It has been the year medical cannabis hit the mainstream. The federal government has announced that it is relaxing laws on when cannabis medicines can be prescribed by doctors, following high-profile cases such as those of Billy Caldwell, the 13-year-old boy hospitalised by his epileptic seizures after he was denied legal access to the cannabis oil that can help control them. Meanwhile a new generation of cannabis medicines has demonstrated great promise (both anecdotally and in early clinical studies) for treating an array of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And you don’t have to get stoned to reap the health benefits.
Caldwell’s medicine was illegal since it contained THC, the psychoactive compound that smoking weed socks you with. However, the new treatments under development make use of a less mind-bending cannabinoid called CBD (or cannabidiol).
Natural, legal with no major negative effects (up to now), CBD is really a marketer’s dream. Hemp-based health items are launching left, right and centre, cashing in while the scientific studies are in their first flush of hazy potential. Along with 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 actually a proponent from the trend, and contains said that taking CBD oil helps her through hard times: “It doesn’t cause you to stoned or anything, just a little relaxed,” she told one beauty website.
Meanwhile, so-called wellness drinks infused with CBD are gaining traction. The UK’s first has been launched by Botanic Lab, promoted as “Dutch courage with a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are considering launching their own versions, while UK craft breweries such as 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 the menu, promising that “you notice the effects immediately upon eating”, without specifying what those effects may be.
While THC could make you feel edgy, CBD does the contrary. Actually, when used together, CBD can temper the negative effects of THC. Unsurprisingly, there isn’t much CBD in recreational cannabis strains such as purple haze or wild afghan; it really is far richer in hemp plants.
Whether these CBD products is going to do anyone any good (or bad) is moot. “Cannabidiol is definitely the hottest new medicine in mental health because the proper clinical studies do suggest it offers clinical effects,” says Philip McGuire, professor of psychiatry and cognitive neuroscience at King’s College London. “It will be the No 1 new treatment we’re interested in. But although there’s tons of stuff in news reports regarding it, there’s still not really that much evidence.” Large, long term studies are needed; a 2017 review paper to the safety profile of CBD figured that “important toxicological parameters are yet to become studied; for instance, if CBD has an effect on hormones”.
McGuire doesn’t advise buying CBD products. You have to differentiate, he says, in between the very high doses of pharmaceutical-grade pure CBD that participants within the handful of successful studies received and also the health supplements available over the counter or online. “These may contain quite small amounts of CBD that might not have large enough concentrations to get any effects,” he says. “It’s the difference between a nutraceutical as well as a pharmaceutical.” These supplements aren’t able to make claims of any effects. “If you’re making creams or sports drinks with CBD, you can say whatever you like providing you don’t say it will do such and such,” he says.
Two cannabis-based pharmaceutical drugs, manufactured in the UK, are licensed for prescription but only for very specific uses. Sativex has become available throughout 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 the united states to deal with rare childhood epilepsies, having a similar decision expected imminently for Europe and the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that folks try them and discover, ‘Oh, it doesn’t seem to work.’ Or they get side-effects from various other ingredient, because, if you purchase an oil or fmavoi product, it’s going to contain all types of other activities which might have different effects.”
You only need to read the reviews within a CBD product on the Holland & Barrett web site to see the extent that anecdotal reports should not be trusted. More than 100 customers gave Jacob Hooy CBD Oil five stars, with just a few saying they always noticed when they missed a dose (presumably this made them less relaxed, although they failed to 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 said 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 can have a placebo effect.” While it looks unlikely the recommended doses of such products will do any harm, McGuire’s guess is that doses are so small “that it’s like homeopathy – it’s not going to do just about anything at all”.