Not so fast

Study reveals the one mistake people make about how to use CBD

"Clearly the public did not randomly infer that CBD cures nearly all medical conditions."

Iryna Veklich/Getty Images

The CBD industry has made the cannabis compound startlingly available — from seltzers to Carls Jr. burgers.

In fact, CBD, the non-psychoactive component of marijuana, is so ubiquitous that it is increasingly hard to separate word of mouth, from the science. According to new research, even the most devoted CBD fans are losing track of what the compound can actually do, and most make one important mistake.

A review of 376 posts to the subreddit r/CBD (which has more than 113,000 members) found that 90 percent of posts mentioned using CBD to treat an assortment of diagnosable medical conditions. But here is the thing. As of right now, CBD — in the form of the drug Epidiolex — is only approved for use in the United States to treat two rare forms of severe epilepsy.

As the compound's popularity has spiked, the research suggests it has garnered a reputation as a cure-all.

According the to the paper, published Thursday in JAMA Network Open, the most common off-label ways people used CBD include:

  1. Psychiatric conditions, like depression or autism (mentioned in 64 percent of posts)
  2. Orthopedic claims, like arthritis (mentioned in 26 percent of posts)
  3. Sleep disorders, like insomnia or nightmares (mentioned in 15 percent of posts)
  4. Neurological conditions, like migraines (mentioned in 7 percent)
  5. GI conditions, like acid reflux (mentioned in 4 percent)
  6. Addiction, like withdrawal symptoms (mentioned in 2 percent)
  7. Sexual health concerns, like erectile dysfunction (mentioned in 1 percent)
  8. Skin conditions, heart conditions and eye conditions were included in less than one percent of posts.

John Ayers is the study's last author and adjunct associate professor at the University of San Diego School of Health. He tells Inverse CBD simply is not proven to be effective as a treatment for the myriad ailments it's currently used for.

"There is a FDA process to bring new therapeutics to market requiring extremely robust study designs, multiple complimenting results, outside oversight of the data, and post marketing surveillance," he says.

"We don't have that with CBD."

90 percent of posts reviewed by the team suggested that users were using CBD to treat diagnosable medical conditions. Tinnakorn Jorruang / EyeEm/ Getty Images

Is using CBD to treat medical conditions risky? –  Scientists are still trying to understand how CBD affects a whole host of ailments. It is currently being investigated as a pain management tool, and as a way to deal with withdrawal symptoms from smoking marijuana.

But there's a big difference between taking part in a study to research CBD's benefits, and using CBD off-label at home to treat actual medical conditions.

Part of the risk stems from the fact it's not always clear what lurks inside each product. In 2017, scientists at the University of Pennsylvania analyzed 84 CBD products and found that 36 of them contained more CBD than advertised on the label, 26 were labeled accurately, and 22 had less CBD than advertised. Eighteen of the products also contained THC, the psychoactive component in marijuana.

There are also reports of CBD products being adulterated. In 2017, 52 people became ill or were hospitalized after taking a CBD product that actually contained a synthetic cannabinoid, according to a CDC report.

Unadulterated or not, CBD is not a substitute for other medicines that are proven to work, Ayers says. People taking CBD to treat heart conditions may benefit more from other treatments that have been tested for that purpose, for example.

"Using over-the-counter CBD to treat any medical condition is not FDA recommended, and doing so will only prolong or exacerbate your illness," he says.

What CBD can and can't do – The idea of CBD as a cure-all didn't come from nowhere, Ayers notes.

The number of posts on r/CBD has continued to climb as CBD becomes more popular. JAMA Network Open

CBD isn't a medical drug (or even, technically, a dietary supplement, according to the FDA). CBD sellers are not allowed to suggest it can cure or treat diagnosable medical condition, but they can make general wellness claims.

In the study, the authors found just 29.5 percent of posts included one general wellness claims, whereas 90 percent included at least one claim that CBD treats a diagnosable condition.

The FDA doesn't review CBD products before they go to market. To control the industry, the agency can issue warning letters to sellers it finds to have made unsupported claims. In 2020, the FDA has issued 11 warning letters to CBD sellers claiming their products could treat or cure coronavirus, for instance.

"Clearly the public did not randomly infer that CBD cures nearly all medical conditions," Ayers says. "They were told that over and over again by an industry that will say anything to sell more product."

Using CBD as a wellness product is well within the guidelines the FDA has put forward. But when the claims start to drift into medical territory, the science just isn't there, Ayers says.

In the interests of transparency, Inverse notes that Davey Smith, a co-author on the study reported fees outside the current work from AG Bayer a pharmaceutics company and non-financial support from Fluxergy, a medical equipment manufacturer.

Partial Abstract:
Results: Of the 376 posts labeled as testimonials, 90.0% (95% CI, 86.8%-92.8%) of testimonials claimed that CBD treated the individual’s diagnosable conditions. Psychiatric conditions (eg, autism or depression) were the most frequently cited subcategory, mentioned in 63.9% (95% CI, 59.0%-69.1%) of testimonials, followed by orthopedic (26.4%; 95% CI, 21.8%-31.1%), sleep (14.6%; 95% CI, 11.3%-18.5%), and neurological (6.9%; 95% CI, 4.4%-9.6%) conditions. Testimonials also claimed that CBD treated gastroenterological conditions (3.9%; 95% CI, 1.9%-6.1%), as well as addiction, cardiological, dermatological, ophthalmological, oral health, and sexual health conditions (<2.0% each). By contrast, just 29.5% (95% CI, 24.8%-34.2%) of testimonies claimed any wellness benefit, with most citing mental wellness (eg, “quieting my mind”) (29.5% [95% CI, 24.2%-34.4%]); 1.4% (95% CI, 0.3%-2.8%) claimed a physical wellness benefit (eg, “exercise performance”).
Conclusions and Relevance: The findings of this case series suggest a need for regulation of factors associated with CBD being used to treat diagnosable conditions, engagement of health care professionals with patients on their potential CBD use, and implementation of public health campaigns that encourage the public to seek treatment advice from health care professionals regarding evidence-based therapies.

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