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Published: 04 June 2024

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This largely unregulated and highly lauded ‘product’ continues to not only fail to fulfil its promised panacea credentials, but the growing harms of these non-clinically trialled or pharmaceutical grade substances are causing increasing short and long-term harms.

Earlier research that flagged warnings, and even some research two years ago that gave some measure of cautious pass on potential harms of CBD are now being eclipsed by new research. It’s important to watch out for the Placebo effect too, as one may be ‘feeling’ better, but only getting worse on other health metrics. 

Cannabidiol (CBD) Products for Pain: Ineffective, Expensive, and With Potential Harms

Abstract A 2021 International Association for the Study of Pain task force examined the evidence for cannabinoids and pain but found no trials of CBD. Sixteen CBD randomized trials using pharmaceutical-supplied CBD or making preparations from such a source and with pain as an outcome have been published subsequently. The trials were conducted in 12 different pain states, using 3 oral, topical, and buccal/sublingual administration, with CBD doses between 6 and 1,600 mg, and durations of treatment between a single dose and 12 weeks. Fifteen of the 16 showed no benefit of CBD over placebo. Small clinical trials using verified CBD suggest the drug to be largely benign; while large-scale evidence of safety is lacking, there is growing evidence linking CBD to increased rates of serious adverse events and hepatotoxicity. In January 2023, the Food and Drug Administration (FDA) announced that a new regulatory pathway for CBD was needed. Consumers and health care providers should rely on evidence-based sources of information on CBD, not just advertisements. Current evidence is that CBD for pain is expensive, ineffective, and possibly harmful.

There is no good reason for thinking that CBD relieves pain, but there are good reasons for doubting the contents of CBD products in terms of CBD content and purity. 

(Source: The Journal of Pain 2023)

CANNABIDIOL (CBD) – POTENTIAL HARMS, SIDE EFFECTS, AND UNKNOWNS

The use of non-Food and Drug Administration (FDA)-approved cannabidiol, or CBD, has gained attention in recent years, as CBD is becoming increasingly popular and is being marketed for various health conditions.1 A poll of American adults aged 18 years and older found that 14 percent reported using CBD products in 2019, and a similar poll conducted in 2020 found that as many as 1 in 3 adults reported using CBD products.2-3 However, non-FDA-approved, commercial CBD products marketed to the public and available over the counter differ significantly in composition from those used in clinical studies,4 and there is limited evidence to support their safety.5 The public should be aware of the misconceptions surrounding CBD products, as well as the potential harms and risks associated with their use. (Source:  SAMHSA 2023)

Review of the oral toxicity of cannabidiol (CBD) 

A B S T R A C T: Information in the published literature indicates that consumption of CBD can result in developmental and reproductive toxicity and hepatotoxicity outcomes in animal models. The trend of CBD-induced male reproductive toxicity has been observed in phylogenetically disparate organisms, from invertebrates to non-human primates. CBD has also been shown to inhibit various cytochrome P450 enzymes and certain efflux transporters, resulting in the potential for drug-drug interactions and cellular accumulation of xenobiotics that are normally transported out of the cell. The mechanisms of CBD-mediated toxicity are not fully understood, but they may involve disruption of critical metabolic pathways and liver enzyme functions, receptor-specific binding activity, disruption of testosterone steroidogenesis, inhibition of reuptake and degradation of endocannabinoids, and the triggering of oxidative stress. The toxicological profile of CBD raises safety concerns, especially for long term consumption by the general population. (Source: Food & Chemical Toxicology 2023)

Also see: 

• More Warnings on CBD!
• Cannabis & Pain – Media Hype & the Placebo Reality?
• CBD Not Recommended for Pain – Again (The placebo works)
• Cannabis as ‘Medicine?’: Pot Propaganda, Emotive Anecdote, Marketing Manipulation, and the Side Stepping of Science
• Cannabis as Medicine Resource Library: Health Impact

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Published: 29 May 2024

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How has non-medical cannabis legalization served the health and welfare of under-age (adolescent) youth in Canada?

• prevalence of cannabis use (in the past 12-months) among ages 16–19 years increased from 36% in 2018 to 43% in 2023. 
• implementation of cannabis legalization (2018–2019), compared with pre-legalization (2001–2017) was associated with a 31% increased likelihood of any cannabis use, a 40% increased likelihood of daily cannabis use and a 98% increased likelihood of cannabis dependence among Ontario secondary students
• under-age youth in Alberta (<18 years) and Ontario (<19 years), legalization was associated with a 20% increase-equivalent (2015–2019) for emergency department visits involving cannabis-related disorder/poisoning, and there were (moderate) increases in cannabis-related (e.g., for psychosis, poisoning, withdrawal, harmful use) hospitalizations among young individuals (ages 15–24) in Canada's four largest provinces
• remained as the respective relative majorities of enforced cannabis offenses in the post-legalization period. Despite a supposed general ‘ban’ on cannabis-related advertisement especially for youth protection, almost two-thirds (63%) of Canadian adolescents reported exposure to cannabis-related advertisements or promotions in 2023.3
• Half-a-decade into legalization and its consequential ‘normalization’ environment for cannabis, we observe a mixed picture of developments for main outcome indicators among underage/adolescent youth in Canada. While cannabis use rates have remained steady at best at comparably high levels, selected adverse cannabis-related health outcomes (e.g., hospitalizations), and some risk-behaviors have increased. 
• With exposure to cannabis commercialization common, adolescents' cannabis sourcing practices have shifted from predominantly ‘illegal’ to ‘legal’ (albeit so only for adults) and ‘grey’ (e.g., ‘social’) sources. [remember it is illegal for children/youth under the age of 18, (some provinces 19 and 21) to buy or use cannabis] Cannabis-related enforcement has been markedly reduced; however, cannabis (possession) offenses remain disproportionately enforced against underage individuals… [because it is illegal for them to have and use] The—widely promoted—objective of effective cannabis access and use reduction for this particular age group has not been achieved through legalization.

(Source:  The Lancet Regional Health – Americas)

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Published: 22 May 2024

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Incident psychotic experiences following self-reported use of high-potency cannabis

Findings: Use of high-potency cannabis at age 16 or 18 was associated with twice the likelihood of experiencing incident psychotic experiences from age 19–24 

Conclusions: Use of high-potency cannabis appears to be associated with increased likelihood of psychotic experiences.

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Published: 13 May 2024

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Psychosis is an increasing risk of today's strong marijuana.

KEY POINTS

• Young adults and teens can develop an addiction to weed and become psychotic.
• Many people don’t know that regular marijuana use may carry serious health risks, especially for the young.
• No medication is FDA-approved for treating cannabis use disorder.
• One cannabis-induced psychotic episode ups the risk of developing bipolar disorder or schizophrenia by 50%.
• Cannabis use disorder (CUD) is also increasing; in 2022, 5.7 million people met diagnostic criteria for this disorder.

(Source: Psychology Today April 2024)