CBD seems to be everywhere now. Given the hype and popularity, are these products safe?

Q:

CBD seems to be everywhere now. Given the hype and popularity, are these products safe?

A:

Cannabidiol (CBD) does appear to be everywhere and is poised to become mainstream. Recently, large box pharmacies in the United States like CVS and Walgreens announced they will carry CBD topicals in their stores. According to Google’s 2018 year-end trend report, CBD gummies were the third most popular food-related Google search of the year. CBD products are prevalent on the Internet (for example, you can order CBD products from Amazon) and are readily available in tincture, topical, capsule, and inhalation form.

However, determining whether CBD product information is accurate can be challenging and healthcare consumers must be well educated to make informed decisions. A recent study determined that, among the top 10 cannabis websites, 90 percent of the information was based on low-quality studies and only one of these websites had used a medical professional to write the articles making cannabis health claims.

Cannabis remains a Schedule I drug and despite the passing of the Agricultural Improvement Act of 2018 (which descheduled hemp), CBD remains in that same schedule. Of course, many of the CBD products readily available online are produced from the hemp plant. Hemp was effectively removed from the Controlled Substance Act (CSA) in December 2018. Currently, hemp-derived products in the US are regulated as dietary supplements and, therefore, can be purchased in health food stores, pet stores, gas stations, and online. In the US, dietary supplements are not required to be reviewed for product safety or efficacy. Consequently, hemp-based products that are now available are not subject to strict regulatory oversight.

In 2017, the Journal of American Medical Association released a study that demonstrated 70 percent of CBD products were mislabeled. The study analyzed various CBD products, including vaporizer cartridges and tinctures. Of the 70 percent of mislabeled CBD concentrations in these products, 42 percent contained more CBD than advertised and 26 percent contained less CBD than advertised.

Additionally, hemp is a bioaccumulator, meaning that it absorbs contaminants and pollutants from the soil and from the surrounding environment. These pollutants can include heavy metals, pesticides, and other toxins that are absorbed from the soil. When hemp oil is extracted or concentrated, these toxins can be found in the final product. Because the hemp industry is not subject to regulatory oversight, healthcare consumers should consider only those products that include a certificate of analysis (COA) from a third-party testing facility.

To ensure that a CBD product is safe, the COA must include testing for potency, pesticides, molds, residual solvents, heavy metals, and mycotoxins. Additionally, healthcare consumers must be sure that all vape cartridge products are free of additives and flavoring agents that contain substances such as propylene glycol, which have not been studied for inhalation safety.

CBD products can be helpful when treating a variety of conditions and disease. Healthcare consumers who are informed about safety considerations can be better equipped when deciding among the multitude of product options.

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Written by Eloise Theisen

Eloise Theisen, AGPCNP-BC, is a dedicated and patient-focused nurse. For over 17 years, she has specialized in aging, cancer, chronic pain, dementia, Alzheimer’s, Parkinson’s, anxiety, depression, fibromyalgia, and various autoimmune and neurological diseases. The founder of Radicle Health, she started her career at John Muir Medical Center caring for patients suffering from cancer, terminal illnesses, respiratory failure/complaints, drug overdoses, acute alcohol ingestion, gastrointestinal bleeds, traumatic brain injury, and multiple traumas.

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