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Cannabidiol, or CBD for short, is a non-psychoactive compound found in cannabis plants like marijuana and hemp. CBD contains only trace amounts of tetrahydrocannabinol (THC), quantities too small to make one high. Because of this, it has no recreational application and there appear to be no public health related problems.
Sales have been increasing. Estimates indicate that the CBD-product market grew 40 percent to $367 million in 2017. By 2022, economists estimate sales for hemp-based CBD products will about double.
CBD is available in many forms, including oils, tinctures, creams, gels, and vapors. It has been touted for health benefits such as treating autism, anxiety, pain, sleeplessness, depression, and eczema. Scientific studies have shown it to reduce the frequency of drug-resistant seizures in some forms of epilepsy and to reduce symptoms in patients with schizophrenia. The FDA has approved CBD for treating epilepsy. It has also been considered as an interesting possible curative drug for some forms of cancer, diabetes, inflammation and neurodegenerative disorders. The major application appears to be for patients seeking alternatives to prescription medications to treat anxiety, insomnia, and chronic pain.
Because much is still unknown about side effects, adverse reactions, proper dosages and interaction with other medications, first-time users should be cautious. In addition, with the exception of treatment for epilepsy, CBD is considered a dietary supplement in the U.S., not a drug regulated by the FDA. (It is regulated as a drug in the United Kingdom.) Consumers should seek out reputable distributors.
As I have detailed previously, dietary supplements are a category of food not subject to the usual premarket safety and effectiveness testing required by the FDA for drugs. These supplements may not be carefully regulated and may contain contaminants. Some off-the-shelf products have been found to contain little to no CBD. The lack of regulation raises issues about the quality of the product, the effective dosage of CBD that is fundamental for its therapeutic effectiveness, the purity, and the absence of chemical or microbiological contaminations.
The legal status of CBD is subject to interpretation. Under federal law, it’s technically illegal, although a 2014 amendment permitted the cultivation of hemp in some cases, as well as the marketing of its products. Hemp-based CBD oil, however, is widely available across the country. A few states ban it outright.
When something sounds too good to be true, it usually is. I would interject a bit of caution before accepting all these claims about the wonders of CBD. The only investigations subjected to rigorous study were those for epilepsy and schizophrenia, so claims of benefits for the host of other illnesses remain unsubstantiated. Future research — carefully performed by skilled researchers, as in the seizure and schizophrenia studies — will determine the rightful place for CBD among our therapeutic choices.
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