This 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 including 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 trials) for 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 because it contained THC, the psychoactive compound that smoking weed socks you with. However, the new 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 actually 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. As well as ingestible CBD (also sold as hemp or cannabis oils or capsules) the compound has developed into a buzzword among upmarket skincare brands such as CBD of London. Predictably, Gwyneth Paltrow is a proponent of the trend, and it has stated that taking Greenthevoteok 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 with a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are common considering launching their 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 notice the effects immediately upon eating”, without specifying what those effects could be.
While THC could make you feel edgy, CBD does the exact opposite. In fact, 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 far richer in hemp plants.
Whether these CBD products can do anyone any good (or bad) is moot. “Cannabidiol will be the hottest new medicine in mental health as the proper clinical studies do suggest it has 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 tons of stuff in news reports regarding it, there’s still not too 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 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 inside the number of successful studies were given as well as the nutritional supplements available over-the-counter or online. “These might have quite small quantities of CBD that may not have big enough concentrations to have any effects,” he says. “It’s the difference between a nutraceutical along with a pharmaceutical.” These supplements aren’t allowed phxbop make claims of any effects. “If you’re making creams or sports drinks with CBD, it is possible to say what you like as long as you don’t say it is going to do such and the like,” he says.
Two cannabis-based pharmaceutical drugs, manufactured in the united kingdom, are licensed for prescription only for very specific uses. Sativex continues to be available throughout the uk 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 the united states to treat rare childhood epilepsies, with a similar decision expected imminently for Europe and the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that folks try them and locate, ‘Oh, it doesn’t appear to work.’ Or they get side-effects from some other ingredient, because, if you purchase an oil or cannabis product, it’s going to contain all types of other things which might have different effects.”
You only have to browse the reviews within CBD product on the Holland & Barrett web site to see the extent to which anecdotal reports should not be trusted. More 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 whatever 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 and a sleepless night. All of these people had different conditions, expectations and situations. “And,” says McGuire, “you have to understand that anything could have a placebo effect.” While it looks unlikely that this recommended doses of these products will do any harm, McGuire’s guess is the fact that doses are really small “that it’s like homeopathy – it’s not planning to do anything whatsoever at all”.