
In addition ,a 1998 federally funded preclinical study showed strong antioxidant and neuroprotective properties in CBD and THC. These findings led to a U.S. patent on cannabinoids as antioxidants and neuroprotectants. THC and CBD products are becoming more mainstream as an increasing number of states legalize cannabis for medicinal and recreational use. (For more on legalized CBD, see below.)
In June of 2018, the first FDA-approved CBD medication, Epidiolex, was approved to treat two rare types of epilepsy. Epidiolex has the possibility of treating other diseases including Parkinson’s, after a study released in 2020 showed that for most participants with Parkinson’s saw improvements in motor function after taking the drug. Nighttime sleep and issues with emotions and behavior improved significantly as well.
CBD and Better Brain Cells
While there are currently no CBD medications approved by the FDA for Parkinson’s disease, it is continued to be studied. In 2017, the Salk University in California found that THC and other compounds found in cannabis, like CBD, reduce the amount of amyloid beta. This is a protein that is toxic in the brains of people with Alzheimer’s disease and dementia. CBD helped in the removal of amyloid beta proteins in order to preserves brain cells. They also kill neurons, cause inflammation and contribute to memory loss and other cognitive issues. This type of plaque is also found in the brains of some people with Parkinson’s disease dementia.
Not giving CBD federal approval made lawmakers write a bill that would force the FDA to do so. Introduced in early 2021, H.R.841 would make hemp and its byproducts legal and labeled as a dietary supplement under the FDA’s protection and jurisdiction.
This potential law is important for two major reasons. First, FDA approval is the key to making it more accessible to patients in all states and all care facilities. In addition, this leads to potentially being covered by insurance as Medicare and Medicaid have set precedence that they normally approve coverage for all FDA approved medicines.
At this point, it is unknown if this Bill will make a difference. H.R.841 has a long time before it will be signed into law; it is estimated at two years before the FDA is forced to decide on CBD’s legality.
CBD Makes You Feel “High”
The effects of CBD and THC (Tetrahydrocannabinol), both cannabinoids that are extracted from cannabis sativa plants, are often confused. Both CBD and THC are known to have healing properties, and some researchers believe a combination of the two are very effective as a means of treatment. However, only THC produces a feeling of being “high” or “stoned.” CBD-rich cannabis usage does not have any mind-altering effects. This makes CBD a desirable option for those that do not want to feel “high” from THC or certain prescription drugs.
CBD is a Regulated Product
Due to a lack of regulation when it comes to CBD products, there is no guarantee that a product labeled as containing a certain amount of CBD mg (for instance 30mg) actually has that amount. A researcher at Penn Medicine in Philadelphia discovered that almost 70% of CBD products sold on the internet are under-labeled or over-labeled when it comes to the concentration of CBD within the product. Just 30% of the products bought contained a concentration of CBD within 10% of what the label indicated. For the best and most consistently produced CBD products, locally sourced medical CBD is recommended. These products are held to a higher level of lab testing for strength and impurities.
CBD has Sedative Properties
While some people may believe that CBD is a sedative, the truth is that it actually produces alertness without negatively impacting one’s sleep. Even if one takes a dose of 600mg of pure CBD, which is a very high dose, it still does not produce a sedating effect. However, one may take a CBD with a terpene (fragrant and flavorful essential oils found in plants) called myrcene, which is produced by several cannabis strains, that has sedating properties.
CBD is Legal in All States
CBD is sold in lots of stores and online because it has been legalized in the United States since 2018 because of the Farm Bill. It is important to note that CBD-rich medical cannabis does not have the same protection. Hemp-based CBD (containing less than 0.3% THC) is the legal standard in all states minus South Dakota and Idaho. In these two states, CBD is only legal with zero THC. Regardless of specific local laws, CBD can be purchased legally online and delivered to all states. One can do so here.
Studies on CBD have shown that this form of treatment is usually tolerated well by users and is regarded as safe. There has also been no evidence for potential of abuse and/or addiction. A few side effects have been, found by some which include diarrhea, appetite changes, and tiredness. The FDA also warns that CBD can cause liver injury (as shown in some animal experiments with high doses). The agency also says that long-term side effects remain unknown. It is crucial that one speaks with their physician prior to adding CBD to any medication regimen. In addition, monitor side effects upon use.
There are a variety of options when it comes to administering CBD and each takes a different amount of time to work and lasts differently.
– Ingestible CBD, which is a very common means of consumption, and includes oils (CBD is mixed with what is called a carrier oil, such as hemp seed, coconut, and olive oil) and tinctures (CBD is in an alcohol solution).
– Sublingual consumption, whereby a few drops of oil or tincture is placed under the tongue for a few minutes, is often suggested because the oil is absorbed quickly into the bloodstream and is generally effective within a few minutes. One can also digest the oil or tincture directly or add to food, such as a smoothie.
– Oil capsules can be taken like pills.
– CBD edibles, like gummies, can take an hour before they start working. The effects can then be felt for 4 hours or even longer.
– Oils and tinctures can also be applied topically, meaning they can be applied to the skin. Like with digesting CBD, it can take an hour or so for the effects to be felt and will last for a few hours. This method of use is good for persons suffering from localized pain.
– One can also opt for CBD vape products (vaporizer pens), CBD inhalers, or smoke high-CBD hemp strains. This method of inhalation allows users to feel the effects of CBD almost immediately and generally lasts a couple of hours.
There is no preferred method of CBD administration for persons with Parkinson’s Disease. Patients should choose a method with which they are most comfortable and one which is not hampered by tremors. If success with CBD is found, users should choose an administration method which can accommodate frequent and ongoing usage.
To understand the legality of CBD, you have to know the difference between hemp-derived CBD and marijuana-derived CBD. As previously mentioned, CBD is derived from both marijuana plants and hemp plants. Marijuana plants can contain as much as 30% THC, while hemp plants do not contain more than 0.3% THC. The percentage of THC in hemp plants is so low that it is impossible for one to get “high. In 2018, the U.S. legalized CBD through the Farm Bill. That gave a national legal standard with guidelines dictating it contains less than 0.3% THC and made from hemp (not marijuana). Because of differences between state and federal laws, each state can have their own requirements on its legality.
A table below breaks down the different requirements by state (as of May 2022) to CDB’s legality.
|Legality of CBD by State (Updated May 2022)|
|Conditions of Legality||States in which these Conditions Apply|
|CBD and medical cannabis is legally available to all adult users (21+)||Alaska, Arizona, California, Colorado, District of Columbia, Illinois, Maine, Massachusetts, Michigan, Nevada, New Jersey, Oregon, Vermont and Washington.|
|CBD and medical cannabis is legally available by prescription only||Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Hawaii, Iowa, Louisiana, Maryland, Minnesota, Missouri, Montana, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Utah, Virginia, West Virginia, Wisconsin and Wyoming.|
|CBD with limited THC content (less than 0.3%) and made from hemp is legally available||Indiana, Kansas, Kentucky, Mississippi, Nebraska, South Carolina, North Carolina, Tennessee and Texas.|
|CBD with zero THC and made from hemp is legally available||South Dakota and Idaho.|
The best place to buy CBD rich medical cannabis is from state licensed medical (and in some states, recreational) dispensaries. Alternatively, CBD can be purchased legally online here.
For convenience, many dispensaries also provide delivery services. Unfortunately, dispensaries are not legal in every state. Oftentimes one can find hemp-derived CBD in local health stores. If taken once daily, a continuous regimen of CBD would cost approximately $2-$3 per day. As detailed in the following section, insurance will not cover the cost, therefore the daily cost would be out-of-pocket.
Unfortunately, private health insurance companies will not cover the cost of CBD products with the exception of Epidiolex, which is FDA-approved for epilepsy. Some Parkinson’s patients and their caretakers may find that high-CBD strains of medical marijuana aren’t overly expensive and are safer (have less harmful side effects) compared to medications prescribed for Parkinson’s disease.
People frequently want to know if Medicare covers the cost of CBD products. CBD (as well as THC) does not have FDA approval, so it is still classified as a Schedule 1 drug. Because of this, Medicare does not cover the cost of any CBD product. In addition, it cannot be used towards a drug plan deductible (like Medicare Part B).
As with Medicare, Medicaid will not cover the cost of CBD products because of lack of FDA approval.
The VA will not directly cover the cost of products containing CBD. However, there are VA pensions, such as the basic pension and Aid & Attendance (A&A) Pension from which veterans or surviving spouses receive a monthly monetary benefit. Recipients of these pensions are able to use the money as they see fit, which means theoretically that one could use it towards purchasing CBD products. Learn more about these pensions here.
Many CBD retailers provide discounts to veterans who might need help covering the costs of their products. It is possible for active duty and military veterans to receive savings of more than 50% from companies that deliver CBD nationwide.