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 relating to 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 shown great promise (both anecdotally and in early clinical studies) for a range of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And you don’t have to get stoned to reap the health advantages.
Caldwell’s medicine was illegal since it contained THC, the psychoactive compound that smoking weed socks you with. However, the newest treatments under development use a less mind-bending cannabinoid known as CBD (or cannabidiol).
Natural, legal along with no major side effects (so far), CBD is really a marketer’s dream. Hemp-based health products are launching left, right and centre, cashing in while 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 developed into a buzzword among upmarket skincare brands such as CBD of London. Predictably, Gwyneth Paltrow is a proponent of the trend, and has said that taking CBD oil benefits helps her through hard times: “It doesn’t allow 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 considering launching their very own versions, while UK craft breweries such as Green Times Brewing (formerly Cloud 9 Brewing) and Stockton Brewing Company are providing 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 experience the effects immediately upon eating”, without specifying what those effects may be.
While THC could make you feel edgy, CBD does the exact opposite. 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 is far richer in hemp plants.
Whether any of these CBD products can do anyone a bit of good (or bad) is moot. “Cannabidiol is definitely the hottest new medicine in mental health since the proper clinical studies do suggest it has clinical effects,” says Philip McGuire, professor of psychiatry and cognitive neuroscience at King’s College London. “It is definitely the No 1 new treatment we’re thinking about. But although there’s tons of stuff in news reports about this, there’s still not that much evidence.” Large, long term studies are essential; a 2017 review paper into the safety profile of CBD determined that “important toxicological parameters are yet to be studied; for instance, if CBD has an impact on hormones”.
McGuire doesn’t advise buying CBD products. You need to differentiate, he says, between the extremely high doses of pharmaceutical-grade pure CBD that participants within the couple of successful studies received as well as the dietary supplements available over the counter or online. “These might have quite small amounts of CBD that might not have big enough concentrations to possess any effects,” he says. “It’s the main difference between a nutraceutical as well as a pharmaceutical.” These supplements aren’t allowed phxbop make claims of any effects. “If you’re making creams or sports drinks with CBD, it is possible to say what you like as long as you don’t say it can do such and such,” he says.
Two cannabis-based pharmaceutical drugs, manufactured throughout the uk, are licensed for prescription only for very specific uses. Sativex has been available in the united kingdom since 2010 and uses THC and CBD to treat spasticity in multiple sclerosis. Along with a new CBD-only drug, Epidiolex, was approved in June in the united states to deal with rare childhood epilepsies, using a similar decision expected imminently for Europe as well as the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that people try them and discover, ‘Oh, it doesn’t appear to work.’ Or they get side-effects from various other ingredient, because, if you purchase an oil or cannabis product, it’s likely to contain all sorts of other stuff which can have different effects.”
You simply have to browse the reviews within a CBD product on the Holland & Barrett website to see the extent to which anecdotal reports should not be trusted. Greater than 100 customers gave Jacob Hooy CBD Oil five stars, with a few saying they always noticed when they missed a dose (presumably this made them less relaxed, although they did not reveal the things 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 and a sleepless night. All of these people had different conditions, expectations and situations. “And,” says McGuire, “you have to remember that anything could have a placebo effect.” While it looks unlikely the recommended doses of those products is going to do any harm, McGuire’s guess is the fact that doses are really small “that it’s like homeopathy – it’s not likely to do anything at all”.