America Loves Its Unregulated Wellness Chemicals
The middle-aged woman in front of me in the Atlanta airport’s check-in line surely meant well. “You should try some CBD for your dog if she gets nervous,” she said, motioning to my chihuahua, who sat atop my suitcase, peering uneasily through the mesh panels of her travel carrier. “They say it’s great for that.”
She didn’t say who “they” were, but at this point, it could be anyone: her teenage kids, her elderly mom, the barista at her local coffee shop. A shop selling only CBD—short for “cannabidiol”—in oils, vapes, tinctures, and gummies might have opened next to her suburban grocery store, or she might have heard that Martha Stewart is developing a line of CBD products for both pets and people. Purveyors of the chemical credit it with alleviating everything from anxiety to autism, with widely varying levels of proof to back up their claims.
Seven months ago, the United States hit Peak CBD, at least according to Google Trends. During the high point, in May, Google received more than three times as many queries for CBD as it did for Beyoncé. CBD belongs to a class of chemicals called cannabinoids, dozens of which have been identified in cannabis and hemp plants, and just a couple of years ago, it was virtually unknown in the U.S. Americans spent last year trying to answer the same questions my parents asked me after Christmas Eve dinner, three days before my airport encounter: What is CBD, why is it everywhere now, and what does it do?
That last question can’t be reliably answered—the research just isn’t there yet. But the knowledge gap hasn’t done much to dampen consumer interest in CBD, and manufacturers looking for the next big thing have already started experimenting with lesser-known cannabinoids like cannabinol, or CBN. Cannabinoids are a salesman’s dream: When little is known, virtually anything can be passed off as possible.
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Until CBD’s ascendance, tetrahydrocannabinol, or THC—the chemical in weed centrally responsible for making people feel high—was the most famous of the cannabinoids. Higher concentrations of THC are what mark the legal distinction between cannabis and hemp, which are virtually identical in most other ways. After a years-long pilot program, growing industrial hemp became legal nationwide at the end of 2018. Most cannabinoids can be extracted from hemp, which means that the U.S. currently has a ready supply of the chemicals for the first time in its history.
Regulations on the manufacture and sale of cannabinoids haven’t kept up with their newly widespread availability. Hemp might be legal, but the Food and Drug Administration has so far not issued any guidance on how CBD—by far the most widely available cannabinoid—should be quality-tested or labeled, what claims can be made about its use, or who can sell it. In the agency’s view, CBD is still illegal to market as a dietary supplement, even though one of the plants from which it is derived is legal to grow and the substance is sold widely and in a variety of forms. The FDA also says it’s illegal to sell as an additive in foods, even though those, too, are widely available, including CBD sodas and gummy bears. For the FDA to make more nuanced rules, it would likely need to reverse its stance on CBD’s legality as a supplement.
To be fair, the FDA does not have much hard evidence on which to make more detailed regulations. Academic research on cannabis and its derivatives has long been restricted, and funding to study cannabis derivatives can be difficult for scientists to secure. Legal hemp cultivation will aid those studying the therapeutic value of the cannabinoids, but clinical trials to establish effects and dosages take years. Earlier this year, Esther Blessing, a researcher at New York University Langone Health currently studying CBD’s effects on anxiety, told me she thought the chemical held significant promise, but that it would take a decade to gather enough information for FDA approval as a drug with standardized dosages and predictable outcomes. She cautioned that currently, it’s impossible for most consumers to know whether what they’re buying has any CBD in it at all, let alone evaluate its quality.
What’s currently known about cannabinoids is preliminary. A 1976 review suggests that CBN has potential as a mild sedative in conjunction with THC, and a 2002 study looked at its pain-relieving properties. CBD, in doses much higher than are commonly available in consumer products, seems to alleviate anxiety under experimental conditions. In 2017, the National Academies of Sciences, Engineering, and Medicine issued a research review that found substantial or conclusive evidence that cannabis or cannabinoids are effective in the treatment of chronic pain, chemotherapy-induced nausea, and some symptoms of multiple sclerosis. The report also recommended that more detailed research be done to address gaps in the evidence, and that better guidelines for evaluating cannabis research be developed. What’s known about the dozens of cannabinoids beyond THC, CBD, and CBN is even more limited.
Americans aren’t waiting for more formal answers on what cannabinoids can do for them, and neither is the consumer-products industry that has helped pique their curiosity. Now is the ideal time to market novel, inexpensive, widely available substances outside the traditional health-care industry. In the United States, two-thirds of people who file for bankruptcy cite medical problems as a major factor. GoFundMe hosts regular crowdfunding efforts in which people literally beg for their life. In 2018, more than 130 people in the United States died from opioid overdoses every day. Anxiety rates in the country have skyrocketed in recent years, but mental-health services are often out of reach for people outside urban areas or with limited financial resources.
Cannabinoids, and particularly CBD, are marketed to fit into the deepening cracks in the American health-care system. The things their purveyors claim they address—from pain, anxiety, and nausea, to inflammatory diseases, multiple sclerosis, and cancer—are chronic problems with few accessible, safe treatments, and often no cure. Even if a person isn’t dealing with one of those problems currently, there are the worries that lurk at the edges of people’s day-to-day lives, threatening personal chaos and financial ruin. The machinery of science moves slowly and deliberately, which is both the safest way to proceed and fundamentally unhelpful to those suffering now, or to those who fear they might be next.
Meanwhile, anecdotal praise abounds for CBD, other cannabinoids, and formulations that combine them in various ratios meant to address specific problems, such as insomnia or joint pain. Many researchers see significant potential in its future therapeutic usage, and it’s easy to find basic CBD in oil form—a reasonably sized bottle might go for $50. CBD doesn’t require the expense of a doctor’s visit or a prescription, and people can adjust their own formulations and dosages. They can rub it on their skin, drink it in their seltzer, or wear it in their gym clothes. The gadget chain Brookstone makes a pillow infused with CBD, promising that the chemical is “known to promote a sense of well-being,” whatever that means.
Virtually no evidence suggests that CBD has any effect at all in the small doses and weird delivery methods in which it’s now often marketed. If you put your CBD pillow in a case, for example, your body won’t even come in contact with it. If you go case-free, the CBD would only affect the parts of your body it touches. But maybe your left cheek is the personal key to your well-being—how are you supposed to know?—or maybe you need a new pillow anyway. Maybe you have no idea what CBD is supposed to do in the first place or how it works, but you’ve heard it’s good for you. Where there’s curiosity, there’s a chance to make a sale.
In that way, CBD and the dozens of other cannabinoids waiting in the wings are like another consumer-products gold mine that has flourished in America for decades: vitamins and supplements. Largely unregulated and untested, subject to few consumer protections, supplements are a marketing free-for-all for much the same reason that cannabinoids have captured people’s imaginations so quickly—consumers feel mistrustful of pharmaceutical companies, they lack access to medical care, or they’ve encountered big promises about the substances’ potential results. If the FDA chooses to regulate CBD as a dietary supplement, that likely means little for the quality of information that Americans are destined to receive about its uses and results.
And even if the FDA does crack down on the CBD gold rush, it’s just the beginning. Marketers and manufacturers can simply move on to the next emerging substance in a game of regulatory Whack-a-Mole that could occupy the agency for years, as cannabinoid after cannabinoid is elevated and commodified as interest in the one before it plateaus. As much promise as cannabis and its derivatives hold for people with chronic health issues, they might hold even more for people hoping to make a quick buck.
Be well!
DrD
Academician Dorodny, Dorodny, Life Enrichment Practitioner, Prof, Dorodny, NEW Institute, myths, , Dr.Dorodny, Victor Dorodny MD, mythology, investigative Mythologist, TRI-PAC, health consumer advocacy, medical/heath investigative mythology, medical myths, skin patches, inhaled, inhaled vitamins, PatchMD.com, health myths, healtcarING, health carING, PatchMD, PatchMD.com, Medical Scientist, Chief Medical Scientist, Investigative Medical Mythologist, Editor-in-Chief AMHSR, DrD, Dr.D, DrD's, Mobility Scooters, www.thehouseofscooters.com, Victor Dorodny, AmazingDrD, #AmazingDrD, assisted mobility scooters, scooters, golden milk,turmeric, coconut oil, honey, cinnamon, cayanne pepper, dialing 911, Health Care Value, Healthcare Consuting Value, HCV., Quality, Healtcare Quality, Quality Healthcare, Cost, Costs
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