This 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 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 need 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 make use of a less mind-bending cannabinoid called CBD (or cannabidiol).
Natural, legal with no major unwanted effects (to date), CBD is a marketer’s dream. Hemp-based health goods are launching left, right and centre, cashing in whilst 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 developed into a buzzword among upmarket skincare brands including CBD of London. Predictably, Gwyneth Paltrow is a proponent in the trend, and contains stated that taking CBD oil helps her through hard times: “It doesn’t cause you to 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 using a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are all considering launching their very own versions, while UK craft breweries such as 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 its menu, promising that “you experience the effects immediately upon eating”, without specifying what those effects could 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 like purple haze or wild afghan; it really is far richer in hemp plants.
Whether any of these CBD products will do anyone anything 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 interested in. But although there’s plenty of stuff in news reports about it, there’s still not that much evidence.” Large, long-term studies are essential; a 2017 review paper to the safety profile of CBD concluded that “important toxicological parameters are yet to become studied; for 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 in the handful of successful studies received and also the health supplements available over the counter or online. “These could have quite small amounts of CBD that may not have access to big enough concentrations to possess any effects,” he says. “It’s the main difference between a nutraceutical and a pharmaceutical.” These supplements aren’t allowed phxbop make claims of any effects. “If you’re making creams or sports drinks with CBD, you are able to say whatever you like providing you don’t say it can do such etc,” 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 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 the US 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 discover, ‘Oh, it doesn’t appear to work.’ Or they get side-effects from various other ingredient, because, if you buy an oil or cannabis product, it’s planning to contain all types of other activities which might have different effects.”
You only need to look at the reviews under a CBD product on the Holland & Barrett site to begin to see the extent to which anecdotal reports cannot be trusted. More 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, even though they failed to 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 stated it gave them palpitations as well as 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.” Even though it looks unlikely the recommended doses of these 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 whatsoever at all”.