Pot Shots: The jury is still out on CBD
Credit: Suharu Ogawa
The health benefits of cannabidoil, a buzz-free cannabis constituent, are very much up in the air
Gather ’round, ladies and gents! You sir, with your thumbs hooked into the belt loops of your dungarees! Come on in, get a little closer. We’re all friends, right? And as your friend, it is a true honour to share news of a Genuine Scientific Discovery™ that will revolutionize your well-being, setting y’all on a path to sustained and dynamic health. Introducing… Cannabidiol!
What’s that? By golly, you’re right—it is a tongue twister. Let’s call it CBD for short.
Now, CBD is a bona fide miracle drug (not to be confused with actual medicine), a veritable Swiss Army knife of disease prevention and eradication. Got yourself a case of the nerves? A dab or two of CBD oil will fix you up. Can’t sleep? Well, this stuff will put you out faster than a Sunday sermon. Caught a touch of the cancer? Not anymore! Let’s just say that if it’s good enough for Kim Kardashian, well, who am I to be putting on airs?
You’re skeptical? Well, for your edification, herewith is a summary of the current state-of-the-art evidence supporting the efficacious use of this truly magical elixir:
OK, perhaps that’s a bit of an exaggeration, but it’s undeniable that the myriad claims made by CBD marketeers today have disturbing parallels with assertions by patent medicine hawkers from the late 1800s.
Of all the developments in the cannabis space, though, the sale of CBD, a non-psychoactive cannabinoid produced by the cannabis plant, may hold the most promise from a marketing perspective. The allure is understandable: CBD allows consumers to tap into the mythical—and largely untested—health benefits of cannabis, but without the buzz. Yet does the evidence support the claims?
“I think if we’re talking about evidence generated from clinical trials,” says M-J Milloy, the Canopy Growth professor of cannabis science at UBC, “there’s very little.” So are the ostensible benefits of CBD overhyped junk science, or is it that we haven’t had the opportunity to conduct adequate research? “I would say yes to both,” says Milloy, adding that during prohibition, conducting clinical trials was almost impossible. “Now that is not to say, in my view as a cannabis scientist, that CBD doesn’t hold a lot of potential.”
There have been a few successes. In the U.S., the FDA approved Epidiolex, a CBD-based treatment for two rare epilepsy syndromes, in 2018. (It is not currently approved for use by Health Canada.) And there is some evidence that CBD may aid chronic pain management, as well as help diminish opioid cravings. Other areas show promise, too—but.
“What we do have are patient reports,” Milloy notes. “Not controlled, not blinded [trials], and not a very high standard of evidence.” Still, these reports do suggest “that CBD is beneficial for some people,” he adds.
But what about physician-prescribed marijuana? Surely there must be some evidence to support writing a prescription? In short, there’s not—because, with the exception of two Health Canada–approved drugs (Nabilone and Sativex), Canadian physicians don’t actually prescribe cannabis. “These substances are not prescribed by physicians, they’re authorized by physicians,” Milloy says. A common misconception. Mea culpa.
None of this has stopped people from lining up to buy CBD formulations to manage a variety of conditions. And that can be problematic when combined with, for example, prescribed anti-anxiety medications. “We have a tremendous amount of claims around the benefits of CBD,” Milloy explains, “and we don’t have enough consideration of the possible risks.”
We’re at the early stages of evaluation. So it’s probably fair to say that when it comes to CBD’s potential medical benefits, absence of evidence is not evidence of absence.
It is, however, at least a little troubling.