As officials clamp down on hundreds of products, including a brand backed by David Beckham, the future could be changing for cannabidiol CBD (cannabidiol) has become a trend before scientists have even fully figured out how it works with our bodies. What will that mean for its future medical use and perception?
Is CBD a miracle cure or snake oil?
They call it the “green rush”. When 23-year-old Jonny Alberto co-founded his CBD company, The Good Level, last year, he joined a flow of fortune seekers who had built a £690 million market – the biggest in Europe, and worth more than that of Vitamin C and D supplements combined. But as with the original gold rush, as deposits were depleted and workers disappointed, it is crunch time for CBD.
If you are unfamiliar with CBD (cannabidiol), you need only look on high street shelves, where it is sold in countless formats: oils, liquids for e-cigarettes, sprays, supplements, shampoos, skincare, gummy bears, chewing gum, tampons and even dog chews. Holland and Barrett alone stocks more than 200 CBD lines, from £1.99 for a can of CBD-infused juice to £99.99 for 30ml of premium CBD oil.
CBD is one of more than 100 compounds found in the hemp plant. Unlike THC – Tetrahydro-cannabinol – it is legal in the UK, and doesn’t have psychoactive effects, so it won’t get you “high”.
Puffed up by endorsements from celebrities including Anthony Joshua, Claudia Winkleman and David Beckham (who bought a five per cent stake in the company Cellular Goods), CBD rapidly rose in popularity following the legalisation of medicinal cannabis in 2018.
Customers come to Alberto’s shop in west London to buy CBD oils and balms they hope will solve sleeplessness, anxiety or chronic pain. But if they ask Alberto what CBD does, he’s not allowed to tell them. “It’s tough. We don’t recommend doses anymore, and making medical claims is not something we’re allowed to do.”
CBD is what the Government labels a “novel food”, meaning it has no history of consumption before 1997 (even if some experts argue otherwise). It’s not a medicine, owing to a paucity of clinical evidence, and it cannot be marketed with health claims – but Alberto says some sellers get around this by saying “it may help, or has a possibility to help” with certain conditions.
Now The Food Standards Agency (FSA) has begun to regulate the market and has published a list of sanctioned CBD products that “have a credible application for authorisation”. They have been assessed based on scientific information including compositional data and a toxicology report. More than 900 applications were submitted, but only “around 70” made the cut. Those that didn’t succeed lacked credible information or did not submit it in time. Products not on the list – including those from Beckham-backed Cellular Goods – must be removed from sale.
A report from Emily Miles, the FSA’s chief executive, to the board in December 2021 identified the potential for “adverse side effects” from CBD based on a report from the Committee on Toxicity and said “the quality of applications was lower than we anticipated… While we haven’t yet been shown enough evidence to say that CBD is unsafe, nor is there enough evidence to show that it is safe.”
Professor David Nutt is the UK’s foremost expert on neuropsychopharmacology and the author of a new book, Cannabis (Seeing Through the Smoke): The New Science of Cannabis and Your Health. “If you put it to a survey, you’d probably find 50 per cent of people using CBD say it improves their sleep. In my mind, that’s pretty good evidence. But it’s not a clinical trial.” In any case, he insists CBD is “ridiculously safe”.
The lack of clinical trials shouldn’t matter, he argues, as CBD is sold as a health supplement rather than a medicine. “We don’t demand most of the things you buy in food shops to have a pharmaceutical analysis of purity.”
The new legislation has caused problems for entrepreneurs. Tony Calamita, CEO of Love Hemp, has spoken of his struggles to open a bank account in a climate of mistrust for CBD brands. A market that was experiencing double-digit growth has nosedived; share prices for Cellular Goods have tumbled by more than 80 per cent in the past six months.
Yet despite the fact that sellers can’t brag about CBD’s benefits, there is no shortage of anecdotal evidence or users willing to evangelise on its behalf. It is pitched as a panacea for all manner of modern ills, and said to alleviate anxiety, insomnia, inflammation and low mood. Users fervently swear that it treats conditions as varied as arthritis, PTSD and Crohn’s disease.
Over-the-counter CBD is different to medical cannabis, which includes the high-strength CBD legalised for the treatment of certain rare types of childhood epilepsy in 2018.
This is where it gets technical. “What you’re buying over the counter is pure cannabidiol extract,” says Nutt. “There is a difference between cannabidiol which is extracted from the cannabis plant, and cannabidiol which is part of the hemp plant, where you get all the other elements to get what we call the ‘entourage effect’. The former is legal, the latter is controversial. My belief is that the whole plant is better than the pure extract.”
Alberto is one of a handful of sellers making “full spectrum” CBD oil, which contains the other compounds Nutt refers to, but still no more than the legal limit of 0.2 per cent THC. His company is excluded from the FSA’s clampdown on a technicality, as cold-pressed CBD oil is not subject to the same laws as oil extracted by different methods. For businesses and consumers, the rules are hazy.
“CBD sellers are in a double bind… it’s a lose-lose situation for them,” says Nutt. “[The FSA] is looking for reasons not to allow it rather than ways to facilitate it… because it’s got the word ‘can’ in it, ‘can’ is cannabis, and cannabis is dangerous.”
As with any industry, Alberto says there are goodies and baddies. There are cowboys “just trying to make a quick buck”, he says, “and those are the people that the FSA needs to kick out. The good guys in the industry really want the legislation to come in… There are big players on the market who have illegal amounts of THC. The FSA are starting to shut people down – there are a few that have been shut already.”
Research conducted by the Centre for Medicinal Cannabis in 2019 found almost two-thirds of the over-the-counter CBD products analysed contained less than 90 per cent of the CBD advertised on the label, some contained more, and 45 per cent contained illegal levels of THC.
If you look closely, is the over-the-counter CBD market little more than a puff of hot air? Even Nutt admits there is a placebo effect at play. “If you’ve got a little bit of anxiety, maybe 30 milligrams of CBD might have a similar effect as having a drink. It probably isn’t going to work, but who knows? It gives you some moral courage.”
Other experts say no, over-the-counter CBD almost definitely won’t work. “I think it just caught on in the public imagination, despite the fact that we’ve only ever seen therapeutic benefit with very high doses, and they’re still very early trials,” says Lucy Chester of King’s College London’s department for psychosis studies. “If someone finds something they think is working for them, then it works – but there’s just not the evidence behind it.”
Dr Mikael Sodergren, head of Imperial College London’s Medical Cannabis Research Group, has been treating patients with CBD and medical cannabis at his Harley Street practice since it was legalised. The medical CBD prescribed in his clinic, he says, bears no resemblance to “wellness products”, which are of unknown quality.
“The CBD we prescribe as medicine has to undergo GMP [Good Manufacturing Practice] processing and tick all the boxes for the Medicines and Healthcare products Regulatory Agency. Neither of those things are applicable to high street CBD, which is essentially unregulated,” he says. “The third point is that the doses we use medicinally are an order of magnitude higher.” Participants in a study for the efficacy of CBD might be given 600mg in one dose, whereas the FSA (and so CBD brands) suggest no more than 70mg over the course of a day.
Extracting CBD from the hemp plant is an art as well as science, and some variation is natural. “CBD is what we call a ‘dirty drug’ – it affects lots of different receptors, but not the ones you’d think,” Chester says. “One of the reasons CBD research is quite confusing is we’re still not entirely sure how it works.”
If it’s a con, it’s a convincing one. As well as those who say CBD improves their sleep and reduces anxiety, people say it can cause physical healing of biblical proportions. “There was one guy who came in the other day who had had a stroke seven years ago and hadn’t been able to walk properly since,” says Alberto. “And four or five days later he returned and said, ‘I can’t believe it.’ So for those people, it really changes their life.”
Depending on who you ask, CBD is snake oil, a medical miracle, a rip-off or a wonder drug. The watchdog is wary, but CBD has already captured the consumer’s imagination.
Alberto insists CBD will become so widely accepted that it’s as commonplace as echinacea or multivitamins. “In some states in America, people have it in the medicine cabinet, just in case someone’s got a headache or someone’s in pain,” he says. “That’s where it’s going to go in the UK.”
Only time – and, hopefully, research – will tell if his optimism will pay off.
Are we turning CBD into snake oil?
B12 deficiency nearly caused my death in 2015; did you have any idea that’s something to worry about? Like me four years ago, you probably didn’t—and it’s largely due to a fellow known as “ Dr. Feelgood .” This charlatan popularized B12 in the 1960s, administering it in a decidedly not-medical fashion, giving it to those without a deficiency because of the energy boost it offered, often combining it with intoxicants and other substances.
CBD has become a trend before scientists have even fully figured out how it works with our bodies.
This eventually led to it culturally being thought of as a “snake oil,” or basically worthless and unnecessary medicine—which had unfortunate and severe effects on how it’s now treated by the medical community at large. And this happened despite the 1934 Nobel Prize in Medicine being awarded to the man who stopped the formerly frequent deaths of the deficiency, then known as pernicious anemia.
In our culture, we like things simple. Even though B12 deficiency was an extremely common cause of death a mere century ago, doctors are now hardly taught about it; they’re not even taught to screen for it correctly , and often not testing even serum levels unless they see anemia, a late-stage symptom that doesn’t happen in everyone.
Let’s talk about what this means for cannabis. CBD , or cannabidiol, is trendy. So trendy, it’s showing up at dinner parties , high-end juice bars , even Carl’s Jr. —and it’s at risk of falling into the same fate as B12.
The Big Deal
Within each and every one of us is a system of receptors that interact with cannabis, allowing us to experience its pleasurable and therapeutic effects. It’s called the endocannabinoid system , or ECS for short. Yet most doctors haven’t been taught about the endocannabinoid system at all, ever.
Despite the willful ignorance of the medical field in this regard, experts have been studying the ECS for nearly 30 years, understanding that it acts as a balancing force in all of the other bodily systems. Put simply, the ECS is an important biological network that medical professionals have yet to fully understand.
What if the result of CBD-mania could be that the medical prowess of the ECS, and the cannabinoids that interact with it, aren’t ever taken seriously?
Because it interacts with the other bodily systems to help achieve homeostasis (or balance), when the ECS isn’t functioning properly, it may affect the body in a multitude of ways , and often in a severe manner.
This is also why cannabinoids like CBD are such medical powerhouses—because they can help the ECS function when it can’t produce enough endocannabinoids (the cannabinoid-like compounds our body naturally produces) to run properly. Different cannabinoids in cannabis work with the ECS in a multitude of ways, empowering it to aid the cacophony of symptoms that can be caused by ECS imbalance.
The “Dr. Feelgoods” of CBD
By way of its effects on the ECS, CBD is a serious subject, and the way it’s regarded has very real implications. All of us need to start treating it appropriately, but especially medical professionals and those profiting from CBD. Since the passing of the Farm Bill , CBD has completed saturated our culture—and the pyramid schemes, ice cream flavors, and sketchy (untested!) products from random websites are affecting the way CBD is viewed.
The stigma around cannabis has already led to a major bodily system being largely ignored by the people who are responsible for protecting our health. CBD has become a trend before scientists have even fully figured out how it works with our bodies.
In our culture, if people think something is irrelevant, history has shown that it will be treated as so, regardless of overwhelming facts to the contrary. Even though the ECS was discovered in the early 90’s, its relation to a stigmatized plant means that it’s been ignored. Our nation has been swept up in the miraculous power of a cannabinoid without even really knowing what it is, or that there’s many more of them waiting to be studied and benefited from.
CBD has already proven to be an important medicine for serious conditions. But if we keep treating CBD with all the relevance of a fidget spinner, it’s hard to imagine that the dinosaur pace of cannabis science will hasten. This means that the lack of an even rudimentary test for endocannabinoid deficiency or dysfunction will persist, and people will continue to be diagnosed with “incurable” and misunderstood diseases—and still suffer the symptoms .