The hot new commodity in states that have legalized medical marijuana has been cannabidiol ( CBD) oil.From epileptic seizures to anxiety to inflammation to sleeplessness, the non-intoxicating marijuana extract is credited with helping to alleviate a host of medical problems.
But analysts say the evidence for several of these touted advantages is scarce.
Worse, Marcel Bonn-Miller, an adjunct assistant professor of psychology in psychiatry at the University of Pennsylvania School of Medicine, said that CBD is being developed without any oversight, resulting in goods that differ widely in quality.
“It’s the Wild West, really,” said Bonn-Miller.”Joe Bob, who’s starting a CBD company, might say whatever the fuck he wants on a label and sell it to people.”
Cannabidiol is derived from marijuana or hemp plants’ flowers and buds. It does not generate intoxication; the chemical tetrahydrocannabinol ( THC) induces the “high” of marijuana.
According to Governing magazine, CBD oil is legal in 30 states where medicinal and/or recreational marijuana is legal.
According to Prevention magazine, 17 additional states have CBD-specific laws on the books. Alabama, Georgia, Indiana, Iowa, Kentucky, Mississippi, Missouri, Oklahoma, North Carolina, South Carolina, Tennessee, South Dakota, Texas, Utah, Wisconsin, Virginia, and Wyoming.
Good Evidence for Epilepsy Care
Just one supposed use of cannabidiol for the treatment of epilepsy has substantial clinical evidence to support it.
This past month, the U.S. The advisory panel of the Food and Drug Administration unanimously approved the approval of the CBD drug Epidiolex for the treatment of two rare types of childhood epilepsy.
“It’s about the only position where the evidence has grown to the point where the FDA has said it’s reasonable to approve a new drug,” said Timothy Welty, chair of the Department of Clinical Sciences at the College of Pharmacy and Health Sciences of Drake University, in Des Moines, Iowa.
There is just too little evidence for the majority of the prospective uses of CBD to draw a firm inference.
Some human clinical trials, for instance, indicate that CBD may be effective in treating anxiety symptoms, particularly social anxiety, Bonn-Miller said.
This is the possible use of CBD with the strongest proof of epilepsy utility, but “there is a respectable distance between the two,” he said.
“Medical trials have been performed in adults, but they are much smaller than epilepsy research conducted in children,” said Bonn-Miller.
The efficacy of CBD as an anti-inflammatory drug is the next most promising, but experts said those findings come more from animal studies.
Many of the other largely unproven uses:
The majority of the possible applications have all been tested in animals as an antipsychotic, antidepressant or sleep aid, with just one or two examples of human research, “Bonn-Miller said.”
And Welty said that either case reports or experiments that did not equate findings to a control group that did not use the oil were the experiments that featured humans for these other CBD uses.
There’s no control, because essentially how do you know whether we’re dealing with the medication’s true effect or just a placebo effect because everyone feels they’ve been given a medication that’s going to be beneficial? “said Welty.” There’s no control over it.
There are also questions, the experts added, about both the nature of CBD oil being produced and its possible side effects.
Lack of legislation relating even to:
The FDA has not stepped in to control products like CBD oil due to the legally murky nature of marijuana, Bonn-Miller said. States are trying to put in place rules, but they do not have the federal government’s deep pockets.
Meanwhile, a Bonn-Miller-led 2017 study found that almost 7 out of 10 CBD products did not contain the quantity of marijuana extract promised on the bottle.
Nearly 43 percent of the goods contained too little CBD, while, Bonn-Miller said, about 26 percent contained too much.
“CBD is sort of a tricky drug because orally it is not very well absorbed,” explained Welty. Less than 20% of the drug is orally consumed. You may not get any medicine into your systemic bloodstream if it is not produced in the right way.”
Worse, the intoxicating marijuana chemical THC contained around 1 in 5 CBD products, Bonn-Miller, and his colleagues found.
“That’s a concern because THC will raise anxiety. In fact, it can make seizures worse. These are the kinds of stuff you need to be vigilant about,” said Bonn-Miller.
“Bonn-Miller concluded,” If I were a customer, buying it for myself or for my brother, I might want to test it so that I knew what it really had in it because I couldn’t trust what was on the bottle.
Potential Other Meds Experiences:
CBD studies have also raised questions about potential interactions with other medicines.
Epilepsy research, for instance, showed that “when people were on CBD, there were very strong rises in blood levels of certain other anti-epileptic medications,” Welty said.
This may mean that, in order to prevent side effects, people taking anti-epilepsy drugs alongside CBD would need to change their dose downwards, Welty noted.
There is also some evidence that CBD can damage the liver. In tests, about 10 percent of individuals taking CBD had changes in liver enzymes, which would suggest potential liver damage, Welty said.
“About 2 to 3 percent of individuals taking CBD actually had to stop because their liver enzymes were so high that they were concerned about the people running the research,” he said.
Welty suggests that people who are interested in CBD search for a doctor who has read about the extract and its possible uses.