Advertisements for CBD oil seem to be everywhere, promising to cure everything from acne to depression.
People can buy it in a variety of forms, including soft gels, balms, drops, gummies and sprays.
Amid all the hype, there is a lot of confusion and people questioning the use and safety of the product.
“It’s everywhere. It’s worldwide,” said Cardinal Drugstore owner Brian West, who began studying CBD oil about nine years ago after learning about it from the Kansas Board of Pharmacy.
“Ever since then I started following it and watching it, and then in June of last year is when Gov. Colyer signed the rule in place that CBD or cannabidiols were excluded from the definition of marijuana, which made it legal, which means it has to be 100 percent THC-free in the state of Kansas,” West said.
Pharmacists made the determination to start tracking it and selling it, which meant a lot of reading, a lot of studying and asking a lot of questions of experts.
“Our stance has been the safety of it,” West said. “We have people coming in with odd things to where it’s black in color, it’s thick and clumpy. It has a more pungent smell than it should due to the fact isolates have oxidized out and different things.”
CBD oil should always be clear. The company should be able to produce a certificate of analysis to show where it came from. It should be always grown, harvested and produced in the United States.
“That’s very important because a lot of the other countries don’t have regulations as far as the soil content, as far as chemicals and minerals that are in it. The hemp plant is a bioaccumulator, meaning the root system is very extensive and it draws all the minerals and chemicals from the ground into the plant. If you vape it, ingest it or put it under the tongue, all of that is part of it. If you have high lead, mercury or zinc, anything like that, it can be detrimental over a period of time. People should really be careful, especially if it comes from China, or some of these other countries where the regulations are not there,” West said. “They don’t care what they import over to us.”
No matter its origination, it ends up on the market, as there is nothing to stop it at this point.
“There are no regulations on it whatsoever because it’s not considered a drug by FDA (Food and Drug Administration) standards. It is not considered a vitamin or supplement. It is considered a food additive. The problem that I have is anything that creates a physiological change in the body is a drug, period. It could be homeopathic, it could be herbal, it could be a vitamin,” West said.
“Echinacea is still a drug because it creates an effect in the body. When you take CBD oil, there are chemical processes that take place that we know definitely will happen, for creating a physiological change, whether it be creating a reduction in anxiety, whether it be help to increase your sleep cycle, or it could also help with narcolepsy, the opposite effect, tremors, seizures, all these things.
Medicinal or placebo
Whether CBD oil is truly medicinal or a placebo, West said, “We don’t know 100 percent.
“There are some that look at it as snake oil or voodoo, things like that. I understand that. I don’t want to say I’m in the middle, but I see both ways of it and I take that into consideration. There have really been no in-depth studies in the United States. You can go outside the country and find studies that have been done. Are their standards the same as ours? Sometimes yes, sometimes no. It kind of depends on where it came from and who did it. Is it the gold standard in a study that meets the criteria? Is it statistically significant? Is that study true and does it make sense and does it relate to what we see?”
A lot of times, the way people in other countries live and eat can have a different effect than Americans’ diets and lifestyles.
“We have to take all of that into effect. Some people come in and react to it completely different. Dose matters as well. We are in a difficult spot really because scientifically, research is not there to back it up, but when you look at the chemistry, and the physiology of it, it makes total sense.”
Know what you are buying
West suggests people research CBD oil before taking it, or ask someone who has done the research. Knowledge is essential to consumers.
“For instance we had a gentleman come in three weeks ago and he bought a bottle from a certain company from a dispensary down in Tulsa. They sold him straight hemp oil. It didn’t have any CBDs. Basically they sold him salad dressing,” West said.
Hemp oil and CBD oil are two different products. Cannabidiol is a natural component of industrial cannabis or hemp. CBD oil has a significant content of cannabidiol, West said, and it is made from the flowers, leaves and stalks of hemp and not from its seeds like hemp oil.
“There is no true medicinal value to hemp oil,” West said. “Maybe a supplement value, but not a medicinal value.”
If a product doesn’t list ingredients such as CBD oil or cannabidiol, terpenes, fatty acids and flavonoids, consumers should avoid it.
“This is where it gets really hard. You have to understand this is going to be a $22 billion industry in just a handful of years, and people are doing whatever they can to get a piece of that pie. So they are going to sell whatever they want,” West said.
It is a situation similar to supplements. If companies do not abide by the FDA standards for prescription drugs – so people know they have a product they can safely take – they do not really know what they are getting.
“You might get 10 milligrams or you might get 2,000 milligrams because some of these companies just smash it together and send it out the door,” West said. “That’s what we are running into here.”
During a conference in February, West said organizers showed pharmacists certificates of analysis from several US companies whose product is sold online, and none of them met any requirements as far as their labeling, and their products did not meet their claims on content. Chemical analysis of certain ones also indicated that while they said made in the U.S., the seeds actually came from China.
“We see that a lot. Not things the general population is going to know. That’s the hard part, too,” West said. “I think they need to find a reputable place to go, one where they know what they are talking about. … I think your wellness centers, your pharmacies, chiropractors, physician offices, those are all great places to go because they are going to do their research.”
The product should come in an amber-colored bottle because sunlight can degrade it. It should be clear and flow easily. It shouldn’t be clumpy or gritty.
If the label is not clearly marked, stating it is CBD or cannabidiol oil, consumers should avoid the product. The label should list active and inactive ingredients.
Quality and benefit
“I think people need to understand you get what you pay for. If you buy a bottle and they tell you it is the best thing in the world and it costs 20 bucks, I promise you right now you are not getting a quality product because good, quality, solid CBD is not cheap, the full spectrum,” West said. “I think the biggest reason is because of the filtering process. The process to get it from plant to product, it’s a big deal, and even to get the plants in the different stages to grow, it takes a lot of time. There is a lot more time and effort involved in getting it from a seed to an oil. You can’t just do it for five bucks. It’s not going to happen.”
So people need to understand if they buy a product and think they got a great one, and it didn’t do anything at all for them and then they try a different product and they get a different response, there is probably something not right with that first product.
That being said, West said, not everybody responds as well to CBD.
“It just depends on what they are trying to treat. If they are trying to treat neuropathic pain, what I’m finding is if it is more serious, we’re not getting a good response. If it’s in the early stages of neuropathic pain, we do see a good response,” West said. “If it’s advanced stages of tremors or Parkinson’s, you just don’t see anything with that, so it is not a cure-all. It’s barely a fix. We’re seeing good and bad with it. It’s no different than a prescription drug. Some people do fine, some people just don’t.”
Full-spectrum versus isolate
When buying CBD oil, consumers should also be aware there is a difference between full-spectrum CBD oil and an isolate.
Full-spectrum oil uses all 116 components of the cannabis plant, meaning the cannabinoids, and that includes THC. It’s accepted in the marketplace for it to be called full-spectrum or broad spectrum, even if it does not contain THC because it has all of the cannabinoids except THC, both major and minor. They are all natural. Nothing has been added.
“The fatty acids, flavonoids and terpenes all have great anti-inflammatory components. Terpenes also aid in the absorption of the CBD. So you get a synergistic effect or an entourage effect, a lot of these places talk about,” West said. “It’s not just your knees, joints or headache; it’s also your gut. If you can reduce inflammation in the gut, that is automatically going to help increase your immune system. All of those ingredients help the CBD to work better, so you can have a lower dose of actual CBD.”
An isolate is strictly CBD, all by itself, with none of the other cannabinoids.
“You have to take a much higher dose of the isolate in order to get the same effect as a low dose of your full-spectrum. The difference is now, when you are up here in the CBD dose, you have drug interaction, and some are significant and it does affect the liver. Your liver is going to have to be tested periodically to make sure you are not overtaxing your liver,” West said. “Anytime it is affecting the liver, there is an enzyme system within the liver. That system breaks down probably 80 percent of all our drugs. When CBD competes for that enzyme to be broken down, if it overpowers that enzyme, swallows it up and prevents it from working, say your antidepressant or your blood thinner or something else, it starts to accumulate because it can’t be broken down and you go toxic.”
Going with a full-spectrum will allow the CBD oil to work at a lower dose without the concerns for the drug interactions.
“I’m not saying isolates are wrong. They certainly have their place in therapy for certain things, but because of that people need to understand if you take an isolate because you think, ‘This is pure CBD and cleaner,’ you have to understand there is a chance for drug interactions and there are health implications with taking doses that high. That’s the whole safety thing,” West said. “People need to understand they work differently at different strengths. You take too much of one, you can really cause yourself problems, and people don’t understand it. It’s like the wild, wild west out there. People think if you can take a Tylenol for a headache, it’s OK to take 10 a day, and it’s not. That can be detrimental to your health and your life. People have got to understand just because it is out there, and there is no regulations, and everyone is selling it, doesn’t necessarily mean it is safe. I hope people will get that message.”
Taking something natural like echinacea can even have ill effects if taking CBD isolate.
“Even in the homeopathic or herbal area, there are several ones that can have a significant interaction with that because of the processes in the areas they work in the body,” West said. “CBD oil also affects blood pressure, and a lot of people don’t know that. It can have a profound effect on blood pressure. If people are taking that and they go to the ER because they don’t feel well, and the doctor says, ‘We need to give you this direct vasodiolator,’ and then your blood pressure bottoms out because they didn’t know.”
It is essential people tell their physicians, pharmacists or ER doctors everything they are taking, whether it is a vitamin, supplement, natural herbal remedy, CBD oil or a prescribed medication because that will change sometimes how they are treated.
West said he is happy to answer people’s questions regarding CBD oil.
“Whether they buy from me or not, people need to be safe,” West said. “I think if we can get in front of this from a safety standpoint, and people have a more educated answer and an understanding, we’re going to be safer in the long run.”
Anyone who purchases the CBD oil in the form of gummies should keep them in a child-proof container and out of the reach of children.
“If people are going to do gummy bears they need to be extremely careful their children do not get into that. That is not a piece of candy; that is a drug,” West said. “They can research and find where there have been kids already in bad emergency room situations because of ingesting too much because of not knowing the difference. Maybe mom and dad just didn’t think far enough, that, ‘Hey, I really need to put this away.’
“Anytime you can put something into a piece of candy that’s medicine and you have young kids around, you are really going to get yourself in trouble and you don’t want to harm your child. Just make sure you’ve got it put away.”
Vaping, whether CBD oil or nicotine, is something West has watched for quite a while and discourages.
“I think it is a very dangerous thing, and the reason is these coils heat up to 300-plus degrees Fahrenheit. … They use propylene glycol as their base. Now propylene glycol has been found safe by the FDA for topical and ingestion. It’s used in a lot of pharmaceutical ingredients, except inhalations. The problem is when it gets heated up, they call it smoldering, but it is actually burning.
Whenever the pieces of that propylene glycol start to evaporate out, it turns into a polymer, something like formaldehyde, which is a level one carcinogen. I’m not saying it is going to cause cancer, but I certainly think your risks have greatly increased.
“I’ve spoken to two physicians groups here in Parsons as well as in Chanute, just telling them we need to be talking to our patients and warning them. You might not get anything now, but in 10 or 15 years, my whole concern is I think we will see greater diagnoses of younger bouts of COPD (chronic obstructive pulmonary disease), exacerbated asthma and wet lung syndrome. Vaping is maybe a safer alternative to smoking, but it really isn’t that safe. We don’t really know. In the beginning of 2018, the U.S. Army had almost 90 of their soldiers that had major issues — psychosis for some, hallucinations, massive bouts of diarrhea, nausea, vomiting, tremors — and they all linked it back to vaping.
“I’m not saying people shouldn’t vape,” West said. “I’m not a fan of it because what’s our health care costs going to be in 20 years because of this.”