Let’s talk about CBD
Everyone has probably heard about the recent explosion of CBD products that seem to be popping up everywhere. I thought it was worth spending some time talking about all things CBD.
What is CBD?
CBD stands for cannabidiol, CBD is one of the ingredients in marijuana. The other, slightly more well known, ingredient is THC (tetrahydrocannabinol). THC is the psychoactive ingredient that gives recreational marijuana users the “high” associated with it, CBD is the anti-psychoactive ingredient that may (or may not) provide some benefit. The Cannabis plant can be grown in variants that have different amounts of each ingredient; those that are low in THC and high in CBD are called hemp, while those high in THC and low in CBD are called marijuana. Hemp is now legal for farmers to grow crops for fuel, fiber, clothing, etc. This has created the somewhat murky legal landscape of whether or not companies can produce over-the-counter items containing CBD.
Do CBD products even work?
Depending upon the definition of the current laws, companies may be able to make CBD products for consumer use as long as they have THC limits under 0.3%, and there are no recommended or approved doses of CBD. There seems to be some limited evidence that CBD products can be helpful for certain types of seizure disorders, evidence for other conditions (pain, anxiety, inflammation) is lacking. The FDA recently approved a prescription product containing plant derived CBD to treat 2 rare forms of seizures… it is licensed as a specialty medication only available from select pharmacies to the tune of about $35k per year, called Epidiolex. Because the CBD products showing up on shelves now are not regulated by the FDA, there is no guarantee that they are being produced at high standards or have the amount of the ingredients in them claimed. In a recent study of CBD product;
- 7 of 10 CBD products did not contain amount advertised (43% under, 26% over)
- 1 of 5 products contained THC over limits allowed (0.3%)
There are also reports of interactions between CBD and prescription medications that can result in elevated levels of the medications, and there have also been low rates of elevated liver enzymes.
Are CBD products legal?
According to a recent statement from the Minnesota Board of Pharmacy… no.
In summary, the sale of most products that contain CBD extracted from any type of cannabis plant and intended to be used to treat medical conditions or to alter the structure and function of human or animal bodies, remains illegal under both federal and state law. The exceptions would be FDA-approved drugs, such as the recently approved Epidiolex®, and the products allowed to be sold under state law by the manufacturers that are regulated by the Minnesota Department of Health, Office of Medical Cannabis.
We are still in the very early stages of figuring out medical marijuana use, recreational marijuana use, CBD containing products, and the rules/regulations around them. For now, most organizations are taking a wait and see approach regarding how to address them. As healthcare providers we can only preach caution as we have no legal ground to stand on yet.
Pharmacy Clinical Program Manager