The agency has also expressed concern regarding risk of drug interactions when taking CBD. Pharmacist counsel is particularly important here, as CBD may increase the chance of adverse effects from, or decreased effectiveness of the patient’s other medications. Other medicines may impact the dose of CBD that can safely be used.
Varieties of Cannabis sativa that produce high THC concentrations are what we commonly know as marijuana. On the other hand, hemp is a strain of Cannabis sativa that has lower concentrations of THC and is a cousin of the marijuana plant.
As stated before, there are no dosage guidelines in place. The only available dosage data comes from Epidiolex’s clinical trials, but it is uncertain whether this information translates to OTC use for other conditions. Because CBD is primarily marketed and sold as a supplement, not a medication, the safety and purity of CBD products is largely unknown, as the FDA currently regulates dietary supplements differently to conventional medications.
Is It Legal?
It is likely pharmacists have been getting numerous requests for, and questions about, cannabidiol (CBD) and CBD oil, and pharmacies across the country have considered adding CBD to their OTC product selection, if they haven’t already. A well-stocked section of nonprescription products can be vital for pharmacy profitability, but CBD is not your average OTC product.
So, CBD is federally legal, but the specifics remain murky. For instance, the Farm Bill doesn’t lay out extraction processes, manufacturing methods, and sale and marketing of CBD in the US. Currently, the FDA is in the process of determining how to regulate cannabidiol. The federal agency appears particularly interested in finding out more about what doses are safe, and the effects of long term use. Moreover, the FDA has emphasized it has seen only limited data about CBD’s safety.
We’re really in the infancy of understanding the physiological effects of cannabidiol, but this has not undermined the popularity of the substance among patients. This is a challenge for all pharmacists, and so this is a time for you to consider getting adequate training to learn about state-of-the-art research on CBD, and help guide those patients looking to incorporate CBD into their regimes.
How Did We Get Here?
Even though the 2018 Farm Bill ended decades of hemp prohibition, the legal landscape continues to be complicated. Marijuana is still considered a Schedule I narcotic, while hemp has been removed from the list. Yet, some state and local authorities in New York, South Dakota and Nebraska have been cracking down on CBD companies and/or consumers. Some lawmakers have said the provision that legalized hemp and its derivatives, also intended to legalize CBD, but without clear rules from the Food and Drug Administration (FDA), confusion still prevails.
CBD is one of dozens of cannabinoid substances found in Cannabis sativa; but unlike THC, CBD by itself does not cause the “high” associated with marijuana.
The popularity of medical marijuana (also known as medical cannabis) continues to grow in the US. In 2018, over 3.5 million patients were registered to use medical cannabis; an increase from 2.6 million in March, 2016. As of January 2019, 33 states and Washington D.C., have laws legalizing medical marijuana. Ten states, Washington D.C., and Canada have legalized recreational marijuana. In addition, a growing number of states have laws specifically addressing the use of cannabidiol (CBD) for medical, as well as nonmedical, purposes.
This CE activity was originally published in The Rx Consultant. If you received credit for it previously, you cannot receive credit for it again.
The use of Cannabis sativa by the Chinese – for its strength as a fiber (in paper, bowstrings, rope, or clothing) and its medicinal properties – has been documented as far back as 4000 years ago. Hemp and marijuana are both plants in the Cannabis sativa family; however, they differ in structure and active ingredients. The most prevalent active ingredient in marijuana is tetrahydrocannabinol (THC), known for its psychoactive effects. Cannabidiol (CBD) is the second most prevalent active ingredient in marijuana (among many other pharmacologically active cannabinoids) and is the most prevalent active ingredient in hemp. Both THC and CBD have pharmacological effects. However, unlike THC, CBD does not have euphoric or intoxicating effects. A growing body of research suggests that CBD may be beneficial for a range of medical conditions including, but not limited to, anxiety, movement disorders, pain, sleep disorders, and seizure disorders. The FDA has approved CBD (Epidiolex ® ) for the treatment of 2 rare childhood-onset epilepsy syndromes. The evidence for CBD use in other conditions is sparse; it is derived mainly from animal, in vitro, and small human trials. However, because of its apparent lack of side effects in low to moderate doses, there is a great interest in CBD as a natural supplement.