To CBD or Not to CBD, That is the Question…

Pssst – hey you.

Yeah, you, the bored person randomly surfing the internet insearch of some infotainment. I ‘ve got something special to tell you about. It’s ahot new product, made of natural ingredients, available in a wide array of edible and topical formulations and guaranteed to um…well…uh… OK it may not actuallybe guaranteed to work, but it’ll be fun to read up on it. Just come along with meon this literary (obviously not literal) magic carpet ride…

With a build-up like that, I could only be referring to CBD (or perhaps pumpkin spice).

CBD refers to cannabidiol, one of the many, many chemical compounds found in cannabis plants (hemp and its relative marijuana). This is not to be confused with CBGB, the now defunct bar where the world was introduced to various punk acts like the Ramones. It so happens that (according to Rolling Stone) the lead singer, Joey Ramone, had a teratoma removed from his spine when he was a fewweeks old. While the National Cancer Institute defines a teratoma as “a type of germ cell tumor that may contain several different types of tissue such as hair,muscle and bone”, it makes no mention of a removed one serving as an evil alterego, and eventually taking physical form. Only the sparrows know for sure. But I digress…

CBD is also not to be confused with THC. They are both found in cannabis plants in varying concentrations but their psychoactive effects are quite different. Cannabidiol, aka CBD, has antipsychotic effects and seems to reduce pain and anxiety (according to webMD). There is one medication (Epidiolex) consisting of CBD that has been approved by the FDA for the treatment of seizures associated with 2 rare and severe forms of epilepsy. Also, per the World Health Organization, it does not have a recreational use.

THC (full name tetrahydocannabinol), on the other hand, is the chemical mostresponsible for marijuana’s psychological effects, according to livescience.com. It attaches to and activates specific receptors in the brain which affects the user’smemory, sensory perception, memory, pleasure, movements, thinking, memory, concentration, coordination and time perception (and did I mention memory?). It also stimulates the release of dopamine in the brain, which causes euphoria. (Hey, man, that doesn’t sound so bad, as long as I don’t have to drive anywhere for thenext several hours…) It can also cause hallucinations, delusions and impaired motor skills. (Bummer, man) It is also rumored to cause paranoia, but considering the disproportionate persecution to which marijuana users have been historically subjected, it may not be unfounded. (They’re out to get me, I’m tellin’ you, man)

The U.S. government has a long and complicated history when it comes to cannabis products. Hemp had already been cultivated for fiber for thousands of years before the British colonized America. In 1619, the Jamestown Colony in Virginia passed a law requiring hemp to be grown on every farm. Those Virginians could also use hemp to pay their taxes. Hemp could also be made into paper, like that said to be used for the first draft of the Declaration of Independence (the final draft is on parchment, which is made from untanned animal skin). Hemp was also made into cloth (the word canvas comes from cannabis). It could even be used as an ingredient in building materials and plastics. One example of this wasHenry Ford’s bioplastic car, of which hemp was a component. (Note – Cheech and Chong had a vehicle with a much higher hemp content. It caught fire, with predictable results.) The industrial use of hemp was all fine and dandy until the1930’s, when the usefulness of the plant was overshadowed by the high ofmarijuana.

Hey man, are you are narc or something?

According to History.com, the repeal of Prohibition left buzzkill bureaucrats in need of a new scapegoat. Marijuana (aka Marihuana) was a convenient target. This led to some states outlawing cannabis. Then the Feds got involved and passed the Marihuana Tax Act in 1937. This did not criminalize possession or use of marijuana per se, but it did impose hefty fines if the tax was not paid. The Marihuana Tax Act was eventually ruled unconstitutional (because it required self-incrimination, not because of the spelling) and was replaced in 1970 by the Controlled Substances Act. This new law created 5 categories (“Schedules”) for medications that are easy to abuse. The Schedules go from V (least potential for abuse) to I (high abuse potential with no accepted medical use). Marijuana was classified as Schedule I(allegedly to criminalize Nixon’s anti-war enemies), and remains so to this day. However, a synthetic version of THC (dronaninol, brand name Marinol) is considered Schedule III. It can be legally prescribed for the accepted medical uses of preventing nausea and vomiting from cancer treatment, and as an appetite stimulant to give AIDS patients the munchies. Go figure.

Hemp production was collateral damage in the War on Drugs. It had already lost the sail business when steam ships took over; it then lost market share in general to cheap synthetic materials (The DuPont company may or may not have been a factor). Then the requirements imposed by the Tax Act made it virtually illegal. It made a brief comeback in 1942, when “Hemp for Victory” encouraged itsproduction during WWII, but the boom in industrial hemp ended when the war ended.

Hemp is now poised to make another comeback. The 2018 Farm Bill, championed by Republican Senator Mitch McConnell and signed by President Trump (yes, you read that right) distinguishes between hemp (which must contain less than 0.3% THC on a dry weight basis) and marijuana. Hemp can now be legally grown, as long as its production is monitored and regulated by the state.

Man, so, like, as long as it comes from legally grown hemp, and the THC is less than 0.3%, CBD is totally legal, right?

Not necessarily. According to pbs.org/newshour/science, “The FDA has prohibited the sale of CBD in any unapproved health products, dietary supplements or food — which literally means everything except for the drug Epidiolex.” The FDAhas 3 “Generally Recognized As Safe” food ingredients that are derived fromhemp seeds: hulled hemp seed, hemp seed protein powder and hemp seed oil. These can be marketed for use in human food, as long as they meet all other requirements. This only applies to use in human food, not for animal food. Cannabis and cannabis derived ingredients are not prohibited in cosmetics, as long as they do not cause the product to be adulterated or misbranded, so lotions and potions for external use may legally contain CBD.

But, dude, CBD is everywhere! They put it in literally everything.

The plethora of CBD products exploding onto the market makes it seem like the greatest cure-all since snake oil. By the way, (according to npr.org) the original snake oil was made from Chinese water snakes and brought to the US by immigrants (low paid indentured laborers) working on the Transcontinental Railroad. The Chinese used it topically for aching joints, with good results. Some westerners tried to imitate it, using locally sourced snakes, but the level of active ingredient (Omega-3 acids) was much lower. That did not stop American hucksters from packaging it and selling it to the masses as the ultimate panacea. By the power vested in them by the Pure Food and Drug Act of 1906, federalinvestigators seized a shipment of Clark Stanley’s Snake Oil Liniment. The Rattlesnake King’s product was found to be snake-oil free, misbranded, and falsely and fraudulently represented as a remedy for all pain. So snake oil got a bad reputation (snakes themselves already had a bad reputation) and the term came to encompass any fake cure and the slippery characters who sell them.

It seems that CBD is a miracle elixir, for whatever ails you, it’ll do the trick sir.For a variety of conditions including (per Tuck.com): cancer, heart disease, irritable bowel syndrome, glaucoma, Seizures/epilepsy, acne, chronic pain, sleep disorders, anxiety, depression, PTSD, and stress, it may be the fix, sir. Buy some, try some, better do it quick, sir.

While good scientific evidence is lacking, one could argue that CBD would likely have some beneficial effects under certain circumstances. For example, it could very well have some anti-anxiety/calming effects, probably some appetite stimulation. Expected side effects would range from lethargy and dry mouth to fits of hysterical laughter and perhaps the desire to hear the piano played really, really fast.

Seriously, man, what’s the harm? You don’t even have to inhale.

There is no shortage of CBD products out there, but there is definitely a shortage of good information regarding the safety and efficacy of these products. There is also a lot of variation between products (and possibly between batches of product). Some companies may not have good quality control in their growing and extraction processes. Some don’t contain the amount of CBD stated on the label. You could very well waste your money on something that is falsely and fraudulently represented as a remedy for all pain, but does not actually contain any active ingredient. Some contain contaminants (yes, THC would be considered a contaminant, but there could also be pesticides, heavy metals and other unwanted substances), which could cause other problems. If there really is CBD (or THC, for that matter) in the product, it may interact with other medications. You may also spend your time and money chasing the CBD fix instead of going to the doctor and getting a prescription for a treatment that has been proven safe and effective.

Hold on, dude, what about CBD for pets?

I would love to offer you some specific guidance, but I can’t. Technically, veterinarians (in the US) are not allowed to discuss, recommend or prescribe CBD for their patients. I can tell you that the FDA has not approved cannabis for any use in animals and state laws regarding cannabis use in people do not pertain to pets.

Hopefully there will come a day when CBD products are readily available in standard doses for specific conditions for which they have been proven to safely and reliably provide relief. There needs to be a lot more research (double-blind placebo-controlled studies) before that can happen.

I don’t know how much of the hippie ethos is cannabis inspired, but, regardless of the origin, I, for one, believe the world could benefit from more peace, love and recycling.

Until next time, the Doctor abides. Dr. Debbie Appleby