This has been the year medical cannabis hit the mainstream. The us government has announced that it is relaxing laws on when cannabis medicines may be prescribed 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 can help control them. Meanwhile a new generation of cannabis medicines has demonstrated great promise (both anecdotally and in early clinical trials) for a range of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And also you don’t have to get stoned to reap the health advantages.
Caldwell’s medicine was illegal as 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 known as CBD (or cannabidiol).
Natural, legal and with no major negative effects (to date), CBD is a marketer’s dream. Hemp-based health goods are launching left, right and centre, cashing in while the research is in its first flush of hazy potential. As well as ingestible CBD (also sold as hemp or cannabis oils or capsules) the compound has become a buzzword among upmarket skincare brands such as CBD of London. Predictably, Gwyneth Paltrow is really a proponent of the trend, and it has said that taking CBD oil benefits helps her through hard times: “It doesn’t make you stoned or anything, a 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 with a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are considering launching their particular versions, while UK craft breweries including Green Times Brewing (formerly Cloud 9 Brewing) and Stockton Brewing Company are selling 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 experience the effects immediately upon eating”, without specifying what those effects might be.
While THC will make you feel edgy, CBD does the contrary. Actually, when used together, CBD can temper the side effects of THC. Unsurprisingly, there isn’t much CBD in recreational cannabis strains like purple haze or wild afghan; it is actually far richer in hemp plants.
Whether any of these CBD products can do anyone anything good (or bad) is moot. “Cannabidiol is the hottest new medicine in mental health as the proper clinical trials 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 thinking about. But although there’s plenty of stuff in the news regarding it, there’s still not really that much evidence.” Large, long term studies are required; a 2017 review paper into the safety profile of CBD determined that “important toxicological parameters are yet to be studied; as an example, if CBD has an impact on hormones”.
McGuire doesn’t advise buying CBD products. You should differentiate, he says, involving the extremely high doses of pharmaceutical-grade pure CBD that participants within the number of successful studies received and the dietary supplements available non-prescription or online. “These might have quite small quantities of CBD that might not have big enough concentrations to have any effects,” he says. “It’s the real difference from a nutraceutical along with a pharmaceutical.” These supplements aren’t allowed phxbop make claims of the effects. “If you’re making creams or sports drinks with CBD, you are able to say what you like as long as you don’t say it will do such etc,” he says.
Two cannabis-based pharmaceutical drugs, manufactured throughout the uk, are licensed for prescription only for very specific uses. Sativex has become available in the UK since 2010 and uses THC and CBD to take care of spasticity in multiple sclerosis. Along with a new CBD-only drug, Epidiolex, was approved in June in america to take care of rare childhood epilepsies, with a similar decision expected imminently for Europe as well as the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that individuals try them and discover, ‘Oh, it doesn’t seem to work.’ Or they get side-effects from a few other ingredient, because, if you pick an oil or cannabis product, it’s going to contain all sorts of other activities which may have different effects.”
You only need to look at the reviews within a CBD product on the Holland & Barrett web site to view the extent which anecdotal reports cannot be trusted. Greater than 100 customers gave Jacob Hooy CBD Oil five stars, with just a few saying they always noticed if they missed a dose (presumably this made them less relaxed, 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 and a sleepless night. All these people had different conditions, expectations and situations. “And,” says McGuire, “you have to understand that anything could have a placebo effect.” While it looks unlikely that this recommended doses of such products can do any harm, McGuire’s guess is that doses are extremely small “that it’s like homeopathy – it’s not planning to do anything at all”.