CBD oil: all the rage, but is it really safe and effective?

May 7, 2018 by Dennis Thompson, Healthday Reporter

(HealthDay)—Cannabidiol (CBD) oil has become the hot new product in states that have legalized medical marijuana.

The non-intoxicating marijuana extract is being credited with helping treat a host of medical problems—everything from epileptic seizures to anxiety to inflammation to sleeplessness.

But experts say the evidence is scant for most of these touted benefits.

Worse, CBD is being produced without any regulation, resulting in products that vary widely in quality, said Marcel Bonn-Miller, an adjunct assistant professor of psychology in psychiatry at the University of Pennsylvania School of Medicine.

"It really is the Wild West," Bonn-Miller said. "Joe Bob who starts up a CBD company could say whatever the hell he wants on a label and sell it to people."

Cannabidiol is extracted from the flowers and buds of marijuana or hemp plants. It does not produce intoxication; marijuana's "high" is caused by the chemical tetrahydrocannabinol (THC).

CBD oil is legal in 30 states where medicinal and/or recreational marijuana is legal, according to Governing magazine.

Seventeen additional states have CBD-specific laws on the books, according to Prevention magazine. Those are Alabama, Georgia, Indiana, Iowa, Kentucky, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming.

Strong Evidence for Treating Epilepsy

Only one purported use for cannabidiol, to treat epilepsy, has significant scientific evidence supporting it.

Last month, a U.S. Food and Drug Administration advisory panel unanimously recommended approval of the CBD medication Epidiolex to treat two rare forms of childhood epilepsy.

"That's really the only area where the evidence has risen to the point where the FDA has said this is acceptable to approve a new drug," said Timothy Welty, chair of the department of clinical sciences at Drake University's College of Pharmacy and Health Sciences, in Des Moines, Iowa.

For the rest of CBD's potential uses, there is simply too little evidence to make a firm conclusion.

For example, some human clinical trials suggest that CBD could be effective in treating symptoms of anxiety, particularly social anxiety, Bonn-Miller said.

This is the potential use for CBD with the most evidence after usefulness in epilepsy, but "there's a decent gap between those two," he said.

"There have been clinical trials in adults, but a lot smaller than the epilepsy studies that have been done in kids," Bonn-Miller said.

CBD's usefulness as an anti-inflammatory medication is the next most promising, but those results come mostly from animal studies, experts said.

Most Other Uses Largely Unproven

The rest of the potential uses—as an antipsychotic, antidepressant or sleep aid "have all been studied in animals, with only one or two examples of studies in humans," Bonn-Miller said.

And Welty said the studies that have featured humans for these other CBD uses have either been case reports or studies that did not compare results against a control group that did not use the oil.

"There's no control, so it's basically how do you know if we're dealing with the true effect of the drug or just simply a placebo effect because somebody thinks they've been given a drug that will be beneficial?" Welty said.

There also are concerns about both the quality of CBD oil being produced and its potential side effects, the experts added.

Lack of Regulation Also Concerning

Because of the legally murky nature of marijuana, the FDA has not stepped in to regulate products like CBD oil, Bonn-Miller said. States are struggling to put regulations in place, but they don't have the deep pockets of the federal government.

Meanwhile, a 2017 study led by Bonn-Miller found that nearly 7 of 10 CBD products didn't contain the amount of marijuana extract promised on the label.

Nearly 43 percent of the products contained too little CBD, while about 26 percent contained too much, Bonn-Miller said.

"CBD is kind of a tricky drug because it's not very well absorbed orally," Welty explained. "Less than 20 percent of the drug is absorbed orally. If it isn't made in the right way, you may not be getting much into your systemic circulation."

Worse, about 1 in 5 CBD products contained the intoxicating pot chemical THC, Bonn-Miller and his colleagues found.

"That's a problem because THC can increase anxiety. It can actually make seizures worse. Those are the sorts of things you need to be careful about," Bonn-Miller said.

"If I were a consumer, purchasing it for myself or my kid, I would want to test it so that I knew what it actually had in it, because I couldn't trust what was on the label," Bonn-Miller concluded.

Potential Interactions With Other Meds

Studies on CBD also have raised concerns about possible interactions with other drugs.

For example, epilepsy studies found that "there were very clearly increases in the blood levels of some other anti-epileptic drugs when people were on CBD," Welty said.

This could mean that people taking anti-epilepsy drugs alongside CBD will need to adjust their dosage downward to avoid side effects, Welty noted.

There also is some indication that CBD might harm the liver. About 10 percent of people taking CBD in studies had increases in liver enzymes, which would indicate possible liver damage, Welty said.

"About 2 to 3 percent of individuals taking CBD actually had to discontinue because their liver enzymes went so high it was of concern to the people running the study," he said.

Welty recommends that people interested in CBD seek out a doctor who has read up on the extract and its potential uses.

"My bottom-line advice is people really need to be under the care of a health care provider who understands CBD. They need to be monitored and managed by that individual, and not just go out and buy CBD thinking it's going to be the answer," Welty said.

Explore further: Study shows nearly 70 percent of cannabidiol extracts sold online are mislabeled

More information: Marcel Bonn-Miller, Ph.D., adjunct assistant professor, psychology in psychiatry, University of Pennsylvania School of Medicine, Philadelphia; Timothy Welty, Pharm.D., chair, department of clinical sciences, College of Pharmacy and Health Sciences, Drake University, Des Moines, Iowa

The U.S. National Institutes of Health has more about cannabidiol.

Related Stories

Study shows nearly 70 percent of cannabidiol extracts sold online are mislabeled

November 7, 2017
In recent years, there has been an increased interest in the medicinal use of Cannabidiol (CBD), a chemical that naturally occurs the in cannabis plant (aka "marijuana"). There is interest in CBD as a medicine because there ...

Why marijuana fans should not see approval for epilepsy drug as a win for weed

April 20, 2018
A Food and Drug Administration panel recommended approval of a drug made of cannabidiol on April 19 to treat two types of epilepsy. The FDA is expected to decide in June whether to accept the panel's 13-0 recommendation to ...

Marijuana-based drug gets positive review from US agency

April 17, 2018
A closely watched medicine made from the marijuana plant reduces seizures in children with severe forms of epilepsy and warrants approval in the United States, health officials said Tuesday.

US experts back marijuana-based drug for childhood seizures

April 19, 2018
A medicine made from the marijuana plant moved one step closer to U.S. approval Thursday after federal health advisers endorsed it for the treatment of severe seizures in children with epilepsy.

Cannabis compound reduces seizures

February 27, 2018
About one third of patients treated for epilepsy continue to have seizures. Cannabidiol (CBD), one of the many active compounds in the cannabis (marijuana) plant, has gained attention as a treatment for epilepsy. Purified ...

Cannabis compound may help curb frequency of epileptic seizures

March 6, 2018
A naturally occurring compound found in cannabis may help to curb the frequency of epileptic seizures, suggests a review of the available evidence, published online in the Journal of Neurology Neurosurgery & Psychiatry.

Recommended for you

Little difference between gun owners, non-gun owners on key gun policies

May 17, 2018
A new national public opinion survey from the Johns Hopkins Bloomberg School of Public Health finds widespread agreement among gun owners and non-gun owners in their support for policies that restrict or regulate firearms.

Giving employees 'decoy' sanitizer options could improve hand hygiene

May 17, 2018
Introducing a less convenient option for hand sanitizing may actually boost workers' use of hand sanitizer and increase sanitary conditions in the workplace, according to findings in Psychological Science, a journal of the ...

Research shows that sexual activity and emotional closeness are unrelated to the rate of cognitive decline

May 16, 2018
Older people who enjoy a sexually active and emotionally close relationship with their partner tend to perform better at memory tests than sexually inactive older adults on a short-term basis, but this is not the case over ...

New study reveals how electronic health records can benefit clinical trials

May 16, 2018
The study entitled "Long term extension of a randomised controlled trial of probiotics using electronic health records" led by researchers in the Swansea University Medical School and the College of Human and Health Sciences, ...

Latest research strengthens case that early exposure to pollution affects long-term health

May 16, 2018
Research led by the University of Southampton has shown increasing evidence that exposure to air pollution in early life has detrimental long-term health consequences.

Researchers find a connection between left-handedness and low birth weight

May 15, 2018
A team of researchers from Finland, the Netherlands and Japan has found a connection between left-handedness and low baby birth weight. In their paper published in Proceedings of the National Academy of Sciences, the group ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

Anonym862620
not rated yet May 08, 2018
My primary doctor diagnosed fibromyalgia. He  prescribed Cymbalta around 4 years ago. Cymbalta was approved for Fibromyalgia treatment. Although it did relieve some of the pain, I still suffered from fatigue. November 2017  my doctor started me on Natural Herbal Gardens fibromyalgia Herbal mixture,With the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using diet, herbs, which i feel has made the most difference. The Fibromyalgia natural formula immensely helped my condition, it reversed my Fibromyalgia. my muscle pain. And then the joint stiffness, and fatigue. gradually disappeared. Visit NATURAL HERBAL GARDENS via their official web-site www. naturalherbalgardens. com.  and i turned 69 today. i am glad to get my life back, I will keep sharing awareness DON'T GIVE UP HOPE!!!

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.