In California, a bee-keeper produces honey infused with cannabidiol (CBD) for friends and family, who say that the products reduce their insomnia, stress, and anxiety. In Montana, patients with cancer use CBD-infused creams and salves on burns and blisters caused by their chemotherapy treatments.
Meanwhile, in Florida, a grandmother was recently arrested at Disney World for having doctor-prescribed CBD used to treat arthritis in her purse (although CBD hemp products have since been made legal in the sunshine state ). At the same time, reports are emerging of possible CBD interactions with prescription medications, effects on liver function, and in extreme cases, contamination with pesticides or mold.
Based on these circumstances, it appears that the truth about CBD’s benefits and risks depends on whom you ask and when. How can consumers make rational choices about CBD products when they are caught in this maelstrom of conflicting information?
The Food and Drug Administration (FDA) recently took action against three companies making some of the most egregious claims about the health benefits of CBD products. Nevertheless, unless the FDA does more — and consumers and industry pitch in — this problem could get worse, as the market for CBD products is projected to reach $16.3 billion by 2026. In an effort to do more, the Food and Drug Administration (FDA) is soliciting public input until July 16 on how to regulate the use of CBD in dietary supplements and foods.
Why is CBD different from other FDA-regulated products, like fish oil, which is available as a prescription medication, supplement, and food additive? CBD is naturally derived from cannabis, which also contains psychoactive tetrahydrocannabinol (THC). When cannabis has a higher concentration of THC, it is considered marijuana and is illegal under federal law. When cannabis contains no more than .3 percent THC, it is considered hemp. In 2018, Congress changed federal law to make hemp legal.
Currently, the only products containing the compounds found in cannabis that may be marketed legally in the U.S. are prescription drugs, including Epidiolex, an FDA-approved CBD medication. Unlike supplements and foods containing fish oil, those containing CBD may not yet be marketed legally because CBD supplements came to the market after the FDA-approved drugs, CBD-containing foods are not yet recognized by experts as safe, and the FDA has not yet issued regulations approving these products.
The FDA is now seeking to answer the same questions many of us have. What is the purpose of consuming CBD, and what scientific evidence demonstrates that it has the intended effect? What concentration and daily intake levels of CBD are generally safe? Are there certain individuals or animals who should not take CBD?
With answers to these and other questions, the FDA should be able to issue CBD supplement and food regulations specifying standards for purity, potency, and consistency. The FDA will likely also need to require warnings about safety concerns in certain individuals or circumstances. Beyond that, for the sake of consistency and clarity for CBD researchers, manufacturers, and consumers, the FDA should strive to follow existing regulatory pathways – such as those that apply to fish-oil medications, supplements, and food additives — to the greatest extent possible.
The FDA is not the only one with a responsibility here. Consumers should be on the lookout for prohibited claims and illegitimate products. Any advertisement stating that a product other than an FDA-approved medication can treat or cure a specific condition is deceptive. If a manufacturer is willing to sidestep advertising rules, it cannot be trusted to follow safety rules, and its product is risky. Consumers should also inform both the FDA and a product’s manufacturer if they have an adverse reaction to a CBD medication, supplement, or food.
Manufacturers of CBD supplements and foods intending to remain in the market for the long haul should support independent, scientifically credible evidence of CBD’s safety for its intended uses. They should ensure their products are standardized for purity and potency and marketed in a manner consistent with the regulations that apply to fish-oil and other supplements and foods.
Finally, while the FDA conducts research and begins what could be a lengthy regulatory process, it should continue to enforce existing law against companies that exploit public interest in CBD by selling contaminated products or making egregious cure-all claims.