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RECENT SURGE IN POPULARITY: Cannabidiol Popularity Raises Questions for Clinicians

2018 marked the passage of the federal Farm Bill, which allows for the cultivation of industrial hemp (defined as Cannabis sativa with a THC content of less than 0.3% per dry weight) from which CBD oil can be extracted. This CBD, if grown on farms authorized by this legislation, is legal under the CSA. Further muddying the waters is that more than 30 states have now made some change to their cannabis laws. As such, in states such as California, one can find CBD products in dispensaries that are extracted from plants that are still considered “marijuana” under federal law and are thus, still illegal under the CSA (though federal enforcement of these laws has been practically nonexistent in recent years). This has led to a flurry of confusion in the marketplace as large national retailers such as Bed, Bath, & Beyond and Amazon have recently begun selling “CBD oil.” Often, the language around these products makes vague health claims, which runs the risk of reprimand from the FDA, which bans unsubstantiated health claims in consumer advertising. Additionally, the FDA has made clear that CBD (as Epidiolex is now a prescriptible medicine) cannot be included in food products, as FDA-approved medications cannot be sold as food. However, as a recent picture in The New York Times of a Brooklyn café offering CBD infused lattes would indicate, enforcement is lax. Much more well-controlled research is needed before it can be said, from the standpoint of evidence-based medicine, that low-dose CBD is an effective treatment for psychiatric ailments.

By Andrew Penn, RN, MS, NP, CNS, APRN-BC

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