Anxiety: There are several neuropsychiatric disorders relating to anxiety, including but not limited to, generalized anxiety disorder, panic disorder, and social anxiety. These disorders combined have a prevalence of 29% in the United States and most go undiagnosed or are under-treated. 2,3 Generalized anxiety disorder, along with the other anxiety-related disorders, are commonly treated with antidepressant drugs and anxiolytic drugs. 4 These medications are linked to limited efficacy and adverse effects. 2 Alternative therapies need to be identified that may have better efficacy and are better tolerated than the current available treatments. 4,5 There is some evidence that suggests that CBD is effective in reducing anxiety. 6

Pain: Pain is the most common reason patients consult primary care providers. 7 According to recent literature, over 40% of the adult Americans, an estimated 100 million people, live with chronic or recurrent pain and pay an estimated $120 billion a year in medical costs in the United States. 7, 8 Continued research is needed to evaluate the impact of pain and the available treatments and determine how to reduce its effect on people’s lives. 7

Sleep: Nearly 50% of the adult population in the United States (US) experiences sleeping problems 9-12 with high rates of dissatisfaction over the efficacy and concerns about side effects of conventional pharmaceutical medications used to address sleep issues. 13 Sleep disorders are also a common issue associated with anxiety. 14 According to the American Sleep Association, sleep can improve by reducing certain symptoms, such as anxiety and pain. Both conditions have been demonstrated to be decreased by CBD, resulting in a better night’s sleep. CBD interacts with certain receptors in the body that will affect the sleep cycle, increasing the duration of a patient’s sleep. 14,15 Evidence has shown that one of the most commonly observed effects of CBD at higher doses is sedation. 16

Acne: According to recent research, the most common skin condition is acne, affecting up to 50 million people in the US. 17 Although its cause is multifactorial, changes in sebaceous gland functions including increased production of sebum is thought to be involved in the development of acne. 18 Studies have demonstrated that CBD influences the creation of sebum through sebocytes. The research shows that CBD prevented excess sebum, later decreasing the amount of acne released. 14 More research is needed to evaluate the efficacy and proper dosing of CBD to provide the maximum effect for patients suffering from acne, in addition to exploring other routes of administration, such as the topical application of CBD for this condition. 14

GI: It is estimated that in the United States 11% of the population suffer from a chronic digestive disease, with a prevalence rate as high as 35% for those 65 years and over. 19 These include conditions of the gastrointestinal tract that are chronic and relapsing. Two main types are Crohn’s disease and ulcerative colitis. Both forms have similar symptoms, i.e. diarrhea, abdomen pain, and weight loss. These conditions are traditionally treated with corticosteroids, immunomodulators, or biologic agents. Researchers continue to identify alternative treatment options that are efficacious and safe. Over the past several years, research evaluating the efficacy of CBD in gastrointestinal disorders has been mixed. 20,21 Studies have shown that CBD has a positive impact on IBD conditions, specifically through an anti-inflammatory effect. Evidence shows that the activation and inhibition of peripheral and central cannabinoid receptors can affect processes of the GI tract. CBD may be a beneficial form of treatment due to the increased rate of clinical response without the traditional side effects reported with other treatment modalities. 22

In this IRB-approved observational study, relevant and validated measurement scales will be incorporated and administered based on the condition that is being treated with CBD to ensure objective responses from clinicians and patients.