Chronic Obstructive Pulmonary Disease (COPD): Cannabinoids and CBD Research Overview

The third leading cause of death in the United States, COPD is a group of lung diseases that block airflow and make it difficult to breath. Research indicates that cannabis can help patients manage the pulmonary diseases by reducing airway inflammation and causing bronchodilation.

Overview of COPD

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease that obstructs airflow to the lungs and makes it difficult to breathe. In the United States, COPD is most commonly associated with the development of emphysema and chronic bronchitis.

When a person has COPD, less air flows in and out of the airways because either they lose their elastic quality or make more mucus than usual, causing clogging. In chronic bronchitis, the walls of the bronchial tubes become thick and inflamed. In emphysema, the walls between the air sacs can be destroyed, reducing airflow.

COPD is caused by long-term exposure to irritating particulate matter or gases. The number one cause of COPD is cigarette smoking, but other irritants like secondhand smoke, air pollution and workplace exposure to dust and smoke can also pose problems. The disease develops slowly and symptoms get worse over time until even the most basic physical activities, like walking or cooking, became too difficult.

The symptoms associated with COPD typically include the coughing up of large amounts of mucus, shortness of breath, wheezing, and chest tightness. Symptoms often don’t appear until significant damage to the lungs has already occurred. A major cause of disability, COPD is most commonly diagnosed in middle-aged or older adults.

COPD has been shown to increase the risk of respiratory infections, heart problems, lung cancer, high blood pressure and depression.

There is no cure for COPD and as of now, damage to the airways and lungs are irreversible. However, treatments can help control symptoms and reduce the risk of complications and exacerbations. Bronchodilators are medications that can be used to relax the muscles around the airways. Inhaled steroids help reduce airway inflammation.

Findings: Effects of Cannabinoids and CBD on COPD

Studies indicate that cannabis could potentially be therapeutically beneficial for managing acute attacks of airway constriction due to inflammation, thereby acting as a preventative measure for patients with COPD. Cannabis has been shown through numerous studies to have efficacy for reducing inflammation, suggesting it could be effective for helping manage inflamed airways in those with chronic bronchitis^4,8,11,17.

Two of the major cannabinoids found in cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD) have shown in several studies to have anti-inflammatory benefits through a variety of mechanisms¹⁴. THC and CBD interact with the endocannabinoid system’s cannabinoid receptors (CB₁ and CB₂) to help the body maintain homeostasis. The activation of CB₁ and CB₂ receptors has shown to reduce airway inflammation^3,6. An animal study concluded that CBD has a potent anti-inflammatory effect and also improves lung function, suggesting it could be a useful therapeutic tool for the treatment of inflammatory lung diseases¹⁰. In another study, CBD was shown to have anti-inflammatory effects following acute lung injury⁹. Studies have also found that terpenes, the aromatic compounds found in cannabis, show anti-inflammatory benefits⁷.

Some research has also shown that the cannabinoids found in cannabis can have bronchodilatory effects, thereby decreasing resistance in the respiratory airway and increasing airflow to the lungs¹². One study found that cannabinoids’ activation of the CB₁ receptor inhibits contraction of the smooth muscle surrounding the lungs to dilate the bronchial tubes and further open up the airways⁷.

It’s important to note that findings in several studies suggest that the smoking of Cannabis may increase the prevalence of acute and chronic bronchitis due to irritants entering the lungs¹³. Heavy smoking of Cannabis on its own can cause airway obstruction^1,16. These findings suggest that patients with COPD should stick with cannabis products that are delivered through methods other than smoking, such as cannabis oils and edibles.

States That Have Approved Medical Cannabis for COPD

While no states have approved medical cannabis specifically for the treatment of COPD, several states will consider approving medical Cannabis for the treatment of other conditions, but require an approval or a recommendation by a physician. These states include: California (any debilitating illness where the medical use of cannabis has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).

In Washington D.C., any condition can be approved for medical cannabis as long as a DC-licensed physician recommends the treatment.

Recent Studies on Cannabinoids and CBD’s Effect on COPD

CBD has a potent anti-inflammatory effect and also improves lung function, suggesting it could be a useful therapeutic tool for the treatment of inflammatory lung diseases.
Cannabidiol improves lung function and inflammation in mice submitted to LPS-induced acute lung injury.
(https://www.ncbi.nlm.nih.gov/pubmed/25356537)

Cannabis has shown to be effective for treating inflammation.
Cannabinoids, endocannabinoids, and related analogs in inflammation.
(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664885/)

References:

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2. Bento, A. F., Marcon, R., Dutra, R. C., Claudino, R. F., Cola, M., Pereira Leite, D. F., and Calixto, J. B. (2011). β-Caryophyllene Inhibits Dextran Sulfate Sodium-Induced Colitis in Mice through CB2 Receptor Activation and PPARγ Pathway. The American Journal of Pathology, 178(3), 1153–1166.
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15. What is COPD? (2014, May 22). National Heart, Lung, and Blood Institute. Retrieved from https://www.nhlbi.nih.gov/health/health-topics/topics/copd.
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