Is CBD A Cure-All?
When it comes to relieving aggravating knee pain, a migraine, and other maladies, many people bypass aspirin and other traditional over-the-counter medications and reach for a Cannabidiol (CBD) product instead.
CBD, the non-psychoactive compound found in cannabis and hemp products, has been marketed for treating various conditions, including anxiety, depression, chronic pain, insomnia, heart disease, and even cancer. What’s more, CBD is available in capsules, sprays, creams, tinctures, oils, lotions, and gummies, so people can choose the best way to feel the effects of the substance.
For people experiencing serious pain, CBD functions similarly to analgesics that relieve pain and reduce inflammation. This is why people with arthritis, inflammatory pain, body aches, and headaches use CBD. Anecdotally, some people with arthritis say they experience noticeable pain relief, sleep improvement, and anxiety reduction after taking CBD, according to the Arthritis Foundation.
Besides arthritis, a growing body of evidence suggests that CBD shows promise in treating cancerous tumors and killing cancer cells, which is why cancer patients are using CBD to manage their condition. For instance, a survey was taken in 2017 of 926 patients at the Fred Hutchinson Cancer Research Centre in Seattle, Washington, a state with legalized medicinal and recreational marijuana. Sixty-six percent of the respondents said they had previously used cannabis, and 222 of respondents, or 24 percent, had used it in the past year. Of the 24 percent, 75 percent used cannabis for physical symptoms, such as pain, nausea, and appetite, while 26 percent said they believed cannabis was helping to treat their cancer.
The CBD market has exploded since the Agriculture Improvement Act of 2018, also known as the 2018 Farm Bill, legalized the regulated production of industrial hemp, a plant that is rich in CBD and used to make rope, textiles, clothing, biofuel, and other products. Both hemp and marijuana come from the Cannabis sativa plant, but they have very different characteristics and effects, according to Kent Vrana, director of the Medical Marijuana Academic Clinical Research Center at Penn State.
“Marijuana possesses tetrahydrocannabinol, or THC, the chemical that produces the characteristic high that is associated with cannabis,” Vrana wrote in an article for The Conversation. “Hemp, on the other hand, is a strain of the cannabis plant that contains virtually no THC, and neither it nor the CBD derived from it can produce a high sensation.”
As a professor and chair of the department of pharmacology at Penn State, Vrana said he has been closely following research on CBD and has seen some promising evidence for using the drug in treating a wide range of medical conditions.
Other researchers are also examining CBD and its uses for treating health conditions. As of the first quarter of 2023, ClinicalTrials.gov, a registry of clinical trials in the United States, listed 222 ongoing or completed scientific trials involving CBD to treat everything from opioid use and knee arthritis to breast cancer, chronic kidney disease, and autism spectrum disorder.
CBD and the FDA
While some may see CBD as a cure-all, the U.S. Food and Drug Administration (FDA) has essentially said, “slow down.” For one, the FDA has not approved CBD to treat cancer. In fact, the agency has approved
only one CBD prescription medication. In 2018, the FDA granted regulatory approval to use Epidiolex, a purified CBD product, to treat two rare but severe forms of epilepsy that begin in early childhood, Lennox-Gastaut and Dravey Syndrome. Both syndromes produce large numbers of frequent seizures that are resistant to traditional epilepsy treatments.
Clinical studies showed that children treated with Epidiolex reported a significant reduction in the number of seizures, with over 90 percent reporting at least a 25 percent reduction in the frequency of seizures and nearly 5 percent reporting a 100 percent seizure reduction.
Over the past several years, companies have touted their CBD products as being effective for a wide range of health conditions. The FDA, however, has sent warning letters to companies the agency said were illegally selling CBD products that claim to “prevent, diagnose, treat or cure serious diseases, including cancer.” The federal regulator said it tested the chemical content of the CBD in some of the products, and many did not contain the levels of CBD they claimed to contain.
Other studies had outcomes similar to the FDA’s findings. For instance, Penn State’s Vrana said he was involved in a 2017 study with a research team that obtained 21 samples of CBD products from patients and analyzed the content. Vrana said virtually none of the samples had the advertised quantity of CBD, 13 samples had little to no CBD at all, and “many contained significant levels of THC,” the compound in marijuana that makes people feel “high.”
The FDA has also sent warning letters to companies advertising that their CBD products contained delta-8 tetrahydrocannabinol (delta-8 THC), a psychoactive and intoxicating compound that gives people a milder high than the THC compound in marijuana. The federal agency found that companies added delta-8 THC in foods, such as gummies, chocolate, caramels, chewing gum, and peanut brittle, and did not include adequate directions for use.
“It is extremely troubling that some of the food products are packaged and labeled in ways that may appeal to children,” Dr. Janet Woodcock, the FDA Principal Deputy, said in a news release.
FDA Warns and Seeks Regulation on CBD
The FDA also warned the public that some products labeled as CBD or hemp might contain pesticides, heavy metals, and bacteria in addition to THC. And according to the U.S. Centers for Disease Control and Prevention, CBD has the potential to cause side effects that include:
- • Liver damage
- • Interference with other drugs you are taking, which may lead to injury or serious side effects
- • Drowsiness or sleepiness
- • Diarrhea or changes in appetite
- • Changes in mood, such as irritability
According to scientists and the FDA, there are still many unanswered questions about CBD, such as what’s the best potency for specific conditions and what’s the most effective form of CBD. In January, the FDA asked Congress to create new regulations for CBD products because there are still so many “unknowns” about CBD products to regulate them as food or drugs under the agency’s current structure.
“A new regulatory pathway for CBD is needed that balances individuals’ desire for access to CBD products with the regulatory oversight needed to manage risks,” the FDA said in its news release.
In the meantime, Vrana encourages people who use CBD to tell their healthcare providers if they take over-the-counter CBD or recreational or medical marijuana to prevent undesirable drug interactions.
“In the end, I believe that CBD will prove to have a place in people’s medicine cabinets—but not until the medical community has established the right form to take and the right dosage for a given medical condition,” Vrana wrote.