Real Scientific Hemp Oil Review May 2022
Overall CBDC Brand Rating for Real Scientific Hemp Oil : 8.6/10
Real Scientific Hemp Oil ( RSHO ) promotes safe and high-quality cannabidiol (CBD) products in the industry by developing a triple lab testing process.
The Utah-based brand works with a testing lab with an International Organization for Standardization (ISO)/International Electrotechnical Commission (IEC) 17025:2005 accreditation to ensure its products’ safety.
RHSO provides CBD products certified by the US Hemp Authority. It also offers a wide range of unique CBD products , including oral applicators .
The brand offers its full-spectrum CBD and CBD isolate products to users inside and outside the US.
The Organization for Economic Co-operation and Development (OECD) also certified the brand’s ingredients as organic. OECD is an international organization that implements standards that support the development of improved international policies.
However, the RSHO website has a confusing layout and has no online shop, which may be inconvenient for buyers. You have to buy RSHO products from the brand’s online distributor, HempMeds . Third-party lab test results are also not published on the brand’s website. Still, you may access the lab reports once they buy a product and receive a QR code.
Looking for something different? See our top CBD Oil for 2021 .
Real Scientific Hemp Oil Company Summary
- RSHO was founded in 2012 in Lindon, Utah, to promote the benefits of CBD to the masses.
- The brand offers full-spectrum CBD and CBD isolate products. It also uses a solvent -free CO 2 extraction process to ensure product safety.
- RSHO developed a triple testing standard, ensuring that all of its products are safe and free from contaminants.
- The brand provides a QR code to customers to view the certificate of analysis (COA) of the product they purchased.
Real Scientific Hemp Oil Pros and Cons
Real Scientific Hemp Oil Pros
- The Real Scientific Hemp Oil offers CBD applicators , which are CBD hemp oils encased in tubes for consistent and convenient dosing.
- The brand claims that it taps a testing lab with an ISO/IEC 17025:2005 accreditation to ensure product safety and quality. The accreditation is awarded to competent calibration and testing laboratories.
- RSHO products are certified by the US Hemp Authority, which recognizes brands with high standards and best practices.
- The brand uses hemp ingredients certified with the OECD for the UK and Central European markets.
Real Scientific Hemp Oil Cons
- The RSHO website has a confusing layout that may redirect you to external sites when you click on featured tabs.
- Unlike other CBD brands , RSHO has no online shop on its website, which might be inconvenient for buyers. Instead of buying on the RSHO website, customers are redirected to the website of the brand’s online distributor, HempMeds .
- Lab test results are not published on the brand’s website. A QR code, given to those who purchased RSHO products , is needed to access lab results.
Review of Real Scientific Hemp Oil Products
Real Scientific Hemp Oil CBD Oil
RSHO’s CBD oil comes in various strengths and sizes to ensure that all CBD users may find the right product they need.
The product is available in three variants: Green Label , Blue Label , and Gold Label , all available in two- and four-oz bottles .
RSHO Green Label tinctures retain the raw state of hemp and contain medium-chain triglyceride ( MCT ) oil derived from coconut oil and palm oil. According to the brand, the MCT oil it uses serves as an excellent source of healthy fatty acids .
The RSHO Green Label 2oz CBD Oil Tincture (500mg CBD) contains full-spectrum CBD . Other natural ingredients of the CBD hemp oil include terpenes , omega-3 and omega-6 fatty acids , and chlorophyll .
Meanwhile, the brand’s Blue Label CBD hemp oils have pure decarboxylated hemp. The decarboxylation process involves heating cannabis plants to activate the plant’s major components (1 ) .
The RSHO Blue Label 2oz CBD Tincture (500mg CBD) contains MCT oil from coconut oil . The product is also available in a one-ounce bottle, which has 100mg of CBD.
Gold Label tinctures contain pure decarboxylated and filtered hemp oil. The products are also infused with MCT oil from coconut oil .
The RSHO Gold Label 2oz CBD Tincture (500mg CBD) is infused with full-spectrum CBD . The brand also claims that the product has minerals, vitamins, terpenes , and other cannabinoids .
According to product labels, RSHO tinctures may be taken once or twice a day. You may also gradually increase the serving size until you achieve the results you want.
You may take the oil sublingually or by using a dropper to put the oil under your tongue.
Real Scientific Hemp Oil CBD Salve
One of the brand’s most popular products is the RSHO 1.3oz CBD Salve (500mg CBD). The salve contains sunflower butter, beeswax, jojoba butter, candelilla, and rice bran .
According to a study, jojoba oil has anti-inflammatory, antimicrobial, and antifungal properties (2 ) . Another research noted that sunflower seeds and sprouts have antioxidant, antimicrobial, anti-inflammatory, and wound-healing properties (3 ) .
Meanwhile, a 2017 study discussed the antimicrobial properties of beeswax in humans. According to the study, beeswax had inhibitory effects against bacteria, including salmonella and Candida albicans , which may cause skin diseases (4 ) .
The brand recommends the salve to users who want to nourish and hydrate dry skin. The salve may also be applied to worn and tired areas of your body, from tired muscles and joints to dry elbows and cuticles.
HempMeds also recommends the salve to more active CBD users, including competitive athletes.
According to RSHO , you may apply the product daily on age spots, wrinkles, and dry skin.
Product reviews show that other product users experienced an improvement in muscle pain after using the salve .
Real Scientific Hemp Oil Capsules
RSHO offers CBD capsules, which are also available in Green Label , Blue Label , and Gold Label variants.
The RSHO Green Label CBD Capsules (25mg CBD) 30 Count costs $98.99. The vegan product contains minimally processed full-spectrum hemp oil.
According to RSHO , the hemp oil in the product is unfiltered to retain the hemp plant ’s raw form.
Meanwhile, the RSHO Blue Label CBD Capsules (25mg CBD) 30 Count is available for $108.99. The hemp oil in the product undergoes decarboxylation to activate the plant’s CBD.
Finally, the $118.99 RSHO Gold Label CBD Capsules (25mg CBD) 30 Count also contains decarboxylated hemp oil. The hemp oil in the product is clean and filtered.
According to RSHO , the capsules also contain 200mg of calcium and 200mg of a special blend of powdered turmeric root and white willow bark.
According to a 2017 study, turmeric contains curcumin, a naturally occurring compound that helps manage a wide range of medical conditions, including inflammatory diseases, anxiety, and arthritis (5 ) .
Meanwhile, a 2013 research noted that white willow bark might help treat fever, pain, and inflammation (6 ) .
The brand recommends a dosage of one to two capsules every day.
Real Scientific Hemp Oil CBD Isolate
RSHO also offers two CBD isolate products: the Real Scientific Hemp Oil -X 4oz CBD Isolate Liquid (1000mg CBD) and the RSHO-X 8oz CBD Isolate Liquid (5000mg CBD).
The $99.99 RSHO-X 4oz CBD Isolate Liquid (1000 mg of CBD ) contains pure CBD isolate and is infused with organic coconut oil .
The RSHO-X liquid is encased in an amber glass bottle to preserve product purity and increase shelf life.
Product reviews show that the CBD isolate liquid helped some users manage sleeping problems.
Meanwhile, the RSHO-X 8oz CBD Isolate Liquid (5000mg CBD) is available for $289.99. The product also received positive reviews from previous users.
According to a 2019 study, CBD may help alleviate anxiety in humans (7 ) .
Real Scientific Hemp Oil CBD Applicators
The brand offers CBD hemp oil products in oral applicators to provide users with a quick and easy way to take CBD.
The oral applicators are available in three- or ten-gram tubes, which come with a plunger for dispensing the oils.
The brand offers applicators with a 15-gram tube, which uses a dial instead of a plunger to dispense the CBD oil.
The RSHO Blue Label 3g Pure CBD Oil (510mg CBD) contains decarboxylated hemp oil for increased CBD concentration . The product is sold at $98.99.
According to the brand, the 3g CBD applicator also has vitamins, minerals, terpenes , essential fatty acids , and other cannabinoids .
Meanwhile, the RSHO Gold Label 3g Pure CBD Oil (720mg CBD) costs $108.99. The product contains decarboxylated CBD and filtered hemp oil to remove any chlorophyll and other plant material .
The brand also offers the RSHO Maximum Strength 10g Pure CBD Oil (4500mg CBD), the brand’s highest concentration full-spectrum CBD oil. The product is a combination of RSHO ’s Green and Gold Label oils.
To use the applicator , you must remove the cap from the device. You may then depress the plunger until you have dispensed the amount of oil you want according to the markers on the side of the applicator .
You may then consume the oil however you see fit. You may place the oil directly on your fingernail, a spoon, or a butter knife, before putting the oil under your tongue. Hold the oil in place for 90 seconds before swallowing.
You may also add the oil to a scoop of honey, yogurt, or other food to mask the taste.
A 2019 study noted that CBD may provide health benefits like anti-seizure properties (8 ) .
Recommended for Optimizing Wellness
RSHO aims to provide customers with the best organic solutions to their health issues. The brand’s products are recommended for individuals wanting to incorporate CBD into their general wellness regimen.
Source of Hemp
According to RSHO , its full-spectrum CBD oils are sourced from hemp grown naturally in the Netherlands. The brand said its hemp plants are grown in a generational family-owned farm with centuries of experience.
The brand’s most popular products are the RSHO 13oz CBD Salve (500mg CBD), RSHO Gold Label 4oz CBD Liquid (1,000mg CBD), and RSHO Gold Label 10g Pure CBD Oil (2,400mg CBD).
RSHO sells both full-spectrum CBD and CBD isolates .
A product with full-spectrum CBD (whole plant CBD) has high concentrations of CBD and other cannabinoids , terpenes , and low levels of tetrahydrocannabinol ( THC ).
A full-spectrum extraction process retains the hemp plant ’s natural terpenes and cannabinoids .
Some users opt for full-spectrum CBD products to take advantage of the “entourage effect,” which helps maximize CBD’s therapeutic properties.
Meanwhile, a CBD product with CBD isolates contains no other cannabinoids except CBD. A CBD isolate is created by removing all non-CBD compounds from a hemp plant , including THC .
CBD isolate products are recommended for users who want to enjoy CBD while keeping their bodies THC -free.
Range of Products/Forms
RSHO offers CBD in liquids, oils, capsules, applicators , and topicals .
The brand’s most affordable product is the $28.99 for the RSHO Blue Label 10oz CBD Oil Tincture (100mg CBD). Meanwhile, the most expensive offering is the $1,949.99 for the RSHO Max Strength 10g Pure CBD Oil (4,500mg CBD) 6 Pack.
RSHO uses the CO 2 extraction process in separating CBD and other phytonutrients from the raw hemp plant material .
The CO 2 extraction process uses pressurized chambers and pumps to induce very high and low temperatures. The method uses one chamber to hold pressurized CO2, while another pressurized chamber holds the hemp plant in place.
Lab Testing Transparency & Availability
According to RSHO, the company developed a triple testing process to ensure the quality and safety of its products.
The brand claimed that it uses ISO/IEC 17025:2005-accredited testing labs to test its hemp oil. The tests include measuring the exact concentration of cannabinoids , including CBD, cannabidiolic acid ( CBDa ), cannabigerol (CBG), and THC .
However, the results of the tests are not published online.
CBD Concentration per Serving Range
The RSHO Blue Label 1oz CBD Oil Tincture (100mg CBD) has a CBD concentration of 100.35mg/unit. The data is collected from a third-party lab report published in June 2019.
The RSHO Blue Label 1oz CBD Oil Tincture (100mg CBD) has a CBD potency of 3.35mg/ml. The data is collected from a third-party lab report published in June 2019.
THC Range of Products %
The RSHO Blue Label 1oz CBD Oil Tincture (100mg CBD) has a THC content of 1.41mg/unit. The data is collected from a third-party lab report published in June 2019.
Tincture Carrier Oil
RSHO uses medium-chain triglyceride ( MCT ) oil derived from coconut oil and palm oil as its tincture carrier oil.
Lab results are not published on the brand’s website. However, the brand claims that its products are made from non-GMO ingredients.
The brand uses organic and natural ingredients certified by the Organization for Economic Co-operation and Development (OECD).
The brand offers free shipping for orders worth more than $75.
RSHO has a 14-day refund policy for customers who wish to return the products they purchased.
However, packages to be returned must be unused and unopened, and shipping costs are not refundable. If you wish to return a product, you must also shoulder the return shipping costs.
A 15% restocking fee must also be paid for all product returns.
According to RSHO , its products are free from contaminants, including herbicides , pesticides , residual solvents , chemical fertilizers , and other harmful compounds.
If you want to reach RSHO , you may send an email to [email protected] realscientifichempoil .com or call +1 866-273-8502.
Although RSHO does not have its online shop on its website, you may purchase RSHO products from HempMeds . You only have to provide your delivery information and proceed to the checkout page to pay online.
The brand delivers its products within the US. It also ships to more than 40 other countries.
More About Real Scientific Hemp Oil
Based in Lindon, Utah, Real Scientific Hemp Oil ( RSHO ) was founded in 2012 by parent company Medical Marijuana Inc ., as an avenue to bring the benefits of CBD to the masses.
The brand uses non-GMO hemp and a solvent -free CO 2 extraction process to ensure product safety.
In line with its commitment to product safety, the brand developed its triple testing standard.
First, cultivators in Europe test the hemp plants throughout the growing season and again after harvest and extraction. According to the brand, doing the initial tests allows hemp growers to maintain optimal CBD content for RSHO products and check for any contaminants.
The second phase of testing begins once the hemp oils arrive in the US from Europe. An ISO/IEC 17025:2005-accredited lab checks for CBD content and verifies the safety of the oils after their shipment.
Aside from testing the cannabinoid concentration, the lab also tests yeast, mold, fungus, mildew, bacteria, heavy metals, and residual solvents to ensure that the products are free from contaminants.
After the second round of tests, the CBD oils are sent to the brand’s California-based formulators. According to RSHO , the formulators are certified to be using Good Manufacturing Practices (GMP).
The formulators begin the final testing, including a batch test of the finished products to ensure product safety.
Aside from ensuring product safety, the brand also promotes global wellness through CBD use.
The brand’s distributor, HempMeds , pushed for the legal import of CBD oil products in Brazil, Mexico, and Paraguay. Additional information about RSHO is available on the HempMeds website.
What Is CBD?
Cannabidiol (CBD) is a naturally occurring compound and is one of the several cannabinoids present in the cannabis plant.
Although typically sourced from the indica strain of the cannabis plant, CBD is also present in trace amounts in the sativa strain of cannabis .
Most CBD brands mix CBD with tincture carrier oils to create CBD oil products. Some of these oils include MCT oil , which is mostly extracted from coconut oil , and hempseed oil, which is extracted from hemp seeds.
Aside from CBD oil formats, CBD may also be taken in the form of gummies, hemp extracts , topicals , teas, vape juice, or capsules.
Is There Any Science Behind CBD Oil?
The brand claims that RSHO CBD products interact with cannabinoid receptors in the body’s endocannabinoid system (ECS).
According to a 2017 study, ECS is a biological system that plays a crucial role in developing the central nervous system (CNS) (9 ) .
A different study noted that modulating the body’s ECS may help treat a wide range of medical conditions, including mood and anxiety disorders, movement disorders, neuropathic pain, multiple sclerosis, cancer, stroke, hypertension, and glaucoma (10 ) .
Is There a Difference Between CBD Oil and Hemp Oil?
CBD oil is made by extracting CBD from hemp and then mixing it into tincture carrier oils, such as hempseed oil or MCT oil .
Meanwhile, hemp oils are made by cold-pressing hemp plants into oils. Hempseed oil is made from hemp seeds.
The main difference between hempseed oil and CBD oil is that hempseed oil has almost zero CBD content , while CBD oil has a high- CBD range .
Most CBD oils are created using the stalks, flowers, and leaves of hemp plants , all of which are rich in CBD. Meanwhile, most hemp oils are sourced from hemp seeds, which contain only trace amounts of cannabinoids (11 ) .
What Are the Side Effects of CBD?
It is essential to consult your doctor before consuming CBD because it may cause side effects, including diarrhea, dry mouth, reduced appetite, drowsiness, and tiredness. It may also interact with other drugs inside your body (12 ) .
Seeking medical advice from your doctor is crucial, especially if you are taking other drugs for a serious medical condition.
Is CBD Legal?
The use of hemp-derived CBD is legal at the federal level in the United States since 2018, when former President Donald Trump passed the Farm Bill. Under the bill, hemp cultivation is permitted as long the plant has less than 0.3% THC (13 ) .
However, it is still recommended to read up on state laws before buying CBD as CBD regulation laws vary depending on the state. It is also important to note that CBD’s use is still unregulated by the US Food and Drug Administration (FDA).
RSHO is on track to successfully educate the masses on CBD’s medicinal benefits by providing the highest quality CBD products . The brand is also on its way to successfully promoting the production of safe CBD products .
The brand may serve as a model to other CBD brands to have triple testing processes to ensure CBD products ‘ safety.
Because RSHO products do not contain THC, they may be recommended for competitive athletes, first responders, or anyone subject to a drug test.
Nevertheless, RSHO may still improve its service by putting more information on its website. The website currently lacks vital product information, and product pages are only available at HempMeds ’ website.
RSHO may also be more transparent by publishing its third-party lab reports on its website. This way, even those who are still planning to buy RSHO products may also view COAs.
Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
All datasets generated for this study are included in the article/supplementary material.
Accumulated evidence indicates that cannabidiol (CBD), a nonpsychotomimetic and nonaddictive main component of the Cannabis sativa plant, reverses anxiety-like behavior. The purpose of the present study was to assess the efficacy of CBD treatment for Japanese late teenagers with social anxiety disorder (SAD). Thirty-seven 18–19-year-old Japanese teenagers with SAD and avoidant personality disorder received, in a double-blind study, cannabis oil (n = 17) containing 300 mg CBD or placebo (n = 20) daily for 4 weeks. SAD symptoms were measured at the beginning and end of the treatment period using the Fear of Negative Evaluation Questionnaire and the Liebowitz Social Anxiety Scale. CBD significantly decreased anxiety measured by both scales. The results indicate that CBD could be a useful option to treat social anxiety.
Keywords: cannabidiol, social anxiety disorder, cannabis, cannabinoid, social phobia, avoidant personality disorder, social withdrawal
The primary noneuphorizing and nonaddictive compound of cannabis, cannabidiol (CBD), has recently been shown to possess considerable therapeutic potential for treating a wide range of neuropsychiatric disorders (De Gregorio et al., 2019). They include chronic pain (Costa et al., 2007), nausea (Parker et al., 2006), epilepsy (Devinsky et al., 2016), psychosis (McGuire et al., 2018), and anxiety (Scuderi et al., 2009; Whiting et al., 2015). CBD in therapeutics is used within a large therapeutic window, which ranges from 2.85 to 50 mg/kg/day (Whiting et al., 2015; Devinsky et al., 2016). While this fact indicates that its therapeutic dose is still mostly unknown, clinical studies have revealed that CBD could produce analgesic and anxiolytic effects exerted through its interaction with 5HT1A receptors (De Gregorio et al., 2019). As a potential anxiolytic treatment, in particular, it has drawn increasing interest. A review (Blessing et al., 2015) concluded that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and posttraumatic disorder when administered acutely.
Clinical data showing therapeutic effects of CBD in patients with anxiety disorders, however, are still meager (Bergamaschi et al., 2011; Crippa et al., 2011). The purpose of the present study was to investigate these effects in patients with social anxiety disorder (SAD).
SAD is characterized by excessive anxiety in situations where a person might feel judged, such as performance situations, and situations involving interpersonal contact with others (American Psychiatric Association, 2000). This is the fear of social situations that may cause humiliation or embarrassment. While it is one of the common anxiety disorders (Craske et al., 2017), it is a relatively new area of research, and thus, its etiology, effects, and treatment are not clearly understood. Even prevalence rates reported in the literature vary across studies (Antony and Rowa, 2008). For instance, lifetime prevalence estimates for SAD based on large community samples in the United States range from 3 to 13%. In addition, some studies report that SAD has a higher incidence in females than in males (Kessler et al., 2005).
Developmentally, SAD is likely to not only begin in adolescence (mid to late teens) but can also occur earlier in childhood (Somers et al., 2006). A significant number of adults report that they have had problems with social anxiety for their entire lives or as long as they can remember (Brown et al., 2001; Masataka, 2003). A large-scale study of individuals presenting at an anxiety clinic found a mean age of onset of 15.7 years, a number that was younger than the onset of other anxiety disorders (Merikangas et al., 2011).
SAD is best treated with psychotropic medication and cognitive behavioral therapies (CBT), and the most effective treatments are a combination of both (Nordahl et al., 2016). They consist of monoamine oxidase inhibitors, the serotonin reuptake inhibitors, benzodiazepines, and individual cognitive behavioral therapy. CBT typically includes 10–15 weekly sessions and consists of a variety of strategies, such as self-monitoring, psychoeducation, cognitive therapy, exposure-based techniques, and social skills training. While this method has been proven to be effective for SAD if it is executed, it is also true that people with the disorder quite often show unwillingness (Ryan and Warner, 2012) to receive CBT. In fact, a study reported that 92% of individuals with SAD expressed concerns about starting treatment and that is the biggest barrier to treatment that should be overcome (Kessler et al., 2005).
In this regard, preliminary findings reported by a study (Bergamaschi et al., 2011) that investigated the efficacy of CBD with patients with SAD are noteworthy. In that study, 12 patients with SAD were provided with a single dose of CBD (600 mg). When the anxiety induced by simulated public speaking was compared between pretreatment and posttreatment, its level showed a significant decrease after the treatment, whereas no such change was observed in the placebo group of 12 other patients.
The purpose of the current study was to pursue this issue further and to investigate the possible efficacy of CBD as at least an adjunctive option for intervention in people with SAD. While SAD has been classified into several subtypes so far (Antony and Rowa, 2008), here, the author concentrated the research on that with avoidant personality disorder because this subtype is the most commonly diagnosed and is becoming a serious social problem in Japan, where the current study was conducted (Ogino, 2004; Saito, 2007; Teo, 2010). The author attempted to systematically assess the efficacy of CBD in a total of 37 18–19-year-old Japanese with SAD, all of whom had been naive to any form of treatment, by measuring the level of the symptoms of SAD with both the Fear of Negative Evaluation Questionnaire (FNE; Watson and Friend, 1969) and the Liebowitz Social Anxiety Scale (LSAS; Liebowitz, 1987) using an exploratory double-blind parallel-group trial experimental paradigm.
FNE is a 30-item measure of apprehension and anxiety over anticipated social evaluations. This measure uses a true-false scale and is known to show good internal consistency and test-retest reliability (Watson and Friend, 1969). FNE has a range from 0 to 30, with high scores indicating higher levels of social anxiety. LSAS is a short questionnaire to assess the range of social interaction and performance situations feared by a person in order to assist in the diagnosis of SAD (Liebowitz, 1987). It has been commonly used to investigate outcomes in clinical trials and, more recently, to evaluate the effectiveness of psychological treatments (De Gregorio et al., 2019). The scale features 24 items, which are divided into two subscales. Thirteen questions relate to performance, and 11 relate to situations.
The author attempted to assess the efficacy of CBD by comparing the FNE and the LSAS scores measured before the commencement of the 4-week-long intervention (preintervention) and the scores measured after the completion of the intervention (postintervention) in the group of participants who were provided with CBD (the CBD group) and in the group whose participants were provided with placebo (the placebo group). The author hypothesized that CBD would significantly decrease anxiety measured by both of the two scales employed.
Materials and Methods
This investigation was conducted according to the principles expressed in the Declaration of Helsinki. All experimental protocols were consistent with the Guide for Experimentation with Humans and were approved by the Institutional Ethics Committee of Kyoto University (#2018-150), the regional committee for medical and health research ethics (#2018/1783), and the Japanese Data Inspectorate for clinical trials (JCT0018004564). The author obtained written informed consent from all of the participants involved in the study. Written informed consent was additionally obtained from the parent/legal guardian of all participants who were younger than the age of consent at the time of the study.
Design and Participants
A randomized, placebo-controlled, comparative study with a total of 37 Japanese adolescents was undertaken. Double masking was conducted, and the participants and the investigator were blinded regarding which condition (CBD oil or placebo) under which each participant was studied.
At the commencement of the study, 40 teenagers with SAD participated, and 20 of them were assigned to the CBD group and the other 20 to the placebo group. This sample size was determined because the current study had been approved by the ethics committee on the condition that, as a pilot study, no more than 20 teenagers take CBD oil. Of the 40 participants, three in the CBD group declined daily treatment with CBD oil during the study because they disliked the smell and the taste of the oil.
In all, 26 males and 11 females 18–19-year olds were included in the study (12 males and 5 females for the CBD group and 14 males and 6 females for the placebo group). They were all naive to cannabis and diagnosed by psychiatrists in several hospitals located in the vicinity of Osaka Prefecture, Japan, using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I/P; Di Nardo et al., 1994) and Axis II Personality Disorders (First et al., 1997). For all of the participants, symptoms had lasted for at least 6 months at the commencement of the study. Exclusion criteria were experience of receiving previous or concurrent psychological or drug treatment, any form of psychotic or organic illness, diagnosis of cluster A or B personality disorder, acute suicidality, and drug and alcohol dependence. They have not had a comorbid diagnosis of other anxiety or mood disorders.
The participants were invited to attend an assessment interview for possible participation in the present study. None of them were under CBT. Assessment of all of them was undertaken by psychiatrists who were trained in administering the Structured Clinical Interview for DSM-IV (SCID I and II; Liebowitz, 1987; Di Nardo et al., 1994; First et al., 1997). The participants completed the first battery of self-report measures before attending the assessment interview. The baseline period for them was a minimum of 3 weeks showing stable FNE scores (Watson and Friend, 1969; the primary outcome measure). Subsequently, after the assessment interview, they rated themselves on the FNE and LSAS (Liebowitz, 1987) over the succeeding weeks (preintervention). All of the participants had a stable FNE score over the 3 consecutive weeks and were therefore scheduled for intervention within a week after the third-baseline measuring point.
When the 4-week-intervention ended, the FNE and LSAS were completed again by each participant (postintervention), and their scores were compared with those recorded at preintervention. Then, the SCID I and II were administered again by the same psychiatrists who met the participants at preintervention.
After the completion of the intervention, at the follow-up, the clinical psychologists who had been responsible for the intervention visited the participants briefly at their home once a week to check for any effect of it on their health. This follow-up continued for up to a 6-month-period.
All of the participants were randomly assigned into either the CBD group, in which they were to daily receive 300 mg of CBD administered in a single dose in the afternoon, or the placebo group, in which they were to daily receive a matching placebo. The CBD dose was based on that used in the first study showing acute anxiolytic effects in healthy subjects exposed to a simulated public speaking test (Zuardi et al., 1993). This assignment was conducted by an independent statistician who did not know about the purpose of the present research. The CBD used was RSHO-X Hemp Oil (the product of HempMeds, USA) that was produced from the stalk of hemp plants. A 236-ml bottle of the product that was for sale by the company contained 5,000 mg of CBD (21.4 mg/ml) but no delta-9-tetrahydrocannabinol (THC). It did not contain other cannabinoids or terpenes.
The placebo contained olive oil. The CBD oil containing 300 mg of CBD or the equivalent amount of the placebo was administered orally to each of the participants of the CBD group and each of the participants of the placebo group, respectively. For each participant, roughly 420 ml of the CBD oil or the same amount of the placebo was rebottled in a container that was different from that in which it had been originally bottled and that was identical in size and color as well as appearance to the oil administered to the other group.
The container was provided to a clinical psychologist who was employed by the principal investigator and was predetermined to be responsible for each participant. The psychologist who did not know whether the bottle contained CBD or not visited the home of the participant with the container every afternoon and administered the necessary amount of the prepared oil to the participant, using a syringe, during the 4-week intervention period.
While CBD oil had a characteristic smell and taste, all of the psychologists and the participants had been naive to the CBD oil as well as the placebo. The interview with them that was conducted after the completion of the study revealed that none of them noticed the difference between the two.
The results of the measurements with FNE of the level of the symptoms that were associated with SAD are shown in Figure 1 . When the collected data were analyzed by a 2 (period of measurements: preintervention versus postintervention, MEASUREMENT) × 2 (participant group: the CBD group versus the Placebo group, PARTICIPANT) repeated-measures ANOVA (analysis of variance), the main effect was statistically significant for MEASUREMENT (F1,35 = 10.35, p = 0.003, η p 2 = 0.0228) but not for PARTICIPANT (F1,35 = 2.69, p = 0.11, η p 2 = 0.071). The interaction between these factors was significant (F1,35 = 44.81, p < 0.001, η p 2 = 0.561). The mean FNE score (SD) of the CBD group was 24.4 (2.7) in the preintervention measurement and 19.1 (2.1) in the postintervention measurement and that of the placebo group was 23.5 (2.1) in the preintervention measurement and 23.3 (2.9) in the postintervention measurement.
Scores of Fear of Negative Evaluation Questionnaire (FNE) in the participants who received the intervention with cannabidiol (CBD; n = 17) and in the participants who received the intervention with placebo (Placebo; n = 20). The participants were evaluated before (Pre) and after (Post) treatment. Error bars represent SDs. * indicates significant difference from pretreatment measurement.
Subsequent analyses of simple main effects (using Bonferroni correction), which were performed because of the significant interactions between MEASUREMENT and PARTICIPANT, revealed that the mean score of the CBD group was lower in the postintervention measurement than in the preintervention measurement (p = 0.02), while no such difference was found in the placebo group (p = 0.29). Scores of the participants in the CBD group were lower than those of the placebo group in the postintervention measurement (p = 0.0002), but the scores were not statistically significantly different from one another in the preintervention measurement (p = 0.71).
Figure 2 presents the results of the measurements with LSAS of the level of the symptoms that are associated with SAD. The results were strikingly similar to those shown in Figure 1 . The main effect was statistically significant for MEASUREMENT (F1,35 = 10.35, p = 0.003, η p 2 = 0.023) but not for PARTICIPANT (F1,35 = 0.45, p = 0.57, η p 2 = 0.011). The interaction between these factors was significant (F1,35 = 39.16, p < 0.001, η p 2 = 0.528). The mean LSAS score (SD) of the CBD group was 74.2 (7.5) in the preintervention measurement and 62.1 (8.7) in the postintervention measurement and that of the placebo group was 69.9 (10.3) in the preintervention measurement and 66.8 (11.2) in the postintervention measurement.
Scores of Liebowitz Social Anxiety Scale (LSAS) in the participants who received the intervention with cannabidiol (CBD; n = 17) and in the participants who received the intervention with placebo (Placebo; n = 20). The participants were evaluated before (Pre) and after (Post) treatment. Error bars represent SDs. * indicates significant difference from pretreatment measurement.
Another post hoc test revealed that the mean LSAS score of the CBD group was lower in the postintervention measurement than in the preintervention measurement (p = 0.03), but no such difference was found in the placebo group (p = 0.42). Scores of the participants in the CBD group were smaller than those of the placebo group in the postintervention measurement (p = 0.0018), but the scores in the two groups were not statistically significantly different from one another in the preintervention measurement (p = 0.66).
At the follow-up conducted after the completion of the intervention, none of the participants had any significant health complaint, although no systematic evaluation of side effects was conducted. At that time, among the 17 participants included in the CBD group, nine reported that they decided to receive some form of treatment (medication and CBT) by regularly visiting hospitals, while none of the 20 participants in the control group was found to make such a decision. The participants of the CBD group were more likely to make such decision than those of the placebo group were (χ 2 (1) = 13.99, p < 0.001).
The anxiolytic effects of CBD have been extensively demonstrated in animal studies and in healthy volunteers subjected to anxiety induced by several procedures, including the simulation of public speaking (Zuardi et al., 1993; Blessing et al., 2015). A pioneering study that investigated the effects on SAD patients showed that CBD reduces anticipatory anxiety (Crippa et al., 2011). Moreover, CBD was found to exert a significant effect on increased brain activity in the right posterior cingulated cortex that is thought to be involved in the processing of emotional information. A subsequent study (Bergamaschi et al., 2011) experimentally demonstrated a reduction in the anxiety provoked by simulated public speaking by a single dose of CBD in patients with SAD, although the findings were preliminary. Based on these findings, the current study was conceived to extend the published research into a more systematic study on the effect of CBD on teenagers with SAD with avoidant personality disorder for a longer period. Its results are consistent with those obtained by the previous research and indicate that intervention with CBD for a 4-week period reduced the level of symptoms in teenagers with SAD, as measured by FSE and LSAS.
As an option for medication treatment for SAD, so far, the use of paroxetine has been reported to be most effective (Nordahl et al., 2016). That study reported that a 26-week daily treatment with paroxetine alone produced a 5.2-point decrease in the FNE score and a 10.2-point decrease in the LSAS score. Those reported decreases in symptoms were almost equivalent to the observed decreases induced by CBD here, although the treatment groups studied in the two studies were not closely compatible.
In children and adolescents, SAD is known to be among the most common mental disorders (De Gregorio et al., 2019). A survey conducted in the United States showed that the disorder starts as early as age 5 and peaks around age 12 (Merikangas et al., 2011). When untreated, it runs a chronic course into adolescence and eventually adulthood. In Japan, notably, the population of such teenagers with avoidant personality disorder who “seclude themselves for more than six months at home” (Saito, 2007) and “typically withdraw from most social activities and retreat into their living spaces” (Teo, 2010) is estimated to have reached 1,000,000 (Ogino, 2004), and this has become a serious social problem. When they are provided with a higher level of social support, their quality of life (QOL) is likely to increase, whereas it deteriorates with poor support. The teenagers with SAD in Japan who have higher levels of social withdrawal along with such poor support are likely to develop a stronger sense of loneliness and to suffer from poorer QOL (Teo, 2010).
Despite such negative impacts of the disorder, the majority of teenagers with SAD are likely to be untreated. Psychotropic medication and CBT are the most common therapeutic options for SAD. However, socially anxious teenagers rarely seek help due to the potential stigma associated with mental issues and fear of interacting therapists and psychiatrists (Ogino, 2004; Teo, 2010). As revealed by the follow-up conducted in the current study, many of the participants treated with CBD became positive in their attitude toward seeking treatment. To overcome the dilemma of teenagers with SAD described above, delivering interventions with CBD could be an effective option for reducing the barriers facing SAD patients in need of treatment.
In all, the results of the current study provide evidence for anxiolytic effects of repeated CBD administration in teenagers with SAD. At the same time, however, the author acknowledges several limitations of the current study. No assay of the blood level of CBD was undertaken. A more detailed baseline sociodemographic evaluation could have been performed to ensure the pretreatment similarity of the treatment groups. Measurements need to be performed at additional times between the baseline and the end of the study. These measures would be essential to show, for example, if CBD could produce rapid improvement of social anxiety (a putative advantage over paroxetine). Moreover, possible side effects should be evaluated systematically. Clearly, these are issues for future research that should also be long-term studies with a positive control (e.g., paroxetine) to better assess the potential usefulness of CBD in the therapy of SAD.
Data Availability Statement
All datasets generated for this study are included in the article/supplementary material.
The studies involving human participants were reviewed and approved by the Institutional Ethics Committee of Kyoto University (#2018-150), the Regional committee for medical and health research ethics (#2018/1783), and the Japanese Data Inspectorate for clinical trials (JCT0018004564). The patients/participants provided their written informed consent to participate in this study.
NM conceived the study, collected and analyzed the data, and drafted the manuscript.
Conflict of Interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author is grateful to Dr. Satomi Yamada, Yoshiyuki Nagai, Atsushi Ishige, Ryohei Tatsumi, and Koji Maki for their assistance in conducting experimentation and Elizabeth Nakajima for making comments on an earlier version of this manuscript.
Funding. This research was supported by a grant-in-aid (JSPS#25285201) as well as by the Grants for Excellent Graduate Schools program from the Ministry of Education, Science, Sports, and Culture, Japanese Government. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.