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 like 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 a variety of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And you don’t need to get stoned to reap the health 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 and with no major unwanted effects (up to now), CBD is really a marketer’s dream. Hemp-based health goods are launching left, right and centre, cashing in as the scientific studies are in the first flush of hazy potential. In addition to ingestible CBD (also sold as hemp or cannabis oils or capsules) the compound has turned into a buzzword among upmarket skincare brands such as CBD of London. Predictably, Gwyneth Paltrow is actually a proponent of the trend, and has said that taking CBD oil 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 continues to be launched by Botanic Lab, promoted as “Dutch courage with 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 might be.
While THC will make you feel edgy, CBD does the contrary. In reality, 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 the hottest new medicine in mental health because 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 a lot 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 concluded that “important toxicological parameters are yet to be studied; for example, if CBD has an impact on hormones”.
McGuire doesn’t advise buying CBD products. You need to differentiate, he says, between the very high doses of pharmaceutical-grade pure CBD that participants within the number of successful studies were given and also the nutritional supplements available over-the-counter or online. “These may contain quite small quantities of CBD which may not have access to large enough concentrations to have any effects,” he says. “It’s the real difference between a nutraceutical along with a pharmaceutical.” These supplements aren’t permitted to make claims for any effects. “If you’re making creams or sports drinks with CBD, you are able to say anything you like so long as you don’t say it will do such and the like,” he says.
Two cannabis-based pharmaceutical drugs, manufactured in the united kingdom, are licensed for prescription but only for very specific uses. Sativex continues to be available in the united kingdom since 2010 and uses THC and CBD to deal with spasticity in multiple sclerosis. And a new CBD-only drug, Epidiolex, was approved in June in america to take care of rare childhood epilepsies, using a similar decision expected imminently for Europe and the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that people try them and locate, ‘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 kinds of other things which can have different effects.”
You only have to read the reviews within CBD product on the Holland & Barrett web site to begin to see the extent that anecdotal reports cannot be trusted. More than 100 customers gave Jacob Hooy CBD Oil five stars, with some saying they always noticed should they missed a dose (presumably this made them less relaxed, even though they did not reveal what 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.” Although it looks unlikely that this recommended doses of those products is going to do any harm, McGuire’s guess is that doses are so small “that it’s like homeopathy – it’s not planning to do just about anything at all”.