By Dennis Thompson
Health Day Reporter
Non-intoxicating marijuana extract is believed to help treat a range of medical problems, from epileptic seizures to anxiety, inflammation and insomnia.
But experts say evidence is scarce for most of these promoted benefits.
Worse, CBD is occurring without any regulation, resulting in products that vary widely in quality, said Marcel Bonn-Miller, an adjunct professor of psychology in psychiatry at the University of Pennsylvania School of Medicine.
“It’s really the wild west,” Bonn-Miller said. “Joe Bob, who runs a CBD company, could say whatever he wants on a label and sell it to people.”
Cannabidiol is extracted from the flowers and buds of marijuana or hemp plants. It does not produce intoxication; The “high” of marijuana is caused by the chemical tetrahydrocannabinol (THC).
CBD oil is legal in 30 states where medical and / or recreational marijuana is legal, according to Governant magazine.
According to seventeen additional states, there are specific CBD laws on books Prevention magazine. These are Alabama, Georgia, Indiana, Iowa, Kentucky, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming.
Solid evidence to treat epilepsy
Only an alleged use of cannabidiol, to treat epilepsy, has significant scientific evidence to support it.
Last month, an advisory group from the U.S. Food and Drug Administration unanimously recommended the approval of the CBD drug Epidiolex to treat two rare forms of childhood epilepsy.
“This is really the only area where the evidence has increased to the point that the FDA has said this is acceptable for approving a new drug,” said Timothy Welty, chair of the clinical sciences department at the Faculty of Pharmacy and Drake University Health Sciences. in Des Moines, Iowa.
For the remaining potential uses of CBD, there is simply too little evidence to draw a firm conclusion.
For example, some human clinical trials suggest that CBD may be effective in treating anxiety symptoms, especially social anxiety, Bonn-Miller said.
This is the potential use of CBD with the most evidence after utility in epilepsy, but “there is a decent gap between the two,” he said.
“There have been clinical trials in adults, but much smaller than epilepsy studies that have been done in children,” Bonn-Miller said.
The usefulness of CBD as an anti-inflammatory drug is the next most promising, but these results come primarily from animal studies, experts said.
Most other uses have not been verified
The remaining potential uses, such as antipsychotics, antidepressants, or sleep aids, “have been studied in animals, with only one or two examples of studies in humans,” Bonn-Miller said.
And Welty said studies that have presented humans for these other uses of CBD have been case reports or studies that did not compare the results with a control group that did not use the oil.
“There’s no control, so it’s basically how do you know if we’re dealing with the true effect of the drug or just with a placebo effect because someone thinks they’ve given them a drug that will be beneficial?” said Welty.
There are also concerns about the quality of CBD oil that is produced and its possible side effects, experts added.
Lack of the regulation also referent
Due to the legally murky nature of marijuana, the FDA has not intervened to regulate products like CBD oil, Bonn-Miller said. States are struggling to establish regulations, but they don’t have the deep pockets of the federal government.
Meanwhile, a 2017 study led by Bonn-Miller found that nearly 7 out of 10 CBD products did not contain the amount of marijuana extract promised on the label.
Nearly 43 percent of the products contained too little CBD, while about 26 percent contained too much of it, Bonn-Miller said.
“CBD is a kind of complicated drug because it’s not absorbed very well orally,” Welty explained. “Less than 20 percent of the drug is absorbed orally. If it’s not done the right way, it may not get much medication into the systemic circulation.”
Worse, about 1 in 5 CBD products contained the intoxicating chemical THC, found Bonn-Miller and colleagues.
“This is a problem because THC can increase anxiety. In fact, it can make seizures worse. That’s the kind of thing to be careful about,” Bonn-Miller said.
“If I were a consumer, buying it for myself or my son, I would want to try it to find out what was really there, because I couldn’t trust what was on the label,” Bonn-Miller concluded.
Potential interactions with other drugs
Studies on CBD have also raised concerns about possible interactions with other drugs.
For example, epilepsy studies found that “there were very clear increases in blood levels of some other antiepileptic drugs when people were taking CBD,” Welty said.
This could mean that people taking epilepsy medications along with CBD will have to adjust their dose downward to avoid side effects, Welty noted.
There are also some indications that CBD could damage the liver. About 10 percent of people taking CBD in studies had increases in liver enzymes, which would indicate possible liver damage, Welty said.
“About 2 to 3 percent of people taking CBD actually had to stop because their liver enzymes were so high that it worried the people running the study,” he said.
Welty recommends that people interested in CBD seek out a doctor who has read the extract and its potential uses.
“My bottom line advice is that people really need to be under the care of a healthcare provider who understands CBD. They need to be supervised and managed by that person, and not just go out and buy CBD thinking that it will be the answer, “Welty said.