This has been the year medical cannabis hit the mainstream. The us government has announced that it is relaxing laws on when cannabis medicines could be given by doctors, following high-profile cases including that of Billy Caldwell, the 13-year-old boy hospitalised by his epileptic seizures after he was denied legal access to the cannabis oil that helps control them. Meanwhile a whole new generation of cannabis medicines has demonstrated great promise (both anecdotally and in early clinical studies) for treating a variety of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And you don’t have to get stoned to reap the benefits.
Caldwell’s medicine was illegal because it contained THC, the psychoactive compound that smoking weed socks you with. However, the newest treatments under development use a less mind-bending cannabinoid referred to as CBD (or cannabidiol).
Natural, legal with no major unwanted effects (so far), CBD is really a marketer’s dream. Hemp-based health items are launching left, right and centre, cashing in whilst the scientific studies are in the first flush of hazy potential. As well as ingestible CBD (also sold as hemp or cannabis oils or capsules) the compound has turned into a buzzword among upmarket skincare brands including CBD of London. Predictably, Gwyneth Paltrow is a proponent of the trend, and contains claimed that taking CBD oil helps her through hard times: “It doesn’t cause you to stoned or anything, a little bit relaxed,” she told one beauty website.
Meanwhile, so-called wellness drinks infused with CBD are gaining traction. The UK’s first has become launched by Botanic Lab, promoted as “Dutch courage using a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are common considering launching their very own versions, while UK craft breweries including Green Times Brewing (formerly Cloud 9 Brewing) and Stockton Brewing Company are offering cannabis-oil laced beers, and mixologists are spiking their cocktails with CBD mellowness. The fancy marshmallow maker, The Marshmallowist, has added CBD-oil flavour to its menu, promising that “you feel the effects immediately upon eating”, without specifying what those effects may be.
While THC could make you feel edgy, CBD does the contrary. In fact, when used together, CBD can temper the side effects of THC. Unsurprisingly, there isn’t much CBD in recreational cannabis strains such as purple haze or wild afghan; it is far richer in hemp plants.
Whether these CBD products will do anyone anything good (or bad) is moot. “Cannabidiol is the hottest new medicine in mental health as the proper clinical studies do suggest it provides clinical effects,” says Philip McGuire, professor of psychiatry and cognitive neuroscience at King’s College London. “It is the No 1 new treatment we’re considering. But although there’s plenty of stuff in the news regarding it, there’s still not too much evidence.” Large, long-term studies are needed; a 2017 review paper into the safety profile of CBD figured that “important toxicological parameters are yet to get studied; as an example, if CBD has an impact on hormones”.
McGuire doesn’t advise buying CBD products. You should differentiate, he says, between the very high doses of pharmaceutical-grade pure CBD that participants inside the number of successful studies were given as well as the health supplements available over-the-counter or online. “These might have quite small quantities of CBD that might not have big enough concentrations to get any effects,” he says. “It’s the real difference between a nutraceutical and a pharmaceutical.” These supplements aren’t allowed to make claims of any effects. “If you’re making creams or sports drinks with CBD, you are able to say anything you like providing you don’t say it is going to do such and the like,” he says.
Two cannabis-based pharmaceutical drugs, manufactured in the UK, are licensed for prescription but only for very specific uses. Sativex continues to be available in the UK since 2010 and uses THC and CBD to take care of spasticity in multiple sclerosis. As well as a new CBD-only drug, Epidiolex, was approved in June in america to treat rare childhood epilepsies, having a similar decision expected imminently for Europe and also the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that individuals try them and find, ‘Oh, it doesn’t appear to work.’ Or they get side-effects from some other ingredient, because, if you purchase an oil or fmavoi product, it’s going to contain all kinds of other activities which may have different effects.”
You only have to browse the reviews under a CBD product on the Holland & Barrett web site to see the extent to which anecdotal reports should not be trusted. A lot more than 100 customers gave Jacob Hooy CBD Oil five stars, with some saying they always noticed when they missed a dose (presumably this made them less relaxed, even though they did not reveal whatever they were taking it for), while 93 people gave it one star, saying it did nothing, or was too weak. One couple even stated it gave them palpitations along with a sleepless night. All of these people had different conditions, expectations and situations. “And,” says McGuire, “you have to remember that anything may have a placebo effect.” Even though it looks unlikely the recommended doses of such products is going to do any harm, McGuire’s guess is the fact doses are really small “that it’s like homeopathy – it’s not going to do anything at all”.