It has been the year medical cannabis hit the mainstream. The government has announced that it is relaxing laws on when cannabis medicines may be prescribed by doctors, following high-profile cases like 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 whole new generation of cannabis medicines indicates 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 benefits.
Caldwell’s medicine was illegal because it contained THC, the psychoactive compound that smoking weed socks you with. However, the new treatments under development utilize a less mind-bending cannabinoid referred to as CBD (or cannabidiol).
Natural, legal and with no major unwanted effects (up to now), 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 like CBD of London. Predictably, Gwyneth Paltrow is a proponent in the trend, and it has said 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 having 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 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 the menu, promising that “you feel the effects immediately upon eating”, without specifying what those effects could be.
While THC will make you feel edgy, CBD does the opposite. In reality, 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 is actually far richer in hemp plants.
Whether any of these CBD products is going to do anyone any good (or bad) is moot. “Cannabidiol is the hottest new medicine in mental health as the proper numerous studies do suggest it offers clinical effects,” says Philip McGuire, professor of psychiatry and cognitive neuroscience at King’s College London. “It is the No 1 new treatment we’re thinking about. But although there’s tons of stuff in the news about it, there’s still not too 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, involving the very high doses of pharmaceutical-grade pure CBD that participants in the handful of successful studies were given as well as the health supplements available over-the-counter or online. “These might have quite small quantities of CBD which may not have access to big enough concentrations to possess any effects,” he says. “It’s the main difference from a nutraceutical along with a pharmaceutical.” These supplements aren’t able to make claims of 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 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 treat spasticity in multiple sclerosis. As well as a new CBD-only drug, Epidiolex, was approved in June in america to take care of 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 appear to work.’ Or they get side-effects from a few other ingredient, because, if you buy an oil or fmavoi product, it’s likely to contain all types of other things which might have different effects.”
You only need to browse the reviews under a CBD product on the Holland & Barrett website to view the extent 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 if they missed a dose (presumably this made them less relaxed, although they failed to 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 said 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 understand that anything may 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 that doses are really small “that it’s like homeopathy – it’s not likely to do anything at all”.