Does CBD live up to claims?

Q: For years, I have been hearing about the advantages of taking CBD products for sleep, pain and just about anything that ails you. I now see these products everywhere being sold over the counter in drug stores. Is CBD beneficial, and does it live up to its claims? A: CBD is one of the main cannabinoids found in cannabis plants. Products made with CBD in the U.S. retail market should not contain THC, the psychoactive ingredient in marijuana that produces a high. These products are supposed to be only derived from the marijuana strain cannabis sativa, which naturally has less than 0.3% of THC.

CBD is available by prescription or as an added ingredient in many overthe-counter products. These products are legal at the federal level as long as the CBD is derived from a cannabis sativa plant grown in the U.S. from a company with a specially issued license. The products are illegal if derived from the higher THCcontaining cannabis indica strain or a sativa plant not grown in the U.S.

Although CBD claims to have many beneficial effects, the Food and Drug Administration classifies it under its orphan drug designation. This is a special designation that must meet criteria of therapy for a rare disease or is used so infrequently that it may not be a profitable product.

CBD has primarily been marketed as an anticonvulsant agent for rare seizure disorders, though some newer indications are being investigated.

At this time, nonprescription CBD products lack oversight to ensure their purity and safety, or to verify manufacturer claims. The CBD that you can buy over the counter is regulated more like herbal supplements than medications. This is because the FDA only enforces quality and safety standards if a safety issue arises once a product is on the market.

The standards for CBD products, like herbal supplements, are based on manufacturers making ethical claims. You cannot rely on the amount of CBD listed unless assessed by an independent party such as the United States Pharmacopeial Convention. You also cannot be assured that CBD is free from contaminants such as THC, pesticides or heavy metals.

At this time, CBD cannot be rated for any condition other than epilepsy due to lack of evidence, even though it is used for many other conditions.

CBD is a depressant, so it can make you drowsy. However, its long half-life of 50-60 hours makes it undesirable as a sleep aid. Half-life is defined as how long half of the drug is eliminated after one dose. Sleep aids are best suited to medications with shorter half-lives, so drowsiness is not experienced the next day. Other common side effects are decreased appetite, fever, anemia, fatigue and gait disturbances.

The highly touted pain relief indication of CBD has not been shown by current research.

CBD is metabolized in a complex way by many enzymes while it interferes with other enzymes that metabolize other drugs. Use CBD carefully if you take other medications.

While research is ongoing into CBD as a treatment for a wide range of conditions, including cancer, hepatitis, Parkinson’s disease, diabetes and some psychiatric disorders, future indications may result in CBD not being classified as an orphan drug.

Until better evidence indicates that more common uses are safe and effective, CBD will continue to be a product that lacks evidence to support claims of efficacy for many conditions.

Before you try nonprescription CBD for any medical concern, speak with your health care provider about whether it would be safe and effective for you. Your provider may be able to help you determine which product to purchase.

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