Last year, the America’s Food And Drug Administration (FDA) legalised a cannabidiol (CBD) oil, trademarked as Epidiolex, for the treatment of two severe forms of rare childhood epilepsy. Now available online and in health shops across the UK, the health chatter around this cannabis-based product is getting louder and more authoritative. But with cannabis still caught in a public relations battle, is this once socially demonised plant revealing it higher purpose – and without the high? From the science, to the legalities, here’s a snapshot of what you need to know…
What is cannabidiol (CBD)?
Cannabidiol is just one of over one hundred cannabinoids that are found – and extracted – from hemp plants. The CBD oil that’s making waves online and in the health industry is simply the cannabidiol extract mixed with an oil, such as coconut.
Does it give you a high, like cannabis?
The short answer is no. And it’s this answer that’s led to so much traction and interest around CBD. For having no psychoactive properties means that it’s medicinal potential is not at risk of being derailed as strongly. It is in fact CBD’s sister cannabinoid called tetrahydrocannabidiol, or THC, that gives you the high experienced with taking cannabis.
‘How would we as a public react to the mainstream use of CBD? Once Brexit is sorted, maybe that can be addressed’
Is it legal?
Well if it’s not, places like Holland & Barrett are about to get in a lot of trouble. It sort of is. I say sort of, as it’s a tad confusing and depends on the source. Under the Misuse Of Drugs Act 1971, the majority of cannabinoids (including THC) are illegal. CBD however, is not. In fact, if you are using CBD for a medical purpose and it is extracted from EU-approved industrial hemp (not your mate’s basement “garden center”) then you are not technically stepping outside the law. For a manufacturer to stay within the law, all CBD oil must contain less than 0.2 per cent THC.
So, what are the benefits of CBD oil
Welcome to the grey area. I say grey because if it was rigorously (and repeatedly) scientifically proven, then we would see it drifting into the NHS. And yet yes, there are many reported benefits of CBD oil. These include reducing anxiety, alleviating pain (especially in people with cancer who have complex pain needs), reducing nausea, improving quality of life in those with chronic fatigue syndrome and helping to control rarer forms of childhood epilepsy. The fly in the ointment to all these is that they are all yet to accrue enough rigorous clinical evidence to see CBD become a sustainable bedfellow within NHS clinical practice.
What are the barriers to CBD?
I’ve written before about the legislation around cannabis use for medical purposes, after William Hague became the most senior Conservative member to call for the need for a review last year. Yet beyond the legal wrangles and lack of medical clarity there is of course the societal opinion. How would we as a public react to the mainstream use of CBD? Once Brexit is sorted, maybe that can (along with every other domestic policy frustratingly sidelined for now) be addressed.
What about shaking the ‘cannabis’ stereotype?
Now this may take some work. CBD will likely need a fairly heavy-handed and seasoned PR machine to shake off the stereotype that comes from sourcing its ingredients from a plant that still draws Bill & Ted’s Excellent Adventure to our frontal cortices.
Are there any side effects?
As with any drug, side effects can be user dependent. However, the side effect profile of CBD is thought to be minimal (with the caveat that we don’t yet clinically know the effects of life-long use). The trouble too with herbal-based medications is that dosage per tablet, drop or sachet can vary, meaning you may neither get the same benefit each time, nor avoid unwanted side effects. What we can guarantee is that you won’t get high…
What’s your opinion?
I don’t want to sound like our intelligence services, neither confirming nor denying, but I will tell you what I would (and have on this subject) told my patients: if you can buy it over the counter, and have done your own reading and feel happy to trial it, then that is your right and your choice. It’s just the same as anything, including alcohol. Just don’t expect me to prescribe it to you. Just yet.
Dr Nick Knight is a GP. Follow him on Instagram (@dr.nickknight).