Navigating the Cannabidiol (CBD) product landscape as a patient can be overwhelming. Fancy websites with glittery products hint that by adding CBD to your health care regimen that YOU TOO could live the life of your dreams. All your pains will just go away and vitality is yours for the taking. CBD is being marketed in everything from hamburgers to pillows, and active wear to coffee. Everywhere, people are talking about the wonders of CBD. When we listen carefully, we hear consumers talking about potential scams and products that aren’t what they seem. Patients are also talking about interactions they didn’t get warnings for and being misled about potential negative consequences, like being dismissed from pain management over a failed drug test. Patients don’t have the luxury to think about supplements like CBD as nutrition. We have underlying issues and conditions that these supplements can legitimately affect, especially when it comes to immune system function. It is important that we treat cannabidiol just like any other therapy and ask the same questions we would for pharmaceuticals.
Cannabidiol has been an amazing tool and according to a survey by The Arthritis Foundation, many with arthritis and autoimmune arthritis diseases are trying it out. A statement by The World Health Organization found that CBD had no potential for abuse, a good safety profile, and most adverse effects were from pharmaceutical interactions and underlying conditions. Unfortunately, those of us with chronic illness and fighting terminal illnesses fall into those last categories. We are almost always on pharmaceuticals and have underlying conditions or symptoms we need to accommodate. It is up to us, the patient and consumer, to question claims being made, ask for science, and check for interactions. Always double check the information being given with a trusted member of your medical and/or legal team.
Cannabidiol works because it interacts with receptor systems in our body’s cells. While this is important for a healthy person to know, it becomes essential when someone is considering CBD to help with chronic/terminal illnesses. A lot of these interactions are desired, but people with chronic illnesses need to know what to expect upfront. Knowing there is a risk to mitigate, whether legal or medical, can make sure the patient has the best chance for success. Here are some common misleading marketing buzzwords that contribute to hype and general misunderstanding. Marketing is designed to make you feel safe about a product. All products have hype, and the CBD industry is no different. Their products have some serious hype, and it is our job to dig through it.
Here are the top 6 patient picks as the “most confusing hype-lines”.
–CBD, even from hemp and isolates, are not “legal in all 50”. Internationally, the same ambiguous situation exists. Always check your local, state/province, and federal/country laws before choosing a product. You may find there are THC limits, local areas may have banned hemp CBD, or some other complication exists. Most CBD sales sites claim hemp CBD products are legal in the United States, and will cite either the 2014 Farm Bill or the 2018 Farm Bill. The 2018 Farm Bill did deschedule cannabinoids found in hemp, but it placed them under the FD&C Act, giving the FDA full regulatory authority. The FDA classifies all cannabinoids as “active pharmaceutical ingredients”, which makes them not so legal when introduced into commerce. Just as before the Farm Bills, hemp and hemp CBD is subject to state legality. This has created a very ambiguous legal framework that no patient could really understand to comply with. Add this governmental nonsense to the constant hums of CBD marketers trying to practice law and it becomes next to impossible to follow along. Websites and hemp traders will sing about the federal deschedule but forget to mention that many areas still consider hemp CBD and CBD isolate to be illegal. For example, check out this statement from the South Dakota Attorney General,
“Current South Dakota law makes industrial hemp illegal and all forms of CBD oil illegal.
The only exception is the prescription drug Epidiolex which was recognized by this year’s legislature as a controlled substance under SB 22. Governor Kristi Noem signed that bill into law on February 19, 2019, with an emergency clause, therefore having the law go into effect immediately.
This action leaves any other use or possession of CBD oil as a violation of state law.”
Always check with the local authorities to see if CBD is legal in your area. Legalities are complex and “legal” doesn’t always mean “legal”.
- You will often hear phrases like “FDA Compliant” or “FDA Approved”. The only FDA approved CBD product is Epidiolex. If the product is marketed as FDA Approved, walk away. Epidiolex is a prescription CBD tincture that is rarely prescribed for Dravet Syndrome and Lennox-Gastaut Syndrome and is the only FDA Approved CBD product. Also know that hemp CBD manufacturers are still waiting on the FDA to come out with their regulations, and as of this publication, they have not yet done so. (March 2020) “FDA Compliant” can mean many things. Their farm may be FDA compliant in some way, not necessarily relating to hemp. The packaging could be FDA compliant. This phrase does not imply the product is approved by the FDA, or that the product is more trustworthy. Right now, any implied FDA stamp of approval should raise eyebrows. Make sure the company is clear about what they are being “compliant” about and whether it is relevant to hemp.
- In the United States, CBD (even isolate use) is illegal in minors unless you participate in the state medical cannabis program. Make sure you consult with a lawyer that specializes in CPS cases before you make any decisions. It seems so contradictory that Child Protective Services will investigate a family for hemp CBD and CBD isolate use when you can purchase it in every corner store. Unfortunately, every state has a loophole that allows them to investigate, and only a few states have taken steps to protect families from CPS interference. If your state has a medical cannabis program, protect your child and your family. We observed that investigations involving parents who are actively on the state registry tend to get their cases dropped. Unfortunately, a lot of doctors and CBD companies are telling parents that they don’t need medical cards to give their children hemp CBD or CBD isolate. Those parents are finding out the hard way. If a salesperson is forceful and insisting that you don’t need a medical card, this is a red flag. For more information and sources, check out this article Is it Legal to Give CBD to Children?
- Watch carefully if you start hearing phrases like, “You have an endocannabinoid system, so you need CBD.” Yes, you have an endocannabinoid system, and yes, it could plausibly be deficient. However, the endocannabinoid system is a balance, and not something you just want to throw stuff at. Right now, everything is theory and pre-clinical and only the most popular theory (endocannabinoid deficiency) is getting press time. There could be other issues like over stimulation, receptor issues, and more at play. Not every issue is going to be an endocannabinoid deficiency, or specifically related to what CBD has to offer. Research is finding new endocannabinoids, new receptors, and new functions all the time. Chronic illness is hard on our body, and we don’t have the extra leeway if we make a mistake. Be on the lookout for those implying that CBD is something your body needs. This is a commonly used phrase with no real meaning. Your body also has an opiate receptor system. That doesn’t mean you need opiates or insinuate opiates are “good for you”.
- Be wary when someone implies CBD is safe because it is from a plant. Always check with a pharmacist to see if there are any important interactions you need to be watching for. Make sure you critically think about any blanket statements being made. As children growing up in the hills, we were always told not to eat random berries in the woods because they could kill people. There were mushrooms we couldn’t eat, and plants we had to take great care not to touch. Trying to make someone believe an active chemical compound is safe simply because it’s a plant is nothing more than a comfort zone marketing ploy. The truth lies more in the middle. Cannabis does have interactions within the body. If it didn’t interact with the body, patients wouldn’t be fighting so hard for access. Cannabis works on multiple receptor systems, interacts with pharmaceuticals, and can even cause some adverse reactions. That is okay. Often these interactions in the body are how we get relief, start healing, and can then talk to our doctors about lessening the pharmaceuticals. I’d rather someone be honest than to find out when liver ALTS measure 588. We watch for interactions and side effects with every other active therapy, whether supplements or pharmaceutical. CBD and cannabis are no different.
- Is CBD from hemp or CBD from “marijuana” better? Guess what marijuana with a THC content at 0.3% or lower is? Hemp. Cannabidiol the molecule is the same whether it comes from something someone calls “hemp” or something called “marijuana”. The only difference is going to be THC levels. Most CBD extracts come from low-THC cannabis, or hemp. Whether an extract is effective depends on how your body reacts to it, and what other things are in the extract (terpenes/flavonoids) not whether it was sourced from hemp or “marijuana”. If your body responds better to higher THC levels, then CBD from “marijuana” (or CBD with higher levels of THC) would be better. If you respond to low-THC CBD extracts, then hemp could be the way to go. The plants are all cannabis. Patients really should know what cannabinoids and terpenes are in their products anyway.