The CBD market for tinctures, oils and food additives is worth hundreds of millions of dollars, and it’s projected to surpass $1 billion in the USA alone by 2020.
Yet CBD is illegal under the federal 1970 Controlled Substances Act. As a Schedule I drug, it’s in the same category as heroin, LSD, and ecstasy–even when it’s derived from hemp, a variety of cannabis that, unlike marijuana, contains only trace amounts of THC, the compound that gets you high.
Despite limited evidence showing CBD can reduce anxiety–or has any other effect in humans – huge amounts are being spent developing CBD products – in tinctures, and infused into food and drink. So far, the only CBD medication approved by the US Food and Drug Administration for medical use is a drug called Epidiolex, which was developed by British company GW Pharma to treat two rare forms of epilepsy. The UK has also accepted a GW product for treatment of spasticity in MS sufferers.
Other drugs may be on the way. A medication called Arvisol, developed by a Dutch pharma company, is expected to treat psychiatric disorders like schizophrenia, and is in early clinical trials. Zynerba Pharmaceuticals is developing a CBD gel to treat symptoms of a genetic condition called fragile X syndrome, which can include anxiety, mood swings, and cognitive impairment.
Limited evidence indicates CBD may help with opioid, cocaine, and tobacco addiction, according to the who report, though “considerably more research is required.”
Although eight states have already legalized both marijuana and hemp, users technically can be prosecuted under federal law. (Republican Sen. Mitch McConnell is pushing for legislation that would federally legalize hemp, which is a big crop in his home state, Kentucky.) Still, experts say getting arrested for using CBD is unlikely:
Shanna Babalonis, assistant professor of behavioral science at the University of Kentucky College of Medicine helped write a 2018 World Health Organization report about CBD. “It’s being sold online with no consequence,” she said.
Some products claim CBD is a “miracle molecule,” treat ailments including nausea, anxiety, cancer, arthritis, and even Alzheimer’s disease. It’s commonly sold as an oil or added to products like candies, teas, and lotions – or in tinctures – whether in health food stores, pet depots, or even on Amazon.
Celebrities CBD endorsers include Gwyneth Paltrow, who’s wellness blog, Goop, recommends a CBD-spiked mint julep “for kicking relaxation mode into overdrive.”
Scientists need approval from the FDA and the Drug Enforcement Administration to study any Schedule I drug, and as a 2017 report from the National Academies of Sciences put it, this barrier has “discouraged a number of cannabis researchers from applying for grant funding or pursuing additional research efforts.” What’s more, the federal government typically only fast-tracks trials for Schedule I substances that treat grave illnesses–so it’s hard for scientists to actually prove CBD is an anti-anxiety wonder drug, despite its reputation. All the red tape has prompted some companies to move their research operations to Israel, where regulations around marijuana are more relaxed.
There is “great potential” for CBD, says Margaret Haney, director of the Marijuana Research Laboratory at the Columbia University Irving Medical Center. Still, Haney, who is currently testing CBD’s ability to treat nerve damage pain, warns that people may be too eager to tout the drug. “I’m excited about it, but I caution people to not jump 20 steps ahead of the science.”
While both CBD and its sister cannabinoid THC have the same chemical formula–21 carbon molecules, 30 hydrogen molecules, and two oxygen molecules–their structures differ significantly. So, while THC can bond with receptors in the brain, causing the high associated with marijuana, CBD cannot. International clinical studies show that even high doses of oral CBD do not cause “THC-like effects” such as impairment, increased heart rate, or dry mouth, according to the who report.
Worldwide, most CBD products sold in brick-and-mortar stores are required to undergo testing, but the reverse is true in the online CBD market. Online is almost entirely unregulated. In 2017, the FDA tested dozens of products from four major online CBD retailers based in Florida, Colorado, and California. Many products did not contain the levels of CBD that retailers advertised, and some made unfounded claims like, “CBD makes cancer cells commit ‘suicide’ without killing other cells.” The FDA sent warning letters to all four companies requiring them to correct the information. These “deceptive marketing” techniques may even prevent some patients from getting the medical care they need, the agency wrote.
Haney and her colleagues agree CBD shows promise–and more research and regulation will help weed out bogus products. In the meantime, it’s still best to proceed with caution: What you purchase online might not even contain CBD. “There’s no regulation, so buyer beware,” says Haney. “You don’t know what you’re really getting.”