Introduction

According to a survey of greater than 4,000 Americans, more than a quarter of the people in the U.S. had tried cannabidiol (CBD) at least once in the 2 years preceding the survey, and of those who had tried it, one out of seven said they used it every day. (Gill) Since that survey, the popularity of CBD has only continued to grow.

The manufacturing and marketing of CBD, a cannabis product, in the US has remained unregulated, meaning that there is a lack of strict federal oversight (Balachandran, Cohen, Rubin), and as a result, “the consumer CBD market ha[s] far outpaced science.” (Sholler) “[W]ell-designed, appropriately controlled, clinical trials and human laboratory studies are needed to definitively support or refute CBD’s therapeutic utility for many disease states,” (Sholler) but people have not been waiting for the results of clinical trials. Instead, they have been allured by the promising (and at times misleading) marketing campaigns. They have been using CBD products in various forms, such as capsules, oils/extracts, gummies, joint balms, topicals, cosmetics, bath salts and food products with the hopes of curing numerous health conditions, including cancer, chronic pain, muscle stiffness, inflammation, anxiety, autism, ADHD, nicotine and opioid addiction, acne, Parkinson’s disease, and Alzheimer’s disease, among many other ailments. (Balachandran, Cohen, FTC letter to Forbush, FTC letter to Nulife and FTC letter to Benning)

Because of the widespread use of cannabidiol (CBD), it is likely that clinicians will encounter patients who use this cannabis-based product. It is important that clinicians be familiar with the physiologic effects of CBD; its drug interactions; side effects; and for which conditions it has been shown by evidence-based clinical studies to be efficacious.

References

• Gill, Lisa.  April 2019, Consumer Reports. https://www.consumerreports.org/cbd/cbd-goes-mainstream/ – Accessed Oct 2019
• Balachandran P, Elsohly M, Hill KP. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. J Gen Intern Med . 2021 Jan 29;  doi: 10.1007/s11606-020-06504-8. Epub ahead of print. PMID: 33515191.
• Cohen P, Sharfstein J. The Opportunity of CBD – Reforming the Law. N Engl J Med 2019 Jul25; 381(4):297-299.
• Rubin R. Cannabidiol Products Are Everywhere, but Should People Be Using Them? 2019;322(22):2156–2158. doi:10.1001/jama.2019.17361
• Sholler D, Schoene L, Spindle T. Therapeutic Efficacy of Cannabidiol (CBD): a Review of the Evidence From Clinical Trials and Human Laboratory Studies. Current Add RepJul 25,2020. doi.org/10.1007/s40429-020-00326-8
• Federal Trade Commission (Mary K. Engle, Associate Director) Letter to Jared Forbush of 4bush Holdings, LLC.  Sept 9 , 2019. 4 pages.
• Federal Trade Commission (Mary K. Engle, Associate Director) Letter to NuLife CBD Oils, LLC.  Sept 9, 2019. 6 pages.
• Federal Trade Commission (Mary K. Engle, Associate Director) Letter to Brent Benning, CEO, Ocanna Co. Sept 9 , 2019. 5 pages.