NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS MD, PH.D., IN THE SPIRIT OF C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., DR. LINDA WHITBY, MD., L.JOSEPH PARKER, MD., EVELYN J. CLEMENT, WALTER F. WRENN III., MD., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
INTRODUCTION
Is Nonprescription CBD a Natural Product?
Mostly not. The U.S. analysis of 105 products found that only 1 in 4 products were accurately labeled for CBD, 1 in 5 had less than 90% of the advertised CBD, and 1 in 2 had more than 110%.22 The range indicated that CBD content varied from almost nothing to very large amounts. While CBD can be synthesized as a pure chemical and synthetic CBD may be used in some clinical trials, most CBD is derived from the hemp plant.
Is Nonprescription CBD Pure?
Labeling products containing hemp extract or CBD does not allow for a dependable assessment of purity. Other substances are likely in any formulation, so it generally will not be just CBD in a tablet, oil, ointment, or spray. Hemp can have over 100 different cannabinoid compounds, many of which could have actions in the body. Depending on the strain of hemp, the amount of the psychoactive delta-9-tetrahydrocannabinol (THC) can vary widely.
ARGUMENT
In an analysis of 105 topical CBD products in the United States, THC was detected in 35%, with a total content of up to 100 mg. Similar disparities were found in Germany and Switzerland. Commercial products may also contain untested synthetic chemicals. 21 25 24 23 22
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CBD PRODUCTS DON’T RELIEVE CHRONIC PAIN
“The authors hope more balanced, evidence-based advice can now be given to patients and their care providers while research focuses on effective pain treatments.
“Untreated chronic pain is known to seriously damage quality of life, and many people live with pain every day,” says senior author Chris Eccleston, a pain scientist at the University of Bath.
“Pain deserves investment in serious science to find serious solutions.”
The International Association for the Study of Pain (IASP) issued a position statement in 2021 stating there was insufficient evidence from high-quality research to support the general use of cannabinoids to treat pain. While animal studies suggested potential pain relief mechanisms, human trials were lacking.”
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Taking CBD is, of course, not the same as ingesting cannabis plants or inhaling burnt cannabis, but 2 strands of evidence would suggest that caution is needed even with products that claim to contain “only” CBD. A “CBD only” label may be inaccurate. Several products claiming not to contain the undoubtedly psychoactive THC did so, and content labeling of cannabis products that are not regulated drugs is likely to be unreliable. 22, 33, 34, 35
DISCUSSION
Summing Up
For people living with pain, the evidence for CBD or hemp extract shows it is expensive, does not work, and is possibly harmful.
Healthcare professionals should use this evaluation to help people living with pain to inform their decisions about unconventional, unproven substances being sold as therapeutic. They will increasingly see patients using CBD or similar products, often for pain, and at present, may have a neutral view of CBD.77 That should probably change.
CONCLUSION
CBD, or Hemp extract products, should have some form of standardization, must not be prohibited, removed federally as a C-1 substance, and made legal for medicinal and recreational use purposes.
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