90% of CBD users think it's real medicine and take it for psychiatric, neurological and other conditions: Study
Despite cannabidiol (CBD) only being approved by the US Food and Drug Administration (FDA) to treat rare forms of childhood epilepsy, it has been widely marketed as a cure-all under the auspices of wellness. Researchers now warn that 90% of CBD users think it is real medicine and use it to treat medical conditions, such as psychiatric, orthopedic, neurological, and sleep conditions, while fewer take CBD for wellness. CBD is a chemical found in hemp or marijuana plants.
The study led by the Qualcomm Institute’s Center for Data Driven Health at the University of California San Diego, reviewed CBD user testimonials to discover why people take CBD. The team turned to Reddit, a social media website with 330 million active users. Reddit is organized into communities focused on specific topics, many of which deal exclusively with health. The investigators monitored all r/CBD posts, where users can find anything and everything CBD related, from its inception in January 2014 through February 2019. A random sample of posts was drawn and analyzed by the authors who labeled them according to if the poster testified to using CBD to treat a diagnosable medical condition or using CBD for non-specific wellness benefits.
The analysis reveals that 90% of testimonials on r/CBD cited using CBD to treat diagnosable medical conditions. For example, many testimonials recounted experiences such as, “after using CBD for 2 months, my autism symptoms have improved. My family has noticed great improvements and I have finally been able to attend important social events.”
The authors grouped the subset of testimonials into 11 categories corresponding to medical subspecialties. Psychiatric conditions (autism or depression) were the most frequently cited sub-category, mentioned in 63.9% of testimonials, followed by orthopedic (26.4%), sleep (14.6%), and neurological (6.9%) conditions. Some testimonials also claimed CBD treated addiction, cardiological, dermatological, gastroenterological, ophthalmological, oral health, and sexual health conditions, ranging from 1% to 4% of all posts. In comparison, just 30% of testimonies cited using CBD for wellness benefits, the vast majority citing mental wellness, such as “quieting my mind,” and about 1% citing any physical wellness benefit, for example, “exercise performance.” The findings have been published in JAMA Network Open.
“The main implication is that CBD users are taking it because they think it will help them treat certain conditions. The problem is that we haven’t subjected CBD to the same level of scrutiny that we apply to other medications that are used for many of these conditions. We don’t know if it works yet. There are challenges there because users may be substituting proven therapies for CBD or potentially exposing themselves to risk if they are using in combination with other medications,” study co-author Dr Alicia Nobles from the Center for Data Driven Health and an assistant professor in the Division of Infectious Disease and Global Public Health, told MEAWW.
Dr Nobles emphasizes that CBD retailers attempt to evade FDA regulation by framing their product as a wellness aid, rather than a therapeutic. But when users explain why they take CBD in absence of any prompts, they will commonly cite they are using it for medicinal purposes like to treat acne, she adds.
“The FDA commissioner said in public congressional testimony that the agency would crack down on CBD marketing claims if the public was being misled to believe CBD is medicine. They clearly have been. By advertising our study it can hopefully motivate the FDA to take action, so those drawn to CBD can instead find real medicine and hopefully, a cure for their ailments,” study co-author Dr John W Ayers, also with the Center for Data Driven Health and vice chief of innovation in the Division of Infectious Disease and Global Public Health, told MEAWW.
While many think that using CBD poses few risks to consumers trying CBD out, the team notes that taking cannabidiol can harm patients in other ways that warrant cautious use. “There are several documented cases of CBD products leading to mass poisons because unlike FDA approved medications there are no uniform safety standards governing the manufacture or distribution of CBD,” cautions Erik Hendrickson, study co-author and research associate with the Center for Data Driven Health.
According to study co-author Dr Davey Smith, chief of Infectious Diseases and Global Public Health and a practicing physician, CBD can also interact with patients’ prescribed medications, including resulting in rare but dangerous side effects such as liver damage and male reproductive toxicity.
The research team says that the findings suggest a need for interventions that address the use of CBD for unproven applications, including regulating therapeutic claims about CBD and redirecting patients to proven therapies in place of CBD. They also caution that the lack of regulation governing the CBD marketplace may drive misperceptions of CBD. “The public isn’t spontaneously coming to the conclusion that CBD is medicine. Instead, this is a natural response to the largely unchecked marketing claims of CBD retailers. A lack of regulation puts the onus on physicians who must raise concerns about CBD with patients one-on-one instead of focussing on evidence-based treatments,” argues Dr Ayers.
Dr Eric Leas, co-founder of the Center for Data Driven Health, and an assistant professor in the Herbert Wertheim School of Public Health and Longevity Science at UC San Diego, suggests that government regulators must step up and give CBD the same level of scrutiny as other proven medications, and that anyone considering taking CBD should consult a physician to identify a proven medication.
According to Dr Nobles, there are several things that regulatory authorities, public health, and physicians can do. “First, many CBD users were targeted with snake-oil-like marketing claims. We need to prevent these claims by making and enforcing common-sense marketing restrictions for false or misleading advertising. Second, there may be a need for some corrective messaging to clarify the known therapeutic applications of CBD. This message is simple, there is currently only one proven application, treating childhood epilepsy. Lastly, clinicians can become more educated about how their patients may be using CBD and use this as a tool to guide conversations towards more appropriate therapies,” recommends Dr Nobles.