For consumers seeking the many positive purported benefits of the suddenly fashionable cannabis compound, there’s little easily-accessible information. Worse yet, we may be witnessing an explosion of misunderstanding and misinformation as an epidemic of lung injuries continues across the US.
Poisoned by black market products, nearly a thousand people have fallen ill across the country. As of this writing, illegal e-cigarettes have been implicated in at least 14 deaths. In over forty states, people have been struck by severe lung injuries from vaping, often at frightening speed. While research is still underway to isolate the specific substance or substances responsible, many hold black market THC e-cigarettes responsible. Something changed in the composition of the oil used by many black marketeers to fill vaporizer cartridges. Initial evidence suggests contamination by fungicides and the misuse of thickening agents to disguise diluted product. (I wrote about the outbreak in mid-September.) Either as a direct result, or in some unknown interaction with tobacco e-cigarettes as well, vaping has been turned deadly.
Consumers interested in CBD have been looking to health organizations, lacking any clarity from the federal government, for support. A week ago, the Arthritis Foundation was issuing guidance on the use of CBD to alleviate chronic pain. Now those same organizations are dialing down support for CBD in the charged environment.
CBD products have been swept up in policies handed down by frantic officials. Many parts of the country are considering or have taken action against vaping, such as the four-month ban handed down in Massachusetts and actions at the local level in states like California. (Other states have stopped short of banning all vaping products; places like Michigan and New York have only halted sales of flavored tobacco e-cigarettes.)
Ironically, only CBD’s murky legal status has shielded CBD-infused vaporizers from increased attention. While the federal government struggles to move CBD out from under the DEA’s jurisdiction as a controlled substance to under the FDA as a supplement or ingredient, only state-level actions will impact CBD vape pens and cartridges. Fortunately, while vaping has been on the upswing, most consumers use drops of oil or dollops of lotion when administering CBD. But headlines such as “CBD products spiked with illegal synthetic marijuana” are adding to trepidation and confusion among consumers even while CBD continues to move into the mainstream by appearing in drug stores and grocery stores nationwide. CBD consumers appear to tolerate such contradictions. Based on consumer research by my firm, we know that only one fifth of current CBD users feel confident distinguishing safe products yet 62% feel comfortable using CBD without any professional guidance.
This speaks to one of several macro issues with CBD on the consumer market. CBD has tremendous promise as a treatment for seizures and pain, and as a palliative for conditions like anxiety, depression and sleeplessness. The most concrete example from a pharmaceutical perspective entered the public arena last year when the FDA issued a first-ever approval to a medication derived from cannabis. (Epidiolex by GW Pharmaceuticals treats rare forms of childhood-onset epilepsies.) But GW Pharma’s entrance onto the CBD stage was preceded by the story of Charlotte Figi, a young girl who was among the first well-known cases of treating seizures with cannabis oil. The story of Charlotte’s seemingly miraculous response to oil derived from high-CBD and low-THC strains of marijuana touched many and served as the impetus behind today’s CBD industry leader Charlotte’s Web. Reading an old CNN.com article on Charlotte’s success conveys a subtle underlying challenge key to CBD in consumer products: it is a different experience for everyone.
Why? Because of several factors:
Bioavailability:
After a period of experimentation, her doctor and parents realized Charlotte’s symptoms responded best when she was taking three to four milligrams per pound of body weight. By contrast, Epidiolex patients take the equivalent of 10-30mg of CBD per kilogram of body weight. For an average American, that equates to anywhere from about 800 to 2400mg of CBD daily. No one definitively knows how CBD functions for other health conditions. At heart, consumers lack any confidence in dosing – just 29% reported confidence administering the right amount. Nor is there much understanding of when to use lotions for spot treatment or how much CBD will be absorbed when administered topically. Skeptics claim none at all while supporters point to chemical receptors (for endocannabinoids) on the skin as reason to believe. The consumer’s shaky understanding of absorption (only 19% understand how the body absorbs CBD) doesn’t stop CBD-infused creams from being the biggest mainstream success to date, with topical products starting to appear in chains like CVS, Kroger, and others.
Labeling:
Because the regulation of CBD has yet to fully form, consumers encounter all manner of product labels. The FDA has only made one point crystal clear: brands can’t tout CBD as a cure-all for everything from cancer or as one brand put it, a “miracle pain remedy”. In lieu of any clear government standards, the consumer’s best champion for transparency may be class action lawyers. Last week a suit filed by a group of Massachusetts consumers challenged the labeling of convenience-store darling Hemp Bombs, makers of numerous CBD gummies, vapes, capsules, and other products. The suit alleges that Hemp Bombs are “grossly under-dosed” compared to the amount of CBD touted on the package. This follows high profile reports such as a 2017 JAMA study that estimated 70% of CBD products bore inaccurate labels.
Sourcing:
The word “spectrum” often appears on CBD labels. In short, hemp flower is processed to extract cannabinoids like CBD. If the process goes through extra steps to pull out any trace amounts of THC, the result is referred to as “broad spectrum” CBD. Less processing results in so-called “whole plant” CBD, referred to as “full spectrum”. The latter contains all the flavors, aromatics, and compounds present in the flower material some of which is lost in broad spectrum. Full spectrum oils can command a higher price point, perhaps due in part to the buzzy nature of the term although production costs are often the chief driver of price. Supporters claim all the material acting in concert creates what is known as the “entourage effect”. There is cause to think some important interactions happen among cannabinoids used in combination. For example, CBD is known to have a moderating effect on THC resulting in a less euphoric experience when used together. A great deal of CBD products are created using an isolate, a powder of 99%+ CBD thought of by some as the compound in its purest form. All of which apparently isn’t understood at all by consumers. No more than a fourth claim to understand the entourage effect, much less explain it at any length. (For the curious, here’s a decent rundown on the differences.)
Processing:
Although we did not specifically ask for respondents’ perspective on extraction methods, I’m confident we would not have seen any more than 20% come back claiming to understand the differences between extracting CBD using carbon dioxide, ethanol, or hydrocarbon. I’d be willing to bet some of that number would’ve been reported by overly confident respondents that, when pressed, couldn’t describe the pros and cons of each. Frankly, I’m not sure I could either although I am fascinated to see the pace of innovation in extraction.
The most egregious examples of false claims and labels can be found in many product categories. For example, unscrupulous brands sell oil-based products as “hemp oil”, labeled and marketed to imply the product contains CBD. When tested, these products indeed contain hemp oil, however it is derived from hemp seeds, not the hemp plant, which might provide some benefit but assuredly does not contain CBD. Other bad actors toy around with labeling concentrations and contents. For example, a $50 tincture claims to contain 100mg of CBD – which sounds like a good amount. It’s reasonable to assume, however (based on the data above), that you will not be getting anywhere near your money’s worth.
The hottest trend in the industry – CBD water – is also open to question. CBD on its own is hydrophobic – you are literally mixing oil and water – and the latest marketing claim (microencapsulation as a means to better deliver CBD) may hold true, but possibly only in the first few minutes of introducing the powdered additive. Left on a shelf to degrade and settle to the bottom, which is especially damaging to product exposed to light through transparent bottles, it’s possible the consumer gets little to no CBD and may be exposed to toxic residue. While CBD water conceptually doesn’t seem like a stretch, the trend has jumped into categories far removed from any form resembling food, beverages, or pharmaceuticals. Activewear, for example. Workout brand Acabada weaves micro-capsules of CBD into strategic spots on sportswear. (The company claims the capsules are activated by friction during exercise and last for up to forty washes.) As much as the company’s “patented textile finishing therapy” for binding CBD to textiles may sound like snake oil, it’s unclear how much skepticism is appropriate.
That is, even if the product delivers nothing more than the placebo effect, does it matter? Somewhat counterintuitively, some argue if consumers hit on a formulation or delivery method that provides relief then how little the consumer understands CBD is a moot point. Taken a step further, maybe we shouldn’t be overly concerned with a product’s contents provided it contains nothing harmful. Imagine an elderly arthritis patient restoring range of motion or alleviating chronic pain without the side effects of prescription medication. That anyone would dispel her belief in CBD’s role in improving her quality of life seems perverse. Yet as the Hemp Bombs case illustrates, questionable business practices may lead too many consumers to avoid CBD products. That the winds seem to be shifting alongside the vaping epidemic may have a thin silver lining: bad actors might not survive the fallout. There’s also some hope greater regulation will force brands to stay within defined guardrails and comply with industry standards.
While the industry and consumers await stringent research results on the many questions above, among the best resources is the classic solution to learning about cannabis: word of mouth. Brand websites are best suited to looking up their Certificate of Analysis, or CoAs, batch numbers, and background on the company and its practices. Numerous sites post reviews of CBD products but some are little more than affiliate marketing programs in disguise. Prominent “Buy Now” buttons should raise an eyebrow. Even Facebook groups can provide some useful connections. For consumers in adult use states, an associate at a cannabis dispensary may be easily accessible as well. Readers looking for criteria should consider the following to identify impostors. Brands that don’t provide recent testing results (CoAs), have opaque quality assurance practices, lack endorsements by agencies such as the US Hemp Authority, or act as thinly disguised pyramid schemes (going by the sanitized term “multilevel marketing” today), can and should be avoided as the shakeout in the CBD consumer market unfolds.
Questions? Comments? Contact Mike directly via [email protected]
