A range of CBD products appeared to be accessible without prescription in seven out of nine countries reviewed. Australia and New Zealand were the exceptions where clinician prescription was required to access any CBD-containing product. CBD products commonly available without prescription included oils, gel capsules, purified crystal and topical products. The daily recommended doses with orally administered non-prescription products were typically well below 150 mg and substantially lower than the doses reported to have therapeutic effects in published clinical trials (e.g., 300-1500 mg). The legal foundations enabling access in several countries were often unclear, with marketed products sometimes failing to meet legal requirements for sale. There was an obvious disparity between federal directives and available products in both the USA and European countries examined.
Accessibility of CBD products was examined in the USA, Canada, Germany, Ireland, United Kingdom, Switzerland, Japan, Australia, and New Zealand as of May 2020. Regulatory and other relevant documents were obtained from government agency websites and related sources. Relevant commercial websites and some physical retailers were visited to verify access to CBD-containing products and the nature of the products available.
Recent legislative change has allowed increased access to cannabis products in many jurisdictions. In some locations, this includes over-the-counter (OTC) and/or online access to products containing cannabidiol (CBD), a non-intoxicating cannabinoid with therapeutic properties. Here we compared the availability of CBD products and the associated legislative and regulatory background in nine selected countries.
There are a variety of approaches in how countries manage access to CBD products. Many countries appear to permit OTC and online availability of CBD products but often without legislative clarity. As consumer demand for CBD escalates, improved legislation, guidelines and quality control of CBD products would seem prudent together with clinical trials exploring the therapeutic benefits of lower-dose CBD formulations.
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CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to antiseizure medications. In numerous studies, CBD was able to reduce the number of seizures, and, in some cases, it was able to stop them altogether. Videos of the effects of CBD on these children and their seizures are readily available on the Internet for viewing, and they are quite striking. Recently the FDA approved the first ever cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.
CBD is readily obtainable in most parts of the United States, though its exact legal status is in flux. All 50 states have laws legalizing CBD with varying degrees of restriction, and while the federal government still considers CBD in the same class as marijuana, it doesn’t habitually enforce against it. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. Currently, many people obtain CBD online without a medical cannabis license. The government’s position on CBD is confusing, and depends in part on whether the CBD comes from hemp or marijuana. The legality of CBD is expected to change, as there is currently bipartisan consensus in Congress to make the hemp crop legal which would, for all intents and purposes, make CBD difficult to prohibit.
The bottom line on cannabidiol
CBD is commonly used to address anxiety, and for patients who suffer through the misery of insomnia, studies suggest that CBD may help with both falling asleep and staying asleep.
CBD stands for cannabidiol. It is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, which is a cousin of the marijuana plant. While CBD is a component of marijuana (one of hundreds), by itself it does not cause a "high." According to a report from the World Health Organization, "In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD."
Cannabidiol (CBD) has been recently covered in the media, and you may have even seen it as an add-in booster to your post-workout smoothie or morning coffee. What exactly is CBD? Why is it suddenly so popular?
Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So, you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.
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1. Professor of Pharmacology, University Pompeu Fabra, Barcelona, Spain
2. Professor of Neurology, Tor Vergata University, Rome, Italy
3. Director of the Neurology Unit, IRCSS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
4. Professor of Psychiatry, Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Germany
Cannabis-Derived Products: Beyond Medicinal Use
The authors have declared no related conflicts of interest.
For example, the 2019 EU CBD Consumer Report stated that 25% of the survey respondents believed that consumption of the non-intoxicating cannabinoid CBD would get the user high, while a further 28% stated that they were unsure if it would. 37 The report also noted that 21% of CBD users cited social media as their primary source of information of CBD, while 18% identified friends and family as their information source. 37 While the information they receive from these sources may not be inaccurate, it is important to be aware that many medicinal cannabis users are not receiving information from traditionally reliable resources and, in order to increase public understanding of cannabis, its derived products, and its potential therapeutic benefits, these resources must be available and easily accessible to them.
In the Netherlands, cultivation of hemp plants is authorised, but only for the production of hemp fibres or seeds; cultivation of these plants for their CBD is a violation of narcotic law. 64 Varieties of plant cultivated to increase CBD yields remain under regulatory assessment and, as such, cannot yet be freely cultivated. 64 The declared content of CBD in some products, however, may be variable and may be reported inaccurately, or not accurately measured. In these products, levels of THC may also exceed the legal limit. 7 In a study carried out in the Netherlands, 26/46 samples of CBD oil tested were found to contain more than the accepted 1% THC, with one sample containing over 57%. Additionally, in 18 of the samples, CBD was barely present at all, with the predominant ingredient being virtually only THC. 64 Products of this nature are, therefore, seemingly not always produced as per regulations and quality controlled as those for approved medicinal use, meaning caution must be exercised. Unregulated products of this nature may also be contaminated with potentially harmful products including those added to improve yield, weight, or potency (pesticides, synthetic cannabinoids, metal particles, bacteria, etc.). 64 Chemicals used to purify CBD for cosmetic-based products, for instance, may also be left behind during the purification process and may result in the presence of toxic solvents in the final CBD preparation. 64