This has been the year medical cannabis hit the mainstream. The federal government has announced that it is relaxing laws on when cannabis medicines may be prescribed by doctors, following high-profile cases such as 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 helps control them. Meanwhile a new generation of cannabis medicines has demonstrated great promise (both anecdotally and in early clinical studies) in treating a range of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And also you don’t need to get stoned to reap the benefits.
Caldwell’s medicine was illegal as it contained THC, the psychoactive compound that smoking weed socks you with. However, the brand new treatments under development use a less mind-bending cannabinoid known as CBD (or cannabidiol).
Natural, legal with no major side effects (to date), CBD is a marketer’s dream. Hemp-based health items are launching left, right and centre, cashing in as the research is in their first flush of hazy potential. As well as 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 a proponent in the trend, and it has said that taking CBD oil helps her through hard times: “It doesn’t make you 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 been launched by Botanic Lab, promoted as “Dutch courage with a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are considering launching their own versions, while UK craft breweries such as 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 the menu, promising that “you notice the effects immediately upon eating”, without specifying what those effects could be.
While THC will make you feel edgy, CBD does the contrary. In fact, when used together, CBD can temper the side effects of THC. Unsurprisingly, there isn’t much CBD in recreational cannabis strains including purple haze or wild afghan; it is far richer in hemp plants.
Whether these CBD products can do anyone any good (or bad) is moot. “Cannabidiol is definitely the hottest new medicine in mental health because 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 interested in. But although there’s plenty of stuff in the news about it, there’s still not that much evidence.” Large, long term studies are needed; a 2017 review paper into the safety profile of CBD determined that “important toxicological parameters are yet to become studied; for instance, if CBD has an impact on hormones”.
McGuire doesn’t advise buying CBD products. You have to differentiate, he says, involving the extremely high doses of pharmaceutical-grade pure CBD that participants within the handful of successful studies were given and the nutritional supplements available non-prescription or online. “These might have quite small quantities of CBD which may not have big enough concentrations to have any effects,” he says. “It’s the main difference from a nutraceutical along with a pharmaceutical.” These supplements aren’t allowed phxbop make claims for any effects. “If you’re making creams or sports drinks with CBD, it is possible to say anything you like as long as you don’t say it is going to do such and such,” he says.
Two cannabis-based pharmaceutical drugs, manufactured throughout the uk, are licensed for prescription but only for very specific uses. Sativex has been available in the united kingdom since 2010 and uses THC and CBD to deal with spasticity in multiple sclerosis. As well as 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 manage to work.’ Or they get side-effects from various other ingredient, because, if you buy an oil or cannabis product, it’s likely to contain all sorts of other stuff which might have different effects.”
You simply have to look at the reviews within a CBD product on the Holland & Barrett web site to see the extent to which anecdotal reports cannot 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, 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 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 may have a placebo effect.” While it looks unlikely the recommended doses of these products is going to do any harm, McGuire’s guess is the fact doses are extremely small “that it’s like homeopathy – it’s not likely to do anything whatsoever at all”.