Believers in cannabidiol oil, or CBD oil, say this hemp-derived product can produce modern medical miracles, from treating depression to curing cancer. But are these benefits too good to be true?
"There may be some benefit for those with sleep problems, anxiety or pain, but the evidence to support this is largely anecdotal," says Brent A. Bauer, M.D., director of research for the Integrative Medicine and Health Program at the Mayo Clinic in Rochester, Minnesota. Currently, there's a lack of high-quality studies in humans about CBD's efficacy. That's because prior to the 2018 Farm Bill, which made CBD derived from hemp federally legal, hemp was highly restricted. "This made it very difficult for medical centers to obtain products to test in clinical trials," says Bauer. "Basically, obtaining CBD required a lot of red tape, which discouraged research."
What is CBD?
Google "CBD oil" and you'll find pages and pages of articles, ads and studies. Makers claim the popular hemp extract-sold online and available in many states in health and natural food stores-may help treat a long list of health problems, from acne to anxiety, chronic pain to cancer. But is it safe, and does it work? Here's a quick guide to what you need to know.
Most of the studies showing promise have been conducted with mice. A report in the European Journal of Pain showed that topical CBD diminished pain and inflammation associated with arthritis in rodents. And rats that were given CBD for seven days displayed fewer signs of pain and anxiety, according to a 2010 study in the journal Pain. Another report—this one a review of research in the journal Neuropsychopharmacology Reviews—boldly stated that there's "an overwhelming body of convincing preclinical evidence" (preclinical meaning not tested in humans) that indicates cannabinoids can block inflammatory and nerve-based pain. But according to Petitpain, "We need more clinical research to really show who benefits, and at what dose."
The exception to this: "There is one prescription product that's achieved FDA approval for treating seizures in children with a rare form of epilepsy," says Edward Mariano, M.D., M.A.S., a professor of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine. There's also a CBD/THC combo drug called Sativex that shows promise at alleviating cancer pain that is chugging along through phase 3 clinical trials, on track to be approved by the FDA.
In addition, purchasing a cannabis product still comes with a bit of ideological cache. Cannabis is, or so its proponents want us to believe, the anti-Big Pharma drug of choice. Its secret benefits have been hidden from the masses by a number of nefarious players, most notably the biomedical industrial complex (or so the story goes). “News” websites like Natural News have played to this intuitively appealing narrative with headlines that declare, “Big Pharma and the government are suppressing marijuana’s medicinal benefits.” This kind of messaging adds to the allure of cannabis and allows it to maintain a smidge of counter-culture cred, even if your cat is dabbling in the same products. (In reality, pharmaceutical companies are also getting into the cannabis game.)
And, of course, celebrities have also played a big role. Melissa McCarthy’s CBD toe therapy was reported in the press as a logical application of an emerging therapy. No scientific proof required.
All this positive press might also lead people to overlook the possible risks associated with cannabis products. One study, for example, found that the positive portrayals of the health applications of cannabis have an impact on the perception of recreational use. And while the emerging evidence suggests that CBD is well tolerated, we need to recognize that we don’t have a lot of safety data, particularly in the context of long-term use.
Why is all this hype concerning? Much of it is straight up misleading marketing that can generate inaccurate and harmful public perceptions. As noted in a recent statement from the FDA about questionable cannabis products: “deceptive marketing of unproven treatments raises significant public health concerns,” including the potential to “keep some patients from accessing appropriate, recognized therapies.”
The current hype surrounding cannabis products is problematic, and this includes all the emerging products derived from cannabis.
Cannabis is, of course, also being marketed for a range of more serious health issues, including childhood ADHD, autism, anxiety and, perhaps most frequently, pain.
The buzz around cannabis is understandable. I am hopeful that in the relatively near future we will know much more about benefits and risks. But we aren’t there yet. For now, you can ignore most of the cannabis noise, whether you are thinking about something for your tension, toes or our tabby.
Because CBD is a seizure medication, the FDA is concerned it could promote suicidal thoughts, as some other seizure medications do. Although no data supports that concern, CBD hasn’t been studied long-term. The most common side effects of CBD include sleepiness and diarrhea, which happens in one-third of users, and vomiting and fever, which happens in 15%.
There are drug interactions too. Add CBD to other drugs you’re taking and it might produce unexpected side effects, or cause those drugs to be less efficient. I wouldn’t take CBD without checking with my doctor or pharmacist to assure me there were no risky drug interactions.
Eating a balanced diet, exercising regularly, getting enough sleep, maintaining a healthy body weight and managing stress are the basis of good health. Nowhere in there is a recommendation to adopt every health fad that comes along. But people are psychologically attracted to health fads because they are novel, they sound plausible (at least on the surface) and they’re easy to use. What’s more, there’s the bandwagon effect: Nobody wants to be left out.
How strong is the CBD data?
CBD is neither a miracle or snake oil. So far, the evidence – or lack of it, for most ailments – suggests the risks may outweigh the benefits.
The claims for CBD’s alleged healing powers have been so exaggerated that it’s no surprise that a CBD maker was warned in 2020 by the New York attorney general for claiming that the molecule can fight COVID-19. There are no credible animal or human studies showing CBD has any effect on SARS-CoV-2 or the course of COVID-19 infection.
Next up was soy and resveratrol, so-called superfoods that could lower rates of heart disease and cancer; then coenzyme Q10, touted to prevent statin-induced muscle damage. All fell from grace when definitive studies were conducted.
Conversely, a few of the products contain more than the legal limit for THC. This places you at risk of arrest for marijuana possession. There are also other unhappy scenarios: You might have used a subpotent product and took 500 mg to get the desired benefits. Then after switching to a better-quality product, you take the same 500 mg and accidentally overdose.