It's easy to buy products containing the chemical compound cannabidiol (CBD) online. CBD is extracted from marijuana and it contains just a small fraction of the amount of tetrahydrocannabinol (THC) that gets people high. Like weed, CBD is illegal at the federal level but 29 states and the District of Columbia have medical marijuana laws and recreational weed use is legal in eight states.
But CBD has already made its way into a host of products, from oils and creams to teas and salves, often pitched to consumers as medicinal using little evidence—just last week, the Food and Drug Administration (FDA) warned multiple companies selling CBD to stop making unsupported claims that their products can treat cancer, Alzheimer's disease, and other maladies.
And now, a new research letter published in the Journal of the American Medical Association suggests that people buying CBD-containing products online may not even be getting what they pay for. The FDA has sent warning letters to a few companies for inaccurate CBD labeling, so a team of researchers led by the University of Pennsylvania wanted to investigate whether this was a systemic problem in the industry or just a few bad actors. Last fall, researchers purchased 84 CBD products from 31 manufacturers including oils, alcohol-based tinctures, and vaporization liquid and had them analyzed at a lab. They then compared the amount of CBD found in the products to what was promised on the label.
They found that nearly 70 percent of the tested extracts did not have the amount of CBD as advertised: 26 percent of the products contained less CBD than indicated, while 43 percent contained more. Just 31 percent of the products were accurately labeled; that is, the CBD content was within 10 percent of the amount on the label. (The research was limited in that it only looked at products purchased online versus in stores, but it's also likely that many people get their CBD online.)
"To me, this tells us that buyers need to be vigilant about the products that they are using," Marcel Bonn-Miller, an adjunct assistant professor of psychology at the University of Pennsylvania Perelman School of Medicine and the letter's lead author, tells Tonic via email. "As there is currently no systematic oversight of this industry from the FDA, it means that it is up to the consumer to test their products to assure that they know what is in their medicine."
One problem is that CBD is even considered medicine at this point. There's some evidence that it can help children with a rare form of epilepsy called Dravet syndrome, but whatever other potential it may have remains unproven. People also use it for inflammation, pain, and anxiety.
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"The effects of CBD are most certainly being exaggerated in the marketplace and on the internet," Alan Budney, a professor of psychiatry at Dartmouth's Geisel School of Medicine, tells Tonic via email. "It may indeed have some therapeutic effects, but to date we have good data for only one condition. Moreover, we have no clue what the dosing amount or frequency should be for any of those conditions, so even if the labels were accurate the public is still being hoodwinked."
With little scientific evidence for its health benefits, and very little FDA oversight, CBD products may seem closer to placebos (or, you know, scams) than proven medicine. But are they dangerous? Bonn-Miller points to the lack of available dosing information—we have no idea what amounts of CBD, given with what frequency and in what form, might be helpful for what ailments, and with what side effects.
He says there's little downside to getting more CBD than you expect, but since more than a quarter of products tested contained less CBD than advertised, people may be paying for a very expensive placebo. These products also contained other cannabinoids, including THC, which were not listed on the label and can have negative side effects. So the downsides of under-labeled products could include parents giving their epileptic child THC without knowing it.
Right now, CBD products exist in a Wild West devoid of meaningful oversight. The FDA may have warned companies not to oversell the benefits of their CBD extracts, but Bonn-Miller believes more needs to be done. The industry could do more to establish consistent production and quality standards and rigorous testing. That would help standardize products and help consumers feel confident in what they're buying.
But there's a role for regulation, too. "I think that we need systematic oversight from the FDA rather than another round of warning letters," he says. "The warning letters are important and are what initially drew our attention to this issue. However, we need to have CBD products under the same regulation and oversight from the FDA as any other medication, or food for that matter."
Bonn-Miller was the author of a 2015 paper for which he had 75 marijuana edibles from 47 brands tested for THC content and found that only 17 percent were accurately labeled, 23 percent had more THC than advertised, and whopping 60 percent had less THC than claimed.