November 2018

Cannabidiol: What you need to know

Cannabidiol (CBD) continues to be a controversial and popular topic. Regulations on this chemical keep changing, creating more questions and misunderstandings. In addition to the recent approval of the CBD oil Epidiolex as a prescription drug, the US Drug Enforcement Agency (DEA) has reclassified CBD from a schedule I controlled substance to a schedule V controlled substance, meaning there’s limited potential for abuse.

So what is CBD? Unlike delta-9-tetrahydrocannabinol (THC), CBD is a non-psychoactive chemical from the Cannabis plant.

Epidiolex is approved for treating seizures from Lennox-Gastaut syndrome and Dravet syndrome in children 2 years of age and older. It’s currently being studied for other types of seizures, but isn’t approved for any other indications yet. Some early evidence on CBD in general, not Epidiolex specifically, is also promising for use in MS, Parkinson’s disease, schizophrenia, and anxiety, but research is limited.

Because CBD is now an approved drug, any product that contains CBD can’t be labeled as a dietary supplement. Even so, there are still plenty of products with CBD in them available online and in stores. Depending on your state, these products may or may not be legal.

Regardless of legal status, it’s important to highlight why these other products might be unsafe to patients. CBD products other than Epidiolex don't have to be tested for safety, efficacy, or quality. Many of these products will not contain the amount of CBD claimed on the label and could include contaminants, including THC. Discourage patients from using other forms of cannabidiol besides Epidiolex. It's hard to know if these forms of cannabidiol are safe or effective.

For more details on CBD, check out our recently updated monograph. Also review a new Comparison of Cannabinoids chart from Pharmacist's Letter.

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