Monday, August 24, 2020

CBD: salve or snake oil?

Cannabidiol (CBD) products are everywhere, in products ranging from bath salts to dog treats, and touted as remedies for just about every ailment. What are they? Do they do any good? Are they safe?

Cannabis sativa, better known as marijuana, is an annual flowering plant that contains over 100 identified compounds. The best known is tetrahydrocannabinol, or THC, which is responsible for the psychoactive effects of marijuana, the euphoria or “high.” Another well-known component is CBD. Unlike THC, CBD does not make users high, but is promoted to reduce pain, ease anxiety and give better sleep.

Commercial use of CBD has exploded, on-line and through herbal and health-food sales outlets. Sales through these sources in 2018 totaled $52.7 million, over triple the amount sold in 2017, and replaced turmeric as the top-selling product of these companies.

What do we know about its benefits? There is an FDA-approved drug (Epidiole) used to treat two rare seizure disorders in children. Every other promoted use has scant evidence behind it. While there have been hundreds of papers published about CBD, most studies have been small and usually without good research design. Moreover, a study published earlier this year in The Annals of Internal Medicine found that a large majority of the authors of articles promoting CBD use had close ties to the CBD industry, raising obvious questions about conflict of interest.

Is CBD safe? A huge problem is the lack of oversight of what you are getting, since CBD is sold as a “supplement” rather than a medication, thus removing FDA regulation. CannaSafe, a California cannabis testing lab, recently analyzed 20 popular CBD products and found that only three of the twenty contained what their labels claimed. Eight contained less than 20% of the amount of CBD on the label, and two contained none. Some of the products were found to contain high levels of poisonous solvents.

CBD can interfere with the way your body deals with many prescription drugs, so if you are using it and are on any medication, be sure to tell your doctor. It can also adversely affect the liver, even when not tainted.

If you want to use one of these products, be sure they are EPA-certified Organic, as this will lessen the chances of chemical contamination. You might also want to get products from Europe, where they are much more closely regulated.

Does CBD do any good? It is unclear at this time, but probably not. The limited studies done to date by legitimate researchers relate in part to the DEA's insistence that marijuana is a "class I" substance, putting it up there with heroin and methamphetamine, even though alcohol would probably be a better analogy. Some very preliminary studies needed to be expanded.

Is CBD safe? Possibly, given the comments above, but caveat emptor.

Next time, let’s look at THC.

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