the antidote · 2020. 2. 20. · acne. insomnia. sex-drive. inflammation. menstrual cramps....
Post on 30-Aug-2020
2 Views
Preview:
TRANSCRIPT
1
contains CBD too, as well as an additional
chemical called tetrahydrocannabinol, or
THC, which gives marijuana its
psychoactive properties. Hemp contains
almost no THC.
CBD does not cause any of the
psychoactive effects associated with
marijuana. Neither hemp nor CBD can
make a user ‘high.’
Is it legal?
The 2018 Farm Bill made it legal for
farmers to grow hemp, although there are
still many regulations and restrictions.
Hemp fibers are used in textiles, paper,
plastics, and other products. Hemp can
also be used for grain. But most hemp is
grown for its flowers which are the source
of CBD. Laws about CBD are confusing and
Cancer. Chronic pain. Epilepsy. Multiple
sclerosis. Stress. Anxiety. Sore muscles.
Acne. Insomnia. Sex-drive. Inflammation.
Menstrual cramps. Arthritis. Depression.
High blood pressure. Alzheimer’s disease.
Parkinson’s disease. Schizophrenia.
Addiction. Diabetes. Irritable bowel
syndrome. Smoking cessation.
These are all conditions that proponents
say can be helped by CBD oil. This product
is surging in popularity and can be
purchased in many forms including pills,
tinctures, skin creams, cosmetics, food,
beverages, powders, massage oils, and
suppositories. There are even products for
pets. But does this “miracle drug” really
work? Is it safe? Here’s what toxicologists
at the Blue Ridge Poison Center want you
to know about CBD.
What is it?
CBD stands for cannabidiol (pronounced
can-uh-bid-EYE-all), a chemical extracted
from the hemp plant. Hemp is very similar
to the marijuana plant. Both fall under the
same plant genus: cannabis. Marijuana
Featured this issue
CBD Oil
National Poisoning
Prevention Week
News and Notes
News & Notes from The Blue Ridge Poison Center February 2020 www.brpc.virginia.edu
THE ANTIDOTE
CBD Oil: What Does a Toxicologist Want You to Know?
BRPC Staff:
Director
Christopher Holstege, MD
Nursing Director
Beth Mehring, MSN
Medical Toxicologists
Andy Baer, MD
Heather Borek, MD
Nathan Charlton, MD
Justin Rizer, MD
Medical Toxicology Fellow
Marissa Kopatic, MD
Jennifer Ross, MD, MPH
Epidemiologist
Saumitra V. Rege, PhD
Poison Specialists
Andre Berkin, BSN, CSPI
Michael Brookshire, BSN, RN
Jenni Goodwin, BSN, CSPI
Jennifer Horn, BSN, CSPI
Sue Kell, Ph.D, M.Ed, CSPI
Teresa Kinzie, RN, CSPI
Kathy Mayo, RN, CSPI
Lisa Turner, BSN, RN
Scott Wiley, BSN, CSPI
Steven Yoder, BSN, CSPI
Public Health Educator
Kristin Wenger, MA, BS
Administrative Specialists
Heather Collier
Teresa Dorrier
continued page 2
POISON TRIVIA
Urushiol is the sap produced by all
parts of the poison ivy plant. It may
cause an itchy, blistering rash when
skin is exposed to it. How long can it
remain active on a garden shovel?
A. 3 hours
B. 3 days
C. 1 year Answer on pg. 4
2
vary by state, by locality, and by circumstance. The
FDA has determined that products containing THC or
CBD cannot be sold legally as dietary supplements, nor
can they be sold between states.7 Whether or not
foods and other products to which CBD has been
added can be sold legally within a state depends on
that state’s laws and regulations. Regardless, laws and
regulations seem to be rarely enforced as consumers
can easily purchase CBD products online and almost
any place they buy groceries, medicines, or
supplements.
Does it work?
Researchers have been looking at the possible
therapeutic uses of CBD. The strongest scientific
evidence so far is for its effectiveness in treating two
childhood epilepsy syndromes: Dravet syndrome and
Lennox-Gastaut. In numerous studies, CBD was able to
reduce the number of seizures, and in some cases it
was able to stop them altogether. Recently the FDA
approved the first (and only) prescription CBD
medicine for these conditions, Epidiolex (see below).
There is some evidence that CBD may help with other
conditions, too, particularly chronic pain,
inflammation, anxiety, and insomnia. However, it’s
too soon to say for certain that CBD is effective
therapeutically. Study results are inconclusive. “There
is still a lack of quality studies done on humans, and a
lack of long-term safety data,” says Dr. Heather
Borek, medical toxicologist at the Blue Ridge Poison
Center. What about all the people who claim CBD
helped them? Dr. Borek cautions against relying on
user claims alone that CBD is a “magic bullet” for all of
continued from front— CBD Oil: What Does a Toxicologist Want You to Know?
News and Notes
Coming soon! March 15-21,
2020 is National Poisoning
Prevention Week. The BRPC
will be honoring the week by
inviting all pharmacies to
include a magnet and
information on safe drug
disposal in every prescription filled during the week. If
you are a pharmacist and want to participate, or if you
want to distribute magnets at your school, place of
business, or community, contact Education Coordinator
Kristin Wenger at KLW2S@VIRGINIA.EDU or 434-982-
4386. All supplies are free! You may also order them
directly from our website: www.brpc.virginia.edu.
An FDA ban on flavored
vapes went into effect this
month. The ban aims to
reduce soaring numbers of
teens who are taking up
vaping and becoming
addicted to nicotine, even
when they did not have a prior
cigarette habit. Studies show
that children and teens are attracted to the sweet,
fruity, candy flavors which have been so popular. The
ban, however, has a couple of loopholes. One: the ban
does not apply to tobacco and menthol flavors. Two:
the ban does not apply to disposable, unrefillable
devices. Wasting no time at all, new products have
sprung up and are attracting huge numbers of young
buyers. Leading the way are, among others, Puff Bar
and Hype Bar, which are imported from China. The
new disposable devices a) are cheaper, and b) contain
a higher nicotine concentration than many of the
refillable products they are replacing, such as the
Juul®. Read the article in the New York Times.
3
those health conditions: “Such claims are compelling,
but do not tell the whole story. Did a person’s health
condition improve because of the CBD, or was it
something else? Was it a placebo effect? Would the
condition have improved on its own even without the
CBD? Does the person making the claim have a
financial stake in CBD products? Only careful, peer-
reviewed research can give us reliable answers.”
Other questions that can only be answered by more
scientific research include:
Is it safe for children? Senior adults? People with
pre-existing health conditions?
What is an effective dose?
Can you overdose on CBD?
What are the possible side effects?
CBD can be ingested, absorbed through the skin,
vaped, smoked, and chewed as a gum. Do these
methods all affect the body the same way?
What are the long-term effects of using CBD?
What other medications or products react poorly
with CBD?
Is CBD addictive?
Can users develop a tolerance to CBD? Will they
experience withdrawal?
Note that at this time, non-prescription CBD products
are not approved by FDA for the diagnosis, cure,
mitigation, treatment, or prevention of any disease.5
From pg. 2— CBD Oil: What Does a Toxicologist Want You to Know?
What could be the harm in trying it?
This is also difficult to answer without more studies.
CBD products are not regulated. There is no oversight
from the U.S. Food and Drug Administration (FDA)
assuring that these products contain what they
advertise on the label. Several studies have
performed laboratory testing on random selections of
products purchased both online and in person.
Results showed that at least half of the time, the
concentration of CBD found in a product was much
higher or lower than the label said.4,5 Surprisingly,
some samples were found to contain THC, the active
compound in marijuana. This could lead to users
experiencing unintended changes in mood, thought,
or behavior; suffering injuries; or even failing urine
drug screens.
Studies have also found that CBD products may be
contaminated with harmful substances.4,5
Contaminants may include things that were added
illicitly to increase the amount, weight, or potency of
a product so it can be sold for more money.
Contaminants may also include substances like
pesticides, heavy metals such as lead and arsenic,
molds, or bacteria which find their way into the
product during poor production practices.
Are there any side effects?
Side effects of CBD have been reported and include
nausea, fatigue, diarrhea, weight changes, and
Side by side: hemp (far left)
and marijuana (immediate left).
Taxonomically, the two are the
same species of cannabis, but
have been bred selectively into
separate varieties which
contain different amounts of
cannabidiol and other
chemicals.
Hemp. (Image: U.S. Fish and Wildlife) Marijuana. (Image: NIDA)
4
irritability.1,2 Some have experienced health effects
serious enough to require hospitalization. It is not
clear whether the side effects were from the CBD or
from contaminants in the product.
The drug may interact with some over-the-counter
(OTC) aids, dietary supplements, and CBD prescription
medications, especially those that warn against
consuming grapefruit. CBD may also disrupt an
enzyme called cytochrome P450 complex. This
disruption can affect the liver's ability to break down
toxins, increasing the risk of liver toxicity.2
According to the American Association of Poison
Control Centers (AAPCC), poison centers nationwide
have seen an increase in calls about CBD cases, up
from 3 in 2014 to 1,526 in 2019.6
Bottom Line:
CBD has been shown to help with some forms of
childhood epilepsy.
There may be other health benefits as well, but
there may also be some risks. More research is
needed.
Since CBD products are unregulated, there is no
way to know for certain what the purity or
concentration of a particular product is, regardless
of what its label says. (Note: this does not apply to
the prescription drug Epidiolex which is highly
regulated.)
From pg. 3— CBD Oil: What Does a Toxicologist Want You to Know?
This free, quarterly newsletter is courtesy of the Blue Ridge Poison Center, serving Southwestern and Central Virginia and
the Shenandoah Valley. We encourage you to print, post, forward, or share in any way. Questions or comments? Contact
Kristin Wenger, Health Educator, Blue Ridge Poison Center, University of Virginia Health: 434-982-4386 or
klw2s@virginia.edu.
POISON TRIVIA ANSWER: C) Handling contaminated items has been known to cause rashes up to a year later. It is im-
portant to wash any tools, clothing, or other objects that may have touched poison ivy to remove the oil.
Dr. Borek advises anyone who wishes to try CBD to
first discuss it with their primary health care
provider, taking care to list all their other
medications and supplements so that known drug
interactions can be avoided. If any unexpected
symptoms arise, they should report them and seek
medical advice. Users may also contact the Blue
Ridge Poison Center for help: 1-800-222-1222.
Poison Safety Tips & More! www.brpc.virginia.edu @blueridgepoison Find us on Facebook
SOURCES:
1. Hazekamp A. The Trouble with CBD Oil. Med Cannabis Canna-
binoids 2018;1:65–72. (DOI:10.1159/000489287).
2. Johnson J. (April 29, 2017). Everything You Need to Know
About CBD Oil. Medical News Today.
https://www.medicalnewstoday.com/articles/317221#what_is
_cbd_oil.
3. Greenspoon, P. (August 27, 2019). Cannabidiol (CBD): What We
Know and What We Don’t. Harvard Health Publishing.
https://www.health.harvard.edu/blog/cannabidiol-cbd-what-
we-know-and-what-we-dont-2018082414476
4. Hazekamp A, Epifanova S: Grote variatie in samenstelling can-
nabisolie noopt tot regels. Pharmaceutisch Weekblad 2017;
152: 16–18.
5. U.S. Food and Drug Administration. Warning Letters and Test
Results for Cannabidiol-Related Products. (2019).
https://www.fda.gov/news-events/public-health-
focus/warning-letters-and-test-results-cannabidiol-related-
products
6. Cannabidiol. National Poison Data System, American Associa-
tion of Poison Control Centers. (2019). https://aapcc.org/CBD-
Alert
7. Cannabis (Marijuana) and Cannabinoids: What You Need to
Know. Dec. 5, 2019. NCCIH Pub No. D508. National Center for
Complementary and Integrative Health. National Institutes of
Health.
top related