Supposedly CBD oil, creams, capsules and even gummies can cure everything from anxiety and depression to cancer. But is it too good to be true?
Even if you don't live in a medical marijuana state, chances are you've seen or heard of CBD extracts.
They come in a range of forms, from oils and tinctures (alcohol-based solutions) to creams, capsules, and even suppositories for menstrual cramp relief, which you may have heard being called "weed tampons."
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CBD is short for cannabidiol, and it's one chemical compound — aka cannabinoid — in marijuana that's been getting major attention lately.
And it's actually taken a lot of the spotlight away from THC, the most well-known cannabinoid, which causes the high associated with smoking marijuana. "CBD has been getting a lot of attention lately because it may have some interesting therapeutic effects, and it is not psychoactive in the way that THC is. It doesn't make people high, and it may even counteract the effects of THC," Susan Weiss, director of the Division of Extramural Research at the National Institute on Drug Abuse and an expert on marijuana science and policy, tells BuzzFeed Health.
But tbh, all the attention is not that surprising when you think about all the health claims surrounding CBD — just look online and you’ll see articles claiming it can cure just about anything. Seriously. In addition to menstrual cramps: anxiety, depression, psychosis, pain, nausea/vomiting, cancer, and way, way more.
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CBD started getting more attention, thanks, in part, to Dr. Sanjay Gupta's CNN special about medical marijuana, Weed. But that also led to confusion about what it could actually do.
"He really publicized CBD when he had those weed shows," Weiss says, pointing to the case of Charlotte, a child with a severe form of epilepsy. "The family claimed that she was made much better when she took a type of cannabis, which is now named Charlotte's Web," she says. "It was a high-CBD form of cannabis."
"In some ways he brought a lot of attention to CBD for that purpose, and it did spur a lot of research. But it also spurred a lot of confusion because people conflated medical marijuana in general with CBD," says Weiss. "It's been purported to have effects on everything, and we really need to figure out what's real and what isn't — what's meaningful. And that's really why we need a lot more research."
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The truth is, the only thing CBD may treat effectively — through clinical trials on humans — is severe forms of childhood epilepsy. All other claims are based purely on anecdotes.
In fact, one drug company just submitted an application to the Food and Drug Administration for approval of it’s purified CBD drug, which seems to help kids with two different kinds of seizure disorders — Lennox-Gastaut syndrome and Dravet syndrome. "It may be that it has broader effects than that, but most studies have been for these forms of epilepsy," says Weiss.
But when it comes to other health issues and diseases, like cancer, she says most of the data come from cell culture and animal studies. "And that's sort of the rub here — people may make claims based on research from cell and animal studies, but we've actually had a lot of things work in cell cultures that don't work when you give them to people."
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But still, there are lots of people who advocate for CBD after it helped them get better.
Dr. Junella Chin, an integrative cannabis physician and founder of MedLeafRx, told BuzzFeed Health in an email about one patient who has benefited from medical marijuana and CBD.
"Andrew, a 57-year-old man came into my office after sustaining a head injury from falling backwards off an 8-foot ladder. He started developing chronic migraines, brain fog, fatigue, nausea — felt dizzy all the time. Then he began to develop a hypersensitivity of his scalp. Simple daily routines, such as riding in a car, were an awful experience; just driving over a small bump would send stabbing pain through his skull," she said. After he started vaping medical marijuana on the recommendation of his son (in the beginning he used THC and CBD, but now just CBD), his pain and migraines are more manageable, she says.
Similarly, she's treated a patient with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease), who was experiencing fatigue, depression, and severe anxiety. The patient improved after using CBD — enough to stop taking prescribed meds for these problems. And when it comes to patients with other kinds of pain and inflammation, she says that *anecdotally* salves, creams, and transdermal patches have worked for them, even though "these products have not gone through rigorous human clinical trials that are double blind, randomized, and controlled" — aka the "gold standard" of scientific experiments because they are seen as having the least amount of bias.
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Unfortunately, with marijuana still being illegal on a federal level, it's pretty hard to find out if any of this anecdotal evidence can apply to the broader population.
And by illegal, we mean that marijuana is considered a schedule I substance under the Controlled Substances Act of 1970. That basically means marijuana is considered to have no currently accepted medical use and a high potential for abuse. (Other drugs classified as schedule I include heroin, ecstasy, and LSD.) It's this scheduling that makes it difficult to get the research done.
"The research isn't the easiest thing to do because CBD, being a component of the marijuana plant, still falls under schedule I, which means there are many administrative burdens to doing this kind of research. ... The DEA is the main thing. You have to get a schedule I license, and these things are very time consuming," says Weiss. "We hear from the research community that they do struggle sometimes with getting a schedule I license."
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Researchers need to obtain a schedule I license to research and really understand CBD.
Because it's relatively difficult to obtain a schedule 1 license, it's hard for researchers to gain a basic understanding of CBD — like what the right dose is for a therapeutic effect, how the dosage should change when administered orally versus transdermally, and whether there are interactions between CBD and other prescription drugs. That information is necessary before it's possible to find out what diseases CBD might actually help. All of this is needed for the FDA to approve a drug to treat a medical condition, Weiss says. "We're really not sure of any of the purported effects; what the mechanisms are.” CBD is a bit more of a mystery than THC, she says, probably because it’s only recently that people have started to become aware of it and its potential benefits.
And without this proof, manufacturers really can't legally claim that their CBD products do anything. That's one reason why the FDA recently sent out warning letters to four companies after finding they made "unfounded claims about their products' ability to limit, treat, or cure cancer and other serious diseases," the agency said in a statement.
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And because medical marijuana and CBD products aren't drugs with FDA-approved medical benefits, they aren't tightly regulated. That means that, like supplements, the product manufacturers are responsible for making sure the content and labels are accurate.
And when it comes to accuracy, the definition of that can be a little ~shaky~ — just look at this study, which was published on Tuesday, for proof. It found that out of 84 CBD products bought online, only about 30% had labels that accurately represented their CBD content. The other 70% were had either higher levels of CBD than was labeled or lower levels, and some even had relatively high levels of THC despite not saying it anywhere on the label.
"You can't trust the accuracy of the labeling," lead author Marcel Bonn-Miller, of the University of Pennsylvania Perelman School of Medicine, tells BuzzFeed Health. "So the onus is on the consumer to identify which products are accurate." And while all of these products were sold online, many could be found in dispensaries throughout the country, he says. "The reason we did it online is because we could get a wider variety of products, whereas if we limited the geographic region to only those sold in brick and mortar shops in Colorado, we probably couldn't pull 84 [products]. I wouldn't expect there to be any difference between those sold online and those in brick and mortar in terms of accuracy."
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And to be honest about what they're selling.
Because not only does accuracy count, but also what's actually in the product. And tbh, it's all kind of a mess. "The trouble is, we are still dealing with a secretive industry; not everyone is an honest vendor," says Chin. "OG Kush or Harlequin might be selling this week, and it's easy for the grower to put that on the label when he's driving to the dispensary to sell his products. There is tremendous variation and strain names are misleading."
And without FDA regulation, there's really no way to know how the products are manufactured. "Whether it's manufactured in a way that's consistent from dose to dose or from batch to batch, and whether or not, if it's coming from the plant, if the plant has been exposed to pesticides or mold or anything else," Weiss says. Ensuring these things would constitute what's called good manufacturing practices, and "this would not be the case for something that has not gone through the FDA."
"Again, it’s about accurate representation of what’s in the product so that people can make informed decisions,” Bonn-Miller says. “As a consumer, you want to know what's in there.”
"Hopefully, with the new state regulations, there will be a system in place in which the consumer can get the biochemical breakdown of the plant/product,” Chin says.
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So basically, it's a "buyer beware" type of situation.
Look, there's obviously a lot of people who say these products have worked for them personally, so we're not going to tell you to stop using them if they've worked for you. BUT — and this is a big one! — you should definitely know that you might not be getting what you think you're getting.
"The research community is very much on board with the idea of that there might be a lot of therapeutic potential But people should not think that just because something works in a cell culture, even if it's in a wonderful scientific journal, that it means it's going to work clinically — they may be putting themselves in great risk,” says Weiss. And some of that risk includes using CBD in place of treatments that have been proven to ACTUALLY WORK, such as with cancer. “You don’t want people to be foregoing something that would be effective for something that’s really unknown.”
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