IT’S BECOMING MORE and more common to see CBD products on shelves and promoted online.
CBD is short for cannabidiol, a chemical compound found in cannabis. It is not psychoactive – people don’t get high from it – and CBD products can be legally sold in Ireland, but there are restrictions.
Tetrahydrocannabinol (THC), on the other hand, is the main psychoactive constituent of cannabis. Under the Misuse of Drugs legislation, products containing THC are strictly controlled and possession is unlawful, except under ministerial licence.
There has been much debate in recent years about the impact cannabis and products derived from its components can have on certain health conditions.
Medicinal cannabis has become big business in the US and elsewhere, as have CBD products.
CBD genuinely helps many people in terms of reducing epileptic seizures, improving sleep and reducing the pain and other side-effects associated with certain conditions.
It is also a wellness bandwagon many companies have happily jumped on – people can buy everything from CBD facials to CBD lattes.
One expert has warned that the real benefits some people experience from taking CBD could be overshadowed by the over-saturation of such products.
“If we sell it as a ‘cure -all’ for everything, it will drown out what it is actually effective for and that would be a crying shame,” Professor Adam R Winstock, consultant psychiatrist and CEO of the Global Drug Survey (GDS), told TheJournal.ie.
Winstock compared the current influx of CBD products to goji berries or jojoba in certain shampoos – basically it’s an ‘on trend’ wellness product and companies want to capitalise on that.
However, he said a serious conversation needs to take place about CBD, what it can do and what it can’t.
‘Running riot’
CBD is labelled as a food supplement and so can’t be sold as a treatment for a particular condition as this would require the product in question to undergo quality control and have any such claim backed up by research.
However, confusion over CBD regulation has resulted in some companies mislabelling products both in terms of what is in them and what they can do.
“Poor labelling and variable quality control often limit the potential of any individual to know exactly what they are consuming and hence determine any link between use and benefit beyond placebo – one of our best and cheapest medicines, if you are lucky enough to be receptive to such effects,” Winstock said.
“The industry will run riot for as long as it is allowed to,” he added.
The GDS 2020, a global survey which will question thousands of people about their drug and alcohol use, will contain a section on CBD use in a bid to get a better understanding of how it works.
Winstock said people with certain conditions see “amazing” results from taking CBD, but that this is not the case for everyone.
In terms of chronic pain, he noted that, by definition, it is “difficult to treat”. He said CBD might help people with chronic pain in different ways – it may ease the pain itself or help the person sleep better or level out their mood. For others, it may have little or no effect.
“The condition affects people in lots of different ways,” he said.
Doctors reluctant to prescribe CBD
Earlier this month, two medicinal cannabis products were approved and registered for use in Ireland under the new Medical Cannabis Access Programme: Aurora High CBD Oil Drops and CannEpil.
The medicinal cannabis access scheme, which was signed into law by Health Minister Simon Harris in June, makes it possible for a medical consultant to prescribe a cannabis-based treatment for a patient under his or her care, but only for patients with specific medical conditions, where the patient has failed to respond to standard treatments.
These conditions are:
Campaigners had unsuccessfully called for chronic pain to be included on this list.
Winstock said doctors are often afraid of discussing CBD or cannabis-use with patients, let alone prescribing it, because it’s unfamiliar territory and there is a lack of research in this area.
Doctors need to start having conversations with patients. Doctors need to learn from patients. If a person comes in and says ‘I’m using cannabis’, the doctor should say ‘Oh amazing. How are you using it? How often are you taking it? How does it work?’
“If the patient says they are smoking it, the doctor should say ‘I’m really pleased it’s useful but you’re still consuming tobacco, have you considered vaping?’
“It’s about learning and giving good information,” Winstock said.
In previous GDS research, 68% of respondents said they did not disclose cannabis use to their doctor because thought the doctor wouldn’t have anything useful to say about it, or because they would judge them.
“A lot of the time, doctors aren’t really quite sure what to say,” Winstock acknowledged. He added that if and when such a conversation takes place, one of the most important things for the doctor to do is check that the patient’s diagnosis is correct.
He noted that a patient may say they are using cannabis to help them sleep because they think they have a particular condition such as anxiety when in fact they have another condition, perhaps diabetes, which is causing the same side-effects.
There are so many different doses and routes of administration. You can’t just say ‘CBD is good for you’, there are too many kinds of variations, it’s more about what you’re trying to treat. In childhood epilepsy, for example, there is very strong evidence that it can help.
“But just because it’s useful for a really rare serious condition, it doesn’t mean it’s good for rheumatoid arthritis, improving memory, reducing gut inflammation,” Winstock said.
He said more research is needed in this area, adding that information collected in the GDS will be analysed to identify patterns of CBD use, dosage, and the impact it has certain conditions.
He said one of the main goals of the GDS is to provide valuable research to governments who are devising relevant policy and legislation.
About 1,800 people from Ireland have taken part in the survey to date. People interested in completing the CBD section of the survey, or other sections which are relevant to them, before can find more information here (the deadline is 30 December).
Results from the GDS will be published on TheJournal.ie, GDS’s Irish media partner, in the new year.
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