CBD can treat all sorts of health problems, but it’s not a panacea, according to a pharmacologist

After decades of debate, the bill made it legal for farmers to grow industrial hemp, a plant rich in CBD. Hemp itself has tremendous value as a cash crop; It is used to produce biofuel, textiles and animal feed. But the CBD extracted from the hemp plant also has numerous medicinal properties, with the potential to help millions of people by treating seizure disorders, pain or anxiety.

Before the bill passed, opposition to hemp’s legalization stemmed from its association with marijuana, its biological cousin. Although hemp and marijuana belong to the same plant species, Cannabis sativa, they each have a unique chemistry with very different properties and effects. Marijuana contains tetrahydrocannabinol, or THC, the chemical that produces the characteristic high associated with cannabis. Hemp, on the other hand, is a strain of the cannabis plant that contains virtually no THC, and neither it nor the CBD derived from it can induce a high.

As a professor and chair of the Department of Pharmacology at Penn State, I have closely followed research developments involving CBD and have seen some promising evidence for its role in treating a wide range of conditions.

Although there is growing evidence that CBD can help with certain conditions, caution is advised. Rigorous scientific studies are limited, so it is important that the marketing of CBD products does not precede research and solid evidence.

Unpacking the hype behind CBD

The main concern with CBD marketing is that the scientific community is unsure of which form of CBD is best. CBD can be produced either as a pure compound or as a complex blend of molecules from hemp that make up CBD oil. CBD can also be formulated as a topical cream or lotion, or as a gummie, capsule, or tincture.

Clinical research-backed guidance is needed on the best dose and dosage form of CBD for each condition. This research is still ongoing.

But since then, the market’s siren call has sounded, creating an environment where CBD is often hyped as a panacea — an elixir for insomnia, anxiety, neuropathic pain, cancer, and heart disease.

Unfortunately, there is little rigorous scientific evidence to support many of these claims, and much of the existing research has been done in animal models.

CBD is simply not a panacea for whatever ails you.

childhood seizure disorders

One thing is known: based on rigorous studies involving hundreds of patients, CBD has been shown to be a safe and effective medication for seizure disorders, especially in children.

In 2018, the U.S. Food and Drug Administration granted regulatory approval for the use of a purified CBD product sold under the brand name Epidiolex to treat Lennox-Gastaut and Dravet syndrome in children.

Both of these rare syndromes, which appear early in life, produce a large number of frequent seizures that are resistant to conventional epilepsy treatments. However, CBD administered as an oral solution as Epidiolex can result in a significant reduction—more than 25%—in seizure frequency in these children, with 5% of patients becoming seizure-free.

More than 200 scientific studies

CBD is what pharmacologists call a promiscuous drug. That means it could be effective in treating a range of conditions. Broadly speaking, CBD affects more than one process in the body — a term referred to as polypharmacology — and therefore could benefit more than one medical condition.

As of early 2023, there are 202 ongoing or completed scientific studies examining the effectiveness of CBD in humans for conditions as diverse as chronic pain, substance use disorders, anxiety, and arthritis.

In particular, CBD appears to be an anti-inflammatory and analgesic, similar to the functions of aspirin. This means it can be helpful in treating people suffering from inflammatory pain such as arthritis or headaches and body aches.

CBD also has potential for use in cancer therapy, although it has not been approved by the FDA for this purpose.

The potential of CBD in relation to cancer is two-fold:

First, there is evidence that it can kill cancer cells directly, improving the ability of traditional therapies to treat the disease. This is not to say that CBD will replace these traditional therapies; the data are not so convincing.

Second, adding CBD to a treatment plan can reduce side effects and improve the quality of life for people with cancer due to its ability to reduce pain and potentially anxiety.

The Risks of Unregulated CBD

While prescription CBD is safe when used as directed, other forms of the molecule come with risks. This is especially true for CBD oils. The over-the-counter CBD oil industry is unregulated and not necessarily safe as there are no regulatory requirements to monitor a product’s contents.

Additionally, rigorous science does not support the unsubstantiated marketing claims of many CBD products.

In a 2018 comment, the author describes the results of his own study, published (2017) in Dutch. His team received samples of CBD products from patients and analyzed their contents. Virtually none of the 21 samples contained the advertised amount of CBD; In fact, 13 had little to no CBD at all, and many contained significant amounts of THC, the compound in marijuana that causes a high—and it shouldn’t have been there.

In fact, studies have shown that the contaminants that can be present in over-the-counter products are almost impossible to control. The FDA has issued numerous warning letters to companies marketing unapproved CBD-containing drugs. Despite marketing CBD oils as all-natural, plant-derived products, consumers should be aware of the risks of unknown compounds in their products or unintended interactions with their prescription medications.

Regulatory guidelines for CBD are sorely lacking. Most recently, in January 2023, the FDA concluded that the existing framework was “not suitable for CBD” and said it would work with Congress to find a way forward. In a statement, the agency said that “a new regulatory pathway for CBD is needed that balances individuals’ desire for access to CBD products with the regulatory oversight needed to manage risk.”

As a natural product, CBD still acts as a drug — similar to aspirin, acetaminophen, or even cancer chemotherapy. Healthcare providers simply need to better understand the risks or benefits.

CBD can interact with the body in unintended ways. CBD is eliminated from the body by the same liver enzymes that remove a variety of medications, such as blood thinners, antidepressants, and organ transplant drugs. Adding CBD oil to your medication list without consulting a doctor could be risky and interfere with prescription medications.

To prevent these unwanted interactions, my colleague Dr. Paul Kocis, a clinical pharmacist, and I created a free online application called CANNabinoid Drug Interaction Resource. It highlights how CBD could potentially interact with other prescription drugs. And we urge all people to disclose both over-the-counter CBD and recreational or medical marijuana use to their healthcare providers to avoid adverse drug interactions.

Ultimately, I believe CBD will have a place in people’s medicine cabinets — but not until the medical community has determined the right route of administration and dosage for a specific medical condition.

Kent E Vrana is Professor and Chair of Pharmacology at Penn State University.