They’re everywhere in the U.S. —in the supermarket, at the chain pharmacy, even the local pet shop. The latest over-the-counter health fad for cannabidiol, or CBD (the main ingredient of cannabis that won’t make you high) has spawned a seemingly infinite stream of new products and dubious health claims.
There’s a lot of hype surrounding CBD products, from them being able to help with anxiety and send you to sleep sooner, to cutting down the risk of dementia or treating cancer. But what does the science say about CBD’s health benefits? And just how excited should you be about buying yourself a CBD burger or your dog some CBD treats?
For starters, it’s worth clarifying the confusing legal landscape in the U.S. in which CBD and cannabis exist.
The federal government, via the Drug Enforcement Agency, has historically classified the cannabis plant and all ingredients processed from it, including CBD, as a Schedule 1 drug, meaning it’s considered to have no accepted medical use. But exceptions have been made at the state level for both the medical and recreational use of cannabis. Last June, the Food and Drug Administration also approved a drug derived from CBD, Epidiolex, for the treatment of certain types of seizure. And this past December, the government passed a provision in its farm bill that legalised the selling and growing of local hemp, a variety of cannabis grown with less than 0.3 per cent of THC, the other major component of cannabis that’s responsible for its characteristic high.
Despite the legalization of hemp, the status of CBD as a consumer product remains murky. The FDA issued a notice soon after the farm bill was passed clarifying that it still had the authority to regulate any products with CBD, regardless of their source. The agency also warned that it doesn’t sanction the selling of CBD as a supplement, nor would it stand idly by if companies marketed their over-the-counter products with any specific health claims. The FDA has since sent warning letters to online retailers that are advertising these products to have specific health benefits.
One particularly egregious claim pointed out by the FDA, for instance, is that CBD can help manage type 2 diabetes. But while studies in mice have suggested a possible benefit, the only human study apparently ever done showed that CBD doesn’t do anything to manage the key aspect of the metabolic condition—poorly controlled levels of blood sugar—in actual patients.
That example highlights the most glaring flaw of CBD research to date. There’s just not much we know about its effects, thanks largely to the longstanding regulatory morass surrounding cannabis and its byproducts that has slowed down research. What little we do know often comes from studying animals.
“Based on the animal literature, or what we call preclinical research, it seems that CBD can have a wide range of therapeutic effects, ranging from decreased inflammation to helping with anxiety, pain, or substance use disorders,” Ziva Cooper, research director of the Cannabis Research Initiative at the University of California, Los Angeles, told Gizmodo. “The real issue is that we don’t have very much science translating what we see in animals and laboratories to humans.”
That doesn’t mean CBD won’t turn out to be even more useful medically than it’s already proven to be for some people with seizures. Nor should we discount the experiences of people who say their chronic pain or anxiety has been relieved with weed or products like CBD oil or creams. It just means we’re on the fringes of understanding CBD’s health effects. And it’s inevitable that some of the rosiest, farthest-reaching claims about it will evaporate under closer scrutiny.
“What we do know is that certain high doses of CBD—300 to 1,000 milligrams—have been shown to be helpful for certain indications, including schizophrenia and severe epilepsy disorders. And there’s a hint that it could help with anxiety as well,” said Cooper, referencing several studies and the Epidiolex approval. Cooper and others are also pursuing research in people that’s testing whether different strains of cannabis (including those that mostly contain CBD) can reduce pain better than others, as well as lower the dosage of opioids needed to manage that pain.
“When I tell the public that I’m studying CBD for pain, or as a substitute for opioids, most people will say ‘Don’t we already know that? Don’t we already have that data out there and available?’” said Cooper. “But the truth is, we don’t. The majority of studies that have looked at CBD for pain have also included THC. We know very little, if anything, about CBD’s effects on pain when given by itself, in people.”
Despite this potential, there’s another big problem when it comes to the trendy CBD-based products you’re likely to see in your checkout aisle, according to Cooper. Even if a certain dosage of CBD could help with your anxiety or insomnia, you’re almost certainly never getting that much from these products.
“CBD-infused foods or the solutions you might pick up at dispensaries across the country will probably not contain those therapeutic, 300 to 1,000 milligram doses. They’ll probably be a lot lower, like 10, maybe 15 milligrams, and very far from what is likely an effective dose,” she said.
Were these products chock full of CBD, though, the different ways they’re introduced into the body, like whether they’re eaten or applied to the skin, could still have a dramatic influence on how we actually respond to them. Topical antibiotics, for example, have to be specially formulated to break through the hardy layers of our skin to get to an infection, while nasal sprays can deliver a drug’s effects quicker than holding a tablet under the tongue. And scientists aren’t sure as to how these differences would manifest with CBD.
“We have no knowledge on how CBD will work using all of these products—the lotions, creams, edibles, suppositories,” Cooper said.
Products marketed with CBD have a labelling problem too. A study in 2017, for instance, found that only 30 per cent of such products bought online accurately labelled how much CBD they had. Many mislabeled products had more CBD than advertised, which isn’t a big problem, since there’s likely no dosage that can gravely harm you. But about a quarter had too little CBD, which essentially means you’d be taking a placebo.
Under-labelling isn’t the only risk with CBD products. Last year, the Centres for Disease Control and Prevention reported that more than 50 people in Utah were poisoned by fake CBD products that actually contained synthetic cannabinoids. These cannabinoids are used to mimic the psychoactive effects of THC in the body, not CBD, but are more potent and capable of causing serious health problems, including hallucinations and psychotic episodes.
With that said, contaminated CBD products are probably rare. And the legalization of hemp will likely streamline and improve the safety of the CBD market overall, as well as speed along research efforts. The FDA has also said it’s beginning to develop a regulatory pathway that will allow the study and marketing of CBD in food or consumer products without any legal hassles. And states such as Utah are creating their own regulatory system for legally selling and accurately labelling CBD products. Given that, the CBD hype train will undoubtedly chug forward, with some financial experts estimating that it’ll become a billion-dollar industry by 2020.
It’ll take some time for the science of CBD to catch up with this hype, though. Cooper’s hypothesis that CBD-heavy cannabis could reduce the need for potentially addictive opioids might very well be proven soon, but people are undoubtedly already using CBD for that exact purpose right now. And while the FDA might disparage that sort of hastiness, it’s tough to blankly tell chronic pain patients with few options to suck it up and wait for a laminated seal of approval.
You’re likely not putting yourself and your loved ones in mortal danger by buying that CBD-loaded cookie or hemp pet supplement, so long as you’re not using them to completely replace standard medical treatments or wholly disregarding the advice of your doctors. But if you’re an average person looking to keep your wallet safe from hucksters selling useless, novelty CBD products, you should probably wait to see how the science turns out.