McGuire doesn’t advise buying CBD products. You need to differentiate, he says, between the extremely high doses of pharmaceutical-grade pure CBD that participants in the handful of successful studies were given and the dietary supplements available over the counter or online. “These may contain quite small amounts of CBD that might not have large enough concentrations to have any effects,” he says. “It’s the difference between a nutraceutical and a pharmaceutical.” These supplements aren’t allowed to make claims of any effects. “If you’re making creams or sports drinks with CBD, you can say anything you like as long as you don’t say it will do such and such,” he says.
Epilepsy Society believes that individuals or their parents or carers should decide whether or not to use CBD-based oils. However they should always discuss any decision with their healthcare professional and should not stop taking their epilepsy medication without the supervision of their doctor. Unlicensed CBD oils may not be produced to the same high standards as licensed products and could interact with epilepsy medication. This could increase the risk of side effects or seizures.
Even as the research proceeds, thousands of people are using CBD as medicine. A British pharmaceutical company, GW Pharma, has developed two CBD drugs: Sativex, which contains a 1-to-1 ratio of CBD and THC, and Epidiolex, which is pure CBD. The former is prescribed for the painful muscle spasms that occur in multiple sclerosis, while the latter is aimed at childhood seizures. Sativex is not available in the United States, but it is approved in 29 other countries, including Canada, England and Israel.
"It's important to know that the research in this area is in its infancy, partly because we haven't really understood much about CBD until relatively recently," said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania Perelman School of Medicine. He pointed out that the classification of marijuana as a Schedule 1 drug by the DEA makes it difficult to get material to use in laboratory studies. Schedule 1 drugs have a high potential for abuse, according to the DEA, and are illegal under federal law.
This has been the year medical cannabis hit the mainstream. The government has announced that it is relaxing laws on when cannabis medicines can be prescribed by doctors, following high-profile cases such as that of Billy Caldwell, the 13-year-old boy hospitalised by his epileptic seizures after he was denied legal access to the cannabis oil that helps control them. Meanwhile a new generation of cannabis medicines has shown great promise (both anecdotally and in early clinical trials) in treating a range of ills from anxiety, psychosis and epilepsy to pain, inflammation and acne. And you don’t have to get stoned to reap the health benefits.
Typically, pharmaceutical companies making cannabis-based medicines have sought to isolate individual compounds from the plant. But Mechoulam strongly suspects that in some cases those chemicals would work much better in concert with other compounds found in marijuana. He calls this the entourage effect, and it’s just one of the many cannabis mysteries that he says require further study.
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