Cannabidiol (CBD) is the predominant cannabinoid (chemical constituent) of the more than 100 cannabinoids found in the hemp variety of the plant Cannabis sativa. There are preliminary, yet unproven, claims that CBD may offer benefits for treating specific ailments such as epilepsy, neuropathic pain, joint pain, inflammation, psychosis, anxiety, and insomnia. At present, the U.S. Food & Drug Administration (FDA) has approved only one CBD drug—Epidiolex—for treating childhood epilepsy. See also: Anxiety disorders; Epilepsy; Hemp; Inflammation; Pain; Psychosis; Sleep disorders
According to the market research company Brightfield Group, CBD product sales—including oils, tinctures, topicals, and capsules—grew from $600 million in 2018 to about $4 billion in the United States in 2019 despite scant evidence of medical benefits, appropriate dosage, or potential risks. On November 25, 2019, the FDA issued warnings to 15 companies for illegally selling products containing CBD, and it also updated consumer warnings of potential health risks. Per FDA regulations, CBD sales are legal in the United States as long as CBD producers do not claim to prevent, treat, or cure diseases, or market CBD as a dietary supplement or food additive. In addition, CBD products must contain less than 0.3 percent tetrahydrocannabinol (THC), the psychoactive cannabinoid found in marijuana variety of C. sativa. Among the health risks cited by the FDA are the potential for liver damage, the possibility of interactions of CBD with other medicines, and male reproductive toxicity. (Note that these warnings are based on animal—not human—studies conducted at very high CBD doses.) Another important warning for consumers is that some CBD products are of unknown quality. Consequently, the FDA recommends that consumers should only purchase products from reputable producers who certify their products through third-party testing labs. See also: Animal testing; Liver disorders; Marijuana; Reproductive system disorders; Toxicology
In 2018, the World Health Organization (WHO) issued a critical review report concluding that CBD is generally well tolerated and safe. In contrast, the FDA says it is taking a cautious approach toward understanding the science, safety, and quality of CBD products. To better understand the effects of CBD, the National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes of Health (NIH), announced in September 2019 funding for nine studies on the potential pain-relieving properties and underlying mechanisms of cannabinoids other than THC. How can the public reconcile these seemingly contradictory reports and investigations? At some future date, the questions concerning the safety, effectiveness, and regulation of CBD may be answered. Until then, perhaps the safest approach to CBD is the principle of caveat emptor, “let the buyer beware.”
