This has been the year medical cannabis hit the mainstream. The government has announced that it is relaxing laws on when cannabis medicines can be given by doctors, following high-profile cases like that of Billy Caldwell, the 13-year-old boy hospitalised by his epileptic seizures after he was denied legal access to the cannabis oil that can help control them. Meanwhile a whole new generation of cannabis medicines indicates great promise (both anecdotally and in early numerous studies) in treating a range of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And you don’t have to get stoned to reap the health advantages.
Caldwell’s medicine was illegal as it contained THC, the psychoactive compound that smoking weed socks you with. However, the new treatments under development use a less mind-bending cannabinoid referred to as CBD (or cannabidiol).
Natural, legal with no major side effects (so far), CBD is really a marketer’s dream. Hemp-based health items are launching left, right and centre, cashing in whilst the research is in their first flush of hazy potential. Along with ingestible CBD (also sold as hemp or cannabis oils or capsules) the compound has developed into a buzzword among upmarket skincare brands such as CBD of London. Predictably, Gwyneth Paltrow is really a proponent in the trend, and has stated that taking CBD oil helps her through hard times: “It doesn’t make you stoned or anything, a little bit relaxed,” she told one beauty website.
Meanwhile, so-called wellness drinks infused with CBD are gaining traction. The UK’s first has been launched by Botanic Lab, promoted as “Dutch courage using a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are all considering launching their particular versions, while UK craft breweries like Green Times Brewing (formerly Cloud 9 Brewing) and Stockton Brewing Company are selling cannabis-oil laced beers, and mixologists are spiking their cocktails with CBD mellowness. The fancy marshmallow maker, The Marshmallowist, has added CBD-oil flavour to its menu, promising that “you experience the effects immediately upon eating”, without specifying what those effects might be.
While THC will make you feel edgy, CBD does the opposite. In fact, when used together, CBD can temper the side effects of THC. Unsurprisingly, there isn’t much CBD in recreational cannabis strains including purple haze or wild afghan; it is far richer in hemp plants.
Whether these CBD products will do anyone a bit of good (or bad) is moot. “Cannabidiol is definitely the hottest new medicine in mental health because the proper clinical studies do suggest it offers clinical effects,” says Philip McGuire, professor of psychiatry and cognitive neuroscience at King’s College London. “It will be the No 1 new treatment we’re thinking about. But although there’s plenty of stuff in the news about this, there’s still not really that much evidence.” Large, long term studies are required; a 2017 review paper in to the safety profile of CBD concluded that “important toxicological parameters are yet to become studied; for instance, if CBD has an effect on hormones”.
McGuire doesn’t advise buying CBD products. You should differentiate, he says, involving the extremely high doses of pharmaceutical-grade pure CBD that participants in the couple of successful studies received as well as the dietary supplements available over the counter or online. “These could have quite small amounts of CBD that might not have big enough concentrations to possess any effects,” he says. “It’s the main difference between a nutraceutical and a pharmaceutical.” These supplements aren’t allowed to make claims of the effects. “If you’re making creams or sports drinks with CBD, you are able to say whatever you like as long as you don’t say it will do such and the like,” he says.
Two cannabis-based pharmaceutical drugs, manufactured throughout the uk, are licensed for prescription only for very specific uses. Sativex continues to be available in the UK since 2010 and uses THC and CBD to deal with spasticity in multiple sclerosis. Along with a new CBD-only drug, Epidiolex, was approved in June in the US to treat rare childhood epilepsies, using a similar decision expected imminently for Europe as well as the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that folks try them and find, ‘Oh, it doesn’t seem to work.’ Or they get side-effects from a few other ingredient, because, if you purchase an oil or fmavoi product, it’s likely to contain all types of other stuff which can have different effects.”
You only need to look at the reviews within a CBD product on the Holland & Barrett web site to view the extent which anecdotal reports cannot be trusted. More than 100 customers gave Jacob Hooy CBD Oil five stars, with a few saying they always noticed if they missed a dose (presumably this made them less relaxed, even though they failed to reveal what they were taking it for), while 93 people gave it one star, saying it did nothing, or was too weak. One couple even said it gave them palpitations and a sleepless night. All these people had different conditions, expectations and situations. “And,” says McGuire, “you have to understand that anything could have a placebo effect.” Although it looks unlikely that this recommended doses of those products is going to do any harm, McGuire’s guess is the fact that doses are really small “that it’s like homeopathy – it’s not planning to do anything whatsoever at all”.