Ask a Doctor: What's the story with CBD oil?


Medical doctor or physician in white gown uniform with stethoscope in hospital or clinic doctor tile clinic tile health care healthcare medicine / Getty Images
Medical doctor or physician in white gown uniform with stethoscope in hospital or clinic doctor tile clinic tile health care healthcare medicine / Getty Images
photo Matt McClanahan, D.O.

Q: I've seen lots of shops pop up in Chattanooga advertising "CBD oil" for pain management and health benefits. Isn't CBD related to marijuana? Is it addictive? Should I consider it for any health benefits?

A: Cannabidiol (CBD) is an active ingredient in cannabis (marijuana), but not the primary ingredient. By itself, it does not cause a "high" in the way smoking marijuana typically would. It is actually derived from the hemp plant, a near cousin of the marijuana plant. There have been no reported cases of dependence on pure CBD by itself. CBD oil is made by extracting CBD from the plant and then diluting it with coconut or hemp seed oil.

CBD markets have touted it as a pain reliever, anxiety reducer or cure-all for a variety of health issues. However, few scientific studies with human trials have shown it to be effective for everything that it is advertised for. Although it can have some pain-reducing elements, it is not by itself a cure for chronic pain, particularly since chronic pain, in and of itself, is a multifactorial state, involving many physiological, neurological and psychological systems.

CBD may have some side effects (e.g., nausea, fatigue, dizziness) and can increase levels of some medications in the blood. Furthermore, it is marketed and sold as a supplement, which means it does not fall under FDA regulation standards. Thus, you cannot know for sure that the product you are buying actually contains the active ingredients listed. Also, the most effective dose of CBD is unknown.

However, some groups, one local to Chattanooga, are increasingly focusing efforts to standardize the process of independently evaluating and certifying CBD products, given the current vacuum of standardized language and oversight. Additionally, the FDA is currently evaluating its policies more broadly surrounding CBD, particularly after the June 2018 approval of Epidiolex, a form of CBD successfully being used to treat some forms of seizure disorders.

Bottom line: We don't know enough about CBD's efficacy or safety to make broad recommendations as to the numerous conditions it's purported to treat. However, its side-effect and addictive profile is low, and there are no known reports of overdose or dramatically harmful effects. Be wary of how it is marketed and recognize that, at this point, you may not be receiving what is advertised. Some local experts can provide more unbiased recommendations and have intentions to continue clarifying what the data does and does not say. Never start using CBD without consulting your physician as it may interact with current medications or be unsuitable for your health needs.

- Matthew McClanahan, D.O., Center for Insight Medicine; member, Chattanooga-Hamilton County Medical Society

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