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Setting the record straight about CBD and Coronavirus

A little more than a hundred years ago, the world faced a pandemic similar to the COVID-19  (coronavirus) that we confront today. According to The Centers for Disease Control (CDC), from 1918—1919, about 500 million people became infected with the H1N1 virus, which claimed the lives of 675,000 Americans and approximately 50 million worldwide. As of April 19, 2020, coronavirus has infected more than 2.4 million and killed 165,000 people.

Pandemics throughout history make people frantic for a cure, and snake oil salesmen have been hustling “cures” for millennia. During the 1918 pandemic, substances touted as such run the gamut: Vick’s VapoRub, Indian Herbs, and Miller’s Antiseptic Oil among them. 

Today is no different, and the proclivity to never let a good crisis go to waste thrives. Recently, a Southern California-based doctor was charged with fraud for selling COVID-19 “treatment packs” for a hefty price. Others looking to cash in on COVID fears are right-wing radio host Alex Jones, hawking COVID-curing gargle and toothpaste from his InfoWars.com website. 

An air purifier company has claimed that their filters can remove coronaviruses from the air, and even others posit exposing contaminated surfaces to ultraviolet light, gargling warm salt water and taking hefty doses of Vitamins C and D. And what about all the claims in cannabis?

The ameliorative effects of CBD came into focus after CNN Chief Medical Correspondent Dr. Sanjay Gupta featured a young Charlotte Figi in the 2013 documentary Weed. Figi, who had an intractable form of epilepsy called Dravet Syndrome, practically eliminated her seizures by using a high-CBD cannabis strain produced by Colorado Springs growers who eventually named the strain after her, Charlotte’s Web. The US Food and Drug Administration (FDA) would approve Epilodilex, a CBD product aimed to reduce seizures from Lennox-Gastaut syndrome and Dravet syndrome, in 2018.    

Snake oil and the cannabis industry

Even the cannabis industry has some COVID-cure bandwagon hoppers, including retired NFL player and CBD evangelist Kyle Turley. In late March, Turley’s CBD company NeuroXPF received an FDA letter of warning for posting misinformation on their website and social media messages such as, “CBD can help keep your immune system at the top of its game … We want everyone to take CBD and take advantage of its potential to help prepare your body to fight a coronavirus infection.” 

While Turley’s CBD company’s social’s claim does not explicitly say that CBD can cure coronavirus, the word choice strongly suggests that taking CBD can protect you from infection. To make matters worse, Turley explicitly said CBD could cure and prevent coronavirus on his personal Twitter account. But is that true? Could an immune system enhanced by CBD keep you from getting coronavirus?

Martin A. Lee is the co-founder and director of Project CBD, a nonprofit whose mission is to promote and publicize research covering the medicinal uses of CBD and other cannabis compounds. “Potential is the keyword here because the research in this area is pre-clinical,” Lee told Weedmaps. “[Covid-19] is a disease that can express itself in different ways, and most people are having relatively mild experiences. But when it does threaten mortality, it does seem likely that what they’re dying from is how their body is reacting to the virus. And they are reacting to the cytokine storm. The immune system goes totally haywire.”

Cytokine storm is a term growing in familiarity as Americans look up their Google searches on how COVID-19 works in the body. According to WebMD, Cytokines are proteins that respond to an infection by triggering inflammation. However, the immune system can overreact to infection and release too many cytokines — ergo the term “cytokine storm” — resulting in hyper-inflammation, which can be deadly. 

What do the research and data say?

A study led by researchers at Mississippi State found in an in vitro setting using human and mouse cells that CBD” induced suppression of cytokine production.” However, it’s important to note that no study directly addresses CBD, cytokines, and COVID-19. Lee acknowledges that the gap between anecdotes and informal research about CBD’s effectiveness — some use CBD to self-treat autoimmune inflammatory conditions like multiple sclerosis — is conflicting. 

Mary Biles wrote in Project CBD, “A new wave of research and mounting anecdotal evidence points toward cannabinoids having an adaptive, immunomodulating effect, rather than just suppressing immune activity.” In other words, it’s possible that cannabinoids like CBD may keep inflammation at bay when healthy, but increase inflammation when getting sick  

But Lee reiterates that there is simply not enough evidence about cannabis and COVID-19 to draw any conclusions. “I think there’s enough evidence, given what we know about CBD, cannabis, and THC to suggest medical scientists should explore this [CBD] as a treatment for cytokine storm. To the extent of knowing if that would work, it’s pure speculation,” he added. 

Like Kyle Turley, those who have experienced the ameliorative effects of CBD firsthand often evangelize about the compound. However, how CBD works in partnership with the immune system lacks substantive, clinical research, leading people to rely heavily on anecdotal evidence. Researchers know even less about COVID-19, but what they do know is that cytokine storms likely contribute to COVID’s lethality.

Claims like Turley’s — in addition to being dangerously misleading — reflect poorly on the CBD industry at large, especially for companies attempting to run legitimate businesses in a mostly unregulated market. 

How some companies are doing it right

Degelis “Dege” Tufts and Kymberly “KymB” Byrnes are the co-founders of Brooklyn, New York-based CBD and cannabis lifestyle company Tribe Tokes. Since COVID erupted, the ladies at Tribe say they have noticed an uptick in sales, but not because they’ve been peddling a cure. “In this era of legalization, we fought so hard to get legitimacy around [CBD] use, and so hard to fight stigma against the plant, making claims [about CBD] can unravel the legitimacy,” says Tufts. “We’re not here to make a profit off a somewhat vulnerable consumer right now.” 

The team at Tribe is keenly aware of what they can and cannot say about CBD on their labels, website, and social media. “There are pretty clear guidelines for CBD brands on what they can and can’t do,” Tufts explained. “We are not supposed to make claims about specific diseases. You can’t go near it, because the studies aren’t there. It’s really a red flag if brands are citing specific diseases, and coronavirus would fall under that umbrella.” 

Byrnes notes that there have been evangelists making healing claims about substances for eons, and CBD is no different. “But the most important thing for companies to do is have integrity. Our responsibility right now as a leader in CBD is to educate and elevate. We don’t have enough studies on corona and cannabis to understand how those two would have a relationship,” she added.

Many consumers have been rethinking their cannabis consumption during the pandemic, especially those who smoke or vape. Brynes and Tufts have noticed an increase in sales, especially from consumers looking to soothe feelings of anxiety during a time of increasing uncertainty, while Lee wonders if it’s safe to use CBD at all, even for consumers who have no symptoms and may be asymptomatic, given that we do not have a full understanding of how the compound may influence the immune system. “Would taking cannabis help [with Covid]? Would it be a good idea to consume CBD? Maybe not? We don’t have any data either way.” 

Featured illustration by autumn/Shutterstock



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CBD Prescription Drug Is No Longer A Federally Controlled Substance

The Drug Enforcement Administration (DEA) has removed a marijuana-based medication from the list of federally controlled substances.

GW Pharmaceuticals announced on Monday that Epidiolex, a prescription drug it developed that’s derived from cannabis and used in the treatment of epilepsy, had been taken off Schedule V of the Controlled Substances Act. Effectively immediately, the CBD medication is no longer a controlled substance, the company said.

That means individuals will be able to more easily obtain Epidiolex. GW said in its notice that it will “begin the process of implementing these changes at the state level and through the EPIDIOLEX distribution network.”

After that point, state reporting requirements under prescription drug monitoring programs will no longer be applicable. Like many non-controlled drugs, people will still need to get a prescription from a doctor, but those prescriptions will be valid for up to a year and can be transferred among pharmacies.

“This notification from DEA fully establishes that EPIDIOLEX, the only CBD medicine approved by FDA, is no longer a controlled substance under the federal Controlled Substances Act,” Justin Gover, CEO of GW, said in a press release. “We would like to thank DEA for confirming the non-controlled status of this medicine.”

“Importantly, the descheduling of EPIDIOLEX has the potential to further ease patient access to this important therapy for patients living with Lennox-Gastaut Syndrome and Dravet syndrome, two of the most debilitating forms of epilepsy,” he said.

The Food and Drug Administration (FDA) approved the medication in 2018. DEA said it would be placed in Schedule V, rather than Schedule I like marijuana and its derivatives.

FDA pushed back in a letter to the agency, arguing that CBD carries minimal risks and has established health benefits and so it shouldn’t be controlled at all. DEA replied that international treaty obligations warrant its control, albeit in the least restrictive category of Schedule V. FDA then said that if that changed, the agency should “promptly” revisit its status as a controlled substance.

Last year, the World Health Organization clarified that CBD containing no more than 0.2 percent THC is “not under international control.”

Meanwhile, FDA is in the process of developing regulations for hemp-derived cannabidiol products that aren’t approved as medications following the 2018 Farm Bill’s legalization of the crop and its derivatives. The agency said in a report to Congress last month that the rulemaking process is ongoing, but it is actively exploring pathways to allow for lawful sales of the cannabis compound as a dietary supplement, and it’s developing enforcement discretion guidance for products that are currently on the market.

Featured image from Shutterstock

This article has been republished from Marijuana Moment under a content-sharing agreement. Read the original article here.



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WTF is Nano CBD? We asked some experts.

CBD, more formally known as cannabidiol, is everywhere. Given the incredible enthusiasm, you would never guess that CBD is not exactly legal, leaving CBD purveyors in a legal grey area. This lack of federal oversight has created a lot of wiggle room for companies seeking an edge or niche in an increasingly crowded and competitive space. One such niche is the very sci-fi sounding name nano (or water-soluble) CBD, touted as being more effective and bioavailable (the degree to which a nutrient is available for the body to use) than other formulations.

CBD is non-intoxicating and reported to ease a wide range of conditions, and consumers are flocking to the cannabinoid to help relieve chronic pain, anxiety, insomnia, and even skin conditions like psoriasis and acne. Even restaurants and cafes are jumping in on this wellness trend, adding it to smoothies or mocktails for a few extra bucks, while chefs are adding CBD to their menus (though officials in cities like New York are cracking down on the practice). Even mainstream stores like Walgreens and CVS are jumping on the bandwagon, stocking their shelves with CBD products.

But nano CBD exists in a world with such a confounding range of CBD products available that can be found in the oddest of places — like the neighborhood bodega, alongside the condoms and Five Hour Energy packets — it begs the question: Is nano CBD a genuine innovation, or a gimmick to help companies differentiate themselves from the pack?

The technology used in Nano CBD isn’t new. 

Dr. Itzhak Kurek, Ph.D., is the co-founder and CEO of Cannformatics, a Northern California biotech company using saliva metabolomics technology to personalize medical cannabis treatment. Weedmaps spoke with Kurek to learn more about nanoparticles and the science behind them. 

Kurek begins by noting that nano-sized delivery technologies are not unique to CBD and are widely used by pharmaceutical companies to ensure bioavailability. “Nano CBD is a CBD molecule coated with very small particles, such as liposomes or lipid nanoparticles (LNPs), that stabilize the CBD and can move in our blood faster than ‘naked’ CBD, to effectively reach the target,” he explained. 

Kurek adds, “Nano CBD is a CBD molecule packaged in nano-carriers that are the size of about 100 nanometers — or one-billionth of a meter — which allows the “package” to stay in the body for a longer time and to slowly release the intact CBD in the targeted tissue.” To illustrate his point, he mentions a 2017 study that reported a 600% increase in bioavailability of oral Nano CBD compared to CBD in a rat model.

What this means is that, theoretically, a person who consumes nano CBD as opposed to regular CBD may feel the effects more quickly. Dr. Mary Clifton, an NYC-based MD specializing in internal medicine, is also a CBD and cannabis expert and has worked with medical marijuana patients for more than 20 years in Michigan and New York State respectively.

Clifton says that she remains undecided about nanotechnology, but she says that some of her patients are enthusiastic about the formulations. “A number of my patients swear by the use of nanotechnology to make their CBD more effective,” she said. However, she notes that the human data on CBD nanotechnology is pretty much nonexistent, though cellular data shows promise. 

Like any trend, nano CBD has its skeptics. 

Project CBD is a California-based nonprofit dedicated to promoting and publicizing research into the medical uses of CBD and other components of the cannabis plant. Their Chief Science Writer, Adrian Devit-Lee, is somewhat skeptical of nano CBD formulations. He agrees with Kurek that the nanoemulsion theoretically makes CBD easier for the body to absorb, but that it doesn’t mean it is “practically” easier to absorb.

Devit-Lee zeroes in on how people consume cannabis compounds generally as potentially altering its bioavailability regardless of formulation. “The way the problem [with nanoemulsion] is often framed is ironic because it’s framed around potency,” he said. “When you eat CBD, if you take it first thing in the morning before food, you might absorb 3-6 percent. If you take it with a fatty food, you might absorb more of it.”

Acknowledging that the onset of nanoparticles takes about half as long as regular CBD, he also notes that the molecule spends about half as much time in your system. “Practically speaking, is that much different than taking a stronger dose? I don’t know that consumers would find it [nano CBD] much different.”

And this is assuming that the CBD product in the bottle is exactly what’s reported on the label, something that some CBD companies are wont to do. In 2019, the FDA issued several warning letters to CBD firms for products that did not contain the amount of CBD they purported to contain, and for using language that suggested CBD could cure, treat, or prevent disease, a big FDA no-no. 

Another area of concern lies in the safety of nanoparticles — when particles are made smaller, there may be unintended consequences. The increased use of nanotechnology in biomedicine, agriculture, and consumer products has led to the rise of nanotoxicology, the study of how engineered nano devices and structures may affect people. In reporting an explainer on weed wine for Weedmaps News, Josh Lizotte, founder and CEO of Rebel Coast, cautioned against the process of using nanoemulsions in cannabis-infused wine because “we don’t know the health effects of nanotechnology, and how such small particles [interact with] the body.”

To nano or not? 

Corona, California-based CBD company CBD Living utilizes nanotechnology for their flagship product, CBD Living Water, as well as topicals, gummies, and others. Chief Operating Officer Sean McDonald said that the company decided to utilize nanoemulsions because of its reported ability to increase bioavailability and speed up the absorption rate. And the customers, he said, feel better, quicker. 

A challenge with cannabinoids generally — regardless of how they’re processed — is cannabinoid degradation. Once cannabis is harvested it begins the degradation process, meaning that the potency of the product, whether it is water or an edible, will decline. Many factors contribute to this process, but the top four are UV light, airflow, humidity, and temperature. 

Though most CBD products come in packages designed to keep out light, the simple act of opening and closing the container will reduce its efficacy. McDonald says that the nanoemulsion process itself insulates their products from degradation — though it should be noted the research backing this is scant — and all their packaging, with the exception of water, is opaque to keep out light. 

But clear CBD water bottles that could sit on store shelves for weeks or even months under the blazing lights of a grocery store aisle might be CBD-free by the time they’re purchased and consumed.

Devit-Lee also notes that every state has different testing requirements, and each lab has a different formulation for detecting drugs. In other words, just because it says something on the label doesn’t make it so. “If you have a good product that has some terpenes that help with absorption and with medicinal effects — if it’s a good quality product in general you don’t need to do this nanoformulation. But if you have bad quality hemp products, maybe [nano] can help them stand out,” he added. 

The bottom line is that there just isn’t much research for a persuasive argument either way. The only thing consumers can really do is to shop thoughtfully for CBD — nano or not — and buy from U.S. companies that can easily show you their third-party lab results and certificate of analysis. 

Featured image: a 3D rendering of nanoparticles on a white background (Photo: Shutterstock)



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NUTHIN’ BUT A CBD THANG! Hempworx Rap! Cannabis! Educational!



#HEMPWORX #mydailychoice #CBD #CBDoil #bussinessfromhome #laptoplifestyle

NUTHIN’ BUT A CBD THANG

Another cool Hempworx Rap

This one features the company owners and is quiet educational

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Take the Free tour watch all four videos them get back to me

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Towards your health and wealth

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CBD BREAST MILK & CANNABIS IN TEXAS | Gruene House Podcast Ep.1



Gruene Cross and Grow House Media combine forces on this new podcast to spread the word cannabis and normalize and educated in central Texas. Gruene House Podcast comes to you with the latest in cannabis education and inspiration from experts deep in the heart of Texas. This is the pilot episode y’all!
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When CBD Pet Products Don’t Have CBD…

Pet health has experienced an enormous boom in the cannabis industry. Numerous companies have unleashed hundreds of CBD pet health products accompanied by glowing customer testimonials claiming that their cannabis wares produce calmer, quieter and pain-free dogs and cats.

But some of these products are all bark and no bite.

“You’d be astounded by the analysis we’ve seen of products on the shelf with virtually no CBD in them,” said Cornell University veterinary researcher Joseph Wakshlag, who studies therapeutic uses for the compound. “There are plenty of folks looking to make a dollar rather than produce anything that’s really beneficial.”

The issue of pet health and anecdotal evidence

The federal government has yet to establish standards for CBD that will help people know whether it works for their pets and how much to give. So products can make it to shelves without being thoroughly vetted or scrutinized. Consumers are basically buying blind. 

Still, there’s lots of individual success stories that help fuel a $400 million market that grew more than tenfold since last year, and is expected to reach $1.7 billion by 2023 according to the cannabis research firm Brightfield Group.

Amy Carter of St. Francis, Wisconsin, decided to go against her veterinarian’s advice and try CBD oil recommended by a friend to treat Bentley, her epileptic Yorkshire terrier-Chihuahua mix. 

“It’s amazing,” Carter said. “Bentley was having multiple seizures a week. To have only six in the past seven months is absolutely incredible.”

But some pet owners have found that CBD didn’t work for their furry companions.

Dawn Thiele, an accountant in Oak Creek, Wisconsin, said she bought a $53 bottle of CBD oil from a local shop in hopes of calming her 2-year-old Yorkshire terrier during long car trips.“I didn’t see a change in his behavior,” said Thiele, who nonetheless remains a believer. “The product is good, it just didn’t work for my dog,” she said.

Why CBD? 

Short for cannabidiol, CBD is a non-intoxicating molecule found in hemp and marijuana. Both are cannabis plants, but only cannabis has enough of the compound THC to get users high. The vast majority of CBD products come from hemp, which has less than 0.3% THC.

CBD has garnered a devoted following among people who swear by it, for everything from stress reduction to better sleep. Passage of the 2018 Farm Bill, which eased federal legal restrictions on hemp cultivation and transport, unleashed a stampede of companies rushing products to the market in an absence of regulations ensuring safety, quality and effectiveness.

Products for people were swiftly followed by CBD chewies, oils and sprays for pets.

“The growth is more rapid than I’ve seen for any product in 20 years in this business,” said Bill Bookout, president of the National Animal Supplement Council, an industry group whose member companies agree to testing and data-gathering requirements. “There’s a gold rush going on now. Probably 95% of the industry participants are responsible, but what’s dangerous is the fly-by-night operative that wants to cash in.”

The U.S. Food and Drug Administration is developing regulations for marketing CBD products, for pets or people. In 2019, it had sent warning letters to 15 companies, citing violations such as making claims about therapeutic uses and treatment of disease in humans or animals, or marketing CBD as a dietary supplement or food ingredient.

How to spot reputable CBD products

“It’s really the Wild West out there,” said S. David Moche, founder of Applied Basic Science, a company formed to support Colorado State University’s veterinary CBD research and now selling CBD online. He advises consumers to look for a certificate of analysis from a third-party testing laboratory to ensure they’re getting what they pay for.

Wakshlag said products must be tested not only for CBD levels, but also to ensure they’re free of toxic contaminants such as heavy metals and pesticides and have only trace amounts of THC, which in higher levels is toxic to dogs. Bookout said his organization has recorded very few health incidents involving CBD and no deaths. Still, scientific documentation of CBD’s safety and efficacy is nearly nonexistent.

That’s starting to change, however. A small clinical trial at Colorado State University published in the Journal of the American Veterinary Medical Association in June found CBD oil reduced seizure frequency in 89% of the epileptic dogs that received it.

Abating seizures and pain with CBD

A clinical study headed by Wakshlag at Cornell, published in Frontiers in Veterinary Science in July 2018, found CBD oil helped increase comfort and activity in dogs with osteoarthritis.

Stephanie McGrath, a Colorado State University researcher, is now doing a larger clinical trial funded by the American Kennel Club’s Canine Health Foundation. “The results of our first epilepsy study were promising, but there was certainly not enough data to say CBD is the new miracle anti-convulsive drug in dogs,” McGrath said.

Seizures are a natural focus for research on veterinary CBD products, since Epidiolex, the only FDA-approved drug containing cannabidiol, was approved last year for treatment of two severe forms of epilepsy in children. Veterinarians are allowed to prescribe Epidiolex for pets, but it’s prohibitively expensive — upwards of $30,000 a year for an average-size dog, McGrath said.

Meantime, the American Veterinary Medical Association is telling veterinarians they can share what they know about CBD with clients but shouldn’t prescribe or recommend it until the FDA gives its blessing.

“There’s no question there’s veterinary interest in these products as therapies, but we really want to see the manufacturers demonstrate that they’re effective and safe and get FDA approval so we can have confidence in the products,” said Gail Golab, chief veterinary officer for the association.

Featured image by Hannah Lim/Unsplash.  

By Mary Esch, reported for the Associated Press.



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Cannabis Today – Marcus Ramkissoon – Cannagreen Consultancy | CBD INFLUENCE



In the latest episode of #CannabisToday, we talk to the legendary Marcus Ramkissoon, who is the advisor for Trinidad and Tobago, alongside the majority of Caribbean governments, when it comes to the decriminalisation and legalisation of Cannabis.

Alongside being a major influence in the Carribean cannabis industry, Marcus shares that he is in fact thought to be one of the most qualified Cannabis experts worldwide, with 73+ qualifications in relation to the beloved greenery!

Marcus gives us a deep insight into his thoughts about the use of cannabis, as a medicine, the progression of the industry, cannabis education and the future of the industry.

We also hear about Marcus’ views on the assesment of major corporations and ‘big pharma’ attempting to monopolize the industry.
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All relevant links to this video and our company below.
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Cannabis Today is a series of interviews, with cannabis professionals, advocates, investors, event organisers, influencers, producers, shops, dispensaries, other industry players. The interviews are being conducted throughout our company’s formative stages, during 2019/2020.

The purpose of the interviews is to give an insight into today’s growing legal cannabis and #hemp industry, by highlighting the experiences, views and opinions of those driving the industry forward.
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To contact Marcus or the Institute, please email: caribbeancannabisinformation@gmail.com
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CBD INFLUENCE INTRO:
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Harvesting My Durga Matta CBD Cannabis Plant



Originally published on August 21, 2019

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Companies Swap Cannabis CBD for Hemp CBD?!?!



Hey Mainey Madness,

I was recently told this last week and it was something that I just had to let you know. The fact that companies are incorporating hemp with cannabis just baffles me because they are two different markets. One is legal THE OTHER IS NOT! At least in the federal eyes anyway.

All opinions are welcome, even with no knowledge of the subject being discussed. Your constructive input is always appreciated!

Watch me every Friday on Twitch! I play a lot of different games while talking about the cannabis industry, funny memes, and what its like to be a growing streamer..and a grower lol

All of my social media links are down below VVVVVVVV

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DISCLAIMER: I am in no way an expert/doctor of cannabis. The information I provide comes from personal experience working with cannabis patients before and after regulation changes in California, as well as research that I have compiled from the sources provided.

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What You and Health Professionals Should Discuss When it Comes to CBD

Whenever registered nurse Heather Manus is out and about in public, she can’t seem to escape discussions of cannabidiol (CBD), a suddenly ubiquitous compound found in cannabis.

Manus often hears people discussing CBD over lunch, or that someone has started giving CBD products to her dog; another to help with human arthritis. A lot of senior citizens take it regularly, she said, to help with the many aches and pains of a long life. Yet many of these conversations reveal a lack of solid information about CBD and its uses.

The 2018 Farm Bill reshaped the legal landscape, opening doors to hemp-derived CBD products nationally. However, the situation remains wildly complicated, with wide variations in state cannabis laws and little oversight of a CBD market that’s projected to reach $20 billion by 2024, according to BDS Analytics.

As with much about the effects and effectiveness of cannabis, little is scientifically proven about the medical applications of CBD, but there are promising indications that it may help with pain, inflammation, anxiety, and overall health. Even the federal government has signaled its interest: The Food and Drug Administration issued its first-ever cannabis-derived drug approval for Epidiolex, which treats certain severe forms of epilepsy. 

CBD is not intoxicating, but it is psychoactive in that it may relieve feelings of anxiety, stress, or pain.  Though most patients can use CBD in a variety of forms without an issue, medical professionals wonder whether that is really the best approach.  And when few medical professionals have been trained in cannabis medicine, where can consumers turn for the best information? Increasingly, the medical professionals who dealt most directly with patients are working to be educated.

Manus is the founder of Cannabis Nurses Network, through which she said aims to inform nurses about the use, benefits, and potential risks of cannabis and cannabis-derived medicines. Nurses can be the first source of information about cannabis because they typically spend more time with patients, have a direct line of communication to doctors, and can serve as patient advocates — even taking the initiative to ask a doctor to recommend an appropriate cannabis regimen. Courts have found that doctors have a constitutional right to recommend, though not prescribe, marijuana, but some doctors still fear the potential risk to their license.

“The nurses have been really leading the way,” Manus said. Now other organizations are aiming to close the knowledge gap.

“Our belief is that nurses as front-line medical practitioners need to know about cannabinoids and their effects on patients so that they can offer the best treatment,” said Malcolm Youngren, Chief Operating Officer of the Pacific College of Oriental Medicine and the director of the school’s New York campus in Manhattan.

Our belief is that nurses as front-line medical practitioners need to know about cannabinoids and their effects on patients so that they can offer the best treatment. Click To Tweet

The school recently began offering a medical cannabis certificate for health-care professionals. Some 55 million Americans used some kind of cannabis product in 2018, he said, while about 70% of current health-care professionals say they are not well-trained to know how to advise their patients about cannabis.

Though the U.S. Food and Drug Administration (FDA) says it’s working on rules governing the sale and use of CBD, so far consumers and producers have little guidance. Many states tolerate CBD sales, even where marijuana remains prohibited, but the FDA has issued warning letters to CBD-producing companies it believes have made unproven claims for their products.

A study released by Penn Medicine in November of 2017, published in the Journal of the American Medical Association, found that a staggering 70% of CBD products sold online are mislabeled, containing either more CBD than claimed or less. That means only three-tenths of the products contained CBD within 10% of the amount claimed on the label.

With so many variables, where should consumers start with CBD?

“We always recommend people start low and go slow. Begin with a very small amount and then work your way up to an effective dose,” Manus said. Quality matters, she added.

“We encourage our patients not to buy CBD in a gas station,” she said. Where there is a state-legal cannabis program, she said, the best bet is to go through the legal market and buy through a licensed dispensary. Where that is not available, there are often CBD specialty stores, where staff can usually offer advice on doses and effectiveness, and usually have information on the source of the CBD.

Jenna Champagne, another nurse member of the Cannabis Nurses’ Network, encouraged patients to talk with their health professional before taking CBD. In some cases, the cannabinoid may interact with other medicines, either blunting or accelerating their combined effectiveness.

Cannabidiol (CBD), a non-intoxicating compound found in cannabis, can be mixed into edibles, consumed in flower, or extracted into a concentrate. (Gina Coleman/Weedmaps News)

Champagne had five suggestions for someone considering CBD:

1. Learn first

Talk to a health-care professional, Champagne said, or at least educate yourself before beginning a regimen of CBD, or any other herbal supplement. Champagne advocates for  CBD as an important way to keep bodies — and the endocannabinoid system — in balance. But like more than 100 other cannabinoids found in the cannabis plant, CBD has the potential to interact with other substances.

“Make sure you don’t have any considerations that warrant medical oversight,” she said. “CBD combined with the wrong medication could become a risk factor,” she noted, particularly with blood thinners.

2. Not all products are created equal

Look for medical-quality suppliers that have been tested by a third party for purity and the concentration of CBD. There are also numerous methods for extracting CBD from the plant.  Champagne recommends looking for broad-spectrum products that maintain as much of the complex chemicals of the plant as possible.

“Don’t just buy it because it has fancy marketing,” Champagne said.

3. Do your research

In addition to speaking with a medical professional about potential benefits and side effects, each of the experts interviewed suggested care in the source of CBD. Champagne uses the mnemonic acronym F.L.O.W., which stands for Flower-derived, Lab-tested, Organic and from the Whole plant, saying products that concentrate the cannabis plant with all of its complexity intact are superior for health in the long run.

Youngren cited studies that found contaminants including heavy metals and pesticides in commercially available CBD products. Without FDA evaluation, consumers have little protection, while there remains a patchwork of laws governing the sale of CBD products around the country, and a variety of extraction methods in use.

“It’s a massive issue,” Youngren said.

4. Use the whole plant

With the passage of the 2018 Farm Bill, much of the CBD on the market throughout the United States has been derived from hemp. It’s genetically the same plant as marijuana, but under the federal definition, it must have less than 0.3% THC.

That’s OK, said Manus, CBD is CBD is CBD. But studies have pointed to the entourage effect, which shows that cannabinoids seem to work better together. Champagne suggested buying CBD products derived from the whole flower. Industrial hemp has great uses, she said. It replenishes the soil and makes great clothing but has few flowers.

“That’s where all the magic happens,” Champagne said.

5. Know your goal

 Some may want a sleep aid, others pain relief or improved health. While Youngren is not a medical practitioner, he suggested looking at complete health goals, any medications taken regularly, as well as diet and exercise.

“If people are using CBD, I think they should know what they want to get out of it,” Youngren said.

The Pacific College of Oriental Medicine also teaches acupuncture and massage therapy, with a focus on maintaining the body’s balance, or homeostasis. Youngren said students are taught to see health as more than an absence of sickness or pain, but as a positive approach to a balanced life. He extended that to CBD use.

“It shouldn’t just be that there’s a CBD cookie in front of me, I think I’ll eat that. It should be taken more methodically,” he said. That should include keeping notes on when CBD is ingested and how much, helping move toward the correct amount while you’re starting low and going slow.

Feature image: Cannabidiol (CBD) is becoming a part of many people’s health and wellness regimen. It’s important to discuss CBD use with a health professional to examine possible interactions with other medications or effects it may have on the body. (Gina Coleman/Weedmaps News)



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