Even without proof, CBD is finding a niche as a cure-all
Supporters say cannibidiol, which comes from the hemp plant, can treat pain, anxiety, inflammation and even cancer. But it might just be snake oil.
Hemp being grown for seizure medicine, the only FDA-approved use of cannabidiol, or CBD. Courtesy GW Pharmaceuticals
Touted as a treatment for a wide range of conditions — including anxiety, pain, inflammation and even cancer — CBD may be the latest version of snake oil. Or perhaps a real relief for numerous ailments.
Nobody really knows which is true because there has been so little solid research on CBD’s effect on humans, experts say.
CBD, or cannabidiol, comes from the hemp plant, a close relative to another member of the cannabis family, marijuana. Both plants contain abundant types of cannabinoids, but marijuana is high in the psychoactive chemical THC, while hemp is rich in CBD, which doesn’t create a buzz but may offer a range of medicinal benefits.
What to know about CBD oil, the health craze getting national buzz
Even without research to back it up, the trendy CBD has been turning up in a vast array of products, including CBD-infused lattes, massage lotions and baked goods. And that means it’s becoming big business, with sales expected to hit $20 billion in the next few years.
Thus far, there is only one use for CBD approved by the Food and Drug Administration, and that’s as a treatment for two rare forms of epilepsy. But that doesn’t stop true believers like Dr. Joseph Cohen, who runs a cannabis clinic in Boulder, Colorado, from making enthusiastic claims.
“It works for anxiety, it works for pain, it works for inflammation, it works for autoimmune disorders, and there’s a slew of other conditions for which you can get benefit,” said Cohen, a former gynecologist.
There’s no clear evidence that CBD works for any of those things, experts told NBC News. “We don’t know any of that,” said Dr. Margaret Haney, a professor of neurobiology at Columbia University Medical Center and director of Columbia’s Marijuana Research Laboratory.
Health FDA approves cannabis-based drug CBD for epilepsy
“There’s an enormous placebo effect,” she said. “If you go in with this expectation, with all of society saying this will cure whatever ails you, it often will.”
Dr. Jeffrey Chen seconds that opinion. “Certainly there is therapeutic potential from CBD, but the amount of human data is minuscule, and popular access and consumption have far outpaced the science,” said Chen, executive director of the Cannabis Research Initiative at the University of California, Los Angeles. “So if you’re going to take it, you have to understand there is little data and you have to be very careful about the source and you need to talk to your doctor about how it might interact with other drugs you are taking.”
Medical marijuana provides relief, while research catches up
With no one regulating cannabinoids, you often can’t be sure what dose you’re actually getting, Chen said. He recommends buying from medical marijuana dispensaries, which are regulated by local governments.
While FDA testing of CBD for use in epilepsy showed that the chemical was relatively safe and free of side effects, it does appear to interact with other drugs, including antidepressants known as SSRIs and blood thinners, boosting their levels in a person’s system because it inhibits an enzyme that breaks them down, Chen said.
Studies in animals suggest that CBD might help with anxiety, pain and inflammation, but Chen is quick to point out that “the majority of times when we see promising drugs in animals they either don’t work in humans or they have horrible, horrible side effects.”
Health As Coca-Cola considers cannabis drinks, hopes for CBD still higher than the science
One thing experts do know is that unlike THC, CBD doesn’t hook onto cannabinoid receptors in the brain or body, said Michael Zemaitis, a professor of pharmaceutical sciences at the University of Pittsburgh.
Instead, it appears to affect enzymes that break down endogenous cannabinoids — the ones made by our own bodies.
“It seems to have a very broad dampening effect,” Zemaitis said. “That’s part of the reason why you see so many indications” for their use.
In that sense, the effects of CBD are very different from those of opioids, which have specific receptors to plug into, turning on cell machinery in much the same way a key in a car ignition turns on the engine.
There is little information about the medicinal effects of both THC and CBD, mainly because of federal laws on marijuana, experts said. Marijuana and its extracts have long been considered Schedule 1 drugs, defined as having no accepted medical use and a high potential for abuse.
That puts any kind of cannabis in the same category as heroin and LSD, which means researchers have to jump through a lot of hoops to even get any cannabinoids to study, Chen said.
Another big concern for experts is that patients will avoid proven medications in favor of CBD.
“We have a long history of people using snake oil to convince people they’re getting something,” Haney said. “Then there have been more dangerous situations where people turn down effective medications” to use unproven products, like CBD.
Things may change soon when it comes to CBD, Chen said. The 2018 Farm Bill contains language that will legalize industrial hemp, he said, “so we’ll be able to start generating data on what it will work for and what it will not.”
CORRECTION (Dec. 12, 2018, 12:12 p.m. ET): An earlier version of this article misstated the change in the status of hemp, now classified as a Schedule 1 drug, anticipated in the new Farm Bill. It would be legalized, not reclassified as a Schedule 3 drug.
Linda Carroll is a regular health contributor to NBC News and Reuters Health. She is coauthor of “The Concussion Crisis: Anatomy of a Silent Epidemic” and “Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings.”
Dr. John Torres is medical contributor for NBC News
Ali Galante is a medical producer for NBC News, covering health-related topics including the opioid crisis, disease, medical treatments and scientific discoveries.
How to Harvest and Dry Hemp for CBD Production
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Estoy de Acuerdo / I agree
There is a lot of interest in growing industrial hemp for CBD production, especially since hemp was legalized in the 2018 Farm Bill. Take a look at some of my previous articles regarding the potential risks and rewards in the CBD market as well as agronomic considerations for successful industrial hemp production.
Fresh cut hemp drying. Whole plants hung in this fashion during the drying phase may have humidity trapped in the center due to the ‘closed umbrella’ shape that an entire plant takes on. Breaking off and hanging individual branches is recommended. Photo by George Place.
CBD oil extraction process. Photo by George Place
Harvesting hemp is a critical stage for CBD production. The presence of molds and mildews will lower the value of hemp floral biomass so a timely harvest is essential. There are visual clues on the hemp bud that growers should monitor. When trichomes on the hemp bud shift from white to milky white it may be time to harvest.
Weekly testing of CBD content can inform the grower of when harvest should be initiated. This is in addition to the required THC test with the North Carolina Department of Agriculture. While some of the tests for CBD, cannabinoids, terpenes, pesticide residue, mold, and heavy metals can cost as much as $300 the return on investment can be significant. For example, if 1000 lbs of biomass will be harvested on one acre the difference between harvesting when the crop is at 6% CBD versus when the crop is at 7%CBD is equivalent to 10 pounds of CBD oil. Current prices for CBD oil are $5 per gram. With 454 grams per pound, a 1% discrepancy in CBD content on one acre can be a $20,000 crop value difference. Growers need to test frequently to make the right decision regarding harvest timing.
Weather will also be a key factor in determining when to pull the harvest trigger. Harvest time for hemp coincides with the hurricane season. Growers will have an easier time drying and curing their hemp floral biomass if they can bring it in before the arrival of a storm. This is the time when adequate labor is crucial. The vast majority of hemp growers for the CBD market are relying on labor to cut the stalk (the machete is the current tool of choice) and load the biomass. This takes a lot of time and physical exertion. I have heard reports of growers that had an excellent crop of hemp floral biomass but suffered massive losses because they could not harvest it in time (their two-person harvest team was not adequate). The importance of measuring the labor requirement is a big reason why we recommend that first-year hemp growers for the CBD market start with 1 acre or less. Growers need to keep track of the amount of man and woman hours that it takes to bring in the harvest. Maintaining sharp tools during the harvest process will also save time and effort.
Drying and Curing Hemp
Hemp biomass made from chipping the entire hemp plant. This biomass is low quality and will receive a reduced price. Photo by George Place
Once hemp is harvested growers should immediately move the floral biomass to the drying facility. This could be a simple structure like a barn. The facility should be under roof, out of direct sunlight, and well ventilated. Growers need to set up several fans and have them blowing continuously. Significant ventilation is crucial! Ideal temperatures for drying and curing are 60 to 70 degrees F at 60% humidity. Some processors say that hemp growers should not dry their floral biomass at the same temperatures as flu-cured tobacco. Those temps are too high and dry the hemp too quickly. A slow drying with high airflow will cure the hemp, produce a higher quality end product (better cannabinoid and terpene spectrum), and fetch a higher price.
It is difficult to estimate the square footage of drying space needed per plant. Using a flu-cured tobacco with 800 square feet a grower was able to dry 1 acre worth of plants (approximately 1350 plants) in 3 days. Another grower was able to dry approximately 1.5 acres worth of hemp (plant number not stated) in a 2500 square foot barn.
Hanging entire plants upside down on wires in the drying barn is a common practice. Unfortunately, as those plants dry the branches droop down in the formation of a closing umbrella. That closing umbrella shape results in less airflow to the center of that entire hemp plant. Thus more mold and mildew will grow in that center portion. We advise growers to break off the individual branches from the hemp plant and hang branches on the drying wire, not whole plants. This step is more labor intensive but will help minimize mold and mildew.
Dry and shucked (stem removed) hemp flower biomass. Photo by George Place
Dry hemp biomass still on the stem, referred to as unshucked. Photo by George Place