CBD oil: Truth and hope about a cannabis product

Years ago, Jim, age 50, had back surgery. Two lumbar vertebrae fused, screws placed. Two weeks ago, severe back pain shot down his left knee, knocked him to the floor, curled him into a fetal position.

He’s been to the ER five times. Doctors think it’s his hip, groin or back. He’s frustrated. Last night, for his pain, he bought a jar of CBD (cannabidiol) cream from his masseuse. “This stuff’s flying off the shelf,” she told him.

What’s CBD oil?

Marijuana plants contain hundreds of chemicals. The two big stars: CBD and THC (tetrahydrocannabinol). CBD does not produce a “high,” unlike THC.

What’s it good for?

Greg Scott, an AIDS activist, credits marijuana with staving off his wasting before HIV medications became available. “Marijuana saved my life. I have no doubts about it and you don’t need to show me any data.”

But I do.

Currently, CBD has one well-supported, legitimate claim. The Food and Drug Administration (FDA) approved a prescription CBD oil called Epidiolex for the treatment of two catastrophic types of seizures. 

Naturally, people want to know if CBD is the next all-purpose drug. Research is underway for Parkinson's disease, schizophrenia, diabetes, multiple sclerosis, anxiety. But it’s too early to draw conclusions.

Is CBD safe?

Yup, it’s pretty benign.

From Epidiolex trials, the most common side effects were diarrhea and fatigue. Liver complications and increased suicidal thoughts/behavior are potential concerns. It can interact with anti-seizure medications, including topiramate (Topamax). Warfarin (Coumadin, a blood thinner) dose may need to be adjusted. At treatment dose, Epidiolex has no addiction potential.

Concerns?

Let’s start with the government. The legality of CBD, the best way I can describe it, is in flux. The federal and state governments dance to different tunes. It’s a bit like your mother says yes; your stepmother says maybe; your father says, “Do whatever, just don’t screw up.” Unfortunately, these discrepancies lead to loopholes, delays in important research, and my biggest worry – lax oversight.

A 2016 study looked at 84 online CBD products. Most (69%) mislabeled CBD content. Worse yet, THC was found in 20% of the products, at a dose high enough to cause impairment – potentially dangerous for children.

Some CBD products have been adulterated with anything from cough medications, to synthetic marijuana, to synthetic cannabinoid, to other dangerous chemicals. In Utah, more than 50 people were hospitalized for confusion, vomiting, or seizures from counterfeit CBD; most vaped (72.5%).

The Illinois public health department reported 156 cases of severe bleeding and 4 deaths linked to contaminated synthetic cannabinoid. The blood thinner used in rat poison was found in some of the worst cases. In a self-regulating industry with thousands of CBD products, it’s hard to know what you’re getting.

Jim wants better pain relief. As a recovering alcoholic, he wants to get off his prescribed narcotic ASAP. The small jar of CBD cream costs $40, lists over 40 ingredients. He thinks the cream helps, briefly. One thing for sure, he smells like pleasantly scented cough drops.