As more retailers fill store shelves with cannabidiol (CBD) products, researchers are urging caution. Marketing is outpacing the evidence, and collectively we would benefit from taking a few steps back to understand what’s real and what’s not concerning the latest health panacea.
A new research review in Mayo Clinic Proceedings takes on the task of separating clinical substance from inflated claims about hemp-derived CBD oils, and offers suggestions for both consumers and health professionals on how to navigate ahead.
Yes some of the research shows promise, but…
Hardly a month passes without new studies pointing to the promise of CBD to treat sleep disorders, anxiety and chronic pain (among the most common claims). Some of these are small pre-clinical trials, others are more impressive clinical studies, and together their results suggest that CBD isn’t a baseless fad.
But, as the authors of the new research review point out, there’s been few worthwhile human studies on the safety and efficacy of CBD products. Clinicians don’t yet have the information they need to make solid recommendations to their patients. At the same time, CBD marketing is exploding with largely unsubstantiated claims circulating for everything from lotions to sprays to capsules.
“There are many intriguing findings in pre-clinical studies that suggest CBD and hemp oil have anti-inflammatory effects and may be helpful with improving sleep and anxiety,” says Brent Bauer, M.D., an internist and director of research for the Mayo Clinic Integrative Medicine program. “But trials in humans are still limited, so it is too early to be definitive about efficacy and safety.”
The researchers note that to-date no rigorous safety studies have been conducted on the heavily marketed “full spectrum” CBD oils that contain other compounds from the hemp plant in addition to CBD. And while the findings aren’t conclusive, concerns about possible liver injury associated with some CBD products merit more investigation.
And remember, CBD products do not have to undergo approval before being sold.
The legislative door that opened last year allowing hemp products to enter a less perilous legal arena—the bipartisan Farm Bill—doesn’t mandate that these products undergo clinical evaluations before going to market. Rather, it simply allows hemp products containing less than 0.3% THC (the psychoactive compound in cannabis) to enjoy legal protection under the new law.
Only one CBD product has earned Food and Drug Administration (FDA) approval so far, and that was for a very specific purpose.
“Other than Epidiolex, a purified form of plant-derived CBD, which was approved in 2018 for treatment of severe forms of epilepsy, all other forms of CBD are not approved by the FDA, but are sold in a variety of formulations, including oral or topical oils, creams, sprays and tablets,” said study co-author Karen Mauck, M.D., an internist at Mayo Clinic. “They contain variable amounts of CBD, may contain other active compounds, and may have labeling inaccuracies.”
In other words, buyer beware. We’re in something of a Wild West moment right now and there’s little certainty about any given claim for any number of products.
In summary, let’s get some perspective.
There’s big money behind CBD and much more coming. We’ve only seen the start of what’s rapidly evolving into a $20 billion market. Consumers need to keep in mind the massive incentive to rush products to eager buyers, and think more critically about product claims. At the same time, healthcare professionals have to get up to speed, and fast.
“Physicians need to become better informed about these products, and it’s important that human trials examine issues of efficacy and safety,” added Dr. Bauer.
The research review appears in the September edition of Mayo Clinic Proceedings.
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