Ask the DOC

It is possible that you may be as in the dark as I was about the many legitimate products derived from the marijuana plant, specifically Cannabis sativa. I knew little about these products until I read a review article on them that was published a few months ago. As you know, this country is in the midst of an opioid use epidemic, which has taken a great toll on our society in the last few years. Therefore, the medical community has been looking for alternate treatments for chronic pain, multiple sclerosis, and other disorders and conditions. One area of promise is medical marijuana and other compounds derived from the cannabis plant. These products include hemp and cannabidiol (CBD) oil. CBD and hemp oils have become popular because of their low tetrahydrocannabinol (THC) content, resulting in medical benefits without the “high” of marijuana (THC is the psychoactive compound in marijuana).

Cannabis sativa has been used across the world for its therapeutic properties, from pain relief to the treatment of epilepsy. Hemp seed oils come from the plant’s seeds. They are high in Omega-6 and Omega-3 fatty acids, linolenic acid, and other nutritious antioxidants. Hemp seed oil contains no THC. Hemp and CBD oils come from the flowers and leaves of the hemp plant. They contain very low levels of THC but higher levels of CBD, phytocannabinoids and terpenoids, and have many medicinal uses.

Recently, the FDA approved the first CBD drug, Epidiolex, which is used to treat intractable seizures due to epilepsy. Cannabis oils are derived from the flowers and leaves of the marijuana plant. They contain mostly THC with low levels of CBD and are used medicinally for pain relief, sleep aid, stress reduction, and other uses. Products may be labeled as “full-spectrum” formulas, dietary supplements, hemp oils, and CBD-enriched products and come in many forms including oils, balms, sprays, foodstuffs like gummy bears, capsules, and even chew toys for pets. Recent research has found phytocannabinoids and terpenoids in other foods like carrots, cloves, black pepper, ginseng, and echinacea.

If you choose to use these products, selecting a high-quality one is important. However, because they are not regulated by the FDA, there can be great variations in their contents and amounts of ingredients. In addition, there are state to state variations in their legality and availability. The FDA deems these products to be herbal supplements akin to food supplements. Therefore, select a product that has the Current Good Manufacturing Practices (CGMP) certification from the U.S. FDA, a European Union (EU), Australian (AUS), or Canadian (CFIA) organic certification, or a National Science Foundation (NSF) international certification. Also, the company’s website should include the following: does it have an independent adverse event reporting program, is the product certified organic or ecofarmed, and has the product been tested by batch to confirm low (<0.3%) THC levels and no pesticides or heavy metals.

To read the full article go to: https://doi.org/10.1016/j.mayocp.2019.01.003 or Mayo Clinic Proceedings, September 2019:94(9):1840-1851

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