It 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 such as those of Billy Caldwell, the 13-year-old boy hospitalised by his epileptic seizures after he was denied legal access to the cannabis oil that assists control them. Meanwhile a new generation of cannabis medicines indicates great promise (both anecdotally and in early clinical studies) for an array of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And you don’t need to get stoned to reap the benefits.
Caldwell’s medicine was illegal since it contained THC, the psychoactive compound that smoking weed socks you with. However, the newest treatments under development make use of a less mind-bending cannabinoid called CBD (or cannabidiol).
Natural, legal along with no major unwanted effects (up to now), CBD is actually a marketer’s dream. Hemp-based health goods are launching left, right and centre, cashing in while the scientific studies are in its first flush of hazy potential. Along with ingestible CBD (also sold as hemp or cannabis oils or capsules) the compound has turned into a buzzword among upmarket skincare brands like CBD of London. Predictably, Gwyneth Paltrow is a proponent from the trend, and it has said that taking CBD oil helps her through hard times: “It doesn’t allow you to stoned or anything, a bit relaxed,” she told one beauty website.
Meanwhile, so-called wellness drinks infused with CBD are gaining traction. The UK’s first continues to be launched by Botanic Lab, promoted as “Dutch courage with a difference”. Drinks giants Coca-Cola, Molson Coors Brewing Company and Diageo are all considering launching their very own versions, while UK craft breweries including 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 notice the effects immediately upon eating”, without specifying what those effects may be.
While THC will make you feel edgy, CBD does the opposite. Actually, when used together, CBD can temper the negative effects of THC. Unsurprisingly, there isn’t much CBD in recreational cannabis strains such as purple haze or wild afghan; it is far richer in hemp plants.
Whether these CBD products is going to do anyone anything good (or bad) is moot. “Cannabidiol is definitely the hottest new medicine in mental health as 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 considering. But although there’s a lot of stuff in news reports about this, there’s still not that much evidence.” Large, long-term studies are needed; a 2017 review paper in to the safety profile of CBD figured that “important toxicological parameters are yet to be studied; as an example, if CBD has an effect on hormones”.
McGuire doesn’t advise buying CBD products. You need to differentiate, he says, involving the very high doses of pharmaceutical-grade pure CBD that participants inside the handful of successful studies were given and the health supplements available over the counter or online. “These could have quite small quantities of CBD that might not have big enough concentrations to get any effects,” he says. “It’s the difference between a nutraceutical and a pharmaceutical.” These supplements aren’t allowed to make claims of any effects. “If you’re making creams or sports drinks with CBD, it is possible to say what you like providing you don’t say it will do such and such,” he says.
Two cannabis-based pharmaceutical drugs, manufactured throughout the uk, are licensed for prescription only for very specific uses. Sativex has become available in the UK since 2010 and uses THC and CBD to deal with spasticity in multiple sclerosis. And a new CBD-only drug, Epidiolex, was approved in June in the US to treat rare childhood epilepsies, with a similar decision expected imminently for Europe and also the UK.
Another concern with non-pharmaceutical products, says McGuire, “is that individuals try them and find, ‘Oh, it doesn’t seem to work.’ Or they get side-effects from various other ingredient, because, if you purchase an oil or fmavoi product, it’s likely to contain all kinds of other activities which can have different effects.”
You only have to read the reviews within CBD product on the Holland & Barrett web site to view the extent to which anecdotal reports can not be trusted. More than 100 customers gave Jacob Hooy CBD Oil five stars, with a few saying they always noticed when they missed a dose (presumably this made them less relaxed, even though they did not 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. Each one of these people had different conditions, expectations and situations. “And,” says McGuire, “you have to understand that anything can have a placebo effect.” Although it looks unlikely that this recommended doses of these products can do any harm, McGuire’s guess is the fact that doses are extremely small “that it’s like homeopathy – it’s not likely to do just about anything at all”.