What’s All the Fuss about CBD?

As I was walking through the local mall, I had to steer around a large sign in front of the GNC store. It read: “CBD Products Available.” It did nothing to raise my opinion of GNC, which I consider to be the epitome of junk science, but I thought I should do some research to make sure my eye rolling was justified.

Cannabidiol (CBD) oil is an extract from industrial-grade hemp or the marijuana plant. It does not have the effect of getting the user “high” as the THC in marijuana does. It recently surged onto the market with a wide variety of health claims. What are the facts?

There is so much information, but it has to be sorted careful, as much of it is pure advertising, telling the stories of miracle cures. Many promises are unreliable to the point that in September the Federal Trade Commission (FTC) ordered three companies to stop making claims that they: relieve pain better than opioid painkillers and that they treat cancer, Alzheimer’s disease, multiple sclerosis (MS), fibromyalgia, cigarette addiction, colitis, autism, anorexia, bipolar disorder, PTSD, schizophrenia, anxiety, depression, Lou Gehrig’s Disease (ALS), stroke, Parkinson’s disease, epilepsy, traumatic brain injuries, diabetes, Crohn’s disease, psoriasis, and AIDS – while using the words miracle and magic to describe the effects. The following month both the FTC and FDA warned a Florida company marketing CBD products about making similar unsubstantiated claims. (These were only the ones that were caught.)

Stepping aside from the hype, Science News published a story earlier this year that is a little more down to earth. “A gaping chasm separates the surging CBD market and the scientific evidence backing it. While there are reasons to be excited about CBD, the science just isn’t there yet.” Trials are underway, but “much of the existing research was done with cells in the lab or in lab animals, with results that don’t necessarily translate to people.”

The next stop was a WebMD article, “CBD Oil: All the Rage, But Is It Safe & Effective?” They remind readers, “experts say the evidence is scant for most of these touted benefits” and it is being sold as a supplement, “produced without any regulation, resulting in products that vary widely in quality.” So far “only one purported use for cannabidiol, to treat epilepsy, has significant scientific evidence supporting it.”

CBS recognized the quality problem in this piece from about three months ago with the warning that “without wide federal oversight, there is no way of really knowing what's inside CBD [products].” They commissioned lab tests of samples from all over the country and found no harmful chemicals but significant differences between the amount of CBD on the label and actual contents making proper dosage a big problem. In addition, “cannabinoids do interact with prescription drugs. But because we lack reliable controlled trials, we don't have enough detail to understand all the interactions.”

The same viewpoint comes from Harvard Medical School. “Without sufficient high-quality evidence in human studies we can’t pinpoint effective doses, and because CBD is currently mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting.” The JAMA network notes that in studies to date "evidence of effectiveness was scarce," and that a California testing company found 85% of samples inaccurately labelled.

This Slate article makes the point clearly. As more and more products, from foods and beverages to creams and lotions, have CBD added “CBD is in everything, but it hasn’t been proven to do much of anything." Despite this, it is forecast to become a $22 billion industry by 2024.

In summary, with no scientific evidence of health benefits outside of the treatment of epilepsy, CBD oil has become all the rage with companies adding it to all sorts of products and selling it as a miracle cure. Some companies have crossed the legal line with their claims, but those that are more careful can easily imply that it’s curative powers are enormous without coming right out and saying it. Instead they rely on endorsements from beneficiaries of the placebo effect, as do many of the other supplements on the market. (In other words, my eye rolling was justified.)

The Latest Big Thing – CBD Oil

I began to wonder about CBD oil when I saw on the local television news a very non-critical report about a new store in town. It was like a press release from the store that the reporters used as an excuse to fill airtime with a very positive interview of the owner, but without questioning any of the exaggerated claims about the its curative powers. I knew that it had been until recently illegal, making good scientific research very difficult and sparce, and that researchers generally look at only one effect at a time when testing any treatment. How could this substance arise out of the blue with so many promises?

This webpage, for example, lists seven benefits including: relieving pain, reducing depression and anxiety, alleviating cancer related symptoms, reducing acne, having neuroprotective properties and benefiting heart health. Of course the last three are conditioned with “may," “might” and “could.” It warns: “Although CBD is generally considered safe, it can cause adverse reactions like diarrhea and fatigue in some people. It may also interfere with certain medications.”

Based on such reviews, it appears to fall into the familiar too-good-to-be-true category. So I was not surprised to find the headline: “FDA warns company marketing unapproved cannabidiol products with unsubstantiated claims to treat cancer, Alzheimer’s disease, opioid withdrawal, pain and pet anxiety.” And if you are going to advertise in the realm of too good to be true anyway, why not throw in that it counteracts the growth of [and/or] spread of cancer, kills breast cancer cells, treats Parkinson’s disease, reduces the severity of opioid-related withdrawal, addresses symptoms of chronic pain, anxiety and ADHD, and helps with PTSD, schizophrenia, fibromyalgia and eating disorders. The FDA objects to all these claims (and more) as “unsupported and unapproved.”

 WebMD calls it “all the rage” but warns that “experts say the evidence is scant for most of these touted benefits." Like many other over-the-counter products and supplements, it is “being produced without any regulation, resulting in products that vary widely in quality.” Dosages vary from one product to another, possibly from one production run to another and from one brand to another. “Only one purported use for cannabidiol, to treat epilepsy, has significant scientific evidence supporting it.”

Last April the USA Today piled on, asking: “Is this hemp plant derivative snake oil or a legit remedy?” In addition to all the powers listed above, they add that it’s also hyped as a cure for inflammation, stress, unsatisfying sex and PMS.  But it's sold at local pharmacies (including the one that stopped selling cigarettes because they care so much about our health) in the form of creams, lotions, oils, tinctures, pills, powder or liquid. But this story also comments that the marketers' therapeutic claims are "rarely supported by medical evidence that CBD is significantly better than a placebo.”

Again from USA Today in a different story: “The head of the National Institute on Drug Abuse said there’s no evidence that marijuana [or CBD] weans people from opioid addiction – and promoting such treatment might deny people a chance at recovery.”

The Mayo Clinic sums it up: “While CBD is being studied as a treatment for a wide range of conditions, …research supporting the drug's benefits is still limited." It can cause more serious side effects than those mentioned above and “can interact with other medications” such as blood thinners.

And remember that part about it being unregulated? “Another cause for concern is the unreliability of the purity and dosage of CBD in products. A recent study of 84 CBD products bought online showed that more than a quarter of the products contained less CBD than labeled. In addition, THC [the psychoactive ingredient found in marijuana] was found in 18 products.” But don’t sweat those pesky details – it’s all-natural and I heard on Facebook…!