Lincoln is a young patient of mine who suffers with a number of medical problems. He sees a host of physicians who haven’t had much success in controlling his symptoms. Lincoln finds it very difficult to manage his life day-to-day. He has a history of addiction problems and recently confided that smoking marijuana helps with his pain, his anxiety and with sleep.
I’ve advised him that, particularly as an asthmatic, smoking marijuana isn’t a smart idea. At his last visit, he was proud to tell me that he had switched to using marijuana edibles rather than cigarettes, and was looking into CBD oil. He assured me that CBD oil was legal to use in all 50 states and that it did not contain THC so there were no concerns about drug testing.
Is this true?
Well, in a word, no. If it sounds too good to be true, it probably is, right? Cannabidiol (CBD) oil from cannabis is legal over-the-counter only in states that have legalized recreational marijuana, and can be legally used by prescription in states that have legalized medical marijuana. 17 other states have CBD-specific laws, the list can be seen here on WebMD.
Hemp oil, which is legal, has only very small and inconsistent levels of CBD. Most supplements don’t tell you what amounts of CBD are in them. There’s a good reason for that. According to the FDA, CBD oil cannot be sold as a dietary supplement. Companies are hoping that by NOT labeling their products as containing CBD they will escape the FDA’s oversight.
I checked with Amazon and found a HUGE number of hemp oil supplements being marketed for reducing chronic pain, anxiety, insomnia and other symptoms. THIS IS ILLEGAL. As someone who markets supplements, I was cringing as I was reading the Amazon listings. These companies are asking for HUGE fines from the FDA.
Another issue with CBD oil is that there is very little evidence that it works for anything. The best evidence is for treating certain severe types of seizures, and in fact there is a formulation called Epidiolex which is working its way through the FDA approval process as a new drug.
There is only weak evidence for CBD oil helping anxiety, insomnia, chronic pain, inflammation or any other problem in humans. Some animal trials have been done but they are of limited use.
Also, testing of CBD oils from cannabis showed over 60% of products didn’t have the amount of CBD shown on the label. Some had more, some had less. Worse, 20% of tested products were contaminated with THC, which is psychoactive (causing the “high”) and potentially causing positive drug tests. Those who must take random drug tests as part of their employment should not use CBD oils.
CBD oils are not perfectly safe either. It is fairly common to have increased liver enzymes, and the products can interact with medications too.
In Ohio, medical marijuana has been legalized but the infrastructure isn’t in place with dispensaries and training for medical personnel yet. Everything is targeted to be in place later this year. Presumably at that point those who are trained to prescribe medical marijuana will also be able to prescribe CBD oil for those who prefer a treatment with no risk of intoxication or dependence.
In the meantime it is important to remember these points:
- CBD oil use without a prescription is against the law in states without legalized medical marijuana, recreational marijuana use, or special state provisions.
- CBD oil cannot be sold as a nutritional supplement by FDA regulations
- Hemp oil, which is legal, has very inconsistent levels of CBD and cannot be marketed with drug claims (such as reducing anxiety or pain or fighting cancer)
- There is no consistent evidence that CBD is effective for anything other than intractable seizures
- CBD has side effects of its own and can interfere with medications
QUESTION: Have you or someone you love tried CBD oil? What was your experience?