If you have COPD, you may have been asked a surprising suggestion recently: Have you considered CBD? CBD (short for cannabidiol) is a chemical found in marijuana and other forms of the cannabis plant that’s now available in a wide variety of products, including tincture drops, capsules, candy, cookies, and even coffee. CBD is also sold in liquids that are warmed and inhaled with a special device (known as “vaping”).
Research shows that CBD appears to have various medicinal properties. Now some proponents are touting CBD’s potential to ease symptoms of COPD, or chronic obstructive pulmonary disease, a condition that affects your airways, making it hard to breathe normally. Can CBD help you catch your breath? As products laced with this cannabis extract pop up in convenience stores and pharmacies in many states (though a few prohibit or place tight restrictions on sales of CBD), you might be tempted to give one a try. Here’s what you should know before you buy.
What Is CBD?
There are about 540 chemicals in cannabis, but the two you may have heard of are tetrahydrocannabinol (THC) and CBD, which are known as cannabinoids. THC is the stuff in pot that makes you feel “high.” CBD doesn’t have that effect and is generally considered safe.
You can also find CBD in hemp, a related cannabis plant that has very little THC. While you can buy marijuana legally in many states, the federal government still considers it an illicit drug. But CBD derived from hemp can be sold legally in most of the United States, with some exceptions. (Hemp seed oil is also available. It contains some CBD but little THC.)
The FDA has approved a prescription drug made with CBD, Epidiolex, to treat some forms of epilepsy and a condition called tuberous sclerosis complex, which causes growth of benign (noncancerous) tumors. But many people use CBD to self-treat a variety of conditions, including pain, insomnia, anxiety, and others. There isn’t much research on whether CBD helps with these health problems, though some evidence is beginning to build. For example, a handful of early studies in both animals and humans suggests that CBD could help ease anxiety, though more research is needed.
Does CBD Work for COPD?
Doctors don’t know if CBD can relieve symptoms of COPD or any other form of lung disease. “There’s not any research that says CBD is effective for COPD,” says April Hatch, a nurse at Cannabis Care Team in Kansas City, MO. She works with patients interested in cannabis-based therapies.
The belief that CBD might ease COPD symptoms may have sprung from research done decades ago, which showed that smoking pot actually relaxed the airways and improved breathing in healthy people and people with asthma. But that benefit was short-lived, and routine pot smoking is known to promote breathing problems, like coughing and wheezing.
Some lab studies have offered early signs that CBD could alter certain biological changes that cause COPD. With COPD. Your lungs become highly inflamed. The inflammation doesn’t go away and leads to irreversible blockages in your airways. CBD does seem to fight inflammation, at least in studies on animals. And a 2020 study in the Journal of Cannabis Research found that cannabis oil (which contained CBD and THC) appeared to act as an anti-inflammatory when exposed to human lung cells in a laboratory.
“The problem with these kinds of studies is that they only offer hints that CBD might help relieve breathing problems," says pulmonologist Andrew Martin, MD, chair of pulmonary medicine at Deborah Heart and Lung Center in Browns Mills, NJ. Unfortunately, he says, some experimental medicines that look promising in the lab end up having no effect when given to real people.
And that’s just what seems to have happened when scientists have tested whether CBD improves breathing in people with and without COPD. In a 1984 study, large doses of CBD given to healthy men failed to relax and widen their airways. In a very small 2011 study that included just four people with COPD, treatment with a drug called Sativex, which has THC and CBD, didn’t improve scores on a test that measures breathing. Interestingly, though, after treatment with the medication, they reported being less out of breath.
In another small study from 2018, researchers had people with advanced COPD inhale vaporized cannabis to see if it gave them more lung power when pedaling exercise cycles. It didn’t help, though in fairness the strain of pot used in the study contained only a very small amount of CBD. Once again, the people who inhaled cannabis said they felt less anxious, though that came at a cost, since they also felt high.
If You Decide to Try CBD
If you’re still thinking of giving CBD a try for your COPD symptoms or any other reason, talk to your doctor first. You might be surprised by their response.
“I have no objections to the use of cannabinoids,” says Martin, who doesn’t think they’ll help, but probably won’t hurt -- if you use the right products. “As a lung physician, I cannot recommend that you smoke cannabis to get your CBD," he says. That includes inhaling cannabis or CBD oil with a vaping device, which he worries could be harmful to the lungs.
“If taking CBD makes you feel better and decreases your anxiety,” he says, “use the edible version.”
Hatch suggests you only buy CBD products from a retailer that can provide a document known as a certificate of analysis. This shows the product has been tested in a lab, is free of contaminants, and contains the amount of CBD listed on the label.
Chances are, your local convenience store can’t or won’t provide those documents, so if possible purchase CBD at a medical marijuana dispensary, Hatch says. Research shows that taking 10 milligrams three times a day is an appropriate starting dose, she says, adding that it may take weeks or even months to notice a benefit. If you feel CBD isn’t helping, ask your doctor what you can do to improve your symptoms.
