Terry Maguire considers the onslaught of information and claims about the supposed benefits of CBD products
Over the 35 years of my career, it has been a cherished wish that the public generally, and pharmacy colleagues specifically, would eventually become enlightened to, if not dependent on, the validity and superiority of science in decision-making, particularly in the choice of medicinal treatments we endorse and use. Sadly, that cherished wish remains unfulfilled and was painfully dashed when I attended the UK Pharmacy Show in the NEC Birmingham at the start of October.
Twenty-three stands featured CBD oil products and it seems pharmacists are being: Educated, coerced, bullied or brainwashed (not sure which) into the ideological belief that CBD is, must be, has to be, the panacea mankind has been seeking since we climbed down from the trees onto the Savannahs of Africa. The commitment to this ideology from venture capitalists is, to say the least, impressive. Not since the infancy of e-cigarettes has venture capital splashed out so much on glitzy stands at the Pharmacy Show. This year, there was only one vaping stand.
I picked a CDB stand at random, and when I asked what I thought to be fairly innocuous questions, I was assigned to Joe as he, I was told, was the most knowledgeable and would be better qualified to deal with me. He was currently writing a book for the company on CBD and has a first-class degree in English. Firstly, he assured me his company was an ethical company — unlike some competitors at the show, he intimated — an assurance I found naïve. He referred me to studies listed online on a website ‘NCBI project cannabis’ and this was set up, he informed me, to advise government, as he felt government really had failed to keep up with all the exciting scientific findings about CBD.
My questions, I told him, were on three issues: The quality, safety and efficacy of CDB products and he wanted first to talk about safety, as he knew something about CBD safety and he quoted a paper published by the UK government that he claimed confirmed CDB products are completely safe, absolutely. I knew this very study, I told him, and he was perhaps exaggerating the study claims. It was designed to confirm that by manipulating CDB oil either in vivo or in vitro, consumers could not easily convert some CBD (the safe molecule) into some THC (delta 9 tetra-hydrocannabinoid) (the dope molecule) no matter how they tried. In this context, CBD was safe. Yet we agreed that on the whole, CBD was probably not a dangerous product.
My questions, I told him, were on three issues: The quality, safety and efficacy of CBD products and he wanted first to talk about safety, as he knew something about CDB safety, and he quoted a paper published by the UK government that he claimed confirmed CDB products are completely safe, absolutely…
Efficacy was a difficult issue to discuss, he told me, as his company cannot make medical claims for their CBD products — yet. This was in contrast to the billboard advertisement currently across Belfast reading: ‘ANXIETY? CBD oil’, or ‘PAIN? CBD oil’, or even ‘INSOMNIA? CBD oil’. No doubt legal advice has assured such advertisements comply with the law.
Joe could quote scores of papers that show efficacy across a range of conditions. The products he sold were licensed as foods, which restricted what he could say, but CBD works. Such as? Well, Dravet syndrome (a rare form of epilepsy) he offered, and confirmed that a medical product will soon get a marketing licence. I told him I didn’t see many such patients in my pharmacy and if I did, I might be reluctant to treat. Had he nothing more, well, common? Eczema is a good example where CDB oil is very effective as it has both antibacterial and anti-inflammatory effects. CBD oil is infused into a cream and I could recommend this to my customers, so long as I don’t claim it works. I asked about the cream formulation and if the cream itself might be the active agent, but he dismissed this out of hand.
We then talked about quality. How did I know that the CBD oil he was selling contained the stated percentage of CBD (1%, 5% or 10%) and he told me all product quality was verified by an independent laboratory, so no worries here. I noted that the label of the CBD oil he sold stated 15ml containing 10,000mg and a direction to use two drops up to three times daily, along with a warning not to use more than 200mg per day. If a drop — a drop is 0.6ml — one drop contains a massive 400mg. He didn’t want to comment on this and would come back to me. I enquired what oil the CBD was contained in and he told me it was coconut oil. He seemed unaware that coconut oil would be solid at room temperature and when I pointed this out, again, he told me he would come back. It turns out, and both of us should have known, that CBD oil is hemp oil as that’s where it comes from — the hemp plant.
His boss was now hanging over us and it was clear he was uncomfortable. He mentioned to Joe that he had an “appointment”, and his appointment had arrived. Joe thanked me for the insightful conversation and he promised he would come back. Unsurprisingly, he never did. I think his boss knew that I was unlikely to be the kind of pharmacist who would stock CBD oils, creams, facial washes and, oh yes, suppositories. Perhaps five years from now, I will read again this column and think how stupid and wrong I was about CBD.