Although CBD is popular with consumers for its medicinal potential, this perception is based largely on testimonials and not academic research.
Cannabis and CBD are being used increasingly by consumers in recent years, yet research has been scarce and largely prohibited by federal regulators. This trend is finally starting to change, especially after passage of the Agricultural Improvement Act of 2018 (farm bill) which legalized industrial hemp, and also opened pathways for academic research into CBD.
The Mayo Clinic has just released its findings after reviewing studies on CBD use. Its conclusions will be published next month in Mayo Clinic Proceedings. Overall, Mayo Clinic researchers found evidence indicating that CBD may be an effective treatment for chronic pain and opioid addiction but still urged caution since available information is in short supply.
“There are many intriguing findings in pre-clinical studies that suggest CBD and hemp oil have anti-inflammatory effects and may be helpful with improving sleep and anxiety,” said Brent Bauer, M.D., director of research for the Mayo Clinic Integrative Medicine program. “But trials in humans are still limited, so it is too early to be definitive about efficacy and safety.”
In particular, Dr. Bauer is concerned with reports of liver damage in consumers who have used CBD. Dr. Bauer acknowledges both the growing popularity of CBD products as well as the growing need for researchers and regulators to understand the benefits of CBD and the potential drawbacks of using the cannabinoid.
“Careful selection of a health care product is crucial, and though these products do not have Food and Drug Administration approval for therapeutic use, patients continue to ask for them and use them,” Dr. Bauer said. “Physicians need to become better informed about these products, and it’s important that human trials examine issues of efficacy and safety.”
Federal cannabis prohibition has led to a dearth of data. Most traditional med schools still do not include cannabinoid research as part of their curriculum and physicians often have little experience or understanding about the topic. Despite this, Dr. Bauer hopes physicians will not dismiss inquiries about CBD from patients.
“We encourage physicians to not disregard their patients’ interest in these products and keep both a clinical curiosity and a healthy skepticism about the claims made,” Dr. Bauer said. “Chronic pain management continues to challenge patients and physicians, and these therapies are a promising area that needs more research. For patients struggling with chronic pain, physicians taking time to listen to them and address their questions compassionately but with an evidence-based approach can help them make informed decisions.”
Study co-author Karen Mauck, M.D., believes physicians need to be a resource for patients interested in CBD, especially as it is widely available for purchase.
“Other than Epidiolex, a purified form of plant-derived CBD which was approved in 2018 for treatment of severe forms of epilepsy, all other forms of CBD are not approved by the Food and Drug Administration but are sold in a variety of formulations, including oral or topical oils, creams, sprays, and tablets,” Dr. Mauck said. “They contain variable amounts of CBD, may contain other active compounds, and may have labeling inaccuracies. Before using CBD or hemp oils, it’s important to consult with your physician about potential side effects and interactions with other medications.”
