Ugh...discouraging argument, Sir.
Somehow, your conclusion is that CBD must be a placebo without offering any substantial evidence toward this argument besides that you ate some
Gummies on a trip to Oregon and didn’t feel a thing.
Indeed, a burgeoning new industry with such market potential will become infested with knockoff, cheap, or lesser quality offerings. But let us not dismiss the profound healing potential available in CBD.
I am a CBD enthusiast, daily user, and advocate of this medicine for wellness. I struggle with anxiety and stress (stay at home mom plus full time college student=stress!) There is a profound difference in my emotional wellbeing on a day I consume CBD and when I do not.
Our society could really use more mental health practitioners who support non-toxic, plant based medicines that work.
34
The FDA regularly approves drugs but only barely perform better than the placebo. The good doctor would have us believe that the placebo effect is worthless; but if he prescribes Zoloft to his patients, he is making his money peddling the placebo effect. When will big pharma and their spokespeople accept that we can not blindly trust them anymore? ...Particularly regarding ANYTHING have to do with the cannabis plant!!
23
This psychiatrist takes on an authority in which he appears, he hasn’t done his research. Ourbodies produce cbd naturally ( or cannabanoids). The endocancanabanoid system is a system in our bodies that regulates homeostatis, inflammation, immune function, neurotransmitters, blood pressure response, endocrine levels and the list goes on and on. Cb1 receptors are primarily found in the brain and cb2 receptors are primarily found in the immune system. Cb1 and 2 receptors have been identified throughout the body .When the body becomes stressed and overburdened naturally occurring cbd is diminished creating imbalances leading to pain, anxiety, insomnia etc. Plant cbd administration( like from cbd oil) restores the endocanabanoid system to normal levels producing balance in the body. It doesn’t work for everyone because not everyone has an imbalance in their endocannabanoid system.
Many well respected nutritional companies that have been in business for over 50 years have just brought their own version of cbd to the marketplace. Not because it’s a fad, but because there has not been one singular nutritional supplement In many years that has yielded amazing positive effects and is supported by scientific studies. These high grade products contain ZERO THC ( psychoactive ingredient that will get u high). Quality is everything and efficacy is determined by quality. This is no different than buying a car. Do your research. Every car is not the same as every cbd oil is not the same.
12
No one knows yet if CBD is really useful or not, most of the evidence is anecdotal. Let people use it that want to and continue some more studies. BUT KEEP THE HANDS OF THE FEDERAL GOVERNMENT OFF OF IT. There are too any government entities making too much money off of keeping any marijuana derivatives illegal.
13
My patients used to swear that spraying WD-40 on their joints gave them complete pain relief.
21
Religion, the concept of making America great again and Brexit are all massively promoted products based on no evidence whatsoever. Yet millions of otherwise sensible folk subscribe to their ideasand ignore the consequences..
There is a reason for the old adage, "Fools rush in. . . . "
16
The scientific research is so out of step with what the users of cannabis and CBD have years of first hand knowledge on. Marijuana and CBD are medicine, and they work.
20
I have been using cbd oil for the passed year for my moms arthritis and it has changed our life! Topikal CBD in Tarzana california has been our life changers. We use their 1500mg oil on a daily basis and I praise that every day because before I found them I was not able to go anywhere with my mom due to her severe pain. She tried taking pills and that made her worse. Thanks to cbd she is now able to live a better quality life. I also use it for my panic attacks and I am so thankful for what it has done to me!!
15
As a scientist and experimenter myself, I was at first skeptical about cannabis extracts and CBD. However, since it’s been legal in CA, it is easy to find just about any cannabis product one wants. Personally, I stopped drinking alcohol about 2 years ago and feel MUCH better, and I was down to only one beer/week toward the end. Wine to me is gross and makes me feel awful. Contrarily, THC extracts in cannabis oils makes me feel great, relieving insomnia, regulating my appetite, and putting me in a generally much better mood with zero side effects. I can also titrate my own dose - just a few drops of oil taken orally every few days is perfect for me. When I want to have a great time, I have a gelcap I can take that is 1;1 THC/CBD, which seems to produce a much more intense high than THC alone.
There are doctors already extensively researching cannabis products (especially in Israel but also here in CA) to treat cancers, autism, PTSD, and general anxiety with great success (though for cancer it depends on the type). Humans have co-evolved with cannabis over 000’s of years; we are finally reconnecting with an important part of our existence after a few centuries of absence based on ignorance and hysteria. Thank goodness!!
24
As someone who has helped research and develop successful medical products, I always favor ongoing research into efficacy and safety. That said, this apologetic statement by the author "the paucity of data about CBD’s efficacy and safety in part reflects the federal government’s irrational restrictions on cannabis research." is the real issue. He suggests we wait another decade to use a natural product despite 10,000 years of human use. It is known to giving relief to many suffering patients.
Open use now protects citizens from over-zealous laws that were partly the result of government repression of research. If controlled studies later show problems, we can then regulate, but meanwhile, let people try if they choose. Do we let people use pot products but NOT CBD's?
19
I have some sympathy for the arguments of this author, primarily that cannabis ought not to be Schedule I and should be researched. However, I don't think cannabis is safe for children and adolescents and when is its use most likely to start? There is plenty of evidence that heavy use of marijuana is not so good for brain development. On the other hand, I have heard much testimony that marijuana, THC, and cannabidiol have medical uses. Decriminalization, yes. Legalization, no. We need more information. Decriminalization means we don't punish people for using it. Legalization is more of an endorsement. Our country endorses alcohol all too much given its devastating impact on its inhabitants. Let's not make the same mistake with marijuana and its derivatives.
8
I have Parkinsons Disease, diagonsed 4 years ago, I am in stage II and have trouble staying asleep in addition to all the other goodies that are part of this disease. I only take 500 to 750 mg of Levodopa/Carbidopa a day (except when I have a social event, then I take 1250 mg) but have settled on a combination of 5 drops CBD at night along with one and a half marijuana brownies that I make.
I tend to wake up a bit sleepy but manage at least 5 hours of uninterrupted sleep a night (I was only able to sleep one and a half hours straight - it was awful) AND THE BEST PART OF ALL, my hand / arm tremors are basically under control for most of the following day and my walking is less stiff, the effect starts to wear off around 5 PM, some 20 hours after ingesting the CBD and THC combination. It also seems to have some positive effect on anxiety and depression which are a part of PD, I don't need to take anti-depressants yet like many other of my PD companions.
I had some friends try the marijuana brownies as a sleeping aid but for some reason it doesn't seem to work as well with normal folks, apparently it only works with the weird ones like myself.
My 2 bits. For me it has given me hope.
32
@JJ Gregg - Clarification: I take the CBD and THC combination at night but not as a replacement for traditional Parkinson's Disease medication, it reduces the amount of PD medicine needed. I have a friend with PD (for 5 years) who takes 2500 mg of Levodopa along with another medicine 3 times a day and anti-depressants, these medicines are scary, the side-effects can be surprising, I feel better now that I have reduced the dosages, I have less occurrence of standing vertigo, common with PD and augmented by PD medication.
15
It is unclear what the point of Richard Friedman's article is.
He cites many examples to say that there are not sufficient scientific studies/evidence of claims for CBD. However, this does not mean CBD is unsafe or lacks efficacy. It actually means that either: (1) CBD may be safe AND efficacious... or (2) it may be (either) safe and/or efficacious... or (3) it may be neither safe nor efficacious. Basically... he says the paucity of research results means WE KNOW LITTLE about CBD. We don't know if it's good or bad or neutral - because there are not enough studies done yet.
However, his final point then puts forward his opinion that CBD is more like an expensive placebo (i.e. it is safe but ineffective).
How can he say that? I am neither for or against CBD... it is not something important for me (it is not something I want or revile).
However, this article basically says "we don't know much about CBD" but then he concludes it's a "placebo". Huh???
This is a problematic unscientific article. I question his scientific training (in statistical/evidence-based decision-making).
42
Dr. Friedman,
Here is a link to a study entitled "A Cross-Sectional Study of Cannabidiol Users," by Jamie Corroon and Joy A. Phillips
https://www.researchgate.net/publication/326335727_A_Cross-Sectional_Study_of_Cannabidiol_Users. It was published in a journal entitled Cannabis and Cannabinoid Research, The study protocol was submitted electronically to the Institutional Review Board (IRB) of San Diego State University. It was an Internet study of 2409 people.
Conclusion
The use of CBD among individuals for both specific health conditions and general health and well-being is widespread. The results of this study demonstrate that individuals are learning about CBD from the internet, friends, or family members, rather than from healthcare professionals. CBD is being used as a specific therapy for a number of diverse medical conditions—particularly pain and inflammatory disorders, in addition to anxiety, depression, and sleep disorders. A large percentage of respondents indicate that CBD treats their condition(s) effectively in the absence of conventional medicine and with nonserious adverse effects.
CBD is most assuredly not a placebo.
113
@Bruce Sterman I hope you realize that one of the reason cross-sectional studies, such as the one you link to, are not persuasive of medical benefits on their own is that they can't distinguish between a therapeutic effect and a placebo effect. Indeed, that's why the actual language you quote doesn't make any medical claims. It says that patients SAY CBD works for them. Just as they say when given placebos.
45
@Edward Swing Yes but don't miss the point that tens of thousands of people are trying and using CBD and the information is primarily from the internet not healthcare professionals.
Healthcare professionals have made it clear that they think this is all hocus pocus silly nonprofessional seekers.The bad part is the government will now get involved and like everything they touch proper studies will never be done and all sorts of ridiculous regulations will be instituted.
15
Dr. Friedman, here is the link to the CBD World Health Organization report published in May 2018.
https://www.who.int/medicines/access/controlled-substances/WHOCBDReportMay2018-2.pdf
Here is a quote from pg. 18 under the heading Other indications:
There is also evidence that CBD may be a useful treatment for a number of other medical conditions. However, this research is considerably less advanced than for treatment of epilepsy. For most indications, there is only pre-clinical evidence, while for some there is a combination of pre-clinical and limited clinical evidence. The range of conditions for which CBD has been assessed is diverse, consistent with its neuroprotective, antiepileptic, hypoxia-ischemia, anxiolytic, antipsychotic, analgesic, anti-inflammatory, anti-asthmatic, and antitumor properties. [39, 53, 71] The evidence for some of these indications was recently reviewed by Pisanti et al.,.[72]. May I suggest you take the time to read it?
11
I'm not buying it. I've been using the CBD oil I bought for my dog as his life was winding down and the pain of arthritis was making the last months of his life miserable. I didn't notice any improvement in his mobility or energy after placing a dozen or more drops on the biscuits I gave him daily. When I finally had to let him go, I had a substantial amount of the oil left over so I thought I'd try it on myself. I've been taking it daily in the intervening months and have notice no change in the chronic back and ankle pain from years of hard active living. I keep hoping it'll work but the skeptic in me knows it won't. In the beginning I'd hoped it would help my dog. There was little chance it would make things worse. But for me, it's been a big zero.
8
Then why SHOULDN'T the FDA and the DEA look at the last line of this piece, "but at present CBD looks more like an expensive placebo than a panacea.", and remove marijuana as a schedule 1 drug, research it, and regulate it so if there REALLY are medicinal effects found that help people, they can be discovered and used?
Or, does big pharma not like the idea, so it will be quelled?
4
Rule one in medicine: if there are multiple treatment options, then none of them clearly work.
Rule two in medicine: if a treatment is touted to work for more than one malady, it's bogus.
Therefore, the idea that CBD fixes everything is clearly a scam.
There will something else next month. There are a lot of rubes out there.
7
Did you make up those rules? Because that is simply not true.
16
As Director of Education for a well-respected botanical medicine company, CBD is not merely 'an expensive placebo,' when one considers the appropriate research and cold facts.
In response to Dr. Friedman's short-sighted account, several corrections are in store: 1) Hemp is officially defined by the FDA as 'cannabis and derivatives of cannabis with extremely low concentrations of...THC.' In other words, cannabis and hemp are not two different plants as your writing implies, but one in the same, i.e. they both refer to the plant Cannabis sativum; 2) CBD is no longer classified by the DEA as a Schedule I drug; The Agriculture Improvement Act of 2018 (otherwise known as the Farm Bill and just signed into law) nullified that; 3) the biological activities of CBD, consistently demonstrated in various clinical studies which led to the approval of the epilepsy drug Epidiolex, would NOT be found in the myriad retail "CBD" products now resting on health food store shelves. Most of those so-called CBD products are made from the seed (oil) and stalks of the plant, which contain NO CBD whatsoever. The bioactive constituent CBD is found only in the plant's leaf and flower. Now that the FDA has released an official statement regarding its position on CBD, its primary focus will be identifying and pulling from the market all of those products that are so egregiously misbranded (i.e. mislabeled).
Before calling wolf the next time, please review and/or contact the proper resources. Thank you.
22
I have to say, I'm a bit surprised by the article. I thought the author was going to say we need to de-classify marijuana as a narcotic so that scientists could do the badly needed research, and the public could get badly needed information and medical relief. The government lies about the harmful effects of pot and the pot industry benefits by making outlandish claims about its benefits. The public is left in the lurch of ignorance and self-experimentation.
Pain is not all the same and people are not all the same. Furthermore, there are so many other active ingredients in the cream, such as menthol, that I wonder whether which one is actually responsible for the relief for those whom it works for. We need the research to learn what kinds of pain it works for, how much is needed, how frequently it's needed, and what the best mode of application is. Is smoking, eating, or topical the best? And when you look at all the side effects of synthetic prescription drugs, not the least of which is impoverishment (synthetic drugs prices are exponentially more expensive), can you really blame people for romanticizing natural pharmaceuticals?
While it's all well and good to be more skeptical of CBD, it's just as well to be skeptical of the pharmaceutical establishment, both in industry and academia, and their anti-pot propaganda.
9
Look to Israel. They’ve been doing this research for 20 years. The information is there.
8
I have had severe ocular migraines since adolescence, the only cure is a dark room and days of rest. I was prescribed Imitrex and other drugs with no positive effects. This past spring I took CBD immediately after feeling a migraine aura, 20 minutes later I was almost without symptoms, that is not a placebo. I have never had that kind of comeback from a migraine!
25
Has it continued to work for you in that same way?
1
Our daughter gave us some CBD salve for Christmas. We're experimenting with it. I wouldn't have gone out to buy it for $40, but now that we have it, we can give it a try for whatever seems appropriate. I suggest, after reading these interesting comments, that giving it as a gift can be a benefit for people with all kinds of issues.
7
OK, let's call this "Doc Friedman's CBD Challenge." Go to a weed shop. Purchase a 1 fluid ounce bottle of Charlotte's Web maximum strength hemp extract (60 mg/serving). Theoretically, it takes 300 mg to impact anxiety. Wash down 600 mg with a few alcoholic beverages and the next morning you make the call: placebo or full body high?
1
What’s the point of the alcohol?
7
Yes it's a fad, but it's not a placebo--this stuff does seem to be an effective anti-seizure med (as Dr. Friedman acknowledges), so it's doing something consequential to the brain.
9
I began using CBD oil sublingually in September. The neuropathy in my feet disappeared in about 6 weeks. CBD oil with THC will make you high. In my very red state of Texas, THC can only be found in your neighbors sock drawer. Purchase high quality CBD at a compounding pharmacy such as People’s.
Incidentally, my dog injured his shoulder while running last month. My vet suggested all kinds of $$$$ tests. I decided to put CBD oil on his food. Problem is gone.
9
It appears that experiences of the past decade have changed NIH's ideas about both opiods and CBD. You can't make this stuff up - but you can find it by putting 'NIH on CBD' into a search engine.
Oddly, the concluding line of a 2008 NIH study, entitled "Cannabinoids in the management of difficult to treat pain" states:
" ...the future for cannabinoid therapeutics appears very bright, indeed."
It also encourages "...the complementary mechanisms and advantages of their combination with opioid therapy..."
and cites ABC News, USA Today as it's number 1 reference!
Oops, scratch all that - the author was employed by GW Pharmaceuticals...
Once upon a time, we could trust peer-reviewed journals to embrace a more scientific attitude, an author who was an actual scientist, and conflict of interest included being on the payroll of the subject being studied. No wonder we are susceptible to anecdotal evidence and don't trust doctors.
6
A few years ago here in NY state, they banned fracking because they couldn't be sure it was safe for the environment and people in general. Seems like a good idea; don't start doing something unless you know it's safe. But now, those same people who were against fracking are all in a panic to legalize marijuana, and CBD. Where's the skepticism? Do we know these drugs are safe? Are they effective? Certainly, if we legalize marijuana, it's only a matter of time before someone who's high on pot while driving kills someone. It's already happened even when pot is illegal. Are we sure CBD won't worsen someone's schizophrenia? Are we sure it won't worsen someone's depression? I agree with Dr. Friedman, treat a drug like a drug, whether it's a "natural" drug or man-made. Don't put something in your body that you don't understand.
48
@Dave CBD cannot be any worse than the "safe drugs" that Big Pharma pushes through the FDA and then have to be yanked off the market because of deadly side effects (the drug testing is financed by the Companies, that is why the FDA employees in that division aren't included in the current government shutdown - they are basically paid by the drug companies).
16
I’m laughing!!! Saying it’s a matter of time before someone who’s high kills someone in a traffic accident? Do you have any idea how many people are killed by drunk drivers? 29 people a day.
25
The article forgot to mention the results of NIH studies. Nothing from the NIH says it's just placebo. Nothing from anyone supports his conclusion of it being placebo.
Anyway, the CBD crowd does not trust psychiatrists. They get kickbacks and push drugs that have really bad side effects. CBD is an escape from the side effects of other drugs. Some people feel sicker with the prescribed medications.
8
I tried various CBD products for about three months, hoping it would relieve pain and help me sleep better. It did neither. I did wake up stoned a few times in the middle of the night, which was not the effect I wanted. Moreover, one CBD laced candy bar cost me $20. All in all, I spent maybe $300 on this little experiment.
3
@MsB - I tried it for $35.
2
A good broad spectrum CBD oil reduces pain, spasticity, and muscle cramps from MS dramatically. It does so with less liver/kidney strain, and much less mental diminishment than prescription drugs. The only negative is that you do need one to two days a week off to keep efficacy high. CBD is expensive to use regularly because it's not covered by insurance, that's proof of it's efficacy.
11
I've never experienced any analgesic effect from CBD. THC works well for pain relief (nerve damage & osteoarthritis), and the higher the THC level the greater the relief but the trade-off, of course, is the intoxicating effect. I've been legally using cannabis medicinally since January, 2000; that's just under 7,000 days so, at two doses (joints) a day, I've partaken almost 14,000 times and I consider myself experienced enough to chime in on this. I've used high-THC, low-CBD strains and I've tried low-THC, high-CBD strains many times. The cannabis was always via the Federal government or from federally-licensed producers so I trust the stated THC and CBD analysis printed on the product label. I once told my doctor that THC does the job fine, but probably so would a daily bottle of vodka. Perhaps, he replied, but correctly noted that I'd probably be dead by now from cirrhosis of the liver whereas THC has no such effect. I'll stick with cannabis.
12
I think we need to compare results from CBD made from hemp and the CBD that has traces of THC in it. I tried CBD made from hemp for my Fibromyalgia pain and it did nothing. I would love to try the THC variety but it is not legal in my state. I am on many chronic pain management sites and those who can legally get the THC variety experience real pain relief vs those who have tried the hemp version who seem to get little relief or none at all.
8
you know what else helps anxiety, depression, and inflammation? a very healthy diet and regular exercise.
6
@AC - Absolutely but even people who do all those things can still end up with conditions like arthritis or insomnia.
11
My brother uses CBD for his arthritic hip. He sleeps better and is a much nicer person because he's not it pain. He didn't change anything in his life except for starting CBD tincture.
I spent $250,000 of my own money trying to figure out what caused me 18 years of consistent stomach pain along with the inability to get enough nutrients from food, being chronically underweight, and deep fatigue. Specialists from around the world, diets and every medicine under the sun did nothing. And my insurance wouldn't pay for any of it even though I was basically disabled.
A close friend suggested Marijuana. I have used it for 6 years now. I have energy, can eat just about everything, and as of my last visit to my doctor, slightly overweight!
17
I have Rheumatoid Arthritis and have had injuries to my lumbar spine that have contributed to three surgeries. Over the years I have been prescribed every pain med, anti-inflammatory, muscle relaxant, and procedures from chiropractic to epidurals and steroid injections, acupuncture, etc. with all the ensuing side effects and little lasting relief. I take weekly methotrexate and every six weeks an IV infusion of a biologic for the RA. And I still had a hard time sleeping thru the night due to pain.
I started CBD oil just about a week ago. (I’m still debating whether to seek a script for medical marijuana). I have stopped taking Tylenol or Aleve at night and have slept, yes, slept, thru the entire night without waking up with pain or
tossing and turning to ease the pain in my joints.
Anecdotal, yes. Placebo effect,
perhaps. You know what? I don’t care. If I can get the pain free sleep I need, I’m thrilled.
26
I've read a lot about placebos and I'm a dedicated CBD user, so there are my bona fides and biases. For migraine and nausea, there's nothing better than smoking CBD - goes instantly to those pesky pain and nausea receptors and blocks them nicely. I can't recommend it highly enough for those specific issues.
I live in Oregon where weed is legal, and I smoke a number of strains. CBD is not what you want for insomnia, in my experience; a good indica will do the trick.
11
So- you think it's a placebo, Mr. Psychiatrist?
Do you know what that means, neurally? We hope so. Are you, as the Hippocratic Oath seeking to "use treatment to help the sick" ?
In grad school, I was deeply disturbed when I heard a lecture at the Mayo Clinic from an "eminent" medical researcher of some other institution, on the efficacy of Vitamin C in treating colds; i.e. rhinoviruses. A major subject in 1972.
He went through all the studies; 96% of which were (are) deeply compromised in some fashion and inconclusive; then gleefully bragged about "enlightening" one of his patients, who was- at the time- experiencing considerable relief from Vitamin C. "Vitamin C doesn't do anything for you- we know it!" (we didn't, still don't)
So. The patient had a medication that was bringing relief. And the physician - took it away; giving her nothing to replace it.
Explain to me how this is "good medical practice."
I agree entirely that scientifically we need to know what is a placebo, and what isn't- but it is part of the placebo effect that IT WORKS. Sometimes, for some people. For variable lengths of time.
Are you here to relieve pain? Or- display your ego?
22
If one is in great pain, making life nearly unbearable, I say pour it into your tea and rub it all over your body!...and check the research later!
125
@AAL
Hey, fella: try arnica. It actually works for many aches and pains.
5
@AAL - And "Vegamite" is even more effective.
1
My wife suffers from functional neurological/conversion disorder and functional motor disorder. She has periodic walking/gait issues and is prone to pseudo seizures. She was unable to look at a tv or computer screen without a pseudo seizure event. She was prescribed benzodiazepines for over ten years with little to no effect on her issues. The side effects were beginning to take a toll on her memory, mental and physical health. We tried cbd/thc at a 1:1 ratio in both oil and gummy form. The subsequent improvement in her abilities is remarkable. She still suffers occasional setbacks but her overall quality of life has improved immensely. The episodes now are minor in comparison. For the last year we have been incrementally weaning her off the benzodiazepines. The side effects of withdrawal have been minimized here as well.
That’s all the proof that we need!
14
The last paragraph of Dr. Friedman's article is not supported by the preceding paragraphs. Why would the Times even publish this?
5
I have inflammatory arthritis in my fingers. I take Celebrex which takes the edge off considerably. But from time-to-time one or two of the fingers will flare up with pain. I apply a roll on CBD oil and the pain is gone within minutes. It will stay away for hours, sometime the remainder of the day. I’ve been using this CBD product for a few years as needed, which isn’t every day, sometimes only a few times a month when the flare up gets past the Celebrex. It works. I’ve heard many similar stories about a variety of problems. It won’t be the cure all, but it can provide amazing results for some people and some problems. Go for it
10
You don’t need a weatherman to know which way the wind blows.
10
This guy writes an article with the least amount of research and his own personal experience from long ago. It is a terrible opinion piece that sounds like fluff. Any child can google more info than you presented in this article. Also CBD does work for my chronic pain where as other drugs and hospitals let me down for years. Also if you take cbd with little to no thx it actually clears your mind up, at least in my case. My sister is a doctor and takes them.
16
Great to hear about your experiences. Everyone has to try these products and see how they work or not with their own body chemistry.
4
That’s why it’s best to grow and make your own cbd oil.
3
There is a difference between plants which have been used for thousands of years (cannabis buds have been discovered among grave goods in some of Europe's oldest burials), whose effects have been well known and documented for centuries, and newly-synthesized chemicals which have never been used on human beings and therefore require extensive trials before unleashing them on the populace.
I do not need a scientist to "inform" me that I do not experience that which I (and legions of others) actually do experience; nor do I need them suggesting that everything needs their blessing before I can use it to alleviate my ills or to improve my health.
Pharmaceutical science lags far behind in many arenas: many drugs on the market today were "discovered" as components in well known natural remedies.
I'm all for scientific research and better understanding of whether, how, and why things work; science has immeasurably improved human life in multiple arenas. Extracting and synthesizing compounds found in some herbs has given doctors a greater measure of quality control and in many cases has resulted in more powerful drugs than could be otherwise obtained. I support this wholeheartedly.
But there is no reason that we have to wait for them to get around to testing the hell out of them before we take advantage of one of the thousands of natural remedies available to us. If it doesn't work, the patient will know soon enough.
11
@Josh Lepsy
Exactly!
3
Isn't this the same psychiatrist who authored this article in the New York Times:
"Marijuana Can Save Lives" By Richard A. Friedman
Feb. 8, 2018
So what is his position on compounds containing both CBD and THC?
6
CBD came to my knowledge only yesterday, the day before I read this article, from my Dog's Vet of all people. My dog is going on 13 years old and I inquired with my Vet about possible medications I could add with my dogs steroids to help with his growing inability to climb stairs and walking. My Vet recommended 2 dog suppliments and then asked me if I'd heard of CBD 'which was still in the experimental stage but had proved successful for some of his clients dogs'. Well, the timing of this story is remarkable, and I'd love to be able to sit down some evening and share some CBD with my beloved dog, J.J. as we're both just 'two old dogs'. However, at this point, I just wouldn't quite feel 'at ease' giving my dog something that's not even being fully tested yet on humans at this stage.
I vape CBD in the crumble form. It seems to easy anxiety and perimopausal mood swings, and produces no unwelcome side effects, for me at least. Your mileage may vary.
I do wonder if CBD derived from sativa (mental) and indica (physical) strains reflect the effects of the flowers.
Also, CBD can be enhanced with terpines from the flower and leaves of the plants, and those terpines enhance the effects of the CBD in an aroma-therapeutic manner. My favorite blend is CBD with Blue Dream terpines, while I find the Jack Herer terpines to be harsh and unpleasant.
Personally, I want to see more research into the entire cannabis plant for medical usage. Mother Nature has given us a valuable gift in this plant.
8
In reading many of these comments, I must ask, how many proponents of CBD oil use oil derived from marijuana plants vs oil from hemp?
From my research, unscientific I will admit, many that use CBD derived from marijuana have much better success than hemp.
Just food for thought, and, if I am wrong, well, convince me.
4
@Dan
The CBD derived from hemp does not have any THC in it, so it will not be effective for pain. THC is only in cannabis. You can buy CBD in an 18:1 or 6:1 CBD to THC ratio, and then the CBD will work. There are probably other ratios available, but these are the two I've used on nerve pain in my back. The 18:1 is very effective and does not affect anything but pain.
4
@DMS Exactly. That is the point. Many are using the CBD extracted from hemp and expect miracles.
3
I am a caretaker at this point in time. My 98 year old Mom has Macular Degeneration and although fully compos mentis, she is now having difficulty in living alone in her NYC apartment. My husband has advanced Alzheimer’s and my Millenial son ( now living with my mother ) is Bipolar and not taking meds. I feel overwhelmed and I HAVE ANXIETY! I often take a dose of CBD oil under my tongue if I awake at 3AM. Whether it is a placebo or not, in about a half hours time, my heart stops racing and I am relaxed enough to get some sleep. I first tried CBD oil when a dear friend had shingles and nothing else could control his intense pain. The CBD was prescribed by his physician and he obtained it at a legal medical marijuana dispensary in NYS.
I have found no side-effects or drawbacks, other than the cost, so I will continue to use CBD as long as it serves its purpose.
13
Dr. Friedman talks about the placebo effect as though it explained away the effectiveness people report from using CBD. But the placebo is the most effective medicine ever invented, useful in curing countless diseases for some who suffer from them, often, in fact, nearly as effective as medicines medical science offers. What other medication can make such a claim?
3
I think it will probably be shown eventually that it is the combination of CBD, THC and many other molecules within the plant such as terpene combinations that is what gives some marijuana medical efficacy. Anecdotally it has been shown that when you isolate just CBD or just THC you do not see the effects of the whole plant. So, the hope is that someday we will have more comprehensive studies which will better illuminate what is really going on when these complex chemicals are combined in various ratios.
From my own experiments with CBD products from a few of the top rated companies, I did not see the same benefits as using the whole plant. Luckily in my state of MA it is much easier to experiment and is now legal to do so. Companies that offer strains with detailed lab analysis such as Ace are what you want to look for, and if growing your own medicine this is critical when evaluating seed sources. From what I can see, unfortunately most dispensaries are only offering the chic, ultra powerful, high THC, "stoner" type, Indica dominant strains so do your homework and find what works for you.
9
If you think it works, it works. Whether it is placebo effect or not is irrelevant.
4
I have tried CBD in an oil base, Argan oil, as well as CBD combined with THC, from Cannabus Indica plants. At least that is what I was told.
I tend to be anxious and the Indica is supposed to be calming whereas the Sativa is stimulating. I really have no idea if any of this information is valid.
What I did notice was that the combo of CBD & THC did put me back to sleep when I took an eyedropper full at 3:00am. I awoke with about the same hangover as benadryl , however, I seem to also suffer from non-alcoholic fatty liver disease and after a couple of days of use I had liver pain that would last for a week or so. I tried this experiment a couple of times with the same result. This scared me off the stuff. Maybe it was the Argan oil, I dunno, but I am sticking with acetaminophen and a half a lorazepam 2 or 3 days a week for insomnia. I feel so much better when I sleep just that extra 2 hours a night. I would love to know if there is a form that would work for me but for now I am staying away from it.
3
If many use CBD with a percentage of THC salve or edibles that they believe lessens the pains of arthritis, helps them sleep, and other symptoms they may have rather than use opiates or other addictive drugs, then go for it.
I too use a salve CBD with a percentage of THC for my arthritic hands, shoulders and knees and it appears to lessen those pains.
The good Dr. Friedman in a way parrots my home state in which the politicians believe that more studies are required to determine efficacy when many of us can attest, albeit unscientifically, that weed works.
So, Doc, you have your opinion, we have ours. Study away. You may come to a scientific conclusion that we are right.
5
CBD works. Taken over a few months and MY back is better. I did the anti-inflammatory for two months and the pain went away and I had to add pills for my stomach. As soon as I stopped with the anti inflammatory the pain returned. CBD for a few months, then stopped...no pain and NO upset stomach. Great stuff.
9
@Mona Houghton
Ditto for me. 18:1 CBD/THC is very effective on nerve pain, even pinched nerves in the back, which can be debilitating.
7
I belong to a Facebook support group for dementia caregivers. CBD oil is constantly recommended for calming dementia behaviors. And it’s amazing how many of the people recommending this are mail-order CBD sellers or run holistic health centers or the like. And god forbid you question the use of CBD; people jump all over you. Thank you for a another look at this. It’s all about money ... and social media is real good at making money for charlatans.
1
@Chris There are many charlatans that peddle questionable CBD products, a fact I will not dispute.
How ever, I don't frequent those peddlers. I have other means of obtaining the products I need-products that are not fake and do work.
7
" as far as I could tell, was a fruit-flavored placebo"
And why did you take it? Was it prescribed for a condition? Was it used under supervision?
Let's not kid ourselves about the lack of research starting with an "opinion" article (it doesn't say "expert" article, does it?) that clearly rises no further than Pot tourism.
It's odd that any loafer can write an op-ed about the lack of controls, regimes, testing ... ad nausea ... and demonstrate such vanity.
2
We desperately need more viable alternatives to prescription pills. The laundry list of negative side effects rattled off at the end of advertisements for the latest pill is almost a form of dark humor.
The recent obituary on Dr. David Duke, the botanist, published by the New York Times was incredibly inspirational and thought-provoking.
There is the "Green Pharmacy" provided by Nature (what's left of it at least), and the Pill Pharmacy pushed by Big Pharma.
This is a nation that uses Round-Up by the millions of gallons each year (which literally causes cancer) to kill "weeds" like dandelions (which Dr. David Duke ate, and have beneficial health properties). We are simply not a very enlightened people, despite the degrees on our walls.
In Big Pharma, it seems that chemical engineers and chemists with little understanding of botany (much less an appreciation), guided by the all-divine bio-statisticians, constantly mix different chemicals together and hope they stumble into a discovery that works, and really don't care about side effects all that much. This is a largely automated, and I would argue, mindless process.
I would bet very few companies employ teams of talented botanists like Dr. David Duke to go out into the field, and investigate and report on findings, to simply discover the cancer drug, like Taxol, that Nature has already made.
I truly believe the cure for every cancer is an active ingredient somewhere in Nature, that simply has to be discovered.
8
One might understand how a piece like this could be written by someone unfamiliar with standards for clinical research. But as Dr. Friedman is apparently well-versed research methodology, I would think he would have used this opinion piece to call for more rigorous studies on CBD and THC to gain more insight into the array of widely reported benefits for cannabis components rather than dwell on "the research isn't there" theme as a means of discounting that body of experience.
8
I have relatively severe arthritis in my lowest thumb joint. A CBD oil has reduced the pain from a 7 to a 2 level. I have also a prescription gel that reduces it from a 7 to a 3. If I use both, the pain goes away entirely.
I'd say it's more than a placebo.
123
@Joe Sabin
I have severe painful arthritis in both thumb joints . Surgery on left thumb joint made pain worse. Considering a CBD oil
Do you rub it on or swallow ?
5
@Pamela it is a topical oil.Verify your source, this is really refined and more potent than some.
3
@Joe Sabin
A pharmaceutical, drug, supplement, intervention, product, device can produce a profound positive or negative clinical response and still act as a placebo.
10
I have used CBD balms for treating pain associated with athletic injuries. It works. It definitely reduced the level of pain. It lasts about four hours. Ibuprofen is more effective for treating pain that is deeper in the body and lasts longer, but it has its own problems like gastric bleeding. CBD for me works best for injuries closer to the skin where it can get to the tissues involved. It works very quickly. I have not tried any ingested CBD.
Pain management is a real problem in this country. CBD gives us another option. Add it to Ibuprofen or Acetaminophen, and the combination could be enough to keep people off of opiods.
Injuries are always best treated with rest. Just leave whatever you hurt alone and let it heal. But sometimes you can't, or the pain makes life extremely difficult.
CBD will not hurt you. It is not toxic. Try it. If it doesn't work, throw it out. A small jar of balm will set you back about $30 to $40. How much does a doctor visit cost? Then, how much do the magic pills they prescribe cost? Doctors always oppose anything that doesn't make them money. That's what many of those studies are for.
252
@Bruce Rozenblit If the NFL would allow CBD and to some extent THC, the need for opioids would diminish. Hooking professional athletes on opioids when it is likely that CBD can help the healing is criminal.
12
Mostly hype. I tried it a couple of times and for a few moments felt a gentle wave of calm sweep over me. Then I discovered listening to Yo Yo Ma playing the Bach cello suites could produce the same effect. Much cheaper.
5
So you tried it and it worked but you’re still calling it “hype”?
2
It is the latest fad. Every conversation with my 85-year-old mother now includes a pitch from her about how wonderful CBD and DC hemp oil are. If I plugged in "glucosamine" and "chondroitin" instead, it would be the same conversation from 5 years ago. Advocates of the latest patent medicine are swayed by the bandwagon effect more than any actual science. In this case, the "marijuana cures everything, dude" crowd also has a stake in the discussion, which has amped up the volume.
43
@John
My 4 decades of experience performing psychiatric consultations on medical & surgical patients in a major teaching hospital contradict your attempt to dismiss medical cannabis as nothing more than a passing fad. Because cannabis has been widely available years before it was legalized for medical use, many patients, desperate when conventional treatments failed, would try cannabis on their own or ask me my opinion about trying it. Their experience has taught me lessons which might not be apparent to you.
I can tell you unequivocally that cannabis is effective for a wide variety of symptoms. To say "Marijuana cures everything" is not accurate, but it is no less misleading than your dismissal of its established benefits. Specifically, it helps many patients reduce the suffering caused by neuropathic pain, nausea (some cancer chemotherapy patients would not be alive today without it!), Crohn's Disease, anxiety, insomnia, Post-Traumatic Stress Disorder, et. al. It is true that many patients need a preparation with some THC (rather than pure CBD) for optimal effect.
John, please leave the practice of medicine to us physicians!
28
Oh, really.
Fine, doc. So tell me:
1. Why’s it work, exactly?
2. What’s your methodology for deciding which patients to try it in?
3. What doesn’t it work in?
4. What are some common side effects? How dangerous are rhey?
5. What’s your documented clinical evidence of efficacy?
Nice try on reasoning by authority; a but of a pity that such reasoning is part of what you’re attacking.
10
@Doctor B
Hey Doc, just gotta point out that your advice to John ("leave the practice of medicine to physicians") directly contradicts your reported experience of learning from your patients.
In the present environment of Big Medicine, we all have to pretty much be our own doctors, and seek consultations but question the authority and wisdom of traditional providers. Then roll the dice, to the degree we can afford to. "Trust us" no longer applies.
12
I use CBD, combined with a small quantity of THC (10mg) and do find that it has similar effects on treating neuralgia, with less side effects. But the effect is small. The best use I've found for it is combining CBD, THC and antiepileptic drugs. Marijuana prolongs the effect of antiepileptic drugs so you can take them at a lower dose and less frequently.
For muscular pain such as post-operative or from an accident, I do not think CBD, even when combined with THC is significantly better than a small dose of opioid.
I do not agree with the author's contention that the absence of evidence, or the inconclusive nature of available scientific evidence in support of CBD's efficacy, means that it has nothing but a placebo effect. Because marijuana was (and still is) illegal, it made it difficult for long term controlled clinical trials to be conducted. We may just see that marijuana and its derivatives like CBD is effective for neuroprotection and preventing degenerative diseases. It may be prescribed in the future preventing Parkinsons or other diseases, just like folate supplements are prescribed to pregnant women.
2
The relentless drive to legalize any form of marijuana is an attempt to breach the legal wall. It is not the government's place to promote anything but sobriety. There are no rational arguments in favor of marijuana use that are legitimate. Even medically approved use is still an attempt to legalize in general. Therefore, even though people may suffer more, or have to obtain it illegally, as always, it must remain illegal, and states must respect the federal laws. I hope the next president will be interested in enforcing them. One thing is certain, anyone who has used marijuana past the age of 21 must recuse themselves from any votes or decisions on the issue.
2
A family member uses CBD drops twice a day for anxiety and swears by it. There are however, many CBD products that provide very little CBD for a lot of money. Do your research and get it from a reputable source that is fairly priced. For anxiety, drops are best taken under the tongue to absorb in a minute or so. It's much less effective getting metabolized through the digestive system.
4
After back surgery, and because I did not want to take the usual opioid pain killers, I took 3 drops of 18:1 CBD + THC oil under my tongue at night and slept like a baby. Without it, I was up 4 or 5 times with pain. I conducted my own test over several nights of trying to sleep without it. I eventually took it during the day as needed and found it had no effect on me except for relieving pain. Even at just 18 parts CBD to 1 part THC, it's effective for nerve pain. Once I was fully recovered, I quit using the drops with no problems whatsoever.
5
As a layperson, my first go-to source for objective data on medical matters is the NIH site.
Here's a rather long article -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569602 -- (much of which was above my medical knowledge) that offers encouraging data on CBD.
However, read the conclusion to the article:
This review could substantiate and expand the findings of Bergamaschi et al. about CBD favorable safety profile.1 Nonetheless, various areas of CBD research should be extended. First, more studies researching CBD side effects after real chronic administration need to be conducted. Many so-called chronic administration studies, cited here were only a couple of weeks long. Second, many trials were conducted with a small number of individuals only. To perform a thorough general safety evaluation, more individuals have to be recruited into future clinical trials. Third, several aspects of a toxicological evaluation of a compound such as genotoxicity studies and research evaluating CBD effect on hormones are still scarce. Especially, chronic studies on CBD effect on, for example, genotoxicity and the immune system are still missing. Last, studies that evaluate whether CBD-drug interactions occur in clinical trials have to be performed.
In conclusion, CBD safety profile is already established in a plethora of ways. However, some knowledge gaps detailed above should be closed by additional clinical trials to have a completely well-tested pharmaceutical compound.
3
There are no standard guidelines for CBD, so depending on the manufacturer, you may get a product with enough CBD oil to actually be effective for pain or you may get it so diluted that it is worthless. CBD oil does work, I know several people who use it for pain control. The issue is the lack of standards and price. A good CBD oil product is not cheap. And forget about trying to grow it yourself to make your own CBD oil because in some states, like mine, still illegal to grow unless you are accepted as a research grower.
3
Dr. Friedman seems to have a wonderful set of credentials in his field. There is one lacking, however. Has the good doctor ever had chronic severe pain? I sincerely doubt it. I am a retired anesthesiologist. What I was taught in med school about pain management had very little to do with the pain I experienced when my back was pretty much crushed. I was paralyzed from the waist down and felt my lower extremities were on fire. Yes, Percodan did help since it would knock me senseless for about 4 hours. Fortunately, I met up with a surgeon who worked out of the box and he got me back to "normal" for the past 35 years (still have back spasms but I am upright and can walk, run and row). However, I have found that CBD, while not a panacea, does help to dull the pain of the spasm episodes and I am opioid free. This is NOT a placebo effect since. I have also used it on my pit bull's ears after he had knee replacement. I used Tramadol for the first post-op week but got him onto CBD cream (do NOT let dogs ingest it) which worked well in his pain management. I'm sure he was not susceptible to a placebo effect. I feel the medical community has all sorts of answers to pain but very few of the clinicians have ever felt REAL pain.
10
I've always wondered how, in evolutionary terms, it came to be that we have naturally occurring cannabinoid (and nicotine) receptors. The benefits of the endorphins is clear, but how did these particular chemicals become adaptive?
1
Dr Friedman, what was the dose of those cbd gummies? Did you try just one, or several over a few days? What issue were you trying to alleviate?
5
It is sad that we don't trust our medical professionals any more for accurate truthful information. Sad but true and we have adequate reasons to not believe them. The author is overtly using fear in this article to keep people in line. He advocates to only trust practitioners such as himself and all else is suspect. He does admit that the lack of tests is a self fulfilling prophecy because they have been restricted from in fact even testing.
I am not an advocate of recreational marijuana but I have seen and experienced the use of both THC and CBD medicines providing great benefits. I used morphine for 9 years for an inoperable back injury and accompanying neuropathy. Two years ago my VA doctor told me that since he was a federal employee he could not suggest CBD oil but I was not constrained from trying it. It's been 2 years since I used any opiate and I can now walk, fish, and visit the mountains. Something I desired to do for so long and couldn't. As a plus most of the severe muscle spasms I suffered with, are gone.
You can wait for the amazing medical tests that will take another 10 years plus another 5 years for the FDA to approve before you try it. I can only say I am very glad I did not wait for a bloated government agency to give me permission to kick opiates.
11
Obviously the gold standard double-blind testing with random assignment to test and control groups using pure tested CBD would give better data. However millions of people using a drug do give useful scientific data on effectiveness and safety even when some of the material sold is fraudulent or mixed with THC or lower dose than advertised. It is just much more difficult to ensure proper analysis and to control for variables, but there is sufficient data to know that CBD is safe and effective for some conditions such as anxiety, and certainly is extremely effective for treating severe epilepsy. Used for chronic pain it's harder to be sure it is not a placebo effect, but the number of people claiming significant pain relief is enough to mandate that a national large scale controlled study should be done.
5
I have used CBD products and in my experience CBD is definitely psychoactive and both habit forming and addicting. I started using it to help with anxiety, which it did for about a week, then the rebound anxiety started. Just like with smoking I would feel super anxious and stressed unless I got the CBD. I had mood swings and was quick to anger which is atypical for me. Quitting was not easy and I experienced slight withdrawal effects, shakes chills sweating. I was very skeptical of the non-psychoactive claim from the get go and experience told me it certainly was. I don’t think it should be regulated but I think people should consider CBD similar to nicotine.
4
A good placebo is perfect. Keep taking it if it works.
4
I had two highly credentialed orthopedic surgeons in Austin, Texas, advise me to take CBD oil when I went to them about my hip arthritis. They must be getting information from somewhere that it helps arthritis and inflammation. I had never heard of CBD until then. I took it and my hip pain was significantly reduced and allowed me to return to the gym within a week, and as an added bonus my anxiety and bouts of depression also disappeared. I've been taking it daily for about 7 weeks and describe it as life-changing. Why would people want to take synthetic drugs with all their harmful side effects when they can take a natural product like CBD oil with no harmful side effects, at least none that research has turned up. I recommend CBD now to family and friends. I take high quality CBD oil, and it's expensive, even at a low to moderate dose ($100 monthly). That's my only complaint.
12
Did you ever think that just be cause it doesn’t work for you doesn’t mean it doesn’t work for others. The implication being we’re all sheep.
4
Smoking pot is the ONLY CURE for INTRACTABLE HICCUPS
3
Big pharma doesn't want patients to be cured, or use products that they don't make. They want sustained cash flow and what patients want is not important. Opiates are dangerous as is obvious. So what are patients to do while waiting for something to treat their pain that won't kill them?
Psychiatrists are legal drug dealers, paid more to prescribe drugs than to listen to their patients. No wonder the author is worried about patients using anything that does not involve them.
The author seems oblivious to the fact that hemp CBD contains less than 0.1% THC. So people who use this product cannot and do not get high or impaired.
But, studies show that CBD combined with THC has a synergistic effect, and is more effective.
And CBD is not addictive, no one has ever died from taking CBD and it is not a cure all.
It is time for the medical profession to wake up and get on board. Psychopharmacology has helped many, and can be used to treat pain, but it is not a cure all, and is not always effective, so does that mean it is only a placebo?
SO WHAT if it is a placebo? It works and that is what we should care about. It works better than anything from the drug industry. And if it doesn't work, a patient won't buy it again.
Patients are not fools. We don't need patriarchal medicine. The doctor does not always know what is best.
7
Healthy skepticism for those of us with serious medical conditions does not mean waiting for the FDA to get on with its clinical trials. It means using our research skills to assess the numerous studies already done, finding the best manufacturer that we can, and introducing CBD in as close as we can get to a single-variable trial, carefully recording results and comparing them against a baseline. It does not mean dropping into a cute little shoppe in Oregon, buying CBD gummie bears at random for no particular condition, and comparing them with THC-rich products. If anyone I know provided me such shoddy evidence as Dr. Friedman I would have to try hard not to look contemptuous and not to say something painfully acidic. He should know better.
17
It's sad that a professor would be so rigid, ill-informed, incurious and hostile towards something that is already helping thousands, but is also in need of more research, development, testing. He should treat, and listen to actual patients. I wouldn't claim CBD to be a miracle cure, but it does make it possible to get relief with significantly less pain medication than without CBD--makes my other pain meds more effective, at a lower dose. Hey, maybe someone should study this! (Having chronic joint pain and neuropathy for nearly two decades, I've tried dozens and dozens of expensive treatments over the years. If in fact this is an "expensive placebo" as he says, it seems very strange that it's the first placebo that worked on me, after dozens of failures.) In the meantime, I'm not going stop using CBD and double my dosage of other pain meds, just because this guy isn't persuaded.
12
The JAMA study cited in the article says the largest group of the 84 samples of CBD products, about 43%, is the group that were underlabeled i.e. had more CBD in them than advertised. That doesn't really support the conclusion that reported effects of CBD are the result of placebo imo.
As far as FDA clinical trials etc., I think most people would agree that large sums of money and rationally self-interested megacorps don't create a great environment for unbiased scientific inquiry
5
I'm baffled by the people in these comments who say that CBD helps them with this or that pain or condition and then insist, "and that's not a placebo effect!" That's the thing about a placebo effect--you don't know it's happening. None of us do. Wouldn't it be more accurate to say, "CBD works for me", period. If it works for you, we don't need to know why, and you don't need to insist that it's the actual properties of the CBD and not a placebo. If you are getting relief in whatever way, great!
14
@Mary Great post! I completely agree about so many folks not understanding the power of the placebo effect, and that the plural of anecdote is not data.
4
CBD helps me sleep and it helps with inflammation. My arthritis is equally as good when I was buying expensive Fish Oil tablets.
3
Recent medical studies unrelated to Cannabis validates the Placebo Effect as therapeutic and efficacious, often with dramatic results medical science can't explain.
Not to say Cannabis is "just" a placebo but even if it is due to the lack of rigorous scientific study, the Placebo Effect alone offers curative benefits that have been documented.
Medical research has focused on Caucasian males almost exclusively. Long-term health surveys of heart disease, hypertension, mental well-being, etc., are gender and race biased. Only recently have population health studies begun to reflect the real world diversity of illness. Until 20 years ago there were no population health surveys of Blacks, Latinx, women or children.
In the Bay Area, with its large Asian population, medical studies confirmed that Asian women have unique health issues, including adverse effects of misdiagnosis and indicated standard treatment.
Placebo effects can be dramatic: numerous studies have shown a difference when, for example, a Black patient is treated by a Black doctor. Likewise for women and other diverse groups. The dark side of medical bias was reflected in the early homophobic discounting of HIV as "Gay Cancer", which retarded prevention and treatment.
Placebo only means we know less than we should. If many find CBD works, even as a placebo, then it belongs in the basket of treatment options whether by prescription or self-medication.
Placebo isn't a pejorative. Nor should CBD be.
9
The cat's out of the bag, so to speak.
Everyday more people come to understand the healing effects of hemp products. Big Pharma and the politicians they own will have a very hard time trying to convince these folks that they are wrong.
But they will try and spend millions to do it. Because that is what they do.
5
For thousands of years mankind has sought a cure all drug. Recently western medicine has discovered cannabis can have an effect (effect, not necessarily cure) on everything from skin rashes to brain cancer. So are many in the medical community calling for more research into the POSSIBILITIES? Some are; but many like Friedman are saying "Now wait a minute!"
After a heart operation my doctor wanted me to take six (!) pills a day. One of them would move my blood pressure from 140 to about 130/90. I told my doctor when I smoke cannabis my blood pressure goes to 100 (!) over 60 (!). He shrugged his shoulders and said it's OK to smoke. He also wanted me on a cholesterol pill even though (I don't eat bread, meat, or cheese) my cholesterol is 70. Yes 70 NOT 170! Seems the medical community for the most part thinks if it's made in a laboratory it's good; if it's natural it doesn't really work. I think just the opposite.
4
I used CBD tinctures for a year, but from the cannabis plant, not industrial hemp, I really can't tell you how good hemp CBD compares. For someone curious as to the effects of CBD I would recommend trying it mixed with thc. You'll notice the high is less euphoric and less paranoid. CBD modulates the receptors which thc activates, changing the effect of thc. I can tell you it doesn't work like a benzo, it's not a body relaxing or stoney effect. It's actually slightly activating and focused. The anti-anxiety quality is real, but maybe not what you would expect. Anxious or self conscious thoughts dissapear, a feeling of being slightly disinhibited. However like i said its not a muscle relaxant. The best information on the subject comes from Ethan Russo who consults for the UK company which was the first to gain permission for a prescription version 1:1 ratio for MS.
4
Ethan Russo runs a biotech company that sells....care to guess?
3
This history of medical research into marijuana and cannabinoids is a history of lies. From the earliest days, the studies have been conducted not to discover objective truth but to support prejudices and pad profits. How long did it take scientists to admit that marijuana did not lead to insanity, as they first argued, or brain damage, or permanent memory loss, as they later argued? Decades. Decades of lies and lengthy prison sentences that disproportionately affected minorities--sentences that partially derived their authority from such bogus studies. When it comes to cannabinoids, there is little reason to trust what "studies" say over what your body tells you. Your body can be wrong, but not as consistently wrong as studies designed to produce a result that defends the interests of power or of pharmaceutical profits.
7
Marijuana can, and does trigger psychosis in many, and there is plenty of data to back that up, as well as the experience inpatient psychiatric providers
2
A few, not many.
3
So let’s sum up, shall we?
A number of folks think CBD helps them—and often, their dog. Who apparently tells them so.
They cannot rely on the quality or dosage of what they’re using. This they airily dismiss, because a) dosages are individual, so who cares, b) sometimes those extras help, c) them dumbo researchers tested it wrong, d) Big Pharma Sabotage.
They have no serious, independent research backing their conclusions. See also BPS, them dumbo researchers, and anyway I feel it works so it does. (note: studies of chemical pathways and dosages do not prove efficacy.)
They Believe that this stuff’s being cooked up by kindly old Ma and Pa Organic Kettle, not a multibillion-dollar Cannabis industry.
They flip out at the suggestion that maybe hold off a little, run some studies, and we’ll see.
Maybe this stuff’s great and I’ll bless it next year—but right now, this looks like quackery and religion.
9
When your arthritic old dog who could barely walk is able to run and play again after taking cbd, that IS them telling you that it’s working.
3
My mother (late 70's) has been using high quality CBD oil orally - under tongue (from MM dispensary) for her arthritis and it's helping immensely! & not placebo effect (she was very skeptical).
In addition, mom burned her hand on Thanksgiving & the burn wasn't healing. It would begin to heal and then crack open. Her doc prescribed a topical but it didn't help. Then her massage therapist gave her a high dose CBD healing cream. She applied it at night and the very next morning the wound had completely closed and scarred. My non-religious mom declared "it's a miracle".
I'm a believer!
10
I had to have 5 operations on triggering in 9 digits in my hands after a car accident. The first three of one to two digits took the normal time of three months to heal and regain full mobility. The last operation was trigger releases on all five digits on my right hand. Recovery was supposed to take longer because of more surgical trauma in a small area.
As soon as the stitches came out and those wounds had healed, I started using a Cbd balm on my right hand, which helped with the pain. I did the usual stretching to loosen up my fingers and was fully recovered in one month. The Cbd balm made this possible and I had my hand back much more quickly than was expected. My doctor was astonished and now suggests the same balm to his patients.
4
Hype? Say that to someone with Parkinson's who it helps. Better yet, tell that to someone with Parkinson's who knows it helps but can't use it because he will fail work related drug tests. I know. . . Science is all about trials and proved efficacy, etc, etc. But for those whose lives are profoundly affected and for whom time feels so short, this is exactly the sort of article that only creates despair
7
Controlled clinical studies of even regular drugs, prescription and over-the-counter, often vary widely in their findings. It's hard to pin down all the variables regarding human subjects' individual physical and even emotional status before and after administering an active chemical agent. We do know digoxin is a potent (cardiac) drug, but then it must be used with great care and patients must be closely monitored for unwanted side effects. Pot (weed) is a great plant and has many uses. Maybe too many! But it should be treated with great respect and given its place as sometimes very helpful, and in some cases very "unhelpful"- drug,and combination in this case of different drugs. What I find even more disturbing are all of the "metabolic boosters" being sold to increase stamina and make you feel "20 years younger".
A diet rich in vitamins and minerals (fresh fruit and vegetables) would "normally" be enough, but pills promising to do "even more" really concern me. I don't want over-regulation, but I do want people to have all the good information available before putting something in- or on- their bodies. False claims have been around for centuries, and good health is the greatest gift you can have. Better than money and fame. Better than blond hair and blue eyes. I sure wish I was healthier than I am. CBD, huh? BTW, will it grow hair..?
3
I am a Stage 3 Colorectal Cancer survivor, almost 13 years out from my initial diagnosis.
I have had to deal with all sorts of ailments, including sometimes excruciating pain as a result of the after effects of my cancer treatments. The doctors basically had to throw the kitchen sink at me in order for me to survive.
After about 5 years of suffering from sometimes debilitating pain in my “nether region”, with no effective relief available from conevntial medicine besides masking it with opioids, I recently tried CBD oil (about 2 weeks ago).
Ever since I started using CBD oil (with a little bit of THCa in it, not enough to make me high), I have had basically zero pain. My opioid use is way down which is fabulous.
I realize that two weeks is not a long enough time to know for sure if CBD oil will be a permanent solution but so far, so good.
I for one am glad that Medical MJ is legal in my home state of California. If it helps some patients, especially with pain, then it should be available to anyone who wants to try it. Also, more research should be conducted without the idiotic restrictions that the federal government puts on it.
8
The issue is not CBDs lack of effect, but the delivery systems don’t promote bioavailability so systemic absorption is low. Adulterated products need to be removed from the market. Are CBDs regulated as a drug or a dietary supplement.
1
What?! Ok, here goes. The lowest bioavailability is in the edibles. It really depends on if you take it on a empty or full stomach and how much is absorbed. It also takes an hour or so to kick in. However, the effects last up to 6 hours, as opposed to smoking which lasts a couple of hours.
Tinctures have the highest rate of bioavailability. You put the dose under your tongue and let it sit there for a minute. The terpines are absorbed by the mucous membranes, bypassing the stomach and going straight to the bloodstream.
Vaping has more bioavailability than smoking but they both have the advantage of going into the bloodstream for an immediate effect, allowing you to adjust your dose accurately.
2
My two cents: CBD is snake oil. Expensive snake oil.
I've tried it for insomnia and noticed little, if any, effect. It has been, in my case, much less effective than either melatonin or valerian, both of which are much, much cheaper and easier to get. With regard to pain relief, I notice no effect whatsoever from CBD. And again, there are numerous clinically proven alternatives that are much cheaper.
This is not to discount the experiences of people who say it helps them. If you're in pain, and you feel like CBD helps, that's your experience. But I would suspect, as Friedman does, that what you're experiencing is a placebo effect, and an expensive one at that.
Paying $45 for a one ounce tincture of CBD, without any guarantee that it actually contains CBD, let alone any scientific proof that it will works, does not seem like a wise choice to me. I did it anyway! But perhaps you can learn from my experience.
9
It is a stunning conclusion, reached by Richard A Friedman, that the positive effects of CBD on millions of users must be imaginary because he has not been able to secure enough research data.
A touch arrogant, don't you think?
By all means, encourage research, though it looks like a bunch of twentysomething kids are way ahead of the pharma-funded lab rats.
We make do with the anecdotal evidence because our research institutions continue to fail us. Then again, who needs them when the preponderance of history cites the benefits of herbal-based medicines.
I am surrounded by friends and acquaintances who praise the benefits of CBD -- intelligent, prosperous, thoughtful people. They are not fad followers. The see cause and effect and reach independent conclusions.
CBD works.
6
And the doc said no such thing.
2
@Robert J. Hawkins I think that you missed the point of the article. The author correctly concludes that there are no controlled studies showing that CBD works for anything except epilepsy. Hence, claims as to its efficacy should be taken with a grain of salt until such evidence arises. Additionally, any drug that users claim have such a wide multitude of effects should be a massive red flag to any potential user - truly effective drugs virtually never do this.
3
Both you are the doctor need to do your research. While there are very few research studies on cbd and cannabis in the US, Israel has been researching both for decades, as have places in Europe. They have solid research that proves that cannabis and cbd are effective medicine. Google is your friend.
As for your statement that one Drug can’t treat as many issues as are claimed, you would be right except for the fact that there are about 100 terpines (chemicals) in cannabis and each one has its own curative effects. So there are 100 different drugs in cannabis, not just one.
Again, google is your friend.
2
Why not just let me grow my own? If the track record of OTC vitamins and herbs are any indication, you're probably not getting what you pay for most of the time.
3
After a recent dinner conversation with Silicon Alley millennials who add CBD oil drops to their morning coffee, rub CBD cream on their sore muscles and treat their anxious pooch with CBD snacks, I decided to give it a try. What did I have to lose? I’m a baby boomer dealing aging parents, quarrelsome siblings, arthritic knees, a tree-damaged house, endless insurance claims and an soul-sapping job search. If it brought calm to the younger generation, could it bring me some relief? Well, it did. Maybe, it’s a placebo. But if it is, it’s an effective one. After putting a few drops of CBD oil behind my tongue, my joints aren’t as creaky and my mind isn’t as jumpy. I can sit down and focus on dealing with my chaotic life. Now I’m thinking of some CBD treats for my arthritic Labrador, so she can play in the water, again.
8
@Louise Witt Good. This placebo effect would have to be on the scale of mass hyposis for it to be real. CBD has been a lifesaver for me - my anxiety and pain are well controlled. Glad you tried it.
3
CBD is a bioactive compound, similar to any other drug, and has multiple biological effects. Short-term safety studies were performed as part of the drug approval process (for certain epilepsies) and indicate a number of mild neurological effects and diarrhea, all of which can be considered minor. It is unclear if these effects are purely short-term or if chronic usage of CBD results in permanent neurological effects. Of greater concern, however, is that it results in elevated transaminase levels in the blood. These effects appear specific to the CBD since the effects on transaminases are greater at higher doses. Typically, elevated transaminase levels indicate liver damage. Since long term safety studies have not been performed, I am not sure that I would want to use CBD on a regular basis until the potential liver damage issue is resolved.
4
Where is the comprehensive, tax-supported NIH report analyzing all credible research and laying out a timetable, plan and budget for feasible government studies and a reasonable policy assuring public safety and continued access to those who are already legally using these products, and believe in their benefits, going forward?
Oh, that's right - it must be hiding behind a paywall, where we mere "patients" are not permitted access. We probably couldn't understand the language, anyway. But we sure can write the checks.
3
Medicinal marijuana is available in many, many states. All products in these stores are regulated for quality and potency. Judging the results from on line sights only, which are not regulated would/should find erratic results.
If we really want to find out the effects, there is now an abundance of regulated products to test.
2
The commenters here are as outraged as if Dr. Friedman had questioned the transgender craze (he did a few years back), and equally off point. He is not saying that CBD is ineffective or dangerous, merely that real research, rather than enthusiastic anecdotes, is badly needed. Breathless claims are made for homeopathy, quinoa, acai, brown rice, green tea, and scores of supplements, all of which have committed boosters but very little scientifically acceptable evidence. In the case of weed, this is due to the disgraceful suppression of research by our government, which should have been overturned decades ago. But the fact remains that there is still very little data, as opposed to anecdotes, upon which to base or test all the health claims for marijuana products.
3
@Jeremy Bounce Rumblethud
I guess it's too much to ask that a NYTimes opinion forum provide in-depth analysis and point the finger at the tax-supported agencies responsible for ensuring public health. If they did that, articles might be equal to the value of the comments we provide here, free of charge!
Where are the editors?
2
@Jeremy Bounce Rumblethud
No, that's was not what he's saying. Read the whole thing. The commenters are correct, it's your interpretation that is not. It would not have been such a disappointing article if he had done so.
1
Have you tried it for pain?
There's even less evidence on the benefit of brushing and flossing teeth, regarding tooth decay and periodontal disease, than CBD. Does Dr. Friedman approach oral hygiene with skepticism? (Because you can't patent brushing and flossing, and it's boring, there's no incentive to research it.)
America, especially in the west, is boom and bust land. That'll scare people always. But take it with a grain of salt - the neon signs will fade, as this becomes normal. Or should I say norml?
2
And yet somehow, googling showed about fifty bazillion.
1
I take 200mg CBD daily. I originally took it for anxiety and while no drug/supplement is a cure-all, keep this in mind, I am almost 63 and my aches and pains have no doubt cleared. The anti-inflammatory benefits of CBD are there for me. You could just tell the author was so excited to throw cold water on anything that might be positive about CBD. It's expensive and maybe he was too stoned with his THC products to know what the CBD gummies might have done to help him and he never mentioned the entourage effect which happens when you take CBD with very low does of THC together. There is too much to discuss here because this opinion piece is not up to the standards of the NYT, let's just say this - Boo to the author
6
I have never used CBD or marijuana or anything substances like that.
It seems some people are helped ; others are not helped and some might be adversely affected.
With ALL drugs that affect mental functioning we need to determine how they work.
It seems too much psychiatry seems to be just blindly prescribing drugs.
For someone with serious mental problems psychiatrists should insist that their patients have a full MEDICAL examination including a screening for inborn errors of metabolism many of which can cause mental symptoms.
A psychiatrist who does not insist on this metabolic investigation BEFORE prescribing drugs is deficient in his responsibility.
1
Like many posters here, you’re confusing cbd and thc. Thc is the psychoactive terpine in cannabis. Cbd itself (which is hemp derived) has no psychoactive properties.
6
@Anita Larson Actually, CBD does have clear neurological effects. Significant side effects of CBD include somnolence, sleep disorders and poor quality sleep, among a host of others.
1
I can only speak from experience....I use two different CBD balms for arthritic wrists/hands, with moderate pain relief. I have used the same balms for back/arm pain from a frozen shoulder with some success, although not as much as would be ideal. We very successfully use bacon flavored CBD oil for our brittany spaniel, who is not a good traveler. It truly seems to reduce the anxiety she normally exhibits during any road trip with us. We got the OK from our vet before giving it a try. Anecdotally, I am hearing of others successfully using oral CBD for pain. With humans there could be a placebo effect, but not with the dog.
1
Future studies may show otherwise, but at present CBD looks more like an expensive placebo than a panacea.
-----------
To be clear, you can't report that there is not enough information to determine its efficacy and then simultaneously decide that it's a placebo. That's not how science works and is shoddy reporting. If there's not enough information, then there's not enough information. Certainly there's a lot of anecdotal information that it might have some certain effects.
7
You attack the article for saying that maybe there’ll be proof but right now there’s not, then turn around and say that there’re guesses it’s good but maybe there’ll be proof later?
Their phrase was “looks like,” by the way. That says probably a placebo, but we don’t know.
Gee whiz. You said EXACTLY the same thing, just drew different conclusions.
2
It’s the high fructose corn syrup of the emerging cannabis industrial complex?
2
What these comments indicate is that many NYT readers who are quick to (correctly) label climate change deniers as science deniers, are equally prone to push science out the window when it suits their own biases.
The article is simply making an argument for the need for good data and science. All of these anecdotal stories do not replace science. Other failures in the pharmaceutical industry do not mean that CND is effective. Good grief...is logic dead?
11
I din’t get it either, or maybe just wish I didn’t. Probably foolish of me, but I had hoped people wouldn’t just be True Believers.
I will say I truly hate the argument about po’ little CBD Industry, up against Big Pharma...as those these guys weren’t raking in billions already, for drugs that have little or no quality control and no real independent research support from outside their industry.
4
As a 12 year veteran in " our" government's war against the cannabis plant, including operating 3 dispensaries in San Diego and co-founding a non profit research group focused on dosing protocols, I find the doctors assertion that the limits on CBD research are only in part the government's fault. To the contrary, the prohibition with the threat of jail and a lack of public fundinghas been a del jure limitation on the pursuit of understanding what this plant can offer.. Full stop.
We have seen and served the broken, sick people subjected to, nay, tortured by, your double blind tested pills. The standard itself comes up wanting in light of the record number of people injured and killed with your pills ( 60k plus with FDA approved opiods).
We are a democratic movement trying to reclaim a plant that has been used for thousands of years in equally grand healing traditions and cultures precisely because your tradition is hurting us. And all you can do is defend incrementalism? The safety profile itself relative to pain pills should be enough to give it a fast track for pain relief.
If you would like more info, visit, www.thecesc.org or read
http://www.positivehealth.com/author/stephen-mccamman
2
That, “nay, tortured by,” was a real gem, and lemme guess your position on the vaccines that have saved hundreds of millions from real misery and damage and death.
2
Among these many comments extolling the benefits of CBD, I don't see even one concerned that Big Tobacco, through Phillip Morris/Altria is buying in to Juul (vaping devices) to gain significant control of the future market. (https://www.msn.com/en-us/finance/companies/altria-doubles-down-on-vice-with-bets-on-vaping-and-marijuana/ar-BBReTgR) Yes, that's right - the same company that hid the known cancerous effects of it's product, and continues to profit hugely from cigarette sales world-wide, wants you to buy their newest pitch and product, trust us, we've learned our lesson. That this company even is allowed to exist and operate freely in the U.S. is indicative of how weak we are as a society to control a rapacious, deadly business. That we aren't even acknowledging this horror is truly surreal.
Why aren't we forcing all the corporate beneficiaries of the rapidly developing CBD/marijuana market to fund independent, (e.g. government controlled) research up front, proving safety & quality control of the products they want to market - never mind efficacy - instead of looking for remedial settlements after the damage is done, as it was with tobacco?
These comments indicate strong consumer demand - the very least responsibility of government should be to ensure product purity and truthful labeling of contents. Then, let doctors and consumers study and decide about efficacy however they wish. Let Big Pharma worry about competing with Big Tobacco - or, heck, just merge.
2
It works. End of story.
3
Faith makes us think and do strange things. Otherwise, no religion on Earth.
3
Currently the clinical studies being performed by Dr. Staci Gruber in the U.S. on the effects of CBD for the treatment of anxiety is mediocre at best. She is testing 1 ml of sublingual cannabidiol tincture (10 mg/ml CBD) administered three times per day for four weeks — as well as a placebo effect trial (phase 2 currently being tested I would assume for somatic analysis). Does anyone know of clinical trials happening in Canada?
Dosing is individual. It depends on every person's endocannibinoid system and absorption metabolism, as well as lifestyle and tolerance/lifetime exposure to thc and CBD. We are all unique individuals. Curious to hear what people have to say about this trial:
https://clinicaltrials.gov/ct2/show/NCT02548559
2
It definitely takes the edge off for me. Get real CBD flowers from a reputable source and not garbage from a gas station
2
I wouldn't think twice about CBD oil, except that my elderly father has begun to suffer very badly from arthritis. It is at some times so painful that he can't dress himself or bend over. His doctor's solution? Prescribe opioids to an 87-year-old man who is looking after his 86-year-old wife, who suffers from dementia. That is just insanity. My dad lives in Florida, a state that legalized medical marijuana, so we looked into that, even though my dad has been a teetotaler all his life - no alcohol, no drugs, not even aspirin. We discovered that even though the people had voted to legalize, the Republican-dominated legislature was trying to make it as difficult as possible to get. Two years after legalization, there are almost no dispensaries in the state, and very few licensed, prescribing physicians. On top of that, the legislature limited access to medical marijuana to people with life-threatening illness, such as HIV and cancer. If you don't have a fatal disease, you can't get it, no matter how debilitating your arthritis is. Out of desperation, he tried CBD oil. At first he said that it didn't do a thing, but after a few weeks of regular use, it seems to be relieving at least some of the pain. He is now managing with a little ibuprofen and some CBD oil. Anecdotal evidence, yes, but it also illustrates some of the obstacles that Republicans have been throwing into the path of dispensing medical marijuana, even when the people of the state have voted to legalize it.
9
If the New York Times was taking medical marijuana seriously it would have hired reporters who are knowledgeable on this subject and committed to this field of research, instead of bringing on a professor of psychiatry (?!?) who *clearly* has no respect for the healing potential this drug brings. Not because he is asking questions about its safety, but because of his approach. His comments here (in particular his claim that consumers want to know exactly what they are getting) reflect an ignorance and a misinformed view about how marijuana works in the first place. He wants CBD to fit neatly into categories of what it will treat -- as if pharmaceutical drugs are that predictable -- and makes comments that subtly mock this as a medicine at all with his "magically cured" phrase. Here's an idea: how about the New York Times apply its serious journalistic standards to this topic and hire cannabis reporters, just like newspapers in Canada did when we went legal.
6
It's hard not to understand skepticism if not cynicism towards the pharmaceutical industry, but for several here, that just as quickly that gets extended to a condemnation of general scientific practices and of course all those "experts" like Dr. Friedman that are in the pocket of big monied interests (sarcasm alert).
I get why it's so hard top separate this from our irrational marijuana policy, but when you try to focus on the topic at hand of the ever-growing CBD industry and the tremendous lack of oversight or research there, the other issues pretty much obscure what Dr. Friedman was hoping to highlight. It would be great if both were resolved soon, but this article looks at a more recent development, one that's far easier to address anytime soon.
Still, for the advocates of marijuana or CBD, if those "long-term clinical trials" do end up showing some negative side effects, does anyone here not see the line of potential lawsuits reaching around the block? Beyond that, what would make me happiest, is one debate about medicine or science without ANY allegorical evidence.
2
it's great to see so many positive stories. like anything that gets such sudden notoriety, every scammer and opportunist on earth will be making fantastic claims and scheming to take advantage of press, popularity and ignorance. especially because the pendulum was pushed so far in the other direction, one has to expect it will swing to extremes before stabilizing at a reasonable place. but that doesn't diminish the true value of the real deal stuff.
for someone close to me who suffers from extreme anxiety, its been a true blessing. although the effectiveness varies with brands and types. other medication has been effective, but with side effects and no idea of real long term effects. (and talk about expensive !!) i am much more skeptical of pharma's solution than of something natural.
2
We need more research. Obviously 8,000 years isn't quite enough.
7
I've got news for you, doc. Since I started putting CBD in my tea at bedtime, I am sleeping great and no more leg cramps. Is it really a placebo? Psychosomatic? Who cares? No hangover-like after effects. Better than Ambien or Benadryl.
5
What is avocado toast? Isn't toast made from bread, not fruit?
3
Oh, just relax! Truly, what’s the bog deal except people getting terrified about a bit of weed!
3
Spent $70 for a tiny vial of CBD oil. At first it had some effect on my chronic insomnia, but that quickly disappeared. I am furious that my backward, anti-small business state of New Hampshire does not allow me to have a medical marijuana card for pain and insomnia without a long wait and red tape. For one thing, the state here is missing a real opportunity for profit and taxation. But our ancient legislators have the idea that approving it means a secret band of hippies will arrive from California to corrupt all our young people (many of whom smoke or use marijuana without the help of hippies, thank you.)
We need a FEDERAL LAW allowing cannabis to be legally sold in all states. It is absolutely ridiculous that I cannot buy marijuana 25 miles from here in Massachusetts because I would be arrested if caught bringing it to New Hampshire. Federal law would enable fair distribution of it and allow for more studies of efficacy and promote regulation for consumers.
New Hampshire also has one of the worst opiate crises in the country and the experts say legalizing it here could potentially really help alleviate that. It falls on the deaf, dumb, blind legislators who refuse to bring our state into the 21st century.
3
This article would be more helpful without the author’s snarky and arrogant tone. One of the reasons doctors have had so much trouble knowing how to deal with CBD and marijuana is that they can’t say, “take two and call me in the morning.” Each strain is different and it affects people differently. That doesn’t mean it’s not helpful. (Acupuncture didn’t work for me but did wonders for my dog’s mobility. That doesn’t mean it “doesn’t work.”)
I take CBD for anxiety and inflammation. A blood test had shown my C-reactive protein levels were high, but a year after taking CBD oil, they had dropped impressively and well within normal ranges. The man who sells it to me (at a mom and pop shop that specializes in reducing waste and offers many products in bulk) told me that he’s heard from customers that you don’t really notice the effects of cbd when you take it—but you definitely do when you don’t.
6
Mr. Richard Friedman, the last sentence of your opinion piece is irresponsible and counter to many of the things that you wrote within it. The placebo or panacea comparison demonstrates how hollow your thinking is about an issue that effects millions of people. By hollow I mean the obvious and cliche´ way you are simplifying and generalizing a massive public health issue in the interest of acquiring readers. You are discussing an alternative to traditional pain management aka opioids, remember the thing that is killing more people than car accidents this year? Does anyone really think that CBD oil fits into one of your rough and ready categories, or does your last sentence reveal some contempt you have for your readership? Do you think we all need to be talked down from thinking CBD oil will save us all from everything?
You pointed out that there is less evidence for the efficacy of CBD because of the Federal governments irrational stance towards it. So with that in mind how do you reach the conclusion that it's an "expensive placebo"? The mounting anecdotal evidence from sufferers of epilepsy drove researchers to engage in the studies that have been conducted which have produced positive results as to CBDs efficacy in treating epilepsy.
Your "Expensive placebo" statement to me is your reaction to the relatively unregulated market for CBD,
We should not let people like you dissuade people that need a non opioid alternative for pain relief from giving it a try.
4
@self
Absolutely correct!
1) The arrogance of doctors has never been subject to influence by non-doctors, especially noncompliant patients. Freidman's "expensive placebo" is better described as an "effective treatment" by hundreds of comments here. How can he possibly presume to know that their experiences are the result of a placebo? Logically, he can't. If it "looks like" that to him, he would do well to reexamine his basic research methodology 101. My professors would have flunked any student coming to that conclusion with this much varied but almost unequivocally positive anecdotal evidence.
2) Misinterpretation of study data and/or results, however, is not limited to professionals - that can be and is done by pretty much anyone. Especially capitalist marketers. So, caveat emptor, as always.
3) "Anecdotal" is not synonymous with "irrelevant"; in fact, first person reports, given by persons without financial or professional interests in the outcome, may be more reliable than large "controlled, double-blind, random, long-term" studies supported by parties seeking to prove/disprove a theory upon which they're seeking to enhance their reputation.
4) NIH spent $140M in research? Are we too stupid to be told what they did and what they concluded? How long did it take to figure out that smoking causes cancer? Have we advanced or have some just become more clever at fleecing the public on behalf of the medical "research"? NIH: great jobs for Ph.D's. but where's the beef?
I don't understand how our brains make this cannabidoid the author calls, "anandamide." Does this mean that our brains are partially made up of cannabis? I thought cannabis is a plant and our brains are animal tissue. I'm afraid that since I have trouble accepting this important part of the article, I also have trouble accepting the rest of the article. Frankly, CBD oil helps me a lot, and so does THC...I live in a civilized state where both are legal. While I welcome a whole lot more research on both CBD and THC, I would prefer more unbiased research than this article shows.
2
There are cannabinoid receptors in our brains and throughout our bodies. Taking cbd and/or cannabis activates these receptors and soothes pain and anxieties.
5
@lynchburglady
While on the macroscopic level, plants and animals appear very different, on the cellular and molecular levels, there are more similarities than differences. This is why plants are so nutritious to us and why plants need decaying animals to thrive. We both evolved from the same ancestral eukaryotes and share many chemical pathways.
2
CBD from a company recommended in a NYT article made me nauseous and headache-y. May be helping my hand.
Why do we not “ demand” safety and efficacy research on “natural products”? Because the legislation know as the Dietary Suppements Health and Education Act of 1994 ( DSHEA 1994) forbids such research. This act was the gift of Senator Orrin Hatchbof Utah to the supplements industry, largely based in Utah. The price of Senator Hatch’s gift is paid by the American people. The Center for Science in the Public Interest (CSPI.org) has been covering this topic for many years. The organization Quackwatch (quackwatch.org) gives much information as well.
5
CDB was recommended for my dog who has severe hip dysplasia. Within 3 days his legs stopped collapsing underneath him and he can walk relatively straight. It is not a panacea, but in this case it has made his quality of life better. Given this is anecdotal evidence, Dr. Friedman may dismiss it. However, it it makes my 13 year old dog feel better, I will use it.
3
This “opinion piece” is just that. There is a conflation of opinion and fact to give a garbled message that can confuse people. Your conclusion is not valid based on “the paucity of data” that you, yourself, claim exists. The question is “does CBD help?” and you include data showing that many online sources are fraudulent. Fraud and CBD efficacy are two different things. You are arguing as a psychiatrist and not a chronic pain specialist. Miss me all the way with your confirmation bias and limited viewpoint.
2
Medicine created from industrial waste could never compete with hemp. So they made all forms of hemp illegal in 1937. Kids found out that marijuana was fun and basically harmless from Jazz musicians. After fifty years of smoking it a new generation of kids rediscovered the medical uses.
Credit Jack Herer's The Emperor Wears No Clothes, first published in 1985 with exposing many of the lies used to suppress marijuana.
https://www.amazon.com/Emperor-Wears-Clothes-Marijuana-Conspiracy/dp/1878125028/ref=sr_1_1?ie=UTF8&qid=1545917886&sr=8-1&keywords=jack+herer+the+emperor+wears+no+clothes
So now we are back to the 1890s when Queen Victoria used cannabis drops as her main analgesic. That's progress?
After seeing my physician for a fairly painful knee injury, he recommended CBD tinctures. I must say the results are great and much preferred to prescription painkillers. What is of concern is the unavoidable bad apples in any business including this one. In addition to recommending CBD he told me about one of the leading companies spiking some of their their CBD products:
https://www.consumerreports.org/marijuana/dangerous-chemicals-found-in-popular-cbd-products-diamond-cbd-5f-adb/
3
I have never used any kind of mood enhancing drugs and am in my eighties. I have arthritis and a friend's gave me half a jar of thc plus cbd cream to use topically and it works. Not suddenly, but after half an hour or so you just notice you aren't aching anymore. People tell me the combo works much better than one or the other. The amount used is way too little too have any systemic impact. Way, way too little, a couple of drops on the end of a finger...
1
Simple-- Legalize, Regulate, Tax, Keep the Corporations OUT!! stephenadairvernon.blogspot.com
2
I don't like CBD. It's the THC that helps with PTSD. CBD seems to block that and it's not a good effect for me.
NB: Trainwreck does not have CBD. It is a pure sativa strain with high amounts of the terpenes associated with concentration and stimulation. It's kinda like a shot of espresso and it will keep me on-task and focused on my work all day. Great for ADD.
You do not adress the terpenes here. Maybe you're not really up.on the latest science?
One problem with doing research on THC vs whole-plant marijuana is that half the effect of an individual strain comes from the terpene content.
So if you study sleep, for example, and your subjects are using pure THC or smoking a sativa like Trainwreck, loaded with stimulant terpenes, you'll find people not sleeping any better. Or maybe, with Trainwreck, staying up all night to clean the closet.
But if you use a Northern Afghan indica strain on your sleep study subjects, with high concentrations of the sedative terpenes, those people are goig to sleep extremely well.
Most medical scientists unfortunately are not up to date enpugh on marijuana science to design their experiments to take into account that strains with the same THC but different terpene content produce different results.
2
Hype is what this article is, it should catch eyeballs.
Big Weed is probably not a good target. I'd suggest a lengthy harang about use of Ketamine for depression. Ketamine is the active ingredient in PCP, angel dust, and Killer Week. It's used licitly as a horse tranquilizer. A horse tranquilizer.
@Real D B Cooper You are parading your ignorance. Ketamine is not the active ingredient in PCP (phencyclidine). It is a dissociative anesthetic, very different from a tranquilizer, and widely used in anesthesia for both humans and animals. It shows very real promise for the treatment of severe depression that has not responded to other drugs.
3
CBD/marijuana may be the best hope yet to break the Big Pharma death grip.
2
I'm all for science and science-based results and recommendations.
However, I have a healthy and growing skepticism about what is called science, when the sponsors of such scientific studies have a stake in the results. I'm not making any specific accusations about CBD research, I'm just saying that while I don't believe that all the claims about CBD are true, nor do I believe that enough unbiased research about CBD has been published.
At the same time, I think it is interesting to note that Altria, a major cigarette industry player, just bought Juul, a major CBD product producer. Either Altria believes there is enough evidence that CBD works, at least for some things, or it is cynically satisfied that any placebo effect is worth the money that is spent to achieve it.
1
@Diane L
Big tobacco and ethics are incompatible. Purveyors of death could care less what "works" - as long as it sells!
CBD certainly has some valid medical applications but the current commercial products need to be regulated so the consumer knows what they are getting. Pain is terrible and its relief should not be ignored, or relief made dependent on being an addict or a criminal. There are probably sincere people making CBD products without a clue about quality control as well as those in it just to make a buck. There is also no standard for dosages as exists in other over-the-counter medications. This will go a long way to combatting the myths about pot for both those in favor and those against.
5
After rubbing my foot (which had been injured a few months ago) with a CBD topical ointment for twenty minutes, I experienced relief from the soreness. I'm going to try WD-40 and see if it's the massage and not the substance that helps. WD-40 is much cheaper.
1
@jbradwell
Your comparative study has as much value as many that cost $140M in taxpayer dollars. Consider publishing the results in the NYTimes.
What is the lab process for CBD extraction and sublimation so that what comes from the plant is now a consumable product? What resources are required, natural and otherwise? What is the ecological footprint of the surge in mass marketing?
And also, what's the research in the EU, UK or Canada? Surely there is science being done in these regions.
3
@NG
Agreed, rather than the musings of one MD with a vested interest in his own profession/approach, an informative article on the actual production and international studies would be infinitely more informative at this point. I found the many detailed and diverse comments moved the needle on my skepticism much more than this author's rambling, superficial and poorly supported dissertation.
Israel has been researching cannabis for decades. Good information there
2
How about the research done in Israel and other countries with modern medicine?
3
Maybe we should put this stuff in the punch at the Republican convention . . . BEFORE the speeches.
2
Ending this article with the JAMA report showing manufacturing inconsistencies and possibly outright fraud, then declaring CBD to be nothing more than a placebo is very misleading. As a professor the writer should know better.
8
Many of the commenters make excellent points I would have made centering on the lhis doctors corporate healthcare bias. Specifically the tactic of knocking TC and CBD for lack of studies. Well study it properly before offering up a conclusion then! This is another "oh please click me" article that regurgitates the same old wishy washy position of most of the medical community. Fortunately it's classified
"opinion" since that is all it is...,
4
Good thing you ran this piece in the Opinion section, rather than as a Science article. Even a cursory (1 minute) online review of the National Institute of Health data reveals a wealth of helpful information about CBD. Dr. Friedman appears to have engaged in a wee bit of cherry-picking when it comes to peer-reviewed studies. Also, his assertion that the "public is quick to demand proof of the safety and efficacy" of ANYTHING is...laughable. Dr. Friedman professes faith in the public's critical thinking skills, and then proceeds to ignore many of the CBD studies already completed. Heal thyself.
3
Wait for the "research" on corporate-driven pharmacueticals? Big pharma's clinical trials are not to be trusted.
https://medium.com/@danwalter/safe-enough-598548095c3b
1
I have tried it and it works. Placebo or not. I certainly prefer it to ibuprofen.
2
Well that was certainly a buzz kill.
1
Doctor, are you putting your DEA registration in danger by admitting in this very public forum that you have bought cannabis?
I would not put it past the feds. Just sayin'.
A fellow doctor.
1
This comment section would be very helpful for anyone studying logical fallacies and conspiratorial thinking. There is nothing controversial about stating there is currently little evidence showing CBD is effective for treating disease. There is also little evidence that it does much harm. Maybe one or both of those will change as more research is conducted.
4
Hey! which 18 had THC?
4
Absurd
Just vote 2020.
Recent medical studies unrelated to Cannabis validates the Placebo Effect as therapeutic and efficacious, often with dramatic results medical science can't explain.
Not to say Cannabis is "just" a placebo but even if it is due to the lack of rigorous scientific study, the Placebo Effect alone offers curative benefits that have been documented.
Medical research has focused on Caucasian males almost exclusively. Long-term health surveys of heart disease, hypertension, mental well-being, etc., are gender and race biased. Only recently have population health studies begun to reflect the real world diversity of illness.
Until 20 years ago there were no population health surveys of Blacks, Latinx, women or children. In the Bay Area, with its large Asian population, medical studies confirmed that Asian women have unique health issues, including adverse effects of misdiagnosis and indicated standard treatment.
Placebo effects can be dramatic: numerous studies have shown a difference when, for example, a Black patient is treated by a Black doctor. Likewise for women and other diverse groups. The dark side of medical bias was reflected in the early homophobic discounting of HIV as "Gay Cancer", which retarded prevention and treatment.
Placebo only means we know less than we should. If many find
CBD works, even as a placebo, then it belongs in the basket of treatment options whether by prescription or self-medication.
Placebo isn't a pejorative. Nor should CBD be.
3
Dr. Friedman,
You need to read the latest research papers on the effect of CBD on eye pressure.
Start here: https://www.sciencedaily.com/releases/2018/12/181217151537.htm
Spoiler alert: CBD can blind.
All you scientific types at the FDA and big pharma think tanks found it preferable to help the Federal and State governments begin and continue a policy of institutional racism and "just say no" to actual research for 80 years and now you sound like "Reefer madness redux" to me. I have no faith either way in your "learned" opinions since they appear to me to have been "purchased" by people with horrible or at best capitalist agendas. You have no idea what "future studies may show" and yet you warn of ill or no effects. Get an education through actual research and until then keep what are only "opinions" to yourself. This is let me remind everyone, in the "opinion" section.
2
Gee. Too bad we don’t have any scientists or agencies that could research and study the issue. How many decades & zillions did we spend on the just plain stupid war on drugs.
2
@Terry
It would be informative to trace the history of the cigarette industry, still allowed to sell products we know are proven harmful, now entering the vaping/CBD/Cannabis field. When will we learn?
1
The fact that so many seem to derive relief using homeopathy--one of the longest-running and most obvious frauds in history--makes me question the effectiveness of CBD as well.
Anything can be a placebo.
4
I tried CBD cream after undergoing radiation treatment for breast cancer. I am usually skeptical about this sort of thing but the cream cleared up the resulting skin issues, including blisters and burns, within a few days. The skin on the treated area is now close to normal and the cream worked better than anything the hospital gave me. I am not sure how it works, but it definitely has amazing skin benefits.
4
Efficacy is enhanced for topiocal application of CBD with the presence of small amounts of THC, in addition to the CBD.
This addition makes the product illegal in states that have not legalized cannabis for medical use.
Medical product with both CBD and THC are available in states where cannabis is legal for medical and / or recreational use.
There is no additional psychoactive affect, just more effective pain relief.
Since we started putting some CBD drops in the dog's food, her arthritis seems to have improved somewhat. I don't think she cares if it's a placebo or not.
7
@Ebble It worked for a friend's dog, too - hard to know if time healed or if it was the CBD oil, but it was a miracle for the dog, who has a new lease on life.
1
Each of us is a big, complex chemistry set and highly individuated in our needs and reactions to foods, medicines, environmental substances and the confusion of advice about them which we may or may not believe.
Nearly eight decades of experience indicate that I am medically & psychologically weird so I have reduced my health strategy to the simple and very effective pursuit of comfort.
My top priority is maintenance of my sense of humor, the punchlines for which are in my mirror. (An angel once told me my distress was due to taking myself seriously. She said, "Just get real and cut it out!" It works.)
When strange symptoms sent me to the ER, a cardio surgeon told me his battery of tests confirmed I'd had a heart attack. I just grinned in doubt and asked how come I didn't feel bad. He was offended and walked away in a huff. He ran a heart catheterization the next day but I never saw him again. Later another doc came in chuckling to tell me, "You are a total anomaly - we can't find anything wrong with you."
I replied, "I am suffering from severe caffeine and nicotine deficiency but I'll fix that as soon as you let me out of here." He laughed & discharged me.
I recovered at home within the hour. My family just shook their heads, as usual.
Go figure.
2
I would take anything a psychiatrist AND director of a drug clinic would say with a big grain of salt. The connections between the two are not indicative of someone like Richard being very objective to say the least.
Secondly, I found two clinical studies within seconds that show much promise for CBD in many applications. The anecdotal evidence is immense.
My take is that this guy is throwing shade on a product that takes money out of his and associates pockets.
5
I have a purely anecdotal testament to CBD's effectiveness, from my barber of over 40 years. He has had serious nerve damage related pain issues for 10 or more years. He has had an endless series of surgical and medical attempts at relieving his agony. He says he hasn't had a full night's sleep in a bed in years (he has to sleep in a special chair/recliner). At my last haircut, he told me he got his hands on some CBD; I didn't ask him in what form. He said it's a "miracle pain reliever" for him. He finally can sleep through the night.
So, there is at least one guy who swears by it. Unfortunately, he has had the same experience with various other methods of pain relief before, only to have them lose their effectiveness over time. I'm not sure that any negative side effects that might be learned would deter him from using anything to get some peace - at least for a while.
When I see him, suddenly my aches and pains are nothing.
3
Hogwash. Friedman contradicts himself left and right. First he says there is research evidence supporting the use of CBD in certain disorders. Then he says there is a paucity of data supporting it's use. Then he says there isn't necessarily even the right amount ofCBD in the CBD you buy. Then he says there is THC which can be even more psychoactive, and finally, he concludes its just a placebo. This is a sloppy article at best, and subpar for the NYTimes. CBD is from experience helpful in managing some symptoms of some medical conditions for some people. It is neither a panacea, a solution to any health problem independent of other treatments nor is it uniformly effective. It may represent an advantage for some compared to opiates, the risks of which clearly exceed those of CBD. Further research might clarify it, but there is little evidence, some of which is cited by Friedman himself, that it is acting as a placebo.
8
Dr. Friedman: CBD works. But it depends on dose and ratio of THC to CBD. 2:1 is the best ratio I have found. 2 parts CBD to one part THC. Frank's Gift, Wedding Cake, Shark Shock are a few strains available her in Oregon which fly off the shelves. Get with the program doc. And, fear not, you'll always have people you can prescribe anti psychotics and benzos to........
6
I'm not conservative and it hasn't worked for me yet. I've been going to CBD parties and dispensaries for years to try out the latest and greatest for myself and my senior dogs. While I would love for CBD to do its magic and reduce our inflammation and joint pain, nothing has as of yet. My dogs still limp, I still limp, and the only thing related to marijuana that reduces any anxiety is good ol' sativa. That said, I'll keep experimenting with CBD until I someday, hopefully find something that works for us.
2
God gave us this plant for a reason. And it wasn't rope.
5
@Billy God gave us everything on this planet and some of it is deadly.
1
One thought on all of the products pouring out of pot research, some are going to be good, many are going to be snake oil, and a few are going to be down right dangerous. Put "Vape" products in the dangerous category. We don't know what is in the oil besides CBD. The lungs are not meant to have poisonous products drawn into them. They are a marvelous organ, self cleaning for the most part, but after 10 - 20 years of abuse, they shutdown the cleaning function and cancer is the result. Do not kid yourself, if you vape anything, you are smoking.
Smoking = Cancer. Is there anything about that you don't understand?
2
Do your research. Vaping is not smoking at all. Vaping heats flower or oil to a temperature that is below combustion. It is combustion (burning) that releases the carcinogenic compounds in tobacco.
You do have combustion if you smoke cannabis but cannabis smoke actually protects the lungs from cancer. As well, very few people actually smoke as much cannabis as they do tobacco so any risk is much lower.
Vaping is considered the best way to consume cannabis. It’s not combustion and since then components go straight to the bloodstream, the effects are immediate so it’s easy to gauge how much you’re taking.
2
@Anita Larson
I will not be able to convince you, but realize that you are betting your life on your beliefs.
For the best information, see https://www.projectcbd.org/
One thing to consider is the actual source of the CBD. Most commercially available cbd extracts come from non-psychoactive industrial hemp, not from strains of high CBD cannabis bred for medicinal purposes. Extracts of whole flowers of high CBD strains is far superior to hemp extracts, and requires a small amount of THC for the best bio-availability, but because of the THC it is not widely available in non-medical states. Buyer beware, and patients, educate yourselves.
3
To the author, and the NY Times: with the latest investigative report by the NY Times on researchers' financial ties to pharmaceutical companies, please provide a disclosure of your financial involvement with the pharmaceutical industry. I am not intending to question your integrity, but I have no insight into your motivations, and a lot of skepticism of any opinions by medical professionals. And, you are not even a researcher on this topic, but you are motivated to write an Opinion piece.
To the NY Times: why aren't you requiring such disclosure now? Read your own investigation.
6
I am a massage therapist and I am experimenting with CBD applied externally as a treatment for trigger points. Some evidence is positive and I don't see much harm from external application.
I am also a recovering pothead and I have known people who used CBD products contaminated with THC and got into considerable trouble.
Given the poverty of the research and the fairly long history of human use of products containing CBD wouldn't it be better if the FDA were to inspect and control the purity and strength of CBD products.
4
@Chris Martin
Keep in mind that Big Tobacco, now heavily investing in the future of CBD/cannabis market, succeeded in transferring their case from DOJ to FDA regulators, after fighting through several administrations. Which should tell you everything you need to know about how effective FDA is in protecting our interests. Nil, in other words.
Tried it once? And now writing a column?
Reefer madness.
I’ve used it twice today, and it’s awesome. No hidden side effects.
4
Big pharma will do all it can to thwart the growth of CBD. As someone who never believed in the hype, I can state without equivocation that CBD saved my life.
Here is my story...
https://www.merryjane.com/health/pascal-pakter-do-or-die-hyperfly-cbd-medical-cannabis-highly-productive
1
I don't have a dog in this fight since I don't currently consume these products, but I am always interested in cultivating critical thinking and freedom of choice. I find this opinion piece remarkably underwhelming. The author sloppily veers from insinuations of the importance of scientific rigor being applied to naturally sourced healing products to a reliance on his own remarkably uncompelling anecdotal evidence that CBD is probably maybe kinda a placebo. Dressing this non-conclusion in a thin negligee of lazy research on mostly irrelevant studies does not make it ready to go out in public. In an article in the New York Times pitched as an answer to a question that's been growing in folks' minds on a pretty important topic for those who may be desperate and in pain – or at the very least genuinely curious – I find this take irresponsible.
Or to put it more succinctly: "fake news."
6
@Ben Thomad
Indeed, one might think that a genuinely unbiased, genuinely curious scientific research project might readily be designed to test the experiences of a variety of folks claiming specific positive impacts. One would think that all the positive anecdotal evidence would lend urgency to the inquiry.
Simply create an actual placebo, indistinguishable in appearance, taste, and smell, for them to substitute for their remedy. If it gives the same result, then there is some basis to suspect that their form of CBD is a placebo. Or that it has worked some permanent magic on them, to the point where they now get the same effect from a placebo.
Until such research is done, we really don't know what's going on, but shouldn't we really, really want to find out?
If you have a sore shoulder and you smear some CBD oil on it and 10 seconds later your shoulder pain is better, the only plausible explanation is placebo response
2
Sell!!! It's the amerikan mantra. CBD? It's available, maybe, for sale. I think I'll get some and be like everyone else. It's a panacea and can cure anything!!!! If the TV and the Internet say it, then it must be true. That number to call again is...
2
I have seen the benefits in a friend for whom I purchased a concentrated tincture. After four months of non-Parkinson's sudden onset idiopathic tremors, there was a response at the four day mark with about 15 mg under the tongue. At the 10 day mark, she was free of the symptoms that 3 neurologists could not treat successfully with a variety of medications. She continues to take 2-3 doses a day to maintain her well being, and has been advised that she could take considerably more before it could possibly interfere with other psychotropic medications she requires daily (per her psychiatrist). It is important to read the label to understand the amount of CBD in the dose, not what is in the package. Try to find products with reputable companies, not over the wannabes. I love gummy bears, but not all CBD gummy bears are the same. Best wishes.
1
So many people touting cannabis benefits with little to no downsides. I don’t understand why they don’t put their energy into getting cannabis (in whatever form) federally approved for recreational use if they think it so safe.
Why are they pushing to get medical approval? That puts lots of time, financial, and legal/liability pressures on our healthcare system.
If certain people think it is so safe, then they should work for recreational availability. That way any and every adult that wants to can take it for whatever illness they think it works for. If it’s not illegal, there’s no shame it taking it for whatever purpose they want.
2
You’re confusing cannabis which contains thc (psychoactive compound) with cbd ( usually from hemp, is not psychoactive).
The U.S. does not test natural products because natural products usually (not always) are not patentable. We are totally business oriented. The business man is what we are about, not the scientist, not the teacher, not the historian, nor social worker, not the doctor, or artist, not even the politician - the greedy business bean counter person is what we are about.
2
If it helps control pain, we should definitely try it, because right now what we're doing to control people's pain is creating thousands of people hooked on heroin, which in turn is why I was at a funeral for a 28-year-old woman. Even if the psychoactive components are present in cannabis-based medications, the worst that happens is that the local convenience store sells out of Doritos, not people dying.
3
Dr. Friedman writess: "The public, rightly, is quick to demand proof of safety and efficacy when it comes to synthetic pharmaceuticals. Why should natural products, like CBD, get a pass?"
This is the same author who wrote a previous NY Times opinion piece whining about the black-box warnings that have to printed on antidepressants and argued these warnings should be removed. Does Richard Friedman really care about the safety of "synthetic pharmaceuticals" like he wants us to think he does? Has he received any money from Big Pharma?
2
Terrible, juvenile article. By calling CBD a placebo you’re doing exactly what you are pining against with the claims of CBD as a miracle worker. Except you’re worse since you frame yourself as the ‘learned’, erudite critic. This article is only one sentence of content, and that is hidden by your ostentatious charlatanism: we don’t know if CBD works as advertised yet.
5
You are wrong Sir!
2
Then do the freakin’ research. Oh wait, no one will pay for it because CBD is available over the counter.
3
Dear Dr. Friedman, we were shocked and saddened to read your glib dismissal opinion piece about CBD. Shocked because you are generally considered a well recognized and thoughtful medical practiontioner who ought not lend your voice to the 'head in the sand' stance taken by so many reactionary adherents to status quo medicine. Saddened because your own psychiatry speciality was derided for decades as nothing more than psycho-sexual talk therapy, but now you denigrate an emerging scientific field with nothing more than your admitted insignificant anecedotal experience. So we offer you the opportunity to participate in a controlled clinical trial of PURE CBD so that you can learn the medical value of a product so non-toxic that it does not need medical experts to prescribe it. While some producers may not yet have reliable, repeatable and consistant dosage forms; our company, Pure Green, provides water-souble, sublingual tablets with proven clinical efficacy to help you and your patients. You and any other medical scientist can contact us and we will include you as investigators in our on-going clinical trials so that you can learn first hand what your patients are learning without you.
Regards,
Stephen Goldner, Esq, R.A.C.
CEO, Pure Green
Inkster Michigan
www.puregreencanna.com
3
Clearly, safety and efficacy are not at the top of the list with traditional pharma products. (See Opiod abuse.) Pharma has lost their credibility. Research is contradictory, studies are supported by those with a financial interest, MDs are bought by the drug companies.
It is all a crap shoot, so why should we be surprised by the quick adoption of another promise to pain free immortality.
2
I see a very strong conflict on interest here. When people, for example, experience drastic reductions in siezures, etc., there is no way we are talking about a "placebo" effect, and to suggest it is simply outrageous. I had a long runniing online debate a few years ago with a psychiatrist who said he saw a lot of problems with mentally unstable kids smoking pot, and therefore it should be kept illegal. Huh? They already have problems, so what is the big deal?
No, the alarmists, like Mr. Friedman, I think, are more concerned with losing their own income than anything else. The long national nightmare that is the war on pot and the war on the American people is coming to an end, and for me, it can't end quick enough. Too many people have been needlessly screwed because of myths and lies.
We promote alcohol abuse to the tune of billions of dollars in ads - for an actually deadly and addictive drug. The social wreckage from alcohol is in the billions too, but we consider this normal. It is the false alarmists like Richard Friedman who need to wake up and get out of the way.
2
I don’t know about CBD for humans, but I give my 12-year-old arthritic lab CBD mobility chews, and it has made a world of difference. He moves so much better and I’ve seen an improvement in his overall tolerance to pain and discomfort. The other day, I ran out, and almost immediately I saw the change. His limping increased and he was less willing to move. The chews I give him were developed by a vet sciences lab in conjunction with Cornell, and were recommended by my vet. Their study showed an 80% improvement in test subjects. Normally, I’m skeptical of treatments I consider “homeopathic” (ok y’all, don’t jump on me!), but I have to say, it’s working for my dog. It’s not cheap, so I wouldn’t keep buying it if I didn’t think it helps.
Considering I have rheumatoid arthritis, I’m looking in to CBD for me too. (I wouldn’t take the dog’s chews though—they smell awful.)
3
help me understand your conclusion that an FDA approval for epilepsy treatment, and a 2017 NAS study concluding insufficient evidence (at worst), supports the conclusion of placebo effect.
once you've done that, you can justify your opinion that, after years of treating cannabis as something down there with heroin and fentanyl, optimism about its medicinal properties is an overreaction and a delusion.
1
Where did that last sentence come from? If there is a lack of regulation and there isn't enough data then we can't know if CBD is a placebo. That's just magical thinking. Here's what I know for a fact: I took Trazadone as a sleeping pill for 30 years, every night. I tried everything to get off Trazadone: progressive relaxation, hypnotism, changing everything in my diet, western herbs, Chinese herbs, melatonin, acupuncture, wearing red goggles before bed and on and on. Nothing worked. For 30 years I woke up every morning with a Trazadone hangover, just glad I was able to sleep at all. And then I tried CBD oil and I'm off Trazadone. It might or might not be helping with my arthritis - I'm not sure. But I am sure that for the first time in 30 years I can fall asleep and wake up refreshed. I've tried a few different brands and they all worked. I believe that there are inconsistencies in content and that more research is needed. But right now I have all the data I need.
5
I have sacroiliac issues. My preventative maintenance includes stretching and exercise. But when it acts up, I use a CBD/THC balm and it really helps. Don't care if it's a placebo effect.
1
I'm also skeptical of CBD, and the paucity of data doesn't help. I've found that our European friends are not nearly as puritanical about research, though, and there isn't exactly an abundance of studies, but there are a fair number that are reasonably compelling that CBD is useful in treating neuropathy and other issues (sometimes, but not always, in conjunction with THC).
This is a somewhat misleading article though, as the NAS paper the author cites states that preliminary evidence exists that CBD might well be helpful for multiple things (in-text citations removed for space):
"[there may be] a potential therapeutic role in pain and inflammation. The antioxidant and anti-inflammatory properties of this compound may explain its potential neuroprotective actions. Irrespective of the mechanism of action, there is evidence that CBD could potentially be exploited in the treatment and symptom relief of various neurological disorders such as epilepsy and seizures, psychosis, anxiety, movement disorders (e.g., Huntington’s disease and amyotrophic lateral sclerosis), and multiple sclerosis."
Yes more data are needed, but the author seems to imply that the panel conclude that there was minimal evidence to support the utility of CBD, but that's not exactly true.
2
Although I found this article to be an interesting and informative read, I question the author’s amount of research. More feedback from actual CBD users would have been constructive. I’m a dual resident of CA and NV & when I head to the dispensaries in both states, I find that each product has been tested by an independant outside lab and comes with a sticker affixed which breaks down all THC/CBD content in easy to read percentages. Never have I encountered anyone who purchased a tested product which was labeled incorrectly. Isn’t this why it became legal and taxed? (35% tax in CA/18% in NV—not cheap!) My Father, 65, is terminally ill and has used both CBD & THC as an effective replacement for his perscribed (Tramadol) synthetic opiods. He had never smoked marijuana before in his entire life. Until gov’t/big pharma is more transparent, I’ll continue to believe in CBD’s medical effectiveness.
4
Total agreement on the authors point that more scientific research of CBD is necessary. However I was disappointed he failed to draw any distinctions between the source of CBD products. Much of what's being commercially sold around the country as CBD oil is crushed seeds from cannabis ruderalis, or hemp, which has no psychoactive properties (low to no THC) as well as low percentages of CBD. Licensed dispensaries sell whole plant cannabis sativa extract with varying ratios of CBD to THC in the form of capsules, tinctures, topicals and edibles. The amounts vary to allow consumers a chance to sample and learn what's the best options for relieving their particular physical pain or emotional distress. CBD may not be the universal silver bullet many believe it to be, but it's also undeniable that more and more people are trying it and finding it's a valid alternative to pharmaceuticals and over the counter pain relievers.
Two things are clear; most folks commenting here (and in the country generally) are:
1) unfamiliar with the "placebo effect", and
2) anecdotes are not evidence.
But hey, why get all sciencey or worry about facts. Not what folks want to hear, apparently.
9
@Homer Then why not try to elevate the conversation, rather than putting down the people who have vested interests? just a non-sciency thought to consider :)
7
Legitimate and peer-reviewed research on cannabinoids is long overdue and the dozens of cannabinoid variants in marijuana need to be analyzed for safety and efficacy. I have no doubt that more useful ones will be found for many applications including plain old recreation. Human beings love a little intoxication from time to time, not to mention safer ways to mitigate pain.
4
About 5 years ago I experienced my first bout with sciatica. I had never experienced muscle/nerve discomfort like it before - and nothing relieved it - Advil, Aleve, Valium, heating pad, hundreds of dollars spent on massage therapy. After 6 months of Physical Therapy, I still had an underlying tightness and the feeling that one wrong move would send me back into a sciatic flare up.
About a year later, that feared flare-up happened and I was back to heating pads, Epsom salt baths, PT, costly massages. Then one night a friend came by with some GrandDaddy Purple Indica Tincture...I took some before bed with an Aleve and the next morning I woke up and it was gone...like completely gone. No residual lurking soreness remained. I couldn't believe it.
I still get the sciatic flare-ups about once a year - I'm not sure what triggers them but instead of being in pain and discomfort for months, I just take some Indica tincture and move on with my life.
5
The constraints on research in the US are delaying work in this country, but there is an emerging body of evidence from Europe and Canada.
Those who are using the inconsistent and untegulated commercial products now available in the US may be exhibiting a healthy skepticism about and frustration with US policies that irrationally stifle bona fide research paths. Perhaps Professor Friedman could use his pundit’s pulpit to address that aspect. He could at least note that the US isn’t the only country that conducts medical research.
https://www.mcgill.ca/newsroom/channels/news/safe-cannabis-pain-relief-without-high-291089
www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
4
What Dr. Friedman ignores is the underlying need, if not desperation, in this country for viable pain management outside the failing medical establishment and hegemony of Big Pharma.
12
It'll be interesting to see how medical marijuana/cannabis develops in the next few years, especially as more opportunity for it to be studied rigorously will occur.
3
I have news for you: products coming from big pharma are not fully tested and many are a detriment to our health.
So please stop claiming that we are safe, thanks to the FDA: it gives the impression that you are in the pocket of big pharma...
7
Still another adjuvant promoted by a billion dollar industry with worthless benefits on a misinformed public. Junk science sold to an unsuspecting public is part of the same Vitamin D, gluten free, organic, non gmo mantra that demands rebuke by well designed studies carried out by responsible scientists.
1
Don’t I read this article or its cousin on a monthly basis? My solution is simple. Every April I buy a clone which soon grows like a weed with little tending :-) The plant provides fresh leaves, then buds for my daily smoothies for several months. The taste is strong and bitter, so you have to play with the ingredients. The costs are obviously minimal and extremely low compared with buying commercial products. Causality is a capricious thing. Am I getting any medicinal value? Who knows?, but if nothing else it is one of the most nutrient-packed greens around, with the bonus of being garden fresh and organic. (I do feed it manure tea)
1
One might say the research has already been done. Millions of people use marijuana and CBD. I don’t see any evidence that they’re going crazy or dropping dead.
A psychiatrist has every motivation to create obstacles or throw cold water on both MJ legalization and CBD effectiveness. They don’t get paid for OTC medicines. Placebo effect, so what? Placebos have been shown to be as effective as many prescription drugs.
4
Friedman couldn't be less logical to argue: "if CBD really had no psychotropic effect at all, it would be hard to understand its popularity." Really? Pain relief w/o psychotropic effects is the holy grail for pharma companies and the definition of a popular drug.
More baffling still is the lede hidden in the article's last sentence: "Future studies may show otherwise, but at present CBD looks more like an expensive placebo than a panacea."
Ironically, Friedman supports his claim not with research but with his personal anecdotal evidence, a one-time purchase from "a few years back": "CBD candy [that] . . . was a fruit-flavored placebo" and by effectively ignoring his own patient's anecdote of the effectiveness of CBD: an educated man "tried mixing CBD oil in his tea, but it didn’t make him calmer. Then he rubbed the oil on his injured knee, and pronounced it a magic cure."
The funny thing about placebos is that they "work" when a patient believes that they'll work, but not when they have direct personal evidence that they don't work (sounds obvious when you say it). Friedman's own patient experienced the failure of the placebo to work for anxiety. At this point, it's not a placebo. He then applied it for pain relief and had a different result. That's no longer a placebo.
And then there's the FDA's own findings: the FDA approved "a CBD concentrate, for two rare and severe forms of epilepsy, ON THE BASIS OF SEVERAL CLINICAL TRIALS.
(That's kind of important)
5
Big Pharma, the group that shells out money for testing of drugs, is never interested in natural medicine or in discovering anything about it. Why? Because Nature cannot be patented.
7
How can that conclusion possibly follow everything else written in the article?
Obviously more research needs to be done before anyone can say whether it's "an expensive placebo" or "panacea" one way or the other.
Also, the inclusion of the word "expensive" in that disconnected conclusion after not a single mention of the cost of the product leads me to believe that the author has some sort of bias.
7
To review: Friedman does not to consult the literature to decide that Trainwreck and 9# Hammer are "as advertised," but he wants pain suffers to wait for research that confirms the relief they feel from using CBD.
That strikes me as arrogant and presumptuous.
3
Dear Dr. Friedman,
All you would have needed is a teenage daughter awash with the symptoms of Tourette's Syndrome, having as a parent exhausted the toolbox all of the finest medical professionals at UCLA had at their disposal for mainstream efforts at cure, then having no other pathway to finding quality of life for your child but to turn to CBD oil (with her doctors' blessings btw) to come to a different opinion. CBD oil saved our daughter's terribly interrupted life. Once essentially unable to access curriculum, now she can read a book, drive a car, and is in her freshman year at college. FACT not HYPE. Work harder.
8
Why all this caution with CBD? Are the problems that much worse than caffeine or nicotine? How about glyphosate or really any organophosphorus pesticides? Or benzene in gasoline? Can you really tell me that CBD is potentially worse than any of these?
But think about the children and be very afraid! You might just be buying from a crook! Could the criminals in this market be there because of the legal doubts cast by our own government? Make it freely legal and the problems you mention go away!
2
Boy, we love our patent medicines, don't we? We just eat up that marketing. Just get up on Saturday, smoke a doob or eat a hash brownie (THC should be heated before ingesting), get some coffee and a light breakfast, read a couple chapters of the book you're reading. Then take a walk, go on a hike, go to the beach, relax, take care of yourself, be here, be healthy.
2
Friedman calls CBD an “expensive placebo”, yet it reduces seizures in serious pediatric epilepsy patients by nearly 50% (FDA trial data, epidiolex). That alone would make it a miracle drug. Does it cure everything? Probably not, but one of the “side effects” documented in the clinical trial was “somnolence”, aka sleepiness. So we now also have clinical data supporting the claims that it is calming or helps with sleep. Serious research into the efficacy of CBD and other minor cannabinoids is just beginning, and I find Friedman’s anecdotal analysis lazy. For example—dosages used in the epidiolex clinical trial are 20-50X higher than the low mg amounts in most consumer products. It’s likely that Friedman’s gummy bears were homeopathic.
3
All I know is that the cannaboid capsules dramatically help with the option in my arthritic knees! I’m a skeptic—just ask my husband!
Lynn
Snake oil is now green.
Without valid research to support these claims; verification of potency stated on labels; and regulation of all health claims based on evidence you can be sure that you are being ripped off by the latest get-rich-quick scheme popular in the U.S.A.
If you can be deceived, you will be –– legally and with no recourse. It's the golden age of snake oil, again. 1905 here we come! (again)
3
Americans are truly naive - willing to be seduced by the latest shiny object, not realizing that it's all only about emptying their wallets to enrich a few people. Only such naive people could have elected the current president they so deserve.
1
Capitalism and medical treatment cannot share the same sentence.
Marijuana and it’s medical uses are a significant threat to today’s drug companies and their bottom line.
Frankly, I do not trust the FDA to weigh in on this with credibility.
1
Israel has done many studies. I tried CBD but didn’t find it helpful. At the time, I contacted a major researcher in Israel. I can’t recall his name but some googling would probably work. Anyway the gentlemen answered my questions quickly and extensively.
1
Calm down, everyone. When our government is certain that marijuana products are generally good for us, they will be legalized and sold. Like cigarettes.
2
Someone please explain how epidiolex was approved by our FDA whilst cannibinoids are still schedule one? How can something illegal be fda approved? Imagine if it takes someone like Trump to reschedule cannabis to a non controlled status like alcohol. Our environment is dying but we would be happily stoned while wearing clothing made of hemp. Trump 2020.
The doctor's opinion piece is not only rife with errors, but he collapses the boundaries of his assertions by conveniently and sloppily trying to use one to prove another.
He does not even mention that the human body has an endocannabinoid system that allows these isomers. He misses that besides these two cannabinoids over 100 others have been identified.
To cite just one specific error of the many he writes, CBD works on the endocannabinoid receptor CB2 rather than the CB1 receptor that THC mostly affects. His comment "Cannabidiol has little direct effect on the cannabinoid receptors in the brain" is completely false and ignoring established science.
Is there hype? Absolutely. But to ignore the many little children whose spasticity has been greatly eased is to ignore the obvious and please let us know how placebo works on a one year old.
So you may focus on the hype or you can look to see where there are real applications and explore the unknown and newly discovered. That is your choice. But if you are going to demonize something with innuendo and false arguments, don't make yourself a public fool in the proess.
8
The cynical dismissive tone by many commentators discrediting CBD help nothing. In fact, a fair number of folks confidently declaring it a 'trend' or snake oil miss the irony of their own claim: one the one hand, insufficient research proves it is useless, rather than suggesting too little is know to make final judgments.
So, how about another bit of unscientific testimony. I use CBD because I have severe arthritic pain in my hands. No 'officially approved' medicine helps, at least not without side effects. Liquid CBD helps. I can open and close my hands with far less pain. Of course, I could be one of those deluded, trend-following hoax victims Dr. Friedman has come to scold. But I can open and close my hands.
3
Dr. Friedman, we have cannabinoid receptors not just in our brains but in every organ of our bodies, including our skin. Why do you think they are there?
And the law allowing researchers to obtain cannabis from other than the poor quality pot at the U. of Mississippi was passed two years ago but it has yet to be implemented.
In every way it can, the government continues to stall on cannabis and to create doubt about its proven effectiveness, as do you. Shame on you both.
You can't make blanket statements.
From the testimonials here, it obviously works, or at least helps, for some people.
Try it if you have a need. It might work for you. Or not.
What's the big deal?
1
I can. not use opioid of any kind and had a knee replacement and did it with CBD and Tylenol.
Still use it in dummies (with THC)) and creams (IRIE 500 mg C
BD the best)
I love the papa Berkeley patches. live in california so totally available.
I am having joint pain and used the CBD to relieve the pain.
IF IT WAS ALL IN MY HEAD that is ok cause It really helps.
It works for me.
Undoubtably conservatives will ruin everything just like they always do.
Get it while you can.
It's not about pleasure.
It's about pain.
Conservatives insist we be in pain. I have Avascular Necrosis. Without CBD, I cannot move. Yesterday, I took a walk around the house. I have not even left the house in ages.
My bones are dying inside my body. I could never even describe the pain.
Today, I am going to make it down the block. I am going to push and push to do it.
My doctors prescribed marinol. It helped. I was in less pain. Cigna, my health insurance company, said no way. They will not pay for pain relief unless it's an opiate.
They will pay for oxycontin but not marinol. And we wonder about hundreds of thousands of opiate deaths.
Marinol is not addictive. No pleasure, Conservatives. Just no pain.
I blame Cigna. Blame whoever you want. I blame Cigna.
One issue is punishment. Conservatives have a burning desire to punish anyone not like them.
Institutional hatred.
One issue is greed. Conservatives own Big Pharma.
They make a boatload of money from selling their outrageous, poisonous opiates. They do not care.
I dare not grow marijuana. North Carolina will put you into prison for twenty years.
Avascular Necrosis in prison. I would hang myself.
Conservatives would laugh to know I am finally dead. It's in my fingers and my knees and my feet and my hips and my shoulders and it makes being alive unbearable.
The only support I get is CDB.
457
Cheers to you!@Tim Barrus
16
@Tim Barrus
Good for you, but you are not a comparative study with placebo.
4
@Tim Barrus I wish you well, Tim, and I wish you could move to California where my neighbors grow their own pot and I'm enjoying a CBD tea right now, all perfectly legal and easy to obtain. Stay strong and positive!
27
I had an extremely painful case of shingles around my rib cage. None of the costly pharmaceuticals helped. CBD taken orally and applied locally stopped the pain. months later, I have post-herpetic neuralgia, and when I apply te CBD, the pain disappears.
2
One more time the NYT is finding out about something we Californians have know for a long time, that CBD is a critical tool for the chronically ill like my wife and myself, now disabled from an 11-year battle with Lyme Disease. CBD relieves chronic pain, STOPS ocular migraines (scintillating scotoma), and provides relief from seizures. I've only found a handful of doctors who support treatments that DON'T make them money. Looks like Dr. Friedman is one of them.
1
And the problerm is? A person who gets relief through a placebo effect gets relief.
4
maybe you should write about psychiatry, since that is apparently your area of expertise. Suddenly you know all about pain, parkinson's, etc. typical of the pseudo-experise which dominates the lay press. and your argument against CBD having effects due to endogenous receptors is rather silly, since all of psychopharmacology is based on manilpulating physiologic neurotransmitters. If there were no CBD receptors in the nervous system it would be a lot less likely that it would have any neurologic effects, no?? so it's reasonable to conclude that CBD hasn'r received adeqate study, this should be your only conculsion (to be fair...)
4
I have found, having used multiple products over a few years, that CBD orally does nothing for me. However, when it is used in a cream as a topical, it can be totally amazing! It literally eliminates or reduces pain w/in minutes. Does it last? No. But you will greatly increase the length of relief if, about 20 min after 1st application, you reapply.
I have also found that you don't have to pay the price at a dispensary, but you have to be careful of where/who you're buying. I have found, as well as everyone to whom I have recommended, uses Dori Balm. I don't mind giving a plug when something works so well. If you call, you actually speak to Dori. Anyway, it's available online at multiple locations or from her, directly.
I'm passing this on because I found a legitimate source with an incredible effectiveness. Truly, I am affiliated in any way to Dori.
I'm starting to see articles questioning the popularization of MJ. It's about time; every issue has at least two sides.
The push to legalize MJ was largely based on the injustice of incarcerating users. So why not relax the laws to fix unfair laws?
The safety of MJ has largely been due to it's limited use. Now that it's legal in in the streets in many states, there will be increased usage and the product has already been modified from relatively mild plant it used to be. With growers cultivating yet more potent plants and entrepreneur scooking yet more attractive products, who knows what MJ is anymore. Furthermore, how do you regulate small kitchen manufacturers?
To date, most of the academic studies on MJ have identified children, adolescents as the most vulnerable to the mind altering effects of MJ. And it's the children who will be targets for slick advertising.
Just wait until Federal legalization and see how it sells when Big Tobacco invents tobacco plus MJ.
Regulation? Have we ever been able to regulate Big Tobacco, let alone any huge industry?
I fear there is no holding back an industry that can make a killing, in more ways than one.
I am amazed that nobody’s attacked the ACTUAL study showing that only about a third of the CBD sold was what it said it was; usually, they start screaming that Big Pharma got to them, or the FDA was too stupid to know how to test stuff by now.
I wonder how long it’ll take folks to figure out that this stuff’s been cranked out by a multibillion-dollar industry that’s far less regulated than their hated Big Pharma?
Maybe it works, maybe it don’t; people are saying, and there’s more than one born every minute.
1
Gee. Actual research has been going on for years outside the U.S., where, if something cannot be patented/monetized, it's ignored, demonized, or both. Single small example: in Israel, where cannabinoids are studied, aerosolized CBD is used for severe seizures, particularly in very young children. I'd call research like this critical. How silly of me. Oh. Perhaps it's a placebo effect when an elderly friend can manage severe essential tremor with CBD oil under her tongue? If so, "it" saves her untold misery. Moi? I spent 30 years working all over the clock, which creates its own sleep peculiarities. A couple drops under my tongue of an evening coincides with deeper sleep, which means dramatically fewer wake-ups in the middle of the night. If that's a placebo effect, I'm all over it. Be nice if there existed just enough regulatory control we could ascertain quality/quantity of CBD. (oh....have two friends from 'Nam era w/PTSD, both of whom assert CBD works wonders for them) Anecdotes, anecdotes.........Oddly, I've not heard a single instance of a negative effect. If it can't hurt.......etc. Psychopharmacology, my sweet...........you know.
I use an over the counter CBD topical for my chronic knee pain. I get it from friends on the west coast where it is legal to purchase w/o a prescription. It is made from the marijuana plant which makes it illegal in many states with and/or without a prescription. I have no clue how it works but it is effective. If simply ingesting CBD into my system would lessen my pain, than in my case I wouldn’t have had any knee pain for over 55 years, which it how long I have been inhaling it. I have friends in Florida who have prescription CBD medication produced from marijuana to relieve joint pain. They have been advised to either place it under their tongue or use as a topical which makes little sense to me. While I would be happy to see studies about these products, it really would not affect me, as I know, much to my initial surprise and relief, that it works for me and my condition.
Since there are both cannabinoid and opioid receptors in the brain it could be assumed that both marijuana and opium plants were domesticated thousands of years ago and cross bred over long period of time to increase their medical usefulness for humanity.
That would mean that cannabis just might be the cure-all people describe it as because that is exactly what it was created for.
1
CBD definitely helps me sleep and has overall a calming effect and therefore also helps reduce anxiety and stress. And that‘s not just a placebo effect. Intelligent people are rightfully skeptical about big pharma products and therefore inclined to welcome less expensivw natural alternatives.. that they can even grow themeselves. We also have little faith in thw FDA wich is by and large a corrupt and paid for agency. Maybe even the author of this article is somewhere on the pay of a company that tries to prevent natural cbd to take hold in the population before big pharma can market it under some fancy ‚scientific‘ sounding name. We know by now that science and academia in the US are generally corrupted by corporate money and their studies will tend to find what they are paid to look for.
118
@heinrich zwahlen The FDA . . . our institutions are neither corrupt or non-corrupt. They are whatever we allow them to become. Did you vote? If not, you're part of the problem. Are you a sheep-voter, who follows a party vote wherever it leads? Ditto, the problem. Think for yourself - read real news, and stand in the hopefully long line at the polls.
11
@heinrich zwahlen
"Maybe" the author is not in anyone's pay and is issuing a very sensible warning that there is no good evidence either way.
12
@heinrich zwahlen and @NYTimes:
I find it hard to believe that the NYTimes is "recommending" a reply that states "intelligent people are rightfully skeptical about big pharma products" and "the FDA wich "stet" is by and large and corrupt and paid for agency."
In which universe is Big Pharma situated? The universe where its employees are robots, not humans like us who develop diseases like we do and need cures like we do, but instead spend all their time on methods to divert us into expensive non-functional medicines? In which universe is the FDA a corrupt entity? who has alleged, let alone proven that fact?
Personally I'll take a doctor-endorsed, scientific-sounding name with loads of properly tested results behind it over some individuals' feel-good stories.
Peoples' ability to fall for snake-oil salesmen over experts has never ceased to amaze me.
12
Yes, CBD is helpful and safe. Cannabis has been a standard medicine for many centuries with a brief interruption based in ignorance and racism. It is the most researched plant on the planet. Both CBD and THC are anti-inflammatory agents as well as moderating and balancing metabolism. CBD is a good treatment for pre-cancerous, and even cancerous skin conditions and both are effective for other cancers as well as certain seizure disorders, anxiety disorders and many other medical conditions. Even better, they do no harm.
107
@Al M
Wow! Your statements sound like Twitter feeds from a high gov't official. "... the most researched plant on the planet.."? Where are you finding your sources to substantiate the claims?
Personally I will withhold judgement on the merits of CBD until I see some studies that are not just anecdotal.
Snake oil salesmen would be envious of your claims.
12
@Veterinarian . Look into the research being done in Israel for years already.
11
@Veterinarian until the studies are done, all we have are people's individual experiences...no studies does not equal not effective. The observations of those with first hand experience are still valuable.
4
Hmmmm. Professor Friedman began well and then fell flat.
Summing it up, the evidence is scantly and inconclusive.
No matter what its efficacy, CBD is the latest fad aggressively marketed by Big Nutra which, with all its phony salves and supplements, is little different from Big Pharma.
CBD may well go the way of chia seeds, açaí berries and - God forbid - kale salads.
1
"Perhaps it’s because many people have romantic and misplaced notions about nature."
An apposite explanation for the current allure of "renewable" energy, neither renewable nor particularly effective at mitigating the threat from climate change.
First the claims that Cannabis was a gateway drug, now the claim is that Cannabis is ineffective.
Interesting.
4
Like many medications it works for some and not for others. There are however, well documented side effects from many drugs, some of which are life threatening. There is little if any harm in trying CBD. Choose your poison.
3
Well, good morning to you too, Dr. Buzz-kill. There's no evidence that CBD is doing any harm. If some people report that it makes them feel better, what's the problem? It cannot categorically be labelled a placebo effect (as you do), simply because there is insufficient evidence (as you point out).
6
This article repeats several common misperceptions about CBD. The manufacturing of CBD products is indeed "completed unregulated" by the FDA, but scores of responsible manufacturers commission third-party lab tests and make the results available to retailers and consumers alike. The most effective products contain not only CBD, but also hundreds of other cannabinoids, not to mention terpenes and flavonoids, which are present in cannabis and which have an effect on mammals, rendering studies on CBD isolate of limited value to those using "full spectrum" products. The author observes, "Nature endowed us with our own cannabinoids, so unless you have a deficiency of them or sluggish receptors, you really don’t need supplementation." Does the author have evidence that we are not deficient in cannabinoids, that we do not have sluggish receptors? In fact, he has proffered two reasonable hypotheses for the efficacy of cannabis. Finally, the placebo effect cannot explain the many dogs, cats and other mammalian pets which benefit from supplemental cannabinoids. A horse is a horse, of course.
David Brickman
Hemp it UP!
Rochester and Syracuse, NY
2
@David: Dog placebo effect. Something else we now have to study.
@Jill C.
Hi Jill, How long have you worked in Pharma? I've been involved for nearly 3 decades.
Like it or not, the clinical trial crowd is not pure. Like it or not, the clinician trial crowd will and do conduct myriad studies until they get the result they want, which is some sort of indicator of which way they shape the claims on their product (efficacy, potency, compliance, frequency, whether or not the application is for chronic conditions, co-morbidities, drug-drug interactions, formulary success, and on and on) that result in the greatest potential market and, thus, profit. Greed is good is not pure, except when applied to senior executive bonuses, then it is pure joy. Ought tax payers pay for pure science? Yes. Do we want all profit taken out of self interest, no; but buyer beware. As for applying the standard of clinical trials to CBD and THC? Yes, of course. Long overdue. Ought only the big players with lots of money in play and lots of return anticipated have the only say. I don't agree. That is what you've described.
As for your skepticism of the experiences of truly millions of people, well, you are as entitled to speak your piece, as do they.
I have found cannabis helpful in my senior years.
1
Please explain why CBD should be treated any differently than the hundreds of "nutraceuticals" that line the shelves of vitamin stores and pharmacies. Rarely do any of these products prove to be useful in trials.
1
Dr. Friedman's reasoning is weak. Consider his statement, "Nature endowed us with our own cannabinoids, so unless you have a deficiency of them or sluggish receptors, you really don’t need supplementation." Well, Nature also endowed us with a great plenitude of opioid receptors, but there clearly are situations where supplementation is called for.
In many locations in the body's pain-controlling pathways, the opioid and cannabinoid systems exist in parallel, and there's a lot of good reason to think that by increasing activation of the cannabinoid systems, we could get away with relying less on opioids. The future may hold a lot of non-addictive pain therapies if this idea holds up.
3
I am a licensed medical-marijuana user, have written about the issue for more than 25 years, and as for my recreational history… well, I saw Jimi Hendrix at Woodstock in 1969.
I have had people whose kids had near-lethal seizures almost every day tell me that CBD relieved them. But the author's point here, which I find valid, is that there is also an incredible amount of hype and unsupported medical claims about CBD's benefits.
Criticizing that argument because FDA-approved pharmaceuticals have bad side effects is the logical fallacy/diversionary debating technique known as "whataboutism."
The point is that proper scientific studies are the best method to determine a drug's effectiveness. But because of prohibition's strictures and political economics (pharmaceutical companies can't get exclusive control over cannabis, so they won't pay for the expensive protocols required for FDA approval), this research hasn't happened in the U.S.
On the other hand, traditional double-blind controlled studies are difficult to do for THC-containing cannabis. I've has more than one researcher tell me that most users "can almost always tell when they got the placebo."
5
Americans are optimists by nature and scientifically ignorant by design. Americans also love anecdotes, particularly if from someone they know or know of, like a so-called celebrity. We are the perfect target for any so-called treatment, irrespective of sound evidence for either benefit or quality. Indeed, to make the point, my wife and I, one a research physician and the other a pharmacist, both steeped in clinical research methodology and analysis, have tried CBD for sleep enhancement and pain relief. We found the placebo effect to be alive and well. We were also reminded that we spent our careers working to differentiate association from causality. Agree completely with Freedman but not optimistic that good science will either be funded and if it does, will trump folklore.
5
"Eighteen of them contained THC, which could lead to intoxication or impairment in some individuals. "
Actual medicine will in fact contain THC and an assortment of cannabinoids - not an isolate or extracted from hemp.
As stated here the science is rather shakey but this much appears to be acknowledged, CBD's efficacy is greatly subdued in isolation.
It is definitely an issue when what is claimed is not what is stated, but please do not take the presence of THC as being a problem - *it* should be there in some measurable way, if not, it's a health supplement, not a medicine. If you want to avoid the effects of THC there are products that have ratios as low as 25:1, just focus on those (although research is beginning to point to lower ratios as having higher efficacy).
That a physician who claims to have studied this industry claims otherwise is rather sad. Please, do your own research here.
"At present CBD looks more like an expensive placebo". How can the author make this claim when the clinical studies he mentioned haven't even been completed? That's like declaring a Super Bowl winner mid-season. Perhaps the good doctor needs a refresher on the scientific method.
7
I cracked a rib a week ago and the ER doc prescribed Tylenol with Codeine. It works but wears off in three hours. I tried CBD drops instead and the pain was completely gone for five hours. Then I took night time CBD ( which has a touch of THC) and I slept through the night with no pain. I’ve also used CBD lotion for my knee pain at night and it works like a charm. I wish there was more research to verify my experience. It’s hard to believe it’s placebo when I have a regulated narcotic to compare with.
8
My dog was diagnosed with cancer at 15 years of age. The veterinarian wanted to euthanize her on the spot. I took her home and gave her a tincture of cannabis, 6% THC and 6% CBD. Within minutes she transformed from the brink of death to literally prancing around the yard. I have video to prove it.
She lived another two weeks and died peacefully. A year later my other dog, paralyzed by IVDD at age 14, also died, in comfort and peacefully, under the influence of cannabis oil.
I hope to be as lucky when my time comes.
2
@Joseph Brown
Both my older pugs are on a 25:1 CBD tincture, slightly more than the recommended dosage per their body weight. The 15 year old female has been effectively paralyzed for a couple years now and incontinent to the degree that she needed a pad to lie down as she would regularly leak. CBD cured her incontinence. My 13 year old male had a severe limp and would refuse to walk more than 10 feet or so. That is gone.
Have met so many pet owners with similar stories.
2
While the author presents some useful information, I don't understand how this conclusion was arrived at: " ... at present CBD looks more like an expensive placebo than a panacea." There's no evidence either way as described in the article. Quality control will be important, as will long term studies on efficacy and potential harm. But I can tell you from my own one-person clinical trial,a few drops of a pure form of CBD will make you sleepy!
1
My 83 year old aunt could not stand up from a chair or get out of her bed without help. Using CBD for a few months, she can now stand on her own and has a renewed feeling of well-being. I'm all for research on this, but I hear more and more of these kinds of stories and I am heartened that CBD could be a huge help for many sufferers.
4
@Richard O do you know what kind she uses? My grandmother bought charlotte's web but was too nervous to try it. I'm curious if it would have helped her :(
Is Dr. Friedman aware of the huge market in non-FDA approved "supplements"? I assume he is because they occupy entire aisles in every drug and grocery store in the land. Does he know whether these are all "safe", or worth the money?
Is he also aware of the millions of prescriptions for "off-label" use of pharmaceuticals that are written every year? I assume he is because he likely does it himself. Most MDs do. What does he think of this hit or miss (unscientific!) practice?
By all means, cannabis should be studied. On the other hand, don't we already know enough about it to conclude that it can't possibly be as dangerous as scores of FDA approved big Pharma products?
3
As a physician using CBD from hemp in my practice for over the past two years I have seen remarkable outcomes which encourage me to dive deeper into current research, I would highly recommend" the realm of caring" which is a US-based clearinghouse for current CBD research co-managed by Johns Hopkins, as most physicians, already know anecdotal evidence always precedes scientific confirmation, Israel is about 30 years ahead of the United States and there is a lot of information that US physicians could benefit from, the federal government would not have taken out a patent on CBD over 15 years ago If they did not agree with its therapeutic importance, with that being said, more research is still necessary
6
I am surprised that Dr. Friedman fails to mention the drug-drug interactions of CBD. It is a well established scientific fact that CBD interferes with the metabolism of numerous prescription drugs and thus alters blood levels of those drugs. Patients need to be aware of this before starting a course of CBD.
10
The pharmaceutical industry is probably seriously worried about CBD cutting into profits. Whether somebody believes that CBD is helpful or not it lacks the serious side effects that so many medications have.
6
Tried 2 balms on my sore knee: one was CBD the other a CBD/THC blend. The latter worked fine, the former did nothing.
As a clinical researcher I, of course, conducted a few more trials and added some additional subjects.
Results suggest the addition of THC seems to reduce swelling and ease pain. CBD alone seems to have less of an effecy than ice and massaging the taget area.
2
@dk I'm curious, how did you do a double blind study on yourself? If it wasn't double blind how do you separate any possible effects of the balm from wishful thinking, bias or placebo effect?
A year and a half ago I was in a totaled car accident where I broke 3 ribs and had various other injuries. I was prescribed narcotic pain relievers which did little. After some research, I tried 5% CBD using 3 large droppers a day. It only works on pain caused by inflammation and that left me almost totally pain-free. Used as an anti-inflammatory I found it to be extremely effective, I have worked in healthcare for many years including clinical research so am accustomed to studying the medical literature on various topics. I do my homework.
4
I have chronic anxiety which worsens in the fall and as the days get darker. This year was no different, I received a small supply of Lorazepam for when the anxiety is particularly bad, and they, as always, worked like a charm.
End of November I received CBD oil for my birthday. I've taken it daily since and haven't once reached for the Lorazepam. I can't tell you if that's the effects of the oil or some sort of placebo effect, but any other year, the Lorazepam would be gone.
6
@memoman
This anecdote alone makes CBD worth trying. Benzodiazepines like lorazepam (Ativan) are highly addictive and have serious side effects with long-term use, such as memory impairment.
4
@memoman what kind are you using?? That's exactly what I would like to for.
2
My only question would be who are researchers and which big drug manufacturers are paying for those studies? After all if CBD works for you, then please use it and live your best life. Every drug, even the approved ones work because of its contents as well as a placebo effect.
2
Agreed that much more research is needed on just what exactly CBD, not to mention the 100+ other cannabanoids, is effective against, and of course that fraudulent products be exposed.
However consider that CBD is a fraction of the overall dietary/herbal supplement industry, and that almost all of these products, whether it's Vitamin B or Emu Oil, are labeled with the statement that [regarding potential benefits], "These statements have not been evaluated b the Food and Drug Administration. This product is not intended to diagnosis, treat, cure or prevent any disease." CBD is hardly an outlier in this respect.
6
The author says: "Nature endowed us with our own cannabinoids, so unless you have a deficiency of them or sluggish receptors, you really don’t need supplementation."
But nature also created a plant where cannabinoids are present, a plant that we have used from earliest times, apparently, (8,000 years is the record), a plant that affects the body and the mind,properly used, with many benefits. I do not fault the author for asking for more and better research, though.
7
The most useful aspect of this article is the part about how the products sold do not always contain the amount of CBD promised on the label. As with many products on the unregulated supplements market, you could be paying for one thing but getting something else entirely, or nothing at all. In such cases, It's difficult to determine the efficacy of CBD on an individual basis.
Many drugs have a placebo effect, especially ones that affect the central nervous system. That has to do with the innate power of belief in humans generally. But the research is clear: CBD has value. The trick is figuring out how to regulate it without limiting its availability.
5
I know many people who use CBD oil successfully to treat anxiety, insomnia and pain. I tried it.
What I found is that there is a wide range of quality. I found that several sources did absolutely nothing except lighten my wallet. However, I did find several sources that helped me to sleep better and more deeply.
Unfortunately they also made me cough convulsively. All the time. Sigh.
Since I had never been able to tolerate marijuana (makes me vomit uncontrollably) I thought it might be an allergy. I asked scientists at many (at least ten) companies who make it and all said that was unlikely (they are all probably wrong). However one asked if I had that response to anything else. Ah hah! Yes, to ACE inhibitors for blood pressure. Drops my blood pressure but makes me cough.
Based on this very limited data point I suspect that when research on CBD is done in earnest, we may find some interesting results.
1
I'm surprised that Dr. Friedman's article doesn't spell out the likely adverse effects of this medicine.
It is fairly clear that marijuana and its derivative cannabidiol can be considered medicine -- some people have successfully used them to treat illness, with (as this column points out) limited but nonzero evidence of efficacy.
What are the *potential* side effects? We know that marijuana use can be correlated with psychosis in a small percentage of users (perhaps 1-5%), though whether it merely triggers latent psychiatric disorders or worsens them is unclear to me as a layperson.
What is Dr. Friedman's view as a clinical psychiatrist of the psychiatric risk of taking marijuana, and could similar risks apply to CBD use?
I understand (and applaud) why the author would want to avoid this topic because in the absence of data, spelling out the worst-case is mere fearmongering; and I suppose it's better to say "we have no data and that alone is scary". Still, I wish the known negative side effects of these medicine got more discussion in the press. I'm happy to see folks have a wide range of options to reduce the unhappiness associated with their disease but I'd like to be sure they understand exactly what they are signing up for.
4
Hopefully some entity like the Consumer Reports is reading this, and performing independent tests for ascertaining the purity of various CBD oils & formulations. Let the buyers be aware.
3
I suspect that Big Pharma isn't happy about the trend, and since they own quite a few politicians, it will be interesting to see when the insane restrictions on Marijuana are lifted so we can do some actual research.
I've seen plenty of anecdotal evidence that CBDs help pain from friends and family. I figure that even if they only think it is helping, it's worth the money, but frankly they are adamant that it helps them.
3
The entire marijuana industry looks like the mass commercialization of what had otherwise been an organic industry. I don't mean organic in any herbal sense either. As a black market product, marijuana was traditionally self-regulating. The biggest consumer risk was always the risk of getting arrested. The consumer decided whether or not the value of the actual product was worth their money or not.
If someone sells a weed smoker a dime bag full of oregano, the weed smoker doesn't pretend to get high. They get smarter about where they buy their weed.
Now the entire debate is really about who gets to profit from marijuana consumption. Whether CBD is a placebo or not is largely irrelevant. Demanding clinical product studies will basically eliminate small independent producers from the market.
Corporate ventures will use medical studies to create barriers to entry in the same way anti-marijuana factions used phony science to keep marijuana illegal. Once the market is sufficiently consolidated, the same corporations will use medical studies to defend their products from government oversight. This is all text book predictable.
Evaluating CBD has nothing to do with consumer well-being.
165
@Andy, science has a lot to do with consumer well-being. So does paranoia and "romantic and misplaced notions about nature", but not for the better.
Maybe acceptance of the truth marijuana itself has become an lucrative corporate venture will bring some perspective to the discussion.
7
@Andy Totally agree. Well put.
I paid $60 for 12 Marinol pills for my dying mother to feel less nauseous. Now we can do it ourselves, legally in California, without companies controlling cannabis products - yet!?.
Until you have experienced yourself or others who benefit directly with cannabis salves (my war wounded nephew) or sleep soundly with a puff before bedtime, or see your dying mother (mine) eat after debilitating cancer treatments - don't publish a half finished mediocre op-ed piece that undermines an otherwise good thing happening.
Analyze That - Dr. Friedman!!! The only placebos being taken in this case are the ones being devised by people who want to control a people, a market, or drive up penal institution populations.
-
12
@Daniel I don't think you bothered to read this at all. Either that, or you are not up on the differences between Marinol and cbd. I suggest you study more, opine less. You are clearly not a scientist.
3
As a resident of a "med state," I can relate my experience with CBD as an attempt to treat assorted aches and pains.
CBD did nothing for arthritic pain, and pain from a knee injury. However, pain from a pinched nerve in my ankle disappears completely. Similar results were reported to me by a friend who has a pinched nerve in his back.
It's not a pain panacea, but it is effective for some kinds of pain, for me. If someone suffers from the kind of "electric" nerve pain you feel when a nerve is pinched, they owe it to themselves to give CBD a try.
The drawbacks are that it makes me a little lethargic and it's way too expensive, unless you grow it yourself.
90
@Richard Scharf
When I have a problem with my back I take 2 Ibuprofen.
CBD can't be any worse for the body than that and I sometimes have insomnia for no known reason. I have had bouts of it all my life - 2 or 3 times a year - and I take an OTC sleep inducer. Maybe this is my answer. Seems like it couldn't hurt to try.
I'll have to check with my PCP to see if it will interfere with my diabetes med.
6
@Richard Scharf I had a pinched nerve in my neck and it helped me with that.
7
I agree. I took CBD oil orally for a month. It did nothing for arthritis pain.
@Richard Scharf
3
I take 50 mg CDB pills from a trusted source when I need help falling asleep and find them very effective. Not as good as Ambian, but effective, and safer.
Just because some of the claims for CDB are false that does not mean it does not help with any conditions. We tend to treat symptoms, but the effectiveness of any medication is related to the underlying cause of the symptom among other factors. My in ability to fall asleep is related to stress. Someone who has trouble sleeping for a different medical reason, might get no help from CDB. If CDB does not work for you personally for a specific ailment it does not mean it does not work for anything. That seems obvious, but a lot of posters are saying it is bunk because it did not work for them.
Also, many products have less than 5 mg CBD which is like eating a quarter of an aspirin and then complaining that it did not work.
4
The only responsible oped is one that focuses squarely on the barriers to scientific study. Anything else is misleading.
4
I was diagnosed with Parkinson's disease 3 year ago at the age of 69. For several months I had noticed tremors in my right hand and the shaking of my right foot when sitting, as the disease progressed i totally lost balance. Neurologist had me walk down the hall and said I didn't swing my right arm. I had never noticed! I was in denial for a while as there is no history in my family. I used amantadine, Carbidopa/levodopa and physical therapy to strenghten muscles all failed. In 2016 a friend suggested Natural Herbal Gardens who have successful herbal treatment for Parkinson's disease, i read a lot of positive reviews from patients who used the treatment and i immediately started on it. I had great relief with this herbal treatment. I walk very much better now, no case of shortness of tremors or Anxiety since treatment. Visit Natural Herbal Gardens website ww w. naturalherbalgardens. com. This Parkinson's treatment is a miracle!!
3
@Kimberly is cbd part of the miracle, or not?
1
Mt 92 year old mother-in-law has crippling, bone on bone arthritis in both her knees. It had become so bad that even while lying in bed, the pain was so severe that she couldn't sleep well.
We bought a bottle of CBD oil and give her some orally every night. It doesn't relieve the pain enough to make walking any easier, but it does let her sleep thru the night.
We are all thankful for that much.
11
There are few health professionals in the US with clinical research experience in cannabis,as the writer pointed out. Most clinical people in the US trying to describe the medicinal effects of cannabis have less experience than a 25 year old cannabis grower virtually anywhere in the world. Like just about every other aspect of American innovation.
The writer is basically proclaiming his ignorance and muddying the water. Why not just use A. European B. Canadian, research. Freedom seems to provide better information. Who’da thought.
8
Did you ever stop to read the literature which accompanies your prescription medicine? It’s frightening! It seems to be acceptable us to pay for a lifetime of prescribed medicines like statins and endure a multitude of side effects, but maintain a healthy skepticism for the benefits of natural remedies? What?
Do your research. Buy a CBD product from a reputable source (not Amazon) which offers a legitimate Certificate of Analysis for your inspection and determine if CBD oil or balm works for you.
225
@PMD In all fairness, the literature contains ailments and problems that test subjects had when the drug was being evaluated. Those ailments and problems were included even if they had nothing to do with the drug in question.
Should CBD get tested in a drug trial it will wind up with a list of side effects and possible problems too.
The fact that it hasn't been, as the author points out, means you don't know if there are side effects.
Until there is double blind testing you are simply hoping there aren't side effects.
CBD is not a panacea. Yes, many drugs have serious even fatal side effects. So we evaluate the reward vs the risks. We do this for everything since everything we do has risks. Just going to the store to buy groceries has risks. Insulin can be deadly, but without it many diabetics will die. Before insulin many children DID die. The same is true of many other drugs.
Another risk is taking an ineffective drug for a serious ailment.
25
@PMD
Aspirin aka salicylic acid is a natural willow bark derivative that can increase risk of bleeding, cause ulcers, Reyes syndrome in kids, severe allergic reactions (death).
It's over the counter and very widely used in people at risk for carsiovascular problems.
There are very good reasons for extracting and standardizing active components. Codeine, morphine, heroin from opium, for example.
The "all the marketed drugs are bad" so we need the cure all marijuana is a tired, lame argument.
It belongs in the regulatory structure of alcohol, which can relieve anxiety or help you pass out before surgery. But there are better agents with much less risk for real medicinal use.
15
@PMD Well, in that case, don't take prescription medicines and see how far that takes you in life threatening situations.
On a more serious note, do you ACTUALLY suffer from all the listed side-effects of every medication that you take? The FDA errs on the side of caution in listing POTENTIAL side-effects because some subjects experienced them during the trial. There are also reporting mechanisms in place to keep collecting information about this after the drug in on the market, so if some new information comes to light, additional warnings and even withdrawals can take place. Wake me up when the purveyors of CBD put this level of infrastructure and accountability in place.
Just because the swimming pool has a sign saying that unattended children can drown doesn't mean you stop taking your family swimming. You take precautions and make sure that a rescue float is at hand.
5
Thanks for your piece, Dr. Friedman.
The heterogeneity in the formulations of these compounds is what most concerns me. That very property renders high quality, reproducible evidence on their efficacy to treat any of the conditions that you mention extremely challenging.
Given the current evidence available, they may indeed have some beneficial properties however until standardization of formulations and dosing are developed we shall never really know.
The other major concern is, of course, the multitude of conditions for which it is purported to have efficacy. While the data on chronic pain, MS , and epilepsy are promising, there is a paucity of information on the conditions for which it may be most used to "treat".
Finally, it is exciting that the NIH will be funding potential experimental trials that may gradually begin to address some of these important questions.
3
I suffer from insomnia, depression, anxiety and type 2 bipolar. I am medicated and see a psychiatrist regularly. I am his first patient to ask to try CBD oil. I started using it as a companion to my sleeping meds. Though I haven't tried it for anxiety or depression, I have been able to decrease my sleeping medication from 200mg to 50mg. I sleep better than I did when I was only on medication and I wake up feeling more rested. I feel like CBD is like any other medication. It works for some people, some people require more, some require less and some require something different.
4
I know personally of two older dogs for whom CBD oil changed them from mopy and slow to jumping back on the couch again. Hardly a placebo!
7
The really useful information in this article is how lack of proper regulation either puts consumers at risk or scams them by not providing what the label claims. Honestly, do you really think anyone would buy beer or wine that either lacked any alcohol at all or else contained airplane fuel instead? Make it all legal, open up studies on all components, and regulate like any other consumable. The effectiveness of both CBD and THC in very specific cases has already been proven. We don’t know more because of goofy legal restrictions.
169
@Jean Sims I don't know what you would think of industry self-regulation, but it's coming. There is too much as stake with the removal of prohibitions on growing hemp and the use of its derivatives to allow shysters into the mix. And believe me, they're there now. It's like the wild west. The hemp industry would love to squeeze them out. Certification and standardization for product content, quality, and purity are on the way.
@Adrien
CBD from hemp alone does not work on pain. Only CBD + THC works on pain. The ratio of 18 parts CBD to 1 part THC is enough to relieve nerve pain specifically.
2
@Jean Sims:
There is great misinformation and misunderstanding throughout the comments here. Most comments are from laypersons, who either say:
• "CBD works because it makes my pain go away" - and this "PROVES it is not a placebo"
• Big pharma or FDA or insurance co's or scientists or scientific agencies ... (whomever)... are complicit or greedy or wrong or trying to fool us
• we should allow CBD to be brought out with no/little regulation (because of point 1 above - "it works for me"). And because regulation "stops progress".
The above are all WRONG ideas. That is not how science works.
1) Just because CBD works for you/your cousin/your hairdresser's dog does not make it real. A placebo CAN work. A placebo "analgesic" WILL take away pain (for some). But the pain does not go away because of that placebo item/pill - it goes away because of your belief (your brain CREATES neurotropic chemicals to make it work) - that pill or placebo does nothing. Today we do not know if CBD is a placebo (ie, fake).
2) The only way to know if CBD is safe AND effective is through good scientific studies. Anecdotal stories do not prove - they only show it may be a placebo (fake). Letting people buy fake "drugs" (which CBD may be -- we don't know) means we are paying for snakeoil. The CBD/Hemp industry knows this - that's why studies found no/low CBD in many sold products - there are shysters. Placebos are dangerous for this reason (they're unregulated). They stop working after time (months).
3
Just to be clear; the author equates a lack of evidence with a likely placebo effect. This is a poor understanding of the meaning of lack of evidence. Lack of evidence means a lack of evidence to reach any conclusions about the benefits or risks of CBD. The author's conclusion that effects of CBD are likely due to placebo effect is simply not warranted from the research he presents. I don't think you can have it both ways: go with the evidence and keep your conclusions consistent with it, or opt for snarky and pseudo-clinical.
365
@Ken If the effect is overall positive, placebo effect is possibly the most desirable effect of all.
23
@Ken Completely agree. There is no evidence presented here that it's a placebo. If you're going to claim it's a placebo, at least offer a single study that, you know, shows that? This is just empty speculation.
20
@Ken I agree. Absence of evidence is not the same as no evidence of benefit (based on an analysis of sufficient evidence). But I do think it's helpful to point out that a vast number of unsubstantiated benefits have been attributed to CBD. These include pain relief, anxiety relief, cancer prevention and treatment, Alzheimer's and Parkinson's prevention and treatment, irritable bowel disease treatment, nausea prevention, and so on. Scientifically, it is not credible for a single molecule to be an effective treatment for all of these ailments. It does make sense to do studies to learn what, over and above a placebo effect, CBD can provide, and in what dosing regimens. A placebo effect by itself is not bad and might be quite substantial. Even regular pharmaceuticals that have well-established bases of action also have placebo effects. The two are not mutually exclusive. Performing studies does not mean that the placebo effect can no longer work.
21
So many comments, so much irrational thinking. Even some MD's who offer claims of miracle cures without any clinical basis. And all this from people who will claim to "believe in Science", but perhaps only when that belief aligns with other beliefs.
A more objective approach to evaluating CBD is the classic double blind test. If you can do better than random in telling when your vape or massage oil contains CBD (or not)--not just that you think you feel better after using a pre-believed miracle product--then your anecdotes might mean something.
6
And yet we are constantly bombarded on TV by Big Pharma drugs seeking to cure every ill and sickness. Where is your questioning and outrage over that?
I see, as long as it doesn't impact Big Pharma's bottom line, it's fine.
But a naturally growing substance that Pharma can't make money off of. That can't possiblly have any positive benefits.
Give it a rest.
11
Cannabis, cannabis derivatives?
Probably in our overpopulated, urban, globalized, technocratic, hemmed in, spied on, regulated, bureaucratized, parceled out, militarized, on need to know basis, and of course always so fragmented, hectic and alternately boring and without genuine wonder world drug use, medicine of all types will increase and without question we will face immense pressure to alter our emotions in the direction of "love" over "hate", whether or not what we are supposed to love is worth loving or not and all "negative emotions" will be eradicated as much as possible, never mind that taste in higher, finer things, not to mention high intellect and discrimination depends on antipathy to lower drives and things in life...
The more ugly, preposterous, absurd, ill designed the human environment becomes the more the powers that be depend on people "liking it", choosing it over any alterations that might be made, any different direction...Routinely on computer the fundamental question asked of you is what you like or dislike and it's a big science to get everybody liking the same thing, directed emotionally in this or that direction, and of course psychiatry, psychology is all but coopted in this project.
Imagine a psychiatrist listening to a patient's bitterness, anger and disgust and actually agreeing that perhaps the patient is right to hate, despise instead of forcing the patient into therapy and on a regimen of drugs to point of becoming happy with the world.
1
History and literature are replete with stories of con artists selling snake oil or love potions to the unhappy and gullible. We have a country that bought copious quantities of Trump with no evidence of any possible efficacy for the ills that supposedly could be cured. It should be no surprise that CBD, of which I had not heard until this article, could become a billion dollar industry on the basis of marketing alone. What has become abundantly clear is that anyone could sell a large portion of Americans almost anything if they put it in a nice package and persuade people that they will feel good using it.
3
Just because you haven’t heard of it doesn’t mean it doesn’t work.
1
The doctor states that he purchases and smokes pot, thereby committing a Federal crime and willingly adversely effecting his judgement and other mental functions.Those are reasons enough for me to ignore his analysis and conclusions. In other words,I won't rely on the medical advice or any other advice of a pothead.
2
My questions about cannabis mainly concern men in the three months prior to impregnating a woman. Many men falsely believe sperm are created everyday from Puff! nothing
Sperm take nearly three months to become sperm from the ingredients in the package. During this time heavy cannabis use with male or both male and female or just female might be researched. Also the chemical makeup of the soil it was grown in.
The old adage when childbearing was a married or living together couple arrangement:
women mind your health for one year before planned birth. 9 + 3 =12 for both men and women planning and benefitting together.
Of course, this data research should be for any substance that men are using to a significantly mind altering degree, legal, semilegal, pharma or homeopathic.
1
I have tried CBD for Depression and it made feel worse. I felt horrible after ingesting it. People say it is not psycho-active but I did feel mentally altered, in a bad way.
1
An expensive placebo that’s permanently stopping kids’ awful seizures? Placebo isn’t doing that. Sorry.
14
@Zach You need to read the article more carefully.
This article is almost useless. Having cared for my 89 year-old mother in the last six months of her life, dying from cancer, you look for any way to comfort them during their suffering. I discovered Marinol (a synthetic form of cannabis in a pill form developed and used for aids patients). I did not tell my mother what it was, but that she should try it because it helped alleviate nausea, produced an appetite whereby she was able to keep food down. What a miracle! I could not believe the sudden and immediate positive affects it produced.
Never having used marijuana prior to his military service, my nephew was injured severely in Afghanistan by a roadside bomb, subsequently given every pharmaceutical pain killer and salve, he started smoking marijuana and using cannabis balms on his injuries. Needless to say he swears by the pain alleviation, especially coming from the cannabis salve. I believe him.
Anyone who visits a cannabis outlet (in California, where I am from) will hear the correct information this "psychiatrist" knows little about. There, you hear each individual persons story as to why they use marijuana products. They work for any number of maladies we humans find we suffer from. From sleep, to relaxation, to nausea to a dying cancer patient looking for a little relief.
8
My schizophrenic roommate was moved off risperdone and prozac onto CBD. It worked for a short while. But she recently entered a full-blown psychosis, from which she has not exited yet. Clearly, CBD's anti-anxiety/etc. properties are overly stated, or at least more temporary than claimed.
2
And you don’t think that schizophrenia isn’t just a little different from garden variety anxiety?
2
@Maani Rantel Schizophrenia is not an anxiety disorder, so it is not surprising that CDB did not help your friend.
1
Next I suppose Dr Friedman will tell us that good people don't use CBD oil. But this medicinal plant has been used successfully for thousands of years. Our wild-eyed "reefer madness"-influenced government has outlawed any research that might illuminate the truth about this plant, but that has not stopped sensible people from taking advantage of it. This column won't, either.
6
@Glassyeyed I had to laugh, and sensed a Friend
in the
ethers
Gullibility, alas, knows no creed or political persuasion. If I had a nickel for every person I’ve encountered who indulged in magical thinking, I’d be able to fund heaps of actual science myself.
Facts or data get you nowhere with some folks. Not worth arguing, so I just shrug and turn off my ears — unless I want a little bit of entertainment.
4
Once again an article is written by someone really unfamiliar with the topic. I live in Northern CA where many grow their own plants and some make medicine. CBD has saved a child from severe chronic epileptic like seizures that the medical establishment gives anti-psychotic drugs for. I personally find it regulates my sleep and at 64 that is a huge benefit. For Xmas I gave a relative some high quality medicine for his chronic pain related to a back surgery gone wrong. He found huge relief within the hour. I have seen studies published saying it helps w bone growth and I recently found out I have osteoporosis. Personally I was on the board of a collective called Mendocino Medicinals which helped farmers connect to candy companies needing CBD . TI could go on and on but will retain myself. We are very blessed here to have access to super high quality breeds which naturally produce 32% CBD- 1%THC . CBD when utilized from the whole plant (not hemp) is miraculous and not a placebo.
11
To preface this article, the government basically shut out valid research in this area for many, many decades, so put that in your pipe and smoke it. We'd know, but big pharma and big corporate have put the thumbscrews to this for way to long. Get over it, and let real research begin.
4
My friends have all been telling me how fantastic it is to increase calm, concentration, etc. I'm not majorly anxious but that sounds good to anybody, right? I'm on my second bottle of the highest potency gummy bears - at about $130 a bottle. I can now confirm that at least for me, it has *zero* effect. An expensive placebo. There's a sucker born every minute and for CBD that's me.
2
Have you ever tried a pharmaceutical and had it not work? Many people have.
1
According to Pubmed, there are currently over 6,000 publications with the search term “CBD”:
https://www.ncbi.nlm.nih.gov/m/pubmed/?term=cbd
Let’s read them, shall we?
One more comment: Dr. Friedman’s argument that we shouldn’t ingest molecules that our body can make on its own is a logical fallacy. Many people’s lives are greatly improved by insulin, melatonin, estrogen, and many other molecules that naturally occur in our bodies. Some people have deficiencies.
6
I'm eagerly awaiting the comments saying that Dr. Friedman, as a psychopharmacologist, is a shill for Big Pharma and that he feels threatened by CBD and cannabis.
But he's sounding a correct note of caution. We really don't know what CBD works for. What we have are people with their own commercial interests promoting CBD as a cure-all with no downsides. Any medication strong enough to have positive effects can have side effects. People are prone to believing that natural means good. (The same arguments about pharma shills are made by defenders of homeopathy.) It doesn't. There's nothing inherently good about nature. Opium derivatives relieve pain, but are addictive. Botulinum toxins will kill you--or can relieve your migraines.
If these products provide relief, is that relief long term? What are the developmental effects in children and teens? We don't know enough yet. That's not the same as saying CBD doesn't and can't work.
Commenters are right that the government has prevented research into cannabis, and this needs to be reversed.
6
@Alexis Plenty of research has been done in other countries.
Cannabidiol is one of over eighty cannabinoids. To get some idea of how potentially effective this one chemical might be, consider the efficacy that pharmaceutical-grade THC had: next to none.
And if this sounds like a greedy and nihilistic scam, just consider what the field of psychiatry has done for Western medicine. An iatrogenic illness for every treatment imaginable! Like Oprah, but implicitly unethical.
2
What a terrible column - so many things wrong with what it seems to be saying and the way it is reasoned - No, CBD is not placebo (it's effects can be subtle, and you just couldn't discern the effects of the gummies through the marijuana high you were experiencing from the other stuff - or it was a very low dosage or you just aren't sensitive to it etc.), and as far as "Why should natural products, like CBD, get a pass?" - obviously it's because people have already been getting a lot of CBD along with their THC when consuming marijuana etc. (so there is in fact a history of CBD consumption already) - and CBD products provide many of the same benefits without the intoxicating effects of THC
6
If I had a dime for every time someone suggested CBD products for my epileptic daughter I would be a rich person.
2
But have you tried it? Because it could actually help her and you’re denying her the chance to find out.
2
@Lee V. Exactly, I agree with Anita; why not try it? It is the one thing that CBD IS clinically proven and approved for. Check out WEED series, but specifically the very fist one. Back then, none of us had heard of CBD.
I take it for anxiety and sleep and since I started taking it, I sleep every night all night. And my anxiety is better. I think one creates the other. Not sure which would come first, but I’ve been sleeping for almost a year now. Everyone is different, but it truly has changed my life and it’s not officially approved like it is for seizures.
1
So the evidence is not conclusive. That means just that. Yet the author persistently demeans those who claim to have felt relief from CBD. He also attacks straw man arguments. (“Some say it’s more natural...”). It’s people like the author who drive patients away from medical doctors and towards naturopathic and holistic medicine. If you are truly committed to the scientific method, why not keep an open mind?
5
This is the newest snake oil out there, sorry. Living in Colorado, CBD is all the rage. So I asked a few different people exactly what CBD is and what it does.
Well sure enough it does EVERYTHING! Seems like from everyone I talked to, it solves pain, sleep problems, and it can even solve world problems.
Pretty much it's like aspirin maybe?
I'll stick with smoking a joint. Why pretend.
3
@frank w Keep smoking, by all means, but from my experience CBD is not snake oil.
You're looking to get high, others are looking for relief from pain. So, something high in CBD but low in THC wouldn't work for you, but that doesn't mean it doesn't work for what others need and want.
2
A recent scientific publication in the British Journal of Medicine (https://www.bmj.com/content/363/bmj.k5094) concluded that "Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention." This study seems germane to the discussion in this NYT article inasmuch as the details of the study is as - or more - important than the specific conclusion and should not be generalized to conditions outside the scope of the study. In the BJM study above, the next sentence was, "However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps."
Second, we should all be alarmed at the way "natural" products are unregulated. We are being scammed on multiple levels and yet we are living at a time when "regulations" are bad. It's enough to make you go for the "Trainwreck"...
2
It's hype. My daughter suggested I try it on arthritis in my wrists. It cost a lot but didn't help one bit.
2
Why should natural products, like CBD, get a pass? Really?
Well, am wrong in thinking that CBD has not gotten a pass? It has been a huge hassle to get to point it is now man.
All of the herbal supplements are pretty poorly regulated BTW. Ask Orin Hatch about that though...
3
Dr. Friedman, thank you for sharing your opinion on cannabidiol. You make some good points, especially around quality control. As a consultant and medical scientist that performed cannabinoid research at National Institutes of Health I can assure you that CBD is not a placebo. In fact, if you take a deep dive into the research you will find that CBD is an active pleiotropic molecule that has alleviated suffering in many conditions. It is true that most of that research has not been done in the US, due to our antiquated politics around Cannabis, but nonetheless there is a body of evidence. While we tend to be suspicious of pharmacological agents that have more than one activity in medicine, in the case of CBD these effects are real. CBD interacts with a number of targets and molecular pathways. The anti-inflammatory, anxiolytic, support on withdrawal from substance and seizure reduction are notable and shown in human clinical trials. CBD is not a panacea as the marketing messaging goes, but it does have useful pharmacological activity to improve the human condition. And after all, isn’t that the point of medicine regardless of whether it comes from plants or from pharma?
14
The medical-pharmaceutical establishment will not be happy with CBD until and unless they control its research, production, sale and profits. Meanwhile, stronger and more addictive forms of Soma are approved and marketed in the midst of an ongoing opioid crisis. In addition to the benefits of CBD, real or perceived, the fact that the healthcare powers-that-be don't control this just makes it that much more attractive to me.
I suspect others feel the same.
10
I appreciate the skepticism which I would expect of a medical professional. But I feel like you did glaze over the part of treating patients with epilepsy.
Is that because the evidence and research inconveniently debunks your claim that it's a placebo?
12
Missing from the article is research on CBD that was performed in other countries. Israel, Europe and others. A trove of data is out there.
21
Tell me, have we done those double blind studies with booze?
Alcohol is legal, and addictive. From the CDC:
" Excessive alcohol use led to approximately 88,000 deaths and 2.5 million years of potential life lost (YPLL) each year in the United States from 2006 – 2010, shortening the lives of those who died by an average of 30 years.
CDC - Fact Sheets-Alcohol Use And Health - Alcohol
But people are obsessing about cannabis, STILL?
15
@RLiss - please flag and report any advertising suggesting that vodka and tequila treat medical issues. It’s illegal.
Or are you unclear on what this piece is, ya know, about? Gotta tell you, I’m sick to death of every discussion even mildly related to weed ending with “but alcohol is leeeeegal!!!” We’re talking about a popular substance and people claiming it fixes nearly literally everything and selling it to people with honest to god issues for significant amounts of money. But thanks for the information that liquor is both legal and can be abused. It really added to the discussion.
I use a ten-to-one ratio CBD to THC tincture in a state where it is legal and therefore I know the dosage of what I am taking. I have perceived no benefits to my various ailments except for the one reason that I take CBD: to stop migraines.
CBD works better than prescription drugs for most of my migraines for a variety of reasons. First is that I can only take the pharmaceuticals twice in a week to prevent the rebound effect. That doesn't help a multi-day migraine. Second, the prescription medications tend to work but with side effects such as nausea and sleepiness. Third, with CBD I take it immediately and get fast results whereas with the pharmaceuticals I have to consider when to take it and whether to take it, thereby risking the likelihood that the migraine will escalate into a full blown affair.
Since cannibis was legalized in my state, I have been able to almost entirely stop using the prescription drug that I have for migraines and my quality of life has improved greatly due to not having migraines day after day.
Don't let the snake oil aspect swallow the fact that CBD is, in fact, useful for some purposes.
24
@Seattle I'm a migraine sufferer and take Imitrex but it doesn't always work. Can you tell me the brand of CBD you use?
1
Yes! Cbd works better for my migraines than any pharmaceutical.
1
@Anita Larson
What dosage do you take? I've tried CBD oil for my migraines but is hasn't been effective. Maybe I'm not taking the correct dosage early enough into the headache.
There is CBD for the funky. The are fish oils for the conventional. Neither has proven beneficial. But both fruitcakes and the mainstream are so desperate to find an elixir, that they sell you nonsense in the name of medical science. CBD and fish oil are wishful thinking from both the unconventional and conventional and both are nonsense.
1
'Where is the healthy skepticism when we need it?'
The healthy can be as sceptical as they like. Those who are sick, sick, sick to death of their years of chronic pain, don't have that luxury.
26
So many of the comments are from people who are getting two things wrong about what the author is trying to say.
First, the article is trying to point out that CBD in the form of pills or oils, is a supplement and therefore it is unregulated. This means that companies can make lots of money selling it without having to prove its effectiveness, nor is there any regulation on the actual content of the supplement. This is bad because research is supposed to show that the supplement does at least more than the placebo effect. When you say that you think that the placebo effect alone is great, you are giving companies power to charge as much as they want for any supplement. The supplement industry is not some small benign niche market, it’s a billion dollars a year industry.
When you say that the placebo effect alone is good enough, just be cautious that a CBD pill does not contain ground up lead or something worse, because all kinds of things have been found in supplements. A CBD supplement may not even contain the amount of CBD it claims to have, but those of you willing to buy anything for the placebo effect don’t care,
Second, the article is about CBD, not marijuana, why are so many of you getting that wrong?
8
Well, because the CBD I purchase in Washington is highly regulated. And, second, because the CBD I use is from cannibis and contains THC.
The sad fact is that we just don’t know enough about marijuana and its component chemicals. The rush to legalize is ill-advised; we need many more peer-reviewed studies and large-scale clinical trials. These studies and trials won’t happen as long as marijuana remains a Schedule I narcotic.
seems to me you are pointing out that buying CBD products can be disappointing ... you might get ripped off ... many sellers are deceiving purchasers ... and i guess the bad products out there include the gummy bears you purchased
4
Now that the market is open for marijuana, soon everyone will be producing their own creams and tinctures so it will be a real mess.
1
@heysus on the contrary. Now I can grow Dyanmed CBD and make my own tincture, thus assuring exactly what I am consuming. It is a dream come true, and really supports my recovery from chronic Lyme Disease.
I am an insomniac. I smoked weed in my youth. Then smoked it again after the kids left. The second time I found that after I smoked, I would sleep through the night. I have tried two different types of cbd but they have not worked. Since I do not want to get high every night, I would appreciate the research to find the effective dose and type.
6
@jo
I am an insomniac. I don’t like to smoke it makes me cough. Edibles especially capsules with THC work for me. 20 to 30 mg and you will have a light buzz (smiley)after about an hour but will sleep well a couple of hours later. You must time it for bedtime. I decided to get a med marijuana license out of desperation. Yes, i Will be pleased when there is more definitive direction from research.
2
Thank you Mr I am fancy Dr you just ruined a placebo effect that was reducing burden of disease to everyone with this article
5
Why does the University of Mississippi have a monopoly on cannabis supplied for research? I didn't know Baptists loved the stuff so much? Then again, the probably love only the government contract.
"Uncle Sam has awarded the University of Mississippi $68.8 million to grow marijuana and analyze it. The contract....will go to a marijuana research lab at Ole Miss, which has been the sole producer of federally legal marijuana since 1968."
And that was ONLY in 2015 dollars. Ole Miss first received this "competitive" contract in 1968. They have been the sole recipient of it since then.
11
@matty
Hmmm, who was the governor and the senators then?
Money will always take precedence over ethics.
In 1968 that wzaas true and it's equally true today.
But what do I know? Maybe someone in government discovered a study that claimed the soil in MS was exactly right for the growth of marijuana.
1
Expensive because it is illegal. CBD will be cheap as water if it were legal to grow. It is a weed. Where does it come from now? Underground and illicit grows which charge a fortune for CBD. Once Nebraska grows Cannabis like corn...it will be cheap.
There is the rub - the current cannabis growers know they control the prices right now. Will they be happy when they cannot grow it profitably any longer? Capitalism means all you get is what makes some rich guy richer - no good ideas, nothing positive...just rich guy riches.
5
Most of the commercially available cbd is derived from hemp, which was just legalized here in the US. Up until now, cbd processors have used hemp grown legally in Canada and a few other countries. Hopefully, growing hemp in the US will lower the cost of cbd.
1
Thank you Dr. Friedman, good points on this new fad. But you lose me with your story of buying marijuana and using it. Is the purpose of the story to make you not seem like a prude when it comes to drug use? Or cool? Or legitimize your criticism of CBD because you use marijuana? Most psychiatrists I know do not endorse marijuana passively or actively. It has negative effects on the brain as you should know. After reading that part of your piece, I lost respect for your opinion on CBD and other topics in psychiatry.
3
I highly recommend the documentary Weed the People about pediatric cancer.
4
A million anecdotes are not data, they are a million anecdotes. The unfortunate conclusion reading the responses to this excellent summary is that for most of the commenters here, belief is more important than fact.
9
@LTJ "belief is more important than fact?" just like profiting from care is more important that providing care, as evidenced by this psychiatrists writing?
Boy, are you wrong!
I'm always amused by the claims that if something is "natural" it must be good. Yet, plants like deadly nightshade, oleander, stinging nettle, caster beans, monkshood, larkspur, foxglove, even daffodils and apple seeds (and, of course hemlock) can kill, if ingested in the right amounts. Nature is not always benign, and the claim that a substance is "natural" might be a warning to stay away from it.
7
@Ms. Pea
Equally amusing is the claim that, if something is not controlled by big entities like the AMA or pharmaceutical corporations, it must be ineffective.
6
I make no counter argument to marijuana use. I have been a user for years. I have known it to be therapeutic both psychologically and it also can effectively treat pain in that it re-wires how the brain processes it.
Having said that, these are known attributes of its psychoactive effects, meaning overwhelmingly effects of THC, not CBD. CBD may have some specific uses (as mentioned for epilepsy), but really could only be clinically effective if used under some generally prescribed dosage, and likely in some derivative form.
"Medical" marijuana is largely being used as a stepping stone to reverse the draconian Nixonian 1970 law that made cannabis use a Schedule 1 drug offense. It's social evolution in much the same way the ACA will eventually lead to a single payer healthcare system. The ACA was never truly intended to be a permanent universal healthcare system.
Likewise, eventually, we will accept marijuana for what it is - a relatively safe recreational drug that people use to self-medicate for its psychoactive effects, not some wonder cure provided by CBD.
7
When you try to prove a fact there are at least two kinds of evidence - statistical and anecdotal. While statistical data can be helpful, it generally does not help those who don't fall into the statistical effectiveness category. Assuming anecdotal evidence is also available, it is also helpful and can be very persuasive, again to those who fall into various categories. In the absence of statistics and the plentiful availability of anecdotal evidence, the effectiveness of CBD oil meets at least a prima facie test supporting its usefulness. Now that marijuana is legal in something like 33 states, the producers are free to disclose the purity and organic nature of their product. I suspect the anecdotal evidence of its effectiveness will only multiply and the statistical research will support that evidence. In the absence of any evidence, statistical or anecdotal, of adverse events associated with this herbal remedy, it should be legal everywhere.
7
The last paragraph may be the most important one. Except for Epidolex, the buyer has no idea what or how much is in the concoction that they are purchasing.
The second issue is that the DEA has stifled research on any and all cannabis products. A colleague of mine had a contract to study CBD from GW Pharma, makers of Epidolex, in an animal learning model. To get the CBD shipped from the U.K. to NC you would have thought that instead of 10 g of oil that they were shipping a kilo of plutonium. Going back to at least the ‘70s we have known that there were many interesting compounds in cannabis that had nothing to do with the high, but research was totally shut down due to irrational DEA policies.
As the policy has changed, maybe soon we will have some real data to work with.
15
Buyers in Washington and Oregon can see what is in the product they are buying. It is tested and labeled.
3
I take nano-enhanced hemp oil daily. It seems to help with anxiety, but the most noticeable effect is on my TMJ; it allows me to stop clenching my jaw. You'd think I could just stop clenching my jaw on my own, but evidently not.
I have a friend who gets quarterly botox injections for the same problem, but the hemp oil is a safer & (slightly) cheaper alternative.
Who cares if it's a placebo effect if it's working?
6
Follow the money - keep your eye on the prize.
All the evidence I have seen supports the notion the CBD may be just as good (or bad) as anything else for the treatment some persons with intractable seizures. Remember, their called intractable for a reason and CBD is by no means decidedly more efficacious than any other drug in controlling them. Beyond that, CBD does nothing (or next to nothing).
CBD is however, very, very useful for one thing - confusing the public by blurring the already blurry lines between cannabinoids, hemp, marijuana and THC. For this use case, CBD's lack of potent psychotropic effect and seemingly benign side effect profile make it the perfect Trojan Horse.
3
My migraines have been diagnosed as intractable. Cbd works when most pharmaceuticals don’t.
1
The last person I would believe about CBD effectiveness is someone whose career involves prescribing and defending powerful psychiatric drugs that also have no clear, consistent, and measurable scientific impact.
The construction of the latest diagnostic Bible (DSM-5) finally revealed to the public just how much guesswork is involved in creating "disease" labels; the profitable bed shared by psychiatry and Big Pharm has also been carefully documented in many recent books.
All of this simply highlights how hungry people are for relief in our increasingly troubled and confusing world. Add in the thoughtless speed of social media, and nearly anything can catch the wind and spread. Our desperation makes us easy prey for the slickest conman around.
Perhaps some people are helped by CBD, just as others swear that psychoactive drugs have changed their lives. The placebo effect is a well-known phenomenon: basically, if you believe something will work, it will. It depends on the weight of the authority that dispenses it.
26
Given that many properly performed double-blinded, placebo-controlled studies of just about any drug or physical intervention demonstrate approximately 25-30 % positive response in the placebo arm should give anyone pause and a basis for well-founded skepticism.
3
@Concerned MD
I find placebo studies very interesting. Apparently some drugs that have been approved for decades perform only slightly better than some placebos.
3
It is regrettable to see a reputable academic psychiatrist dismiss the possibility of benefit from cannabis. The government's "Reefer Madness" era policy restricting cannabis research has prevented physicians from performing the type of studies done for pharmaceuticals to get FDA approval. So, what should our patients believe?
The best available evidence comes from the tens of millions of people who have been benefitting from cannabis for several decades. Their verdict is overwhelmingly clear.
For 4 decades, I have served as a psychiatric consultant to the medical & surgical services at a major teaching hospital. Thus, I have personally spoken with hundreds of patients who have used cannabis to treat a wide variety of symptoms. It is indisputable that the benefits of cannabis outweigh its miniscule risks; something which cannot be said for the many FDA-approved treatments which failed to help these patients before they got the relief they were seeking via cannabis. Dr. Friedman does patients a disservice when he discourages patients from trying cannabis.
35
As a family doc in California I have used topical marihuana (not CBD per se) in olive oil to treat peripheral neuropathy for years. I have observed often dramatic effects (in sceptical - usually elderly patients) on alcoholic neuropathy, diabetic neuropathy, trigeminal neuralgia, post-herpetic neuropathy - far better than commercial RX gabapentin, Lyrica, elavil, etc. with any general physical or mental side effects. Due to formerly heavy legal restrictions on formal medical research, peripheral neuropathy is not even listed in the index of the National Institue's 400 page compendium.
Doctor, don't be so sceptical -open your mind up to practical reality where benefit not rules are the gold standard.
37
@paradocs2 : If I knew your name and address you would soon have another patient, as I am moving to your area this spring. I am 82 years and have peripheral neuropathy caused by radiation treatments for prostate cancer which causes me great pain.
@paradocs2 I meant without any side effects.
@paradocs2 Doctor, don't be so foolish - open your mind to actually reading the article. It is about CBD. Not topical marijuana.
1
" Why should natural products, like CBD, get a pass?"
Well, that is an interesting, though hypocritical, question coming from a psychiatrist. Lithium is also a natural product and, despite well established evidence that its use can lead to organ failure and serious metabolic disorders at the levels it is commonly prescribed, it remains a common remedy for bipolar disorder despite relatively low efficacy over the course of several years or decades that psychiatrists push it on their patients. Unless there is evidence of comparable harm due to CBD, why shouldn't it get a pass?
"Some even point out that we come hard-wired with cannabinoid receptors in our brains and they must have a purpose, so why not use them? This is not exactly a persuasive argument: Nature endowed us with our own cannabinoids, so unless you have a deficiency of them or sluggish receptors, you really don’t need supplementation."
More hypocrisy. No one is prescribed lithium on the basis of a lithium deficiency. Thus, according to the good doctor's reasoning, there is no justification for prescribing lithium. Why, then, does it continue to be a popular psychiatric prescription instead of being pulled out of concern for the safety of patients?
26
I got some CBD cream and capsules for Christmas.
I have moderate osteoarthritis pretty much everywhere and some
mild sleep issues. You can bet I"m going to try this.
7
@jo : I have been using Canna Oil for my arthritic knees for some time and it works wonders for me, and I made it myself. Both my right knee and hip were causing me so much pain I could hardly go up and down stairs, now no more joint pain.
I now have developed peripheral neuropathy in my left leg and am trying it on that - so far with no results, but then that is nerve pain which is different from joint pain.
Good luck !
2
The chemical / pharmaceutical industry controls modern medicine. They bribe congressmen and medical researchers to promote their toxic products. Do you think they are going to sit back and allow an amazingly effective herbal cure to eventually dominate their market? They were the ones who lobbied so strongly to make cannabis illegal to begin.
Let's just give some credit to the kids who refused to believe the industry propaganda and started to experiment on their own. Thank You Millennials!
12
One day researchers will use their fMRIs to study the links between dopamine and the most common addictions to Maslow's psychological deficiency needs for safety/power, attention/acceptance/approval, and esteem/status. Then the drive to write misleading articles such as this one will make sense. Especially to the growing numbers of individuals who are convinced CBD is not only a panacea, it's a bargain.
The only valid point Friedman suggests but fails to make is that CBD providers should be held legally accountable for false labeling claims.
DopamineProject.org
5
Dr. Friedman: Please read the NYT comments and wake up. So-called "health care" in the United States is all about profit, not patients and has the poor outcomes as proof.
The last real in-person contact I had with my family practitioner (who is one of the best our HMO has to offer) was for a long-term cough. Guess what his offering was? A black box warning fluoroquinolone, Cipro, known to cause nerve damage after one dose. I only utilize him for testing now and communicate via email. Like so many, I realized I am mostly on my own. My cough is under control via natural means: grapefruit seed extract and hemp oil.
8
There is no real reason for a lack of clinical trials - outside of dumb schedule 1 policy - other than people who do clinical trials expect to profit from them.
At this point we have recreational marijuana and mostly that is all. Medical marijuana exists for some, but basically dosages, purity, standardization does not exist, and the user is on his or her own. A pot gummy can have half of what you need, or three times it.
Looking at the chemicals in pot is no different from looking at the chemicals in foxglove, St. John's wort, green tea, datura or nightshades and countless other botanicals to determine if they have beneficial medical application.
But that look will not come for free - we can expect to get the benefits in pill form for profit, or not get a trial at all.
4
Wa and Co are doing it right with strict laws for cannabis to be lab tested and labeling for the cannabinoids. All states should do this. Certain cannabinoids help my migraines so all I have to do is is look for the cannabis that contains the right ones for me.
1
"Future studies may show otherwise, but at present CBD looks more like an expensive placebo than a panacea."
But we know, from a previous NYT article, that pacebos are effective.
https://www.nytimes.com/2018/11/07/magazine/placebo-effect-medicine.html
3
Initially I found it to be mildly helpful, but not now. Like every thing else it seems to be just a big marketing hype.
1
@Vivien Hessel
Everybody is different. Thankfully.
What works for one person will have no effect on another. That's why clinical trials involve more than one person.
Most people swear that drinking coffee late at night will keep them awake. Not me. i sleep like a baby. I've only known one other person that said coffee, too much, puts him to sleep. Me too. Why? Who knows.
I have a problem with my back sometimes. I may try rubbing some oil on L4 and L5 and see what happens.
If people had just scraped off the mold on bread and not looked further into it's medicinal properties way back when, we'd never have the benefits of penicillin.
I say keep an open mind. You never know where the next miracle cure will come from. :-)
8
What dose were you taking? It sounds like increasing the amount may help.
Just before declaring it a placebo, the doctor enumerates the many ways studies have found errors in labeling. Errors in labeling are not proof of ineffectiveness.
There is a universal ethic of human suffering that states if a person says it relieves pain and it is not harmful to them, then they should be permitted to use it. We also know what works for some does not work for everyone.
If you have pain and an extra $50, give it a try. If it doesn't work, you won't need a government bureaucrat to tell you not to buy it again.
8
Regardless, if I wish to put it in or on my body, it's nobodies' business but my own. Secondly, I live with a cancer patient and it relieves his pain. A problem?
12
CBD users should be aware that CBD interacts with some specific enzymes in our bodies to increase blood serum concentrations of a number of common drugs. So, use with awareness and caution; investigate further if you are taking any of these. From a government publication:
CBD is a potent inhibitor of CYP3A4 and CYP2D6.
As CYP3A4 metabolizes about a quarter of all drugs, CBD may increase serum concentrations of macrolides, calcium channel blockers, benzodiazepines, cyclosporine, sildenafil (and other PDE5 inhibitors), antihistamines, haloperidol, antiretrovirals, and
some statins (atorvastatin and simvastatin, but not pravastatin or rosuvastatin).
CYP2D6 metabolizes many antidepressants, so CBD may increase serum concentrations of SSRIs, tricyclic antidepressants, antipsychotics, beta blockers and opioids (including codeine and oxycodone).
9
In a couple of years, probably all diseases in people on Medicare and Medicaid will be treated with pot and nothing else. It's just grass so very easy and inexpensive to grow. The taxpayer will save money if the government doesn't have to pay for real pharmaceuticals and it will save money if more people on Medicare and Medicaid die faster.
1
@Kay
Oh come now!
Not too cynical this morning I see. Try some CBD on your avocado toast and maybe you'll feel better.
That's a huge leap you make there from pondering the efficacy of a substance and killing people off by denying them medicine that works.
Had a visit from a sister who believes that her daily drink of blueberries smushed with carrots and seeds of some plant is keeping her safe and sound. She tripped over my cat, fell and banged her knee. So I rushed to my medicine cabinet and pulled out a little bottle of stuff that I told her contained CBD oil.
Poof. Her pain was gone in a flash!
(I didn't show her the mosquito repellent label.)
9
@Rea Tarr
Sure, there are also a huge number of people who believe in the magic and potency of crystals, numerology, horoscopes and Donal Trump's excuse for his draft dodging.
It takes all kinds and there's a sucker born every minute.
BUT, the placebo effect does sometimes work for believers. The mind is a very powerful worker of magic on its own.
3
A decidedly amateur crowd promotes CBD contrary to science. But it is more striking that medical professionals promote unhelpful fish oils. An otherwise conventional psychiatrist and a veterinarian had me using doses of fish oil until a recent authoritative study in the TImes reported that fish oil was useless. When amateurs are behind quackery, it is hardly surprising. When the professionals go that route, it’s a lot more disturbing.
7
DEA and FDA only permit legal research on marijuana if the plant is grown by University of Mississippi.There are selected research hospitals in Israel that have been prescribing marijuana therapy from their secured gardens since 1990's. Doctors at UCSF and many other universities have been researching cannabis therapy since 2014. American Cannabis Nurses, coast to coast, have years of witnessing the mercy of this plant. California and Colorado cannabis used for research is highly tested for pesticides and is often grown by health care staff. But marijuana grown outside Mississippi is forbidden taboo, by DEA and FDA.
5
I have tried CBD a few times and had good results. Indeed. I found it to be slightly intoxicating, so I purchased a urinalysis kit. Sure enough, it came up positive. So, due to my job requirements, I ceased use. Too bad. It really helped my sleep.
4
The well documented Placebo effect happens ~ 1 out of 3 people. Unsurprisingly, it has a stronger perceived impact on depression, pain, sleep disorders, menopause, and other chronic issues. There is nothing wrong with the Placebo effect in so far as the person experiencing it has a self-reported improvement. The problem is that is makes for fertile grounds for con artists. There may be real effects to CBDs and credible, well designed independent research will uncover these. In the meantime, like Homeopathic "remedies", snake oil, and a thousand years of fake treatments, the Placebo effect + greed = ready marks.
9
Thank you Dr. Friedman. It would be helpful to list the brands that have been tested and the content of CBD or lack thereof. Clearly more testing & research is needed but at least let us know what companies are selling what they advertise since you say that has been done.
7
"To be fair, the paucity of data about CBD’s efficacy and safety in part reflects the federal government’s irrational restrictions on cannabis research."
Thank you for being 'fair'. I remember reading a medical journal article decades ago referring to possible medical benefits of cannabis if the 'undesirable side effect of euphoria" could be eliminated.
As far as I can tell, the biggest 'side effect' that prohibits and criminalizes CBD, hemp and cannabis is a potential threat to pharmaceutical and other corporate interests.
21
It’s the corporations who control our government that have caused the “government” to irrationally restrict research on marijuana.
1
Like the conclusion it comes to, this piece offers far less than promised. Most of it just states (and restates) the need for research, and goes on to explain why people might want it to work, as well as why many CBD products contain less of the substance than advertised. But to say that it is "more placebo than panacea" is both dismissive of many users (who have never seen it as a panacea), AND makes the assumption - without research - that it doesn't work. Neither of those claims are justified on the evidence.
24
I was a skeptic until a recent high ankle sprain inspired me to give CBD ointment a try. Applied it to the most swollen and painful area to relieve the deep ache that was depriving me of sleep and bingo, pain disappeared in few minutes and I got a great night's rest. Has worked for past few nights, too. Could be the placebo effect but, hey, any port in a storm!
18
Maybe it is just a placebo. So what? It still helps me sleep better. (I do wonder about the long-term effects, though long-term doesn't mean what it used to. I'm in my late 70s.)
25
Absence of evidence of benefit is different than evidence of absence of benefit.
33
I can't speak to the effects if taken internally, but I have two aging parents with lots of aches and pains who grew up in a time when anything cannabis related was evil and they say CBD helps quite a lot topically. They, like many people like them, confuse CBD and THC, I think. My point was their background tells them it's bad and they still think it works. And I've heard it can really help aging animals who have no dog in the hunt so to speak.
We've just legalized Marijuana for recreational use in my state. I never liked pot as a kid because it put me to sleep. And this article is about CBD not THC, but I plan to do a thorough study of it once our dispensaries start to open because I'm aging too. If the dispensaries are like they are in Nevada there will plenty of knowledgeable people to help.
8
As a practicing physician, I have witnessed how many patients are using CBD. Part of their actions are prompted by the failure of the medical community to engage with patients who then seek solutions outside the established medical norms. In addition, due to financial success, there is little incentive to study these compounds. People have become believers and don’t want to be confused with facts. Ring familiar?
7
As a topical agent for spasm, CBD worked for me. Instantly.
I have cercvical disc disease to the point where there is knot-like spasm unrelieved except by traction (most of the time) and massage (some of the time).
The application of topical CBD six months ago at the suggestion of a friend was magical and instant. I couldn’t believe it (and I am a clinician).
I am sure CBD is not the cure-all purported by advocates, but in this case it was astoundingly effective.
36
You can’t pick and choose when science is believable or not. I’m guessing most of those critical of this article support the idea that climate change is real. But here they are skeptical. There is a big industry supporting CBD oil. So it’s not the usual anti profit argument.
2
@Evan Climate change has numerous studies confirming the change. As stated by the author there are few CBD studies upon which to draw similar accurate conclusions. Comparing vastly different study sets and trying to connect results to findings is clickbait.
2
Right now, it's just hype - mixed with a little bit of science.
Our understanding of THC and CBD are no better than our understanding of antibiotics when penicillin first showed up on a slice of stale bread. Back then, you couldn't cure much be just eating the bread, but that didn't mean the mold growing on it wasn't useful.
The lifting of federal prohibitions on research (associated with its illegality at the federal level) will help us all understand the potential benefits - if there are any - of THC and CBD.
16
@Chris
How does lack of understanding make it hype?
Just because we don't understand how it works doesn't mean it doesn't.
Your logic is flawed.
2
Perhaps the doctor can explain why our nervous system synapses have canibinoid receptors similar to our opiate receptors
How could this be unless we have used it for thousands of years?
Modern medicine has a way to go before we learn it all.
6
@John as the doctor says in the piece (consider reading it), our brains have naturally cannabinoids. That's what the receptors are for.
7
I am currently trying CBD oil for treating my UC. I wasn’t seeing the results I was hoping for and met w the pharmacist at my dispensary. He suggested upping my dosage by 2 drops a day, under the tongue. He could not tell me how much of an increase I would need to see effects. Not very scientific, but I’m getting desperate here as surgery seems likely for me. Hoping it works for me...
4
@Richard Murphy I have tried both THC & CBD (in various forms) for neuromuscular pain in my back. THC forms made me "stoned"; CBD forms did nothing. At last (some 3-5 years later) my PCP has referred me to neurosurgeons (after 2 MRIs & an EMG, as well as countless other tests) in Boston (MGH). I didn't like being stoned 40 years ago, and I don't like feeling the doggoned same pain right through the stoned feeling.
1
@Richard Murphy. Look into fecal transplants for UC. Some good evidence
Dear Dr. Friedman. I have two herniated disks in my back and one in my neck, both from a severe rear-end car accident 30 years ago. I was also diagnosed after a spinal MRI with degenerative stenosis and mild scoliosis. I"m 63 and for the past 4 years have been in constant pain, despite regular massage and Chiropractic treatment. I was taking opioids for about as long as I was suffering from the pain. Last summer I visited my Daughter in San Francisco. Seeing me suffering to walk the city, she finally convinced me to go to the Harvest Dispensary. I purchased two bags of cookies which where 10% THC and two different strains of smokeable marijuana. It has changed my life. When I returned to DE, where we have medical marijuana, I easily qualified and have incorporated it into my daily activities. Long story short: I have not taken a single opiod since August and I now live my life as the person I used to be before constant pain led me to isolation and depression. It's a crime that marijuana has not be legalized nationally.
237
@Anthony : so happy to hear how much Medical MJ has helped you with what sounds like a highly improved quality of life.
I just started using CBD oil with a little bit of THCa in it to help me manage the sometimes excruciating pain as a result of the treatments, including two major abdominal surgeries, for Stage 3 Colorectal Cancer 13 years ago.
After 2 weeks on the CBD oil I am now basically pain free. I know I have a ways to go to see if it will be a permanent solution but so far, so good.
One of the best things about the CBD oil is that my use of opioid pain medication has gone way down. I hope one day to eliminate it entirely.
Too many people have antiquated ideas about cannibis and even think that people like you and me who use it only for medical reasons are a bunch of degenerates. I am 65 years old and have no interest in getting high — I am just looking for pain relief and, like you, an improved quality of life.
4
As in my previous letter, the company I found to buy CBD oil also works with the Realm of Caring, which has worked with John Hopkins Hospital for years. One of the requirements of participating with the Realm of Caring is providing surveys to John Hopkins. One of the first benefits of CBD oil was helping a child with epilepsy when no other medicines worked. These farmers have had their bank acc'ts closed, money seized, no crop insurance, etc. The product comes from the industrial hemp, think rope. All marijuana plants contain THC, but the plants used for CBD oil contain 0.03%. The gov't and DEA had very strict rules under the previous "Farm Act" bills. But, now that big business is starting to make big $$$ (think billions) congress wants the tax money so they removed CBD from being a scheduled 1 drug with this last Farm Act bill. Why, because it never really had any THC in it in the first place. It would be good if big pharma were to get into the act, maybe the price would come down, or ins would help pay. After my using CBD other family members started using it and it's helped them quite a bit. I'm 70, & my family members are older than me.
20
@Dan O
CBD has not been removed from the schedule 1 classification.
And it is Johns Hopkins.
1
But, soon:
Changes Made in the 2018 Farm Bill
Senate Majority Leader Mitch McConnell has been instrumental in trying to pass more tolerant hemp product regulations. McConnell added language to the Farm Bill that would remove hemp from the CSA’s list of illegal drugs and authorize farmers to obtain insurance for hemp crops. Significantly, the definition of hemp has been expanded in the 2018 Farm Bill to include seeds, extracts, cannabinoids (including CBD oil), isomers, acids, salts, and salts of isomers. Additionally, if the latest version of the Farm Bill is written into law, the various states of the Union will be left to regulate commercial hemp farming in their respective jurisdictions after submitting a regulation plan to the United States Department of Agriculture (“USDA”).
Thank you for correcting the name Johns Hopkins. Regarding the scheduling of CBD oil I came across this article:
THE ERA OF HEMP PROHIBITION IS OVER!
At 4:00 PM on December 20, 2018, President Donald Trump signed the 2018 Farm Bill which permanently removed hemp and popular hemp products such as cannabidiol (CBD) from the purview of the Controlled Substances Act.
1
This kind of attitude can deprive people of real relief. I have recently purchased CBD gummies from the Daily Beast website for pain. I take one in the evening--and it works! Not a study but proof enough for me. Research should continue on long term effects and safety.
22
America is currently doing massive research into methods of taxing sales, use, and production, and Updating ways for law enforcement to keep the jails full, write tickets, and confiscate stuff. When that is finished, the FDA will give it marijuana seal of approval.
As far as health goes, how much research went into the health effects of Juul pods before those things got approved?
34
I've used Medical Marijuana for over a year now. I use a high CBD to low THC tincture so it's obviously not the same as what the author is using because mine requires a government issued card to purchase. BUT...it has changed my life.
I have a ruptured disk, degenerative disks, and arthritis in my spine. For years I daily used pain killers and anti-inflammatories and also Advil/Tylenol to get relief.
Now, none of those things. I use my CBD/THC combo twice a day. For me it's been a life changer. My spine DR. and pain management team all are amazed at my improvement and I couldn't be happier not taking those drugs. So it does work.
46
The important thing to remember is that the plural of anecdote is not data. A single anecdote is not data. I have no doubt that CBD oil has helped people with many different issues. Some of this may be placebo effect -- people THINK it will work, so it works. Some of it may be due to the concentration, which can very greatly in an unregulated product. And there may very well BE real efficacy. But the only way to know this is through well-designed clinical trials that can produce reproducible results in a statistically significant population.
Of course the Great Medical Conspiracy crowd will pooh-pooh this, saying that clinical trials are just a plot by the pharma companies in the name of their profit motive. To that, I would say "OK, so you don't want any profit motive to come into play, fine. So just who should fund this research? Are you willing to pay higher taxes for the government to fund it?" Research is expensive. These same woo-woos will tell you that chemotherapy is useless because not 100% of all patients respond. And yet, they insist that CBD oil is a cure oil based on Some Guy's Web Site. I simply do not understand this mindset.
31
@Jill C.
Mindset for psychoactive smoke, vapor, concentrates and elixirs is severely impacted by DEA and FDA threatening felony conviction for personal cannabis use.
4
@Jill C.
Hi Jill, How long have you worked in Pharma? I've been involved for nearly 3 decades.
Like it or not, the clinical trial crowd is not pure. Like it or not, the clinician trial crowd will and do conduct myriad studies until they get the result they want, which is some sort of indicator of which way they shape the claims on their product (efficacy, potency, compliance, frequency, whether or not the application is for chronic conditions, co-morbidities, drug-drug interactions, formulary success, and on and on) that result in the greatest potential market and, thus, profit. Greed is good is not pure, except when applied to senior executive bonuses, then it is pure joy. Ought tax payers pay for pure science? Yes. Do we want all profit taken out of self interest, no; but buyer beware. As for applying the standard of clinical trials to CBD and THC? Yes, of course. Long overdue. Ought only the big players with lots of money in play and lots of return anticipated have the only say. I don't agree. That is what you've described.
As for your skepticism of the experiences of truly millions of people, well you are as entitled to speak your piece, as do they.
I have found cannabis helpful in my senior years.
5
@Jill C.
Jeeez. So don't use it. Rather a harsh response this morning.
Maybe a bit of CBD in your tea will help. LOL
2
Sometimes you have to debunk the debunkers. I wouldn't buy any ointment, cream, or shampoo online, for starters. A salve that contains both CBD and THC made locally is helpful when I have sore muscles. Supposedly they work better together.
Just stop the hand wringing and legalize marijuana nationally. Alcohol is legal and widely available and has contributed to a lot more misery than pot ever did.
78
The comments here seem to be mostly from a bunch of stoners either afraid of pot becoming less legal or as a way to justify their marijuana ingestion.
Scientific trials can reveal what CBD actually does and doesn't do as well as helping to regulate dosages.
All drugs should be legal for almost the same moral reasons: to reveal what these drugs actually do and don't do as well as helping to regulate dosages. However, the ethical reasons of legalizing all drugs creates fewer criminals, fewer black-markets (read unregulated and violently guarded), and more taxes to pay for research, distribution, etc, ...
18
I commented and I am very very far from being a stoner. Just FYI. Since you are intent on tarring all the commenters with one brush.
3
It helps with nausea from chemotherapy. The article acknowledges this and I can verify that it works better than the prescription medication for this purpose. Causes drowsiness, though.
11
I suffer from severe nerve damage in my low back. As a result I had to take an opioid for relief, but there were times that I put undue stress upon myself causing an increased pain. My family doctor (Dr) suggested CBD oil. I talked to my pain mgmnt Dr who said, Okay try the oil. It took time for me to research CBD oil and find a good supplier, I then started taking the CBD oil. After some time I caught myself feeling good, happy, not stressed out, life was good. Unfortunately, due to the 0.03% of THC in CBD oil it builds up in your fat cells and gives a false positive on drug screen tests required by my opioid use. I had to quit using CBD oil. (I know there's a CBD oil that is 100% THC free but the product that worked best still contained the 0.03%.) My wife starting using it for sleep and neuropathy and it is helping her. On the subject of opioid addiction, moving to Texas from California, I had to withdraw from 25 yrs of opioid use that allowed me to work and retire. I withdrew by myself, it was challenging. Bottom, I wasn't addicted, the pain meds allowed me a dignity of life. My quality of life diminished to sitting all day. I used to exercise, etc., that stopped. I finally found a doctor who understood my condition and am now on a very small dose of pain meds. My neuropathy is greatly reduced, I'm very active, I play with the grandsons, 9 & 7, we travel. But, I wish I could take the CBD oil again.
11
My vet opined on how little research is being done on CBD and cannabis here in the states because of outdated ideas about "recreational" drugs. I do hope when this dark time is over that a new administration will fund a lot of research on alternative therapies for humans and our four legged family members. It' long overdue and we are poorer for the lack of knowledge.
13
After a hard 3-4 hour bike ride, my legs are destroyed and I have trouble sleeping at night. Add a little anxiety and it is definitely not a good night sleep.
A CBD spray really helps before going to sleep. I am not sure it helps with insomnia, but it does help with restless legs and mild anxiety.
1
I didn’t realize a bike ride could be destructive. If you take out the fun, I guess you’ll need CBD.
@carlos
Maybe try a shorter, not so hard bike ride?
My 11 year old dog has been slowing down, with a pain from arthritis and joint surgeries. 2 months in, taking CBD in her food, she’s acting like a much younger dog, especially wanting to play. I think I’ll try it.
5
So here are my choices for severe insomnia: take nothing and not sleep, take benzodiazepines and sleeping pills, both of which are addicting, or cbd oil, according to this article may be an expense placebo. I go with the cbd oil and sleep. I also have a shoulder that has endured four surgeries and now has a damaged rotator cuff. Cbd lotion removes the pain and lets me enjoy pilates instead of dreading it. There are so many supplements out there with little or no research to back up claims and big Pharma has proven itself to be a non trust worthy entity (see Perdue and opioids). So what is the suffering public to do? Waiting for the Feds to remove cannabis from a schedule one drug so it can be studied will probably not happen in my time; it is rife with political issues. So just as with anecdotal evidence for various herbs and vitamin supplements one must use their one judgment. Two years ago, my psychiatrist told me that the recommended anxiety treatment is acupuncture. Here is western medicine recommending a treatment that a few years prior thought it was hocus pocus and a placebo.
I see little difference between clinicians prescribing drugs to use off label and people responding to increasing anecdotal evidence for a non traditional treatment. Research has not been done for drugs used off label but that seems to be accepted because those recommendations from a clinician. I have been led astray by more clinicians than I can count.
16
@Janet- I'm skeptical. However, even if CBD is an 'expensive placebo,' it's working for you. Use it 'til it don't work. Best of luck and Good Health.
3
@Janet
Can you share the name of the product you use to help sleep? Thanks!
Unfortunately in our modern world, the general population is quite uninformed of how science works and thus we see many personal testimonials exclaiming the wonders of CBD, and how that should be enough to prove its worth. Unfortunately that proves nothing whatsoever and does not disprove the possibility that CBD is just a powerful placebo because of the strength of belief in its value. It also tells us nothing at all about potential long term side effects, or the effects of impurities as noted
especially since there is no standardization of purity or dosing currently. Even after prescription drugs pass the FDA gauntlet there can be side effects that are discovered after the drug is out in the market for awhile. This happens because there are established methods of reporting side effects which must be investigated and if frequent reported by the Pharma company. It is laughable how so many will put an untested drug into their body while decrying “big Pharma” and their poison. I am all for studying CBD to see if any of the claims are true, but unfortunately this is unlikely to happen. The companies making it are making a huge fortune, the average person just wants it regardless, and there is no upside for anyone to pay for studies that might show it’s just another expensive placebo. We have 10,000 supplements on the market, a recent review showed only 2 or 3 have validated scientific benefit. We need more regulation of this market, not less.
10
@Rob
"the possibility that CBD is just a powerful placebo because of the strength of belief in its value"
That's certainly where the evidence points at this time.
It's occurred to me that the slow pace and reluctance to expand legal use and access to marijuana and related substances and derivatives may ultimately be increasing its popularity; so many people are so outraged that it isn't more easily accessible - although in fact it seems pretty darned accessible ...
2
There was a time I would agree with you 100%, but after thoroughly researching CBD oil and the companies I have to disagree. The DEA came down hard on CBD oil that comes from the industrial hemp, think rope, and has 0.03% THC, but they classified it as a schedule 1 drug anyway. The farmers would have bank accounts closed, money taken, no crop ins, etc. They followed all of the gov't guidelines. Now comes big business and big $$$ and congress wants the tax money. So now CBD is everywhere and the new farm bill removes it from a scheduled 1 drug, viola!!! It's a multi-billion dollar industry. Do I wish big pharma would get into this product, Yes, it's expensive and no insurance coverage. After my using CBD oil other members of my family started using it and have receive great results. Something is in the CBD oil that's working for a number of ailments. Just saying.
1
@Rob
Pharmaceutical Grade CBD oil is available in Canada and is available to research facilities around the world.
I was very disappointed by the lack of beneficial effects from various CBD oils ingested either under the tongue or through a vape pen, until I happened upon a CBD pain relief cream that is the one and only thing that almost instantly relieves the pain of bursitis in my hips.
The cream contains arnica (which I've found mildly effective on its own), juniper, peppermint and CBD, and is just magical. I sent some to a friend who is having a similar result on areas of continual pain.
My guess is that both the quality (intensity or purity) of the CBD and the method of use are key to effectiveness. One thing that is not a guess is that CBD can be an extremely effective and undoubtedly safe painkiller.
21
@Porter: Is it possible that perhaps the painkiller that is working is any of the other ingredients? It seems you have a predisposition to believe that it is the CBD, so therefore, you attribute your results to the CBD. That is not a scientific observation and this is who controlled studies are needed.
1
Yet another member of the medical establishment trying to burn down anything not coming from a factory.
Please face it, the medicine approval system is highly in favor of rich pharma corporations.
In medicine things are moving towards personal medicine. Not everyone diagnosed with the a symptom reacts the same towards a pharmaceutical product. Looking to DNA and body chemistry often can help better targeting the prescription.
In that light the medical profession to shed its arrogance and no longer hide behind big - usually corporate funded - studies and instead try to find explanations for the reports from all those people who do report experiencing benefits.
29
I think a better way to conclude this would be, "It seems rather dubious that CBD is a panacea. However, due to the paucity of good research, it's too soon to determine how much of the effects of CBD are placebo and how much are the result of therapeutic action."
I would personally add that placebo is itself a therapeutic action, even if it isn't fully understood.
60
I'd never used ANY recreational drugs in my 59 years, but having been a lifelong migraine sufferer I began last May using CBD oil, one spray every morning of a 2000mg 'cocktail' consisting solely of olive oil and cannabis extract grown in the Netherlands, Lithuania, Slovenia and Croatia. (Lab results are included on the company's website.)
Have my migraines disappeared? Nope. But their frequency and intensity have markedly decreased. More importantly, I'm much calmer when my head pain does arise or explode. The reduction of pain-related anxiety is worth my taking the CBD oil alone. So, not a panacea, but not, in my experience, just a placebo either.
As an aside, thanks to Michael Pollan's latest book, "How to Change Your Mind: The New Science of Psychedelics," this past weekend I raised the bar (and expanded my comfort zone) by attending a psilocybin retreat in the Netherlands, where magic truffles (Sclerotia) are legal. I'm hoping the psilocybin will 'reboot' my brain and along with the CBD oil reduce my chronic pain and reactions to it. Still coming down from a very intense, emotional and mind-blowing experience!
36
A thoughtful and helpful review on the topic of CBD.
A year or so ago it was coconut oil. I expect CBD will also run its course.
It is interesting that some are willing to put in their body an unregulated and unproven substance of questionable origin, but then balk at therapies that have been tested rigorously with established efficacy and identified potential adverse effects.
13
What do the spokesmen of the predator Pharmaceutical industry say about CBD? How effective are Antidepressants, Statins, Chemotherapeutics comparatively? And how effective are they when compared to placebos? Does the author support extensive studies on placebos? Placebos work far better than the Pharm industry would care to admit. They are just not profitable.
CBD is about to become cheaper and profitable. It is not a panacea.
We do make cannabinoids, and opiates, and antidepressants, and anti inflammatories but Pharma does not hesitate to parasitize our need for them.
We should become alarmed about Roundup, a globally recognized carcinogen that is wildly distributed in our grain foods and the meat of all animals that were fed grains that were exposed to or genetically altered to endure Roundup. That is a genuine threat to our health. CBD is a distraction in this context. Since we make it, supplements will not kill us like toxins. Cannabis does need studying but it should be done by objective parties that are not allied with Pharma.
44
@Joseph Huben
I was chatting recently to someone who has worked for a national nonprofit advocating for cleaner water and to someone who had worked for the state pesticide control board for years. They both thought roundup was better for the environment than the alternatives. They commented that when one product was demonized, people rarely stop using herbicides (or whatevericide) they just use something else, which is rarely better, because better would have replaced the demonized product without demonization. Efficacy matters a lot, as an effective product is applied at a far lower dosage and less often and far less of a slightly more toxic product is often better for the environment than more of a less toxic one.
2
@Joseph Huben
"Since we make it, supplements will not kill us like toxins"
What??????
1
I purchased a cream of CBD and emu oil in hopes of alleviating the arthritis pain in my hand. It took a week of daily use before it had any effect. So it might be that for some, it has an accumultive effect. I, for one, am glad I didn't give up on it. All other topical applications had ceased to work.
16
While it's illegal in your country, and a Schedule I, it makes if difficult to do any proper medical studies on the benefits of cannabis. It also makes it more difficult to control the black market. Maybe your country should legalize it like we did here in Canada.
36
Try asking some people with diagnosed chronic pain whether or not it helps. When someone is virtually non-functional due to chronic pain that can't easily be medicated away, CBD, even if it's a placebo, can make the difference between getting by and giving up on life.
I'm not a supporter of the "marijuana cures everything" camp, at all. However, to me, watching my wife crumble under the effects of chronic pain from endometriosis on a daily basis, and manage to find some footing to deal with some of her pain using CBD, questions like, "Is CBD just hype," are daft and uninformed. Eating a few CBD gummy bears and using that as evidence towards the "hype" camp is irresponsible.
It's easy to take a purely intellectual perspective until you're down in the trenches. Then you learn that sometimes you have to take what you can get. Taking things like CBD away from people who are desperate for any relief whatsoever can move their reality from functional to suicidal. I agree that more research is needed, in which case people who want to see hard science on a question have a responsibility to work to create the conditions for the question to be explored.
51
@KrisnaMadhu
As an endo sufferer for many years, I empathize with your wife. I have found that CBD - the real product that you have to purchase at a dispensary and NOT places like smoke shops - is a Godsend.
It does have to build up in your system. After three weeks of taking 50mg CBD tablets a day, most of my pain and hot flashes dissipated. It also improved my mood.
Now I'm vaping it to quit smoking and the results have stunned me. I haven't smoked in several weeks. It took me a few tries to find a product that I liked and gave a heavy throat hit and I haven't had any issues. It's even helped my husband's arthritis. We have a typical that he uses and the pain is just gone. He was a complete sceptic before that.
Big Pharma is looking at a big threat to their bottom line and they don't like it.
24
CBD and medical marijuana did nothing to help my mom's chronic pain. She tried then in every form. I felt so bad for her because she was so hopeful.
3
A very thin analysis I’m afraid. Science exists beyond the USA and there is plenty of it. Look at pub Med and don’t start about clinical trials. Cannabis is the most widely tested substance known to man, across cultures for over 5000 years and never one reported fatality.
18
@Joe Dolce It is not entirely true that Cannabis has never killed anyone. All one has to do is think Rope, and realize Hemp has killed a great many who never even used it as a drug.
But seriously, I have smoked pot myself since early age, and at the time I had decided to be an adult and quit, my doc, whom I was seeing for neck and back problems (which would lead to rebuild of C5-6-7) told me that he had recently tried pot himself, and it was a help for HIS pain, so if I had not already tried it, to do so. So, I quit the cigs instead, and did much better. I found I had been smoking for the pain relief anyhow, before they started me on opioids and surgery. My doc recently told me to smoke More!
And in that time, from late teen to now 56, I have known people that were allergic to it, some violently so so as to require real hospitalization if they are around it being used. I know of one gent who passed due to having a heart attack during a coughing fit after a heavy hit. So truly one cannot say it is entirely 'safe'.
That said, the fact that it HAS been in use for 5000 years, and well documented in that, and the very very low reported numbers that have had problems puts it to be at least as safe as peanuts in the general market today.
Peanuts are on the low end of toxicity for normal stuff we use during our normal day, cleansers of all sorts, plasticizers and all the petro-products are much worse than peanuts. Yet they have been less restricted than this very helpful plant!
1
I’ve been using both CBD and cannabis for chronic pain for years after a car accident (5 surgeries and years of physical therapy) and the subsequent onset of chronic migraines, occipital neuralgia and cervicogenic headaches.
CBD is fantastic for relieving pain and anxiety. Together with a little cannabis (entourage effect) my pains are stopped in their tracks. CBD is also great to help me sleep and daily use has cured my asthma.
Instead of looking at the very few American studies on these products, you should look at the many studies done in Europe and Israel. They are miles ahead of the US and have repeatedly proven the efficacy of CBD and cannabis.
37
To quote the journalist John Diamond: “There is really no such thing as alternative medicine, just medicine that works and medicine that doesn't.”
The key is scientific method: until a treatment ("natural", Chinese, Ayurvedic, ancient, modern, dietary, chemical, electrical, pharmaceutical or otherwise) is subjected to double-blind, placebo-controlled clinical trials and shown to be effective above placebo baseline, it is just wishful thinking, romanticism and fuzzy therapy. And personal "testimonials" are worthless.
Furthermore, once "efficacy" is established, it remains to ask whether it is worth the cost -- financial, side effects and ultimate safety ("natural" treatments included) -- because there's no such thing as a "free lunch" in medicine, either.
15
@Douglas I was given some CBD ointment as part of a "birthday package" at a pot shop I was frequenting at the time. I never had any intention of pursuing or seeking out CBD for any reason, let alone for pain management. I went for a hike about a week later and twisted my knee. I made it down off the hill and thought I would try some of the cream before I considered an urgent care, the pain was a 7/10 pretty constantly. On contact with the cream I could feel it's effects. The pain went away entirely and the swelling that had been present started to vanish immediately.
I say all that to say this: personal testimonials are never worthless, as all people have worth, and those stories have worth to the folks that experienced them and inform their judgement: I won't need a study to tell me that CBD helps with inflammation and pain, my knee already did.
I appreciate the author's consideration of a need for regulation of the business, but this is a logical fallacy: all cannabis products need better regulation to insure quality control, not just CBD. Legalization is the easiest path to regulation.
24
@Scott Nelson You are completely right and my language was imprecise. Personal testimonials have worth to the person who perceives benefit and, quite frankly, in providing avenues of possible scientific follow-up. That being said, personal testimonies (largely because of the placebo effect) are worthless in establishing large-scale benefit for randomly-chosen others, as well as analyzing safety, cost-benefit and side effects profiles. I'm amazed at the number of people who excoriate the claims of pharmaceutical companies (regarding cost, safety and potential side effects) while uncritically accepting the claims of "natural" and "ancient" therapies, demanding no scientific information regarding safety or side effects.
10
@Douglas You must know a large number of people who do what you claim. I personally don't know anyone who does that. To "excoriate" pharmaceutical meds or "uncritically" accept the claims of others re CBD implies an incurious mind. The people I know simply want to reduce pain and after trial and error find that acupuncture and CBD are often the most effective and safe. If you have a study showing the behavior you describe, please share it. Otherwise, your comment comes across as condescending.
2
This article is an opinion piece which means it is not held to any standard other than the author's opinion. It happens that the author is a Dr. speaking from his personal experience. The fact that he selected to try a cannabis strain called "Nine-pound hammer" really makes me question him, not cbd.
I use cbd every day and in my experience it is very effective and definitely not a placebo. I use it daily topically to relieve joint pain/stiffness and periodically under the tongue for insomnia. I like that it is a non-addictive product and I can easily control the amount I use.
It is true that there are lots of substandard and even bogus products out there. I was fortunate to learn a lot from a very well researched retailer who advised me as follows: the most important thing to look for is organic, pharmaceutical grade hemp (not marijuana) cbd made by a reputable producer suing CO2 method, not chemical extraction.
As to the result of the gummy bears that Dr. Friedman tried, I have found that edible cbd or edible marijuana has very little noticeable effect for me personally. I am not looking to get high. I am interested in the medicinal properties.
17
When my mother was dying of terminal liver cancer, we were not allowed to get morphine for her--she wanted to die at home. A relative drove to a town where he knew a physician who would give him morphine, dreading that he would be stopped by police. While it was never necessary to use it, it was a comfort to us to have it. The whole notion that terminal patients could not have "drugs" because they might become addicted was. and is, absurd. When our nation become rational (will that eve happen), we will allow people to access whatever will alleviate their pain.
27
How about we just let people decide on their own? If it works for them, they'll use it. If not, they won't. I thought that's what this whole "freedom" thing was about. Sure would beat opioid addiction, anyway.
27
American Cannabis Nurse Association witnesses the greatest number of patients who respond positively to CBD ,THC, or combination therapies. ACNA's coast to coast experience is empirical real life evidence. Many, not all, clients in severe pain with sleep deficits sleep after dosing with preferably 20-80 parts CBD to 5-10 parts THC. Those who do respond with sleep often tried or were prescribed every medicine possible. CBD in ratios with less THC than CBD have resulted in mercy for those patients whom it works for.
In health care practice, education and legislation, there should be greater professional nursing advocacy for a lot more than just cannabis therapies. Registered Nurses rule---with compassion.
17
@Michael shenk Maybe we need to have a real Nurse as President and give us a GOOD shakeup, not the shakedown we are presently getting.
1. The marketing of medical marijuana, including CBD pills and topicals, has been massive and very, very effective.
2. Placebos have real, measurable benefits.
3. People desperately want to believe in SOMETHING.
12
"yeah, there's this ingredient in weed that you can't feel if it's working, and you can't tell if it's even there, and it doesn't do anything, but basically it cures all diseases."
-- every CBD advocate I've ever spoken with.
5
Where is the evidence for the idea that CBD is a placebo, Dr. Friedman? The same evidence for efficacy is needed to prove placebo response, and as you’ve rightly pointed out, that evidence is lacking. So, calling it an “expensive placebo” is as baseless as saying it definitely does what it is purported to. The fact is, we just don’t yet know.
21
@Rachel Berko
He doesn't call it an expensive placebo, he points out that in the absence of definitive evidence but also many glowing personal testimonials, expensive placebo is the default explanation, and scientifically he's right, that's how testing of drugs works.
It's the scientific method. We don't ask that something be "proved" to be a placebo; we assume that something does not work until it has been proven that it DOES work. If you think about it, it makes sense. We could spend all day asking for "proof" that the coffee pot and the toaster and the curtains and the drapes "aren't placebos," but clearly this isn't the way a rational approach to identifying effective drugs works.
So "expensive placebo" becomes a not unreasonable potential interim, default explanation of the glowing personal testimonials - until a better explanation is available, scientifically.
2
A placebo is defined as: “a substance having no pharmacological effect but given merely to satisfy a patient who supposes it to be a medicine.” The way a substance is scientifically proven to be a placebo is to do “double blind placebo controlled” studies, to compare it to a known, already proven placebo. You will need to review your scientific research 101 if you think that CBD has already been shown to be a placebo.
1
@Rachel Berko
Did I claim that CBD has been proven to be a placebo? Maybe you just need to go back and slowly reread what claims are made here, both in the article and in the comments. You did not follow the author's claims and you didn't follow my claims about drug testing. I have no argument witb your ideas about how we might prove something is a placebo; check what I wrote and see.
I’ve tried many herbal remedies - from lavender to St. John’s Wort for constant pain (foot neuropathy from a surgeon who destroyed the nerve in my leg) and depression. The only thing that has ever had any curative effect at all is CBD. The author declares it a “placebo” without any evidence or research to support his position. His elitist attitude may serve pharmaceutical corporations well but he seems to be throwing a temper tantrum over the fact that he has arrived so late to the party. The common sense approach is not to declare it a placebo but to call on intensive research to document its effects. Marijuana already is known to reduce inflammation in glaucoma. It reduces inflammation in my foot and relieves the pain. It also treats depression and many other things. The most upsetting thing to the powers that be may lie in the effectiveness of a plant that everyone has access to - at a fraction of the cost.
22
This article is the first source of my hearing about CBD.
As an inveterate cigar smoker, who finds cigar smoke reviving, calming, and making the gears in the head turn vigorously, CBD story reads to me as a mixture of superstition, snobism, and seeking something new, possibly completely useless, in the world of sensual gratification.
1
@Tuvw Xyz
I've heard that cancer patients get relief from CBD. File that away for the future.
1
@Tuvw XyzYikes, You’re the one who should be trying THC if not CBD! Get off that evil tobacco before it gets you. There are safer ways to get your sensual gratification and spin those gears.
1
“The public, rightly, is quick to demand proof of safety and efficacy when it comes to synthetic pharmaceuticals.”
Your faith in the public outstrips the evidence for the public’s conspiracy-minded demand of safety and efficacy. The public views every FDA approved prescription drug as a Big-pharma conspiracy, while they will imbibe the latest eye-of-newt potion or cannabinol tincture with no evidence at all.
4
The term placebo is tossed around for anything that doctors say shouldn't be healing or helping, but somehow it still does...
Addiction is tossed around for any habit people have that other people consider well outside the bounds of what they themselves would do or that they think society should accept...
Ultimately, let people themselves decide what is right for their own health and happiness.
The government should protect you from me... not you from yourself. If you think something helps you or makes you feel better... ask yourself "does this hurt anyone else?" and if the answer is "no" then do it... don't let other people bring you down because they themselves would never do it.
You're the only one that knows what makes you happy and you're the only one who knows your personal acceptable level of healthy.
7
Torn.
On the one hand, it's easy to see how the Pharma complex and its puppet, the FDA, would want to quash a natural compound.
On the other, CBD seems poised to be the gluten-free of 2019, a treatment that is initially useful for a tiny sliver of the population with an actual, relevant condition - and then blows up into an embarrassing hula-hoop fad.
Will drop some melatonin and sleep on it.
3
Ideally the principle of giving to those who are less fortunate would become the primary meaning of Boxing Day and it would become part of a 3 day Christmas Holiday – (Christmas Eve, Christmas Day and Boxing/Giving Day).
Seems like that should resonate with true Christians.
@Paul Habib
And if we gave each other a joyous box of CBD? :)
Paucity of evidence does not equal evidence of placebo. Why would you suggest otherwise?
10
Placebos without side effects or high cost are worth inclusion in a pharmacopeia.
5
About eight years ago, my eldest son suffered from extreme light sensitivity causing painful headaches. He was diagnosed with a pea-sized tumor in his brain that was up against his optic nerve. Surgeons claimed there was too great a risk in removing the tumor and nicking the nerve resulting in blindness. One doctor, however, recommended using a tincture of CBD oil in water three times a day as a possible way of reducing the size of the tumor. A few months later, an MRI shoed the tumor had indeed gotten smaller and was no longer up against the optic nerve. The resulting operation was a success and he is headache free with full vision.
You draw your own conclusions.
21
I firmly believe there's a huge amount of hype with all aspects of medical marijuana, CBD included. I think there are individual success stories and some kind of actual benefit in there that we don't understand yet.
It seems astonishingly unlikely that CBD-only products are going to turn out to be dangerous or damaging. The most likely outcomes seems that it's only slightly effective for some people and neutral for everyone else.
My concern with articles like this is that I'm worried that they're fuel for the anti-legalization crowd who are constantly pushing fear, uncertainty and doubt about cannabis as a justification for not outright legalizing it.
Is most of what's promised about cannabis likely to be hocus-pocus? Probably. Is it going to be wind up bad for some folks? No doubt. But the real issue isn't whether it's ultimately 100% guaranteed safe or effective, it's whether it should be legalized because existing public policy doesn't work.
13
@Mobocracy
Well said. That is exactly what I think too.
Lets see what the research says before writing articles suggesting inefficacy or efficacy. Let's do radically more research and then Let's see what the research says. What the research has shown clearly so far is that we can say is the downside of CBD is minimal. And what we can say is advertised content should be more tightly scrutinized and verified. On that I totally agree.
16
@Trebor Except that a lot of people are spending a lot of money on the hype. Doesn't it make sense to show what the current research says? Isn't this information consumers can use?
11
There is a plethora of research done in Israel and som European countries which prove the efficacy of cbd and cannabis.
My wife is trying CBD for knee pain and knee inflammation. She has upcoming knee surgery and doesn't tolerate opioids or over the counter pain medicines and anti-inflammatories. She tried CBD orally with no pain reduction. She rubbed CBD salve on her knee and it reduced pain substantially. This anecdote from Dr. Friedman's article stands out:
"Many of my patients have tried it or want to learn more about it. One of them, an educated, successful and anxious man in his 40s, recently told me he tried mixing CBD oil in his tea, but it didn’t make him calmer. Then he rubbed the oil on his injured knee, and pronounced it a magic cure.
Like Dr. Friedman and others, we look forward to more research. However, we disagree with the traditional medical approach of not trying alternatives that have been used for many years, especially in moderation. I was given an ayurvedic oil by an expert in that method and found it effective. The herbal pharmacopeia known by many traditions is well worth exploring, and Europe is ahead of us there. There's the potential efficacy of CBD, and then there are other factors, like knowing where to find information that's available from scientific and traditional sources, and there's the big pharma lobby. Living isn't safe, but soothing pain seems worth a try if something like CBD is tried in moderation and as a short-term remedy, at least.
15
1. Where’d your “expert,” go to school?
2. Did you happen to notice the amount of moolah that’s now flowing into this David of a drug industry—without quality control, and without real testing?
3. Ever wonder what happens to kids when they come into regular skin contact because grandma’s beeb slathering this stuff on?
I started using CBD oil with very little THC last December for chronic pain associated with an unsuccessful knee replacement (my 2nd on the same knee). It is from a reputable source and is tested. It replaced a low dose morphine I had been taking for 7 years. I take 20 mg of oil under my tongue when I need it: every 2-7 days. The pain is far better managed than with any other medication I have taken. I rarely limp, no longer use a cane and the pain level is neglible. It is working quite well.
23
CBD oil, from hemp, with no THC has helped me sleep like nothing else. I wasn’t expecting any particular result. I was trying it to test effects before having my brother, in recovery and having recently lost a kidney, try it. I experienced a major reduction in insomnia and anxiety. This was unexpected and incredibly life changing.
13
@Cassie Curtis. Which proves what, exactly? Correlation is not proof of causation.
As a physician myself, I have been guarded regarding the CBD hype. My primary concern regards isolating and potentiating chemicals, like CBD, from a plant with centuries of safe usage, marijuana, that has over 200 active components. History suggests this approach will create new remedies with stronger effects offsef with unpredictable side effects. I have personally seen high CBD products that also have low THC as well as other constituent factors have profound effects reducing pain associated with neurologic pain, like RSD.
5
@Bill Prange
You can see some pretty terrible side effects from all kinds of drugs that are routinely prescribed to children, teens, and adults alike.
Take anti-convulsants, which as you know, are prescribed for seizures, depression, anxiety, and who knows what else on a routine basis. Those drugs, depending on the patient's brain chemistry and dosage, can have anything ranging from no adverse side-effects to suicidal ideation, self-injury, etc.
Marijuana in some people, can cause paranoid ideation and increased anxiety. My guess is that those same people are probably prone to paradoxical reactions to particular drugs.
For most people, however, CBD brings significant benefits. There is also hemp-derived CBD, for those who don't tolerate cannabis.
10
@Bill Prange, I have been titrating my dosage of CBD oil up, over the course of many weeks. It has had a beneficial effect on my nerve pain and related muscle spasms, think. The side effects I have experienced are a temporary ringing of the ears for about 20 minutes after dosage, and a slight sore throat that dissipates after a bit. When I first started taking the oil my digestion was upset for several days, but I adjusted to it and got back to normal after about a week. I tend to be super-sensitive to meds. When I am prescribed a pharmaceutical (I have gone through several for treating migraine), more often than not I will experience most of the first-tier side effects, and a few of the “contact your doctor” second-tier ones. So I am happy with the CBD oil. (I think my migraines are fewer, but they are often triggered my muscle spasm and nerve pain, so it is all a big loop.)
4
@Bill Prange Look into CBD isolated from hemp rather than marijuana.
ProjectCBD.com is a great resource, they’ve compiled all the scientific research, and you can search by ailment. We’ve got a long way to go to understanding CBD’s effects, but I do believe it’s a promising chemical compound and the very least.
9
Yeah, except I looked.
There are no studies from independent researchers. It’s all from guys in the CBD industry, including a guy who’s in Big Pharma that sells—guess what?—CBDs.
Whoops - projectCBD.org !
@Laurel Andrews
Should be ProjectCBD.org not .com
Great link, thanks.
I did a lot of research before trying CBD oil because I know there is a lot of rubbish on the market. I found a highly recommended, reputable online source for it, and I now take droppers of CBD oil under my tongue for maximum absorption. I think it has had a beneficial effect on my pain (almost constant muscle spasms in my neck, which trigger migraine and trigeminal nerve pain) because I get fewer bouts of extreme spasm. I don’t think it’s a placebo, in other words, in my case. It’s pretty arrogant of the writer to say it is for “most” people. I don’t have some magic-wand belief in the healing power of nature, as the writer implies. Let each person make their own judgement on it’s efficacy.
15
The whole point of having a placebo in a trial is so that every patient believes he or she is getting "the real thing". In other words, if you believe something or other is going to work (against pain, in this case), and believe it is working, there's a very good chance it will work. As a placebo. That you don't believe it's not acting as a placebo in your case means only that you believe that.
9
@Texan Most often the point of a placebo is so recipients don't know whether or not they are getting the study medication. The idea is to try to avoid the "placebo effect" by having the recipients not know which they are getting. The study model you describe could be a study to measure the placebo effect itself.
Your point about expectation and individual results is correct. Belief in the effectiveness of some treatments on some types of disease is sometimes significantly effective just by itself. It is it's own interesting area of research.
3
My dear old friend Marion had terminal cancer and was in a lot of pain. Here in Oregon she could buy recreational marijuana at a dozen different stores in the neighborhood, but the combination of CBD oil activated with a small amount of THC required a doctor's Rx--and then the Rx had to go to the state office in Salem for approval. Approval would take 2 months. My friend didn't have 2 months to live. She also want to fog up her mind with recreational marijuana or with morphine.
We found another friend with the Rx approved already and got some through him. (He just had a chronic pain condition, not a terminal illness.) Marion was able to have a decent, almost pain-free last two months and even go to the Renee Fleming concert a couple of days before she died.
BTW, I understand that CBD by itself doesn't alleviate pain. It needs a bit of THC in order to work. Perhaps the researchers should talk to people who've already used the stuff before they design their studies.
42
@Martha Shelley
Correction, I meant she didn't want to fog up her mind with recreational marijuana or morphine.
1
Just for future reference, it’s possible to create that mix yourself. Take the cbd oil and wait about 10 minutes, then vape a small amount of cannabis. Go slowly to see what ratios work for you. After some trial and error, I found the right ratio of both to treat my migraines.
2
The federal governments stringent laws against marijuana are based on racial bias. Back in the late 50's and early 60's when these laws were adopted, African Americans were the predominant stereotype of the drug's consumers. In addition to the federal laws mandating marijuana as a Schedule 1 substance, the federal law specifically states that anyone using marijuana is prohibited from possessing firearms and ammunition. No other Schedule 1 substance invokes that restriction. That, combined with the fearmongering over 'Refer Madness', white male legislators of the era embraced the combined prohibition of African American marijuana users and gun ownership.
Regarding CBD, I will say that as a former prescription opioid recipient for over 12 years taking 220mg daily, I was able to become completely opioid free (through a 3 month gradual step-down) and the use of CBD tablets (40mg/day) with a CBD vape for breakthrough pain.
Given the ubiquitous abuse that opioids are associated with, thankfully Connecticut has put a comprehensive Medical Marijuana program in place. I am sure it is saving lives. Homeopathic remedies are a challenge for clinical research. Regardless of the clinical conclusions about CBD, it works for me and I highly (no pun) recommend it.
25
Even with regard to cannabinoids, the benefits for pain have yet to be proven. Essentially all the research has been anecdotal and there are no good quality studies demonstrating their efficacy as analgesics.
Yes, I know many people will write how much marijuana relieved their pain. This is called anecdotal evidence and no drug can be approved by the FDA based on it.
4
The problem is that the people designing these studies don't know enough about cannabis to design their studies properly.
For one thing, the effects of whole plant cannabis are not caused by cannabinoids alone. The terpenes that contribute to the smell of the plant also add a spectrum of effects like stimulation, sedation, anti-microbial activity and inflammation and pain relief. This is why different strains of cannabis carry different names and deliver different effects.
And this is why you cannot use pure THC or pure CBD to judge the medical efficacy of whole plant cannabis in a clinical trial. Without the terpenes, you've learned only half the story.
It appears right now that this knowledge of cannabis terpenes is still largely sequestered within the cannabis community.
I hope eventually medical researchers will wake up and smell the terpenes so they can design clear and valid studies of how different strains of marijuana work or don't work on different medical problems.
6
@Steve, you need to break “pain” down into physiological parts. Put aside CBD oil and consider the effect of marijuana. Would you agree that marijuana, ingested or smoked, causes relaxation? Now think of reasons someone might be in pain. Nerve pain can be caused by muscle spasm, clenching, the grinding of teeth, or the constant cramping of an arm, leg or muscles in the lower back. If you can relax those spasms, the pain will subside. That is not “anecdotal,” but a true, physiological process.
5
@Patricia
People can design the studies that can demonstrate the efficacy of any treatment for chronic pain. These involve objective measures of whether or not the treatment improves the level of functioning.
The problem with cannabinoids is that no one has been willing to do these studies on them and this should tell you something.
I have a vascular pain disorder for which some people have reported relief from CBD oil. It did not help me. It was rather expensive as well, considering insurance would not cover it. Had it worked and I continued taking it, the cost was around $50 per week.
2
For nearly three years, I’ve been custom formulating CBD and other key cannabinoids for dogs with four conditions: cancer, arthritis, seizures and anxiety.
Dogs don’t lie, our products have efficacy but the major medical work is done by CBDa, THCa (both precursor acids that are non-psychoactive) and good old THCd-9. The only time I need high amounts of CBD is for seizures from epilepsy. I’ll take the right ratio of those cannabinoids over 2000 mg of CBD in all but seizure cases.
Sadly, the coming tsunami of CBD products will likely obfuscate the benefits as limited they might be. It’s good though to see the federal government move towards a modern approach to cannabis and hopefully whole plant medicine.
10
There is a substantial body of clinical research that demonstrates the effectiveness of CBD in treating epilepsy, inflammation, pain, migraines, insomnia, MS, Parkinsons, eczema, arthritis, opioid addiction and many more ailments. Read the peer-reviewed science and medical journals and keep up on the research before making judgement.
CBD efficacy is dose dependent. Take too little and the effect won't be noticeable. The public and especially the medical community need to educate themselves on CBD hemp use in order to obtain its benefits.
Read the labels before assuming a cbd content. It's difficult to standardize on cbd as its content varies within any given batch. Often manufacturers standardize on the amount of hemp extract and not CBD. Those that standardize on CBD typically use a crystalline CBD isolate and not hemp extract. Most labels reflect the chemical analysis of one or more samples from the batch or the raw crude oil. Yes, there is variation in CBD content in hemp extracts, just like the amount of vitamin C varies from one orange juice to the next and between batches of orange juice from a single manufacturer.
CBD bio-availability is highest for transdermal application and across the mucous membrane, which is why ingesting gummy bears or edibles isn't as efficacious.
16
While undergoing chemotherapy last year, I found anti-nausea medication to be largely ineffective. Fortunately, a cannabinoid oil containing a mixture of CBD (80%) and THC (20%), taken once daily, allowed me to nearly complete the recommended regimen. The CBD significantly reduced nausea, worked as a muscle relaxant, and in combination with a mild THC "high", which dialed down anxiety, allowed for a restful and enjoyable evening and an unbroken deep sleep. CBD worked for me and, I suspect, would do so for many others suffering from the effects of chemotherapy.
27
I had a similar experience, tried it for anxiety and insomnia and couldn't tell if it was just placebo. But the one thing I'm sure it worked for was anti-inflammation. I'm sensitive to pollens and other airborne allergens and in summer with the a/c on, I wake in the morning with my face very puffy and red. Same thing when I drink alcohol in the evening. But when I took 25-30 mg of CBD sublingually before bed, my skin was completely calm and even-complexioned. I couldn't believe it. I also got my oil from Green Roads World.
I'm not surprised at all that the majority of vendors' oils contained less CBD than claimed. I shopped around with three different vendors and even though they show their third-party lab tests and all, you're buying with blind faith. Some just don't work. Green Roads World was the only one that worked for me so I stuck with it even though it's more expensive.
Another peculiarity of CBD oil is that it's labeled with the total mg CBD per bottle. Like you're going to chug the whole thing? Be sure to know the mg/ml and keep notes on what doses and vendors work for you.
9
I am using CBD for my sleep disorder which I have had for years. I don’t know if it is a placebo effect or if it is actually helping medically but I really don’t care. All I know is I am sleeping better, don’t notice any side effects, and that’s good enough for me.
32
I used cbd for 2 months for anxiety. I believe it did help. I also believe I gained weight from the cbd. I bought a second tincture from the same store under the same label and immediately lost the effect. No conclusion here, just sharing.
4
I recently started using CBD sublingual drops for chronic arthritis pain throughout my body. It doesn't completely eliminate pain; nothing really does. But it lessens my pain considerably and I'd rather use CBD than continue to get steroid injections and take prescription anti-inflammatory medications.
Everyone reacts differently to treatments but I'm convinced that CBD and THC based products have a role in treating certain chronic conditions. It sure beats opioids, we can all see what happened when big pharma morphed into pill pushers.
17
In the absence of sensible federal regulation, a bootleg industry has cropped up. No surprise there; capitalism on the move. What we need is for the puritan congress to de-criminalize cannabis and fund long overdue research. Consumers should not be at the mercy of possibly unscrupulous purveyors. If a tincture says 500mg CBD, that's what should be in there, nothing else.
47
A number of people here have claimed that CBD is not effective without some additional DHC. However, I have been using CBD oil sublingually with good results for about a year. I get it from "Green Roads" because it is tested by a third part pharmacist and it claims that it contains no DHC. Some of the claims here make me want to try CBD with small qualities of DHC. Where can it be legally obtained from a legitimate outfit through the mail?
1
@JerryV, do you mean THC? If so, I think the question is whether THC oil — or THC-augmented CBD oil — can legally travel through the mail. I believe the answer to that is no.
1
@Passion for Peaches, Thank you for correcting me. Yes, I did mean THC (Tetrahydrocannabinol), the psychoactive component of hemp extracts. I agree with you that the answer is probably "no" but a lot of people in this thread have been advocating the use of a small amount of THC together with CBD. Where are they getting it? Are these in States that have liberal laws for the use of cannabis? Or are they getting it from shady sources that they do not wish to share?
@JerryV, Sorry - should be a "third party pharmacist".
Reading that CBD oil taken sublingually helps with chronic severe pain on the advice from the MD specialist treating me that I should try it I ordered a vial that gives the 50mg dosage recommended for my body mass and severity of symptoms. What I found that within a short time it takes the edge off. At 30 minutes the effect stabilizes and for six to eight hours I have substantial relief with some benefit lasting for close to 24 hours. That is with a product guaranteed to meet FDA requirements for sale as zero THC but with all the other compounds for the so-called entourage benefits. But with sales tax it amounts to close to $170 for sixty doses which is a lot to handle out of pocket. And I wonder if a product with some THC might work better. What seems clear though is that the legal declaration of marijuana as having no medicinal benefits and requiing cannabis to be listed as a Schedule one drug is indefensible today and should be rescinded by Congress immediately if just to permit the studies that should have been done long ago and to permit doctors to recommend it as an herbal supplement for conditions where it is proving beneficial in the 33 states that have already legalized its use.
31
Medicine will soon discover that every person reacts to different drugs differently- and that large scale studies don’t reflect the effect of drugs on individuals. Studies have already shown that the placeobo effect may be linked to certain genes- ie not something that works universally. Personally, I have found sugar to directly impact my depression. No studies support my anectdotall experience, but staying away from sugar works for me.
CBD creams and salves do often relieve my aches and pains. The tinctures do little for me, so I don’t use them.
Many Shiites, in my experience, don’t honor their patients exeriencrs of their bodies. But if we stop trusting our experiences of our bodies what do we have to hold on? How can be sure if any reality?
I say trust your experience of your body. If it helps use it. If not stop.
7
@Morth
Of course large scale studies "reflect the effect of drugs on individuals." That is precisely the point of the studies.
4
The evidence doesn't suggest that it's an expensive placebo! It suggests we need more studies to determine its effectiveness.
93
Clearly the prolifiration of CBD products overnight is a legal and thoughtful marketing and distribution place holder for THC products about to hit more states that are legalizing the use of marijuana. Once the real thing is out everywhere - CBD’s fame will fade like passing fad.
8
@Ofer C. - I don't necessarily agree. CBD may offer people pain relief, help with sleep, etc. without the psychotropic effects of THC. Many people who have kids and 9-5 jobs and mortgages and etc. can't afford to be high all the time and are not necessarily interested in THC-containing products. The way I see it, THC-containing products may be used for occasional recreation but CBD can be for everyday.
5
This hasn't been the case in Colorado which has both legal hemp and marijuana. Profit margins are too slim for many to make it in MJ becasue of high taxes, overhead, intense regulation, falling prices and inability to obtain banking services. Most people prefer hemp over MJ for pain, sleep and anxiety. Alternatively, hemp has higher profit margins than MJ, as it has no special tax, low overhead, banking services and a multitude of products.
3
There are some advantages to CBD over anything with THC. I have a legal weed card in New York State so I can purchase THC products and I do but they make me sleep too much and I don't always want to get high. CBD is very useful for mellowing out and for chronic pain when you don't want to get stoned.
I tried it, and it definitely made me a little bit high. It also helped a great deal with the muscle spasm in my back. I would like more research on whether it makes people a little bit high, as in my case, but there certainly appear to be a lot of credible people who say it helps them. As long as it isn’t being used to mask underlying causes which should be addressed, that seems like a very good development. I’m puzzled as to why that isn’t more of a cause for celebration for this writer.
21
@Mara Dolan
Mara, that "little high" you felt was a placebo effect, just like all the other phony vitamins and supplements.
@Mara Dolan CBD oil – without THC –made you “a little bit high”?
@zigful26
nope - I'm a daily marijuana user and CBD flower (0% THC) def makes me a bit spacey. what is it with people and their placebo obsession?! CBD affects different people differently
While reasearch is important, the ability for people to use a natural compound for medicinal purposes should not be trivalized. As a survivor of major surgeries to repair aortic dissections, sleeping after weening off oxy was a problem. CBD helped me sleep, and I would hope doctors and scientists would see the opiate connection.
22
I had the same experience after my major surgery last year. The CBD I took helped with sleep and avoiding more Oxy.
12
Yep. Didn't use opioids after my elbow surgery; CBD and/or THC sufficed.
1
Maybe, after sampling both "Nine Pound Hammer " and "Trainwreck" as his points of comparison rather than, perhaps, "Floating Lotus" or Butterfly's Wing" any effects from CBD gummy bears were unnoticeable by comparison?
CBD oil certainly is the au courant drug: I was encouraged to look at it for a trial for my mother, by nursing home staff!
37
Ha! Thanks for making me laugh!
I am a regular user of Trainwreck and it does not have CBD. It is a pure sativa with stimulant terpenes that promote focus and keep me on task.
Hilarious that the medical community is so gravely concerned that there's not enough data on CBD, hinting that it may not be effective.
Amidst all this hand-wringing, the FDA greenlit yet another synthetic opioid in November: sufentanil, 5-10 times stronger than fentanyl. I suppose that makes sense. After all, we can be certain that *this* drug is effective: there were 72,000 opioid overdose deaths last year to attest to that. (How many overdose deaths have been attributed solely to marijuana products?)
There are already dozens of comments here by CBD users and their relatives attesting to the efficacy of this product for pain relief and other uses. Elitist practitioners like Dr. Friedman discount these stories, asking "but what does the evidence show?", as if FDA approval is an infallible golden standard of truth.
In effect, they are pumping the brakes on alternatives to the medically accepted, profitable status quo: epidemic physician-prescribed death. It is not anti-intellectualism to regard arguments like the one seen here with cynicism and distrust.
390
@trapstar Not many have overdosed on tobacco either. That doesn't make it (marijuana) a harmless substance.
7
If a drug can be patented it will be exploited. Monopoly pricing trumps science.
4
@trapstar
Don't you know, it's not manufactured in a lab costing millions in research made out of chemicals that do heaven knows what, so it can't possibly be effective. It has to be smoke and mirrors.
Meanwhile, tens of millions of people pop anti-depressants that no one really understand how and if they work. I'd also like to draw your attention to thalidomide. If you are too young to remember that wonder drug, look it up.
8
I have used CBD capsules to sleep through the night for the past year. When I run out, I wake up at 4 am and can't get back to sleep. That's my own anecdotal experience and not a placebo effect.
67
Why don't you think it could be a placebo effect?
1
Chopper crash Vietnam 1969. Fractured cervical spine, subluxed sacroiliac joint, pelvic/hip joint damage. Chronic pain for 49 years. Opiates? No chance. Morphine at aid station before evac made it clear—I would become an addict. Marijuana? Not a chance. Three surgeries—meh. CBD vape with minimal THC? My son bought it for me and said try it, or we’re done. Immediate: Relaxation. 15 minutes: Hip and knee arthritis relieved. 30 minutes: Greater trochanter bursitis relief.
1 hour: Sacroiliac joint relaxed enough so I could self-adjust. After about a month, with maybe 10 self-adjusts per day, significant relief to sciatica—SI joint stays where it is supposed to be. Can you go to a chiropractor 10 times a day? For a month? I had to titrate to find my dose, and son did significant research to find reliable product. I’m not a real doctor, just a retired dentist. Works for me, only occasional use to relieve/prevent spasms. We need the FDA to authorise testing and production standards to provide real data for dosage and medical standards.
738
You should be a CBD lobbyist! Thank you for your service. Sorry for your injuries.
11
@James D Ritchie The teeny tiny but hugely important bit of information that you dropped is that CBD is largely ineffective with out at least a small amount of THC. The research has barley begun, but those of us who have had the chance to experiment with high quality medicinals know to just skip the CBD extracts that do not contain a minium of THC. As someone who uses edibles as a performance enhancer I have come to value that little extra "sparkle" I get when I go on a long run. I am not surprised the author, (or anyone) found the isolated CBD ineffective.
9
Reply to James Ritchie: Dr. Ritchie, I’m so glad you found some relief from your pain, but so sorry you suffered such traumatic injuries. Thank you so much for your service for us and our country. I was a little girl during Vietnam but I remember it. And I remember the sacrifices made. God Bless.
8
The last sentence of this opinion piece simply doesn't follow from the rest. What is the basis for concluding that "at present CBD looks more like an expensive placebo than a panacea"?
The author has just made a convincing case for a very different proposition: that we actually have no idea whether this drug is effective, or for what. I was convinced of that proposition. That's where the science is at the moment. But that's a very different conclusion than the sentence I just quoted.
It may be that Professor Friedman's view is that everything is an "expensive placebo" until convincingly proven otherwise. That's what I'm gathering from the inexplicable last sentence. But that view makes no sense at all. In fact, it is actually a kind of dangerous assumption to go through life making.
134
@JR dangerous? How so? Isn’t the opposite dangerous? Not sure why this comment has so many recommendations. Considering everything to be a placebo until proven otherwise is exactly how science determines which medicines actually work.
3
The doctor and his brethren that are of the same mind will happily believe in, and prescribe, CBD once its distribution is in the hands of Big Pharma.
9
@JR Look at gabapentin and the medical community’s overprescribing of that placebo drug. They tell people it can help their neuropathies and some will inevitably believe it. That’s called the placebo effect, and It’s never stopped medical doctors from exploiting their patients. Then they give us Lyrica and Cymbalta and have the audacity to tell us they will help our nerve pain. Statistics are always in favor of pharma and money and the FDA is complicit.
5
CBD may not be a cure all but this natural product has been in use for hundreds of years as a natural remedy. I do not see any reason not to try it out and see what happens for you personally. After all, most expensively developed and researched pharmaceuticals only are effective on slightly more than 50 percent of people that they test in order to get approval by the FDA even with horrible side effects. And those very same pharmaceutical companies have NO interest in a natural remedy cutting into their sales. Do your own research. Trust what your body tells you. Almost anything in moderation is okay.
24
I have had terrible insomnia for years. Nothing helped and the stronger drugs had awful side effects( having Trump in office doesn't help either). Five months ago I started taking CBD oil at bed time and it has been a miracle. I sleep long and even dream most nights. Whatever the reason for its effectiveness, I thank the universe and and whoever brought this to market.
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@Mark Thank Republicans (and Booker) for legalizing industrial hemp production in farm bill. Also Trump getting rid of Sessions who was a weed hawk.
@Mark
Would you mind sharing the name and source of the product that works for you? Thanks!
@Rowan Williams Donny appointed Sessions to begin with and fired him due to his refusal on overseeing Mueller, no thanks due there.
2
I'm sure CBD has clinical use. I'm also sure it's use will be clarified by research. What this article warns against is yet another industry whose sole purpose is separating customers from their money. Advertising, especially free through social media, accelerates the wide spread sale and pressure. Capital investment surely underlies this spread. Some minority will praise it's anecdotal assistance, taking advantage of coincidence. To be clear there never has been a magic elixir, though they've been sold through the ages.
10
I’m not sure if I believe all the hype about CBD but it is interesting that commonly used non-narcotic pain medications such as gabapentin or Lyrica are anticonvulsants. Although the mechanism of action is not known, they are thought to inhibit neural signals of pain. CBD has proven effectiveness for seizures. It is not difficult to believe that CBD works for chronic pain.
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I have witnessed CBD withdrawal in a daily user; rebound anxiety beyond that originally treated. It resolved when his supplier returned from vacation.
4
It's a darned good thing that most people taking medication for psychiatric disorders don't have to wait for their suppliers to come back from vacation. When you are able to get your medication prescriptions filled legally at a regular store, forced sudden withdrawal due to lack of a supplier ceases to be a concern.
I produce and sell a topical CBD balm, and I am also a natural skeptic. The panacea effects folks ascribe to CBD is more than enough to make me wonder, but based on a surfeit of personal experience and observations over the last 2 years, I can say for sure that CBD really helps some folks out. In some cases in a life-changing way.
I summarize my anecdotal efficacy observations as such - CBD seems to do something for about 75% of people, and that can range anywhere from ibuprofen-like effects, all the way up to "you've changed my life, I'm never taking opiods again" (a piece of feedback I've gotten numerous times).
I have seen folks that CBD didn't not help one condition very much (Arachnoiditis, for example) but it helped immensely with an unrelated condition for the same person (slipped disc in the case of the Arachnoiditis sufferer).
anybody telling you that CBD doesn't work without THC is confused & misinformed. My product has zero THC by design and multiple health care professionals in the town I live in have started recommending it after seeing how well it works. There's a lot of "full spectrum hemp oil" multi level marketing campaigns out there misinforming folks on that level. CBD works great on it's own, THC definitely helps, but we don't know why or how much.
yes, it is amazing for pets. I've never met a dog that didn't like CBD and have seen so many elderly animals gain such benefit, movement, and pain relief from it.
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@Chris Henry
How do you treat the pets/elderly animals you mention it helps?
Orally? If so how much?
Or administered via massage on the affected painful area of the body?
Since animals cant tell you, how do you know it works?
what are the results. How do you know it's beneficial for pets? Can it be dangerous -if not sure of amount or if animal tolerates it, has allergic or adverse reaction -
Please explain further
3
@yogaheals
When you see a cat or dog that moved only to eat or go potty before and is frisky and playful again again, you *know.*
10
@Chris Henry Oh man, slipped disc you say? Mine is still slipped. Tried 3 bottles of CBD product 2 years ago. Did not get even a placebo effect. I think CBD is mostly or all hype. Feeding it to your pet is cruel treatment. CBD was also ineffective for some insomnia, anxiety and various other pains. I'd like to see solid, reproducible studies before reading so much hyperbole.
1
Consumer Reports had a cover story on this awhile back. I've been meaning to read it, but after this piece, not sure I want to spend the time.
A few years ago, before Massachusetts had approved marijuana for recreational use, it had already approved certain medicinals such as topical creams and patches for chronic pain from restricted dispensaries.
After talking it over with my doctor I told myself if my chronic pain from an accident got bad enough, I'd try it, to see if it could be more helpful than arnica which is probably more placebo than remedy.
But given the paucity of research, I think I'll wait. The last thing I need is to spend money on dubious products with no proven track record.
Unfortunately, like so many things, including fad diets and wrinkle creams, this seems to be another area where there's a sucker born every minute.
6
Despite Dr. Friedman’s declaration to the contrary, anecdotal evidence is one kind of scientific evidence that is used widely in the off-label use of FDA approved medicines. Under the direction of a physician, how would trying CBD hurt, especially if other things haven’t helped your chronic pain?
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@ChristineMcM
CBD oil made me cranky not mellow or relaxed. I really think the results vary from person to person.
1
I have chronic pain from a car accident. Cbd alleviates it with no damage to my liver or kidney.
6
It’s not the cure all and some family members, depending on your family, will look at you differently. When I can afford it, I take CBD oil with a slight mix of THC. I’ve tried a number of combinations and have titrated, yes I said that, my amounts that I take. This took a couple of years. Now, I have what works, but 90 days worth costs around $140. Not much for some, but for me, it is a dent into our finances. I stopped taking my formula for the holidays. It’s not that I’m saying not to take it or to take it. For my peace of mind, I would like the federal government to change its classification and for the AMA to sponsor studies outside of the pharmaceutical industry. The thing is that this does hold promise. I do not have faith in our healthcare and federal government to do what is right and necessary for its people to make marijuana and its products an efficacious part of the formulary.
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@Joe Gaston
What are you using it for?
I bought a vial of CBD capsules a week and a half ago when I was in Palm Springs because I was told it would help me sleep better. I took one at bedtime...in that limited time I gained 5 lbs. I became ravenous so it had a similar, while less severe, effect as marijuana. The last time I smoked pot was about 30 years ago when I was at some guy’s apartment and he was trying to seduce me. His plans were suddenly thwarted by the munchies. I ended up eating a wilted carrot dipped in a jar of peanut butter before I frantically left to devour what I could in my own sparsely populated refrigerator...no it didn’t discernibly help my sleep ...and it was a wasted $93.
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@Ardyth
This is the funniest story I have heard!
Listen up people.
@Ardyth
Good story, 5 stars, would read again.
Take note potheads, keep more food on hand if you want to seal the deal. Even a minifridge in the bedroom and this women's life experience could have been even better...although her story might be less entertaining.
@Ardyth, I think your “CBD” capsules must have contained THC. This is from a 2015 article on the reason marijuana makes you hungry. It’s the THC:
***Our brains produce their own cannabinoids, lipids that help control our appetite, mood, memory and pain reception. Tetrahydrocannabinol, or THC, produced in marijuana latches on to cannabinoid receptors in our brain, mimicking the same chemicals.
...THC flips a switch in the mouse’s hypothalamus. Instead of producing the chemical that signals you’re full, suddenly neurons start telling the hypothalamus you’re hungry.
“Even if you just had dinner and you smoke the pot, all of a sudden these neurons that told you to stop eating become the drivers of hunger,” Horvath told NPR.***
I use CBD oil from a reliable pharmacy. Each batch is independently tested by 3 different labs for the correct content and concentration.
I tried it on my German Shepherd and adopted dog with abuse history. CBD oil greatly reduced PTSD issues, and threshold for anxiety attacks. (You haven't lived, till a GSD paces wildly unconsolable, when frightened!)
I am now using it for central canal stenosis, while awaiting back surgery. I used a few Aleve a week, and manage to stay off any other pain meds. Real CBD oils, when pharmacologically certified have no THC, heavy metals, or other toxic issues.
I buy in bulk, dilute with peanut oil for the dog, and titrate for myself at low levels. I am 70+ and high functioning.
It is dramatically cost effective, and minimal to no noted side effects.
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@Virginia Beck, NP - If you're considering fusion, check out Vertiflex spinal inserts. My local NP suggested them as an alternative to the 5-vertebrae fusion I was facing for stenosis pain. One year later, I'm delighted w/ the inserts.
@Virginia Beck, NP Information from NPs-"naturopathic practitioners"-not "nurse Practitioners", are non-scientific wishful thinkers and often outright frauds or quacks, dishonest persons who should not be making medical diagnoses nor prescribing "treatment". It's not nice to fool people under the guise of "helping" them.
1
I have chronic pain in the groin area from hernia mesh complications from hernia repair surgery. The pain was unbearable on some days. Acupuncture gave me temporary relief. My surgeon sent me to a pain doctor who was going give me a nerve blocker or prescribe medical marijuana. I wanted neither. (And forget about opioids. They would have been the death of me.) Instead he had me try CBD oil which I take orally, 15 mg, 3 times a day. It has given me remarkable relief. I feel no negative side effects. Unfortunately, none of the cost of the CBD is covered by health insurance, so it’s costing me about $180/month out-of-pocket. But it’s worth it to have significantly diminished pain. For reasons that would take too long to explain, I am convinced that there is no placebo effect involved – but I wouldn’t care if there was. I have an 80 to 90 percent reduction in pain on most days.
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If there was an absence of benefit why do all the old arthritic people keep coming back to the pot shop for more. The mechanism behind many prescribed drugs is completely unknown, for example allergy shots. The physiological mechanism behind antidepressants is an unproven theory. It is just a marketing statement that promotes the notion of chemical imbalances of the brain: No real proof except for results in many people. It is also not known why electric shock treatments have benefits - just theories and results that make it worth a try for desperate people. Chronic arthritic pain is well addressed with a glass of wine or a shot of whiskey and a few tokes of good bud. Works everytime!
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Maybe they like to be high?!
@Andrew LOL - that drug induced pain relief comes with some intoxication is indisputable. Opiates make a person high too. But the claim is that CBD is minimally intoxicating.
1
CBD without a small amount of THC to activate it, is not effective. This is why you are thinking that CBD has no effect. Tinctures usually come in ratios, such as 18:1, which is 18x more CBD than THC. I have patients that have had success with 18:1, but note that it is the product that stops seizures in epileptic children. For adults, I recommend 8:1, the higher amount of THC does not usually bring any "high" as the amount is too low, it just activates the CBD.
I have years of experience in this field and 1,700 patients, we all agree that CBD without THC is not effective.
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Word of caution: before you try CBD, Google it with any pharmaceuticals you take. Recent research shows that it can increase or decrease, in certain cases radically, blood levels of drugs your normally take. In those cases your life could be at stake. Also be aware that not enough research has been done to determine every drug interaction, and that will take some time. Caveat emptor.
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@ADN
There really is limited research on any polypharmacy, so taking multiple prescribed medications is a risky venture and the cause of many bad outcomes.
2
@Ellen
Of course that’s true. But better some research than none, especially if the significant interaction happens to involve drugs that one takes. With CBD there’s very little research, but in the little there is, some of the clinical findings are extraordinarily significant. Also, one can start on a drug or a supplement like CBD and then ask a doctor to run a comp metabolic panel as a precaution. Not every doctor would run it but if I were trying something new I’d push hard for it.
The conclusion of the article seems at odds with the evidence presented in it. The FDA would not have approved the CBD concentrate, Epidiolex, if it were a placebo.
18
Just along a several block stretch in my neighborhood, there are three stores with signs touting they now carry CBD. From my own readings, I know that the methods of processing hemp are highly variable, much less the actual honesty of manufacturer. I've considered trying CBD myself but wish there was some standardization or list of reliable suppliers before I do.
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@stan continople
IF you want to try CBD oil without the THC, there is a product called Charlotte's Web that has been on the market for several years now. Its quality is consistent. They make transdermal products as well.
With time, consistency will improve in the pot products. With hemp, I think there are many products that are reliable.
Don't let people scare you away from trying. If you find relief, great. If not, move on to the next thing.
Live well.
27
For the same reasons -- lack of of studies -- that this article cites in cautioning against the claims made for CBD, it's completely groundless and irrational to call it is an "expensive placebo." We simply don't know enough to say either way.
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@Dr Russell Potter
We actually do.
Cancer patients, post-chemo, are counseled to try pot to help with nausea and appetite. When a patient comes back to see you and they haven't lost weight and you know they just had chemo, something's done the trick. Right?
When your Vagal Nerve Stimulator patient comes back a month after starting CBD oil every night and the number of seizures their implant records has fallen from 7 to 2 a night and you know nothing else in their treatment plan changed, other than the addition of the CBD, then it must be doing the trick, right?
When your severely arthritic patient stops asking for heavy-duty pain meds, something else is taking care of it, right?
We've gotten so used to being told, through the media, what is officially sanctioned and what isn't! In this case, these attempts at sowing doubts will fail. Too many states have legalized marijuana to hide the truth. If it didn't help, we'd know. Go to a pot shop and look at who the customers are. It isn't just young people.
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Sing it, Rima..... from the rooftops !
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@Rima Regas
Almost everyone I know here in the over 70 age bracket is using some form of CBD or THC for one thing or another. These remedies, along with severely limiting or avoiding prescription drugs, plus a warm climate and close community, add up to a pretty happy life, even with creaky knees.
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Last time I checked green coffee, there wasn't much valid scientific research but it seemed Dr. Oz's endosement was good enough for most Americans.
2
People are treating CBD as a fix now solution and you can't do that. Also, there are a lot of companies who have no integrity and do not stand by quality. It is important to have some basic common sense when dealing with CBD. 1- you have to always consult your doctor specially if you are taking medications. 2- always read the label. 3- do not mix alcohol with CBD, CBD can have different reactions with people. 4- Always keep a journal. 5- always read the label ( I did mentioned that, right?) and know your source. 6- CBD by itself will not always help you. You need a healthy balance in exercise and nutrition as well. People looking to relief pain need to understand the root cause of their pain. While CBD is good for inflammation, it becomes even better if you understand where your pain is coming from and you are complementing its anti-inflammation properties with the right treatment for your condition.
I love CBD because it helps me be more in balance with my body but I do not put pressure on our relationship because there are other ways like exercise, nutrition and a good anatomy understanding of my body that helps me have a good relationship with CBD.
One last thing, there are countless of studies of people who have used CBD to treat epilepsy who have seen incredible results. These are the brave ones who have gone to great lengths to make CBD a national conversation and given us the opportunity to talk about it today.
Just know the source you are getting it from!
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CBD tinctures have been very helpful as I await double hip replacement surgery. I sleep much better, have less anxiety and can occasionally skip the anti inflammatory meds that are proven to ruin kidneys. All I can say is I feel better when taking than the times I’ve taken a break from them.
10
There are far more studies of CBD and medicinal cannabis in general than the doctor implies. For the latter, there are over 3000 peer-reviewed studies according to NORML, and over 25,000 scientific papers since the year 2000, with most of them having positive indications if not compelling evidence.
And then there's the over a million satisfied US patients. As an author whose name I can't remember says, ten or even a hundred anecdotes are just that, "anecdotal evidence," but a hundred thousand reports is a clinical evidence case study.
If you want the straight story (and this take is biased to the big pharma model), try a non-profit site like Project CBD with high standards of writing and evidence.
That being said, much of what's being sold IS wild west days stuff, and responsible reformers are in favor of consumer protection and product testing to make sure that products both contain what they say they do, and that they don't contain dangerous adulterants and contaminants.
However the plain fact - always omitted from takes like these - is that cannabis is already likely the most clinically studied drug in history - even with the 80 year plus US embargo.
Most approved Rx drugs have no more than two or three successful clinical trials, and are also often not studied interaction with other drugs patients taking them may typically take. And virtually of them are more toxic than cannabis.
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@Maynard K. Nicotine is the most "clinically studied" drug. That, and caffeine, have been investigated intensively due to their ubiquity and the utility that the study models provide to researchers.
3
CBD taken with certain immunosuppressants can be not only toxic but lethal.
1
@ADN - Citation please. I couldn't find it on the All-Powerful Google.
3
Quoted by the author ‘Nature endowed us with our own cannabinoids, so unless you have a deficiency of them or sluggish receptors, you really don’t need supplementation.” It deserves an applaud. The professional sectors do not attempt to usurp any opportunity which can contribute to the medical advances. However, precaution, caution and any possible idiosyncratic reactions must be in consideration. In terms of medical specialists, misapprehension of patients is a precursor of complication. In terms of legal issues, it is an incipience of turtuous cases. In research, it is an overture of misinterpretaion. It is not an argument between predilection or fatalism. Once a negative effect kicks in, it is irremediable.
1
@Brigitte - did you get a word of the day calendar for Christmas? Nobody writes or speaks like that unless you are a literature professor writing a paper that only other professors will read.
1
My veterinarian and I had worked together, trying a series of conventional medical treatments for my aging Airedale Terrier's joint pain. One after another, either the pain remained uncontrolled or the side effects were potentially life-threatening and unacceptable. Eventually, he recommended that we try using CBD oil as an additive to her food. The CBD notably controlled my dog's joint pain without any side effects, allowing her to have a infinitely better quality of life. Later, when my dog's cancer reasserted itself, the CBD oil -- albeit in larger doses -- kept her pain in check and helped her come in for a smooth landing. This particular dog had reacted extremely poorly in the past to hallucinogenic or intoxicating or impairing effects of Vicodin and other pain killers after surgeries.
Dogs do not come with predisposed attitudes toward treatment. If some treatment appears to provide a dog with pain relief, one can understand that it is working.
I am most grateful that my vet suggested the CBD as treatment for my dog, and most grateful that it was an available means of treatment.
Based on my and my dog's experience, I would recommend CBD for treatment for pain, irrespective of species.
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@Beatrice Pinch As a doctor (pediatrician), I can understand your desire to generalize the very impressive results of CBD in your dog in recommending CBD to ailing humans. I also second your great observation about no predisposed attitudes toward treatment (although "double-blind" scientific studies work because the observer, as well as the patient, is blind to the treatment arm).
However, just as "children are not little adults" and adult treatments can have disastrous results in children (and vice versa), humans are not just big dogs and cross-species treatments have a long and storied history (acetaminophen -- generic Tylenol -- for example, is highly toxic to cats).
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@Beatrice Pinch:
glad she got help with it.
The point you made :
"Dogs do not come with predisposed attitudes toward treatment. If some treatment appears to provide a dog with pain relief, one can understand that it is working."
is an excellent point and should be mandatory reading !
8
Notably, until CA passed AB-2215, veterinarians risked their license discussing medical cannabis for pets. As of January 1, 2019, the new law changes that.
My company, right:ratio, supported that bill in Feb 2018 and I testified in front of the Veterinarian Medical Board in California but they couldn’t even support allowing vets to discuss, not recommend or prescribe, medical cannabis, including CBD.
Things are changing, but sadly humans have legislated for their benefit by allowing access to CBD and medical cannabis in California for over 20 years but not one step toward medical cannabis for pets with cancer except AB-2215. Shameful typical human behavior.
9
As a physician I appreciate Dr. Friedman's skepticism. There are no impressive data suggesting any medical benefits to marijuana use or the fad utilization of CBD products. There are however great amounts of data pointing to the harmful effects of marijuana use on the developing mind of the adolescent including the fact that 30% of those under 18 who use recreational marijuana develop a marijuana use disorder and the more than 6 fold increase in later opioid addiction in those who begin in adolescence as "wake and bake stoners" and then go on to chase that next high.
10
@thewiseking I agree. Living in Colorado I can observe plenty of issues, and use by youth is a major problem. On balance is it worse than the problems created by the War on Drugs and lives ruined for being caught with small amounts of cannabis? There was plenty to be skeptical of there as well. Hopefully, with research and the hard work of establishing an appropriate regulatory structure (such as how to determine when someone is under the influence and driving) we will find blance.
3
@thewiseking
Marijuana is not a "gateway" drug. It is a plant, not a drug. Funny how a prohibition will spur misinformation.
3
Cannabis (weed) nearly ruined my son's life. He has been to multiple in patient addiction treatment programs. It is very addictive for a small portion of the population (10-15%) and nearly impossible to stop.
He was diagnosed with bipolar 1 at age 20 which makes weed very dangerous. Taking a posi-psychotic like weed has big risks for some.
Too many people are too skeptical about the wrong things and too credulous about the wrong things as well. The medical marijuana movement was intended to be the forerunner of full legalization of marijuana use. Now THC and CBD can also be touted for all sorts of conditions. They can be cynically marketed for health promotion. As long as no claim is made for curing specific medical conditions, FDA approval is not needed and FDA regulation not operative. Considering how many people use cannabis and it's components, how many claims are made for its benefits, and how few beneficial effects have been substantiated, I believe the medical uses for THC and CBD will eventually prove quite limited.
7
@MEM But you really don't know that, do you?
@bobbo
Skepticism is warranted about most medical claims. Failed treatments outnumber breakthroughs.
Super anecdotal evidence, but CBD was the only thing that helped speed my headaches and fogginess of mind after a bad concussion.
I’d like for more research to come out before I tout it as a cure all, but it is certainly worth evaluating
13
Good Goddess, can we lose the Reefer Madness myth about marijuana once and for all? Why the double standard for pot?
Citizens can legally buy booze (0 health benefits, 88,000 deaths/yr + 10,000 drunk driving deaths, addictive); Opioids (questionable pain relief efficacy, 33,000 deaths/yr, highly addictive), tobacco (0 health benefit, 480,000 deaths/yr, highly addictive). Nearly $65 Billion of cosmetics are sold in the US annually and those chemicals that women put on their lips are totally unregulated - what is that stuff??
Yet some among us continue to fret about the lack of "long-term clinical trials" for marijuana (and related substances) which has been in use for gazillions of years around the globe, offers a wide range of benefits as testified to by a broad group of beneficiaries based on their personal experience, has resulted in 0 documented deaths - ever, in all of history - and is less addictive than coffee for the vast majority of users.
Plus we spend huge amounts of taxpayer dollars to arrest and imprison non-violent pot users while forgoing the tax revenues that would be generated via legalization.
The results on marijuana are in, we know everything we need to now. Legalize it and move on to the long list of far more important national issues on which we could expend our energy.
903
I have no issue with legalizing for recreational use.
However, the claim that “we know everything there is to know” is spurious at best. In fact, this is one of the key points of the article: we don’t know it’s efficacy, or safety profile for a large set of conditions. In other words there’s A LOT to learn about it’s medical risks and benefits. This is absolutely critical to public health on multiple levels:
(1) hopeful patients chasing ineffective treatment at the cost of missing something else that could be effective;
(2) understanding effective dose levels for targeted conditions (vs too low or overdose levels);
(3) clear profile of interactions with other common medications (importance of this point can not be overstated);
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@Miss Anne Thrope, I would argue with you on 2 points you make, i.e., : "Citizens can legally buy booze (0 health benefits, 88,000 deaths/yr + 10,000 drunk driving deaths, addictive); Opioids (questionable pain relief efficacy, 33,000 deaths/yr, highly addictive)" No argument with you on the deleterious effects of booze. But many people have found that modest and responsible use of booze cn be beneficial to some people's health. And I fully agree with you with your comments on the deleterious effects of the irresponsible use of opioids. But you are way off base when you say that opioids have a questionable pain relief efficacy. After thousands of years of experience with the buds of the opium poppy (and its descendents), opioids are the ONLY class of drugs that can reliably relieve pain. It is irresponsible to suggest otherwise!
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@Miss Anne Thrope Years ago when I asked why marijuana was made illegal in the first place, I remember the answer had something to do with Hearst’s lobby of the US Congress and its assent to corporate empire. Hemp was made illegal so that Hearst-owned forests could supply the wood pulp for newspapers across the denuded land.
46
No matter the outcome of any future studies, people will continue to use hemp and marijuana. Great ropes, clothes, euphoria but something you don't want to live next to on an industrial scale. Big pharma does not like the idea that consumers can grow their own pharmaceuticals to treat pain and anxiety.
One plus for any studies, they won't have trouble finding people with a history of use or volunteers.
44
CDB! is a wonderful book by William Steig which treats all kinds of ills like boredom, lack of imagination, and rainy-day syndrome, when a parent has no idea what to do with a kid. No clinical trials have been done on it, so I have no idea if it is a placebo.
I recommend it, based on my own experience with it. But you should probably consult your librarian before using.
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@Chris
My children absolutely loved that book ("CDB").
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@Chris no, no. we librarians can't give medical advice!
I have not needed to resort to CBD for anything. But one thing I have learned over the years is this: whenever someone takes up against an alternative sort of medicine like this it's usually not based on fact. Our medical establishment, and Dr. Friedman is certainly part of it, often uses drugs for off label uses that have not been thoroughly researched and then objects to this? Forgive me if I laugh. Perhaps if physicians spent more time with patients than with lab tests, and didn't overschedule, they might be of more help to their patients.
In other words, don't blame patients for trying to find their own remedies when you are often overbooked, unreachable, talk down to us, and cost more than we can afford to pay.
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@hen3ry
A friend just reminded me... Richard Nixon had put together a commission that studied marijuana. They recommended legalizing it. Instead of going with that, Nixon started the War on Drugs.
As for patients trying to find their own remedies... That's not accurate. It has long been known that marijuana has healing properties. The same is true of hemp. Big Pharma now has a CBD based drug for Epilepsy that was approved. It is many times more costly than the CBD oil you can buy at a pot shop or health food store.
This is about trapping the neediest of patients into the Big Pharma trap.
Shame on Dr. Friedman for shilling for big business instead of doing no harm.
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@hen3ry:
this is not really an "alternative" new med. Marijuana in its various forms has been around forever....but has been irrationally made illegal.
10
@hen3ry
Our entire model of delivering medical care--particularly preventative care and care of chronic illness/disease--is suspect. I don't blame the doctors for the system ("don't hate the player, hate the game") because the vast majority of them have worked hard and committed themselves to being healers.
We need to transform our business model for delivering care. The profit motive for Big Pharma and Big Insurance guarantee that doctors don't have time for us, can't consider all possible remedies for our ills, and will have limited ability to do their jobs.
19
My daughter has been on CBD for two years through a clinical trial. She went from having 15 seizures a day to being almost entirely seizure-free. CBD has given her a different childhood and a chance to learn. It also helped her avoid brain surgery. It may not cure every ill, but it’s an important, legitimate drug.
815
Thank you for your valuable reporting, Caroline Ramirez.
Best wishes to you and your daughter.
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@Caroline Ramirez
No.Richard, an expert, says it's your imagination.
His thinking makes me ill.
8
@Caroline Ramirez - thanks for the encouraging anecdote.
For those who despair the supposed near-absence of hard evidence (randomized controlled human clinical trials of cannabis-based pharmaceuticals), see here: https://www.gwpharm.com/healthcare-professionals/research/therapeutic-areas
3
There is research on cannabis - but it is not research from the US. I live on WA state and grow and use marijuana. I actually have a green card (needed to grow enough for my own use) The most effective pain relief for the systemic arthrtis and neurological symptoms I suffer from comes from high cbd strains that have some THC (relatively little ratio wise) Pure CBD doesnt do much. We need to do more research. Good luck getting the permission to do that in this country today.
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CBD Has worked for me where other things have not. Frankly I don't care if it's a placebo effect or not. In fact, there are actually medical prescriptions written for sugar pills labeled as placebos that reportedly get positive results according to results of studies. I've used the CBD oil mixed with peppermint oil on my hands and fingers. I suffer from mild arthritis. I find it helpful, though it requires repeated applications. The same when I've used it on my feet. As a psychologist, I ask the question: If a medication can be approved if it demonstrates a 20 to 30% therapeutic effect and a placebo can produce a therapeutic effect in the same range, what difference does it make if both responses are due to placebo effects? And if it turns out that the CBD does have a therapeutic effect beyond it's typical placebo effect, so much the better. Psychodynamically, the prescription of and taking of a medication symbolizes giving and receiving nurturance. Especially if the medication is prescribe in the context of an empathic interaction with the prescriber. I'm referring specifically to CBD and my personal experience. But I do believe that traditional medications (AKA "holistic" medications) may affect areas of the brain related to emotion as well as the functioning of other parts of the brain and body. I recall being tearful after getting injection as a young child. My mother gave me a sip of water and a hug afterward. The empathy did result in positive responses.
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@John Jones
I’m pretty astonished at the fact that so many people, including some people who studied a science, are so critical of this article. The only point that the author is making is that we need to be careful about buying a supplement, which like all supplements, is not regulated and makes claims that are not supported by research. Of course the placebo effect is great and will always be there with whatever is sold as any supplement. The point is that research is supposed to distinguish the science from the placebo. Companies make a lot of money making health claims that are unsupported and sell products that do not always contain what they are supposed to.
Please New York Times readers, read up on supplement scams, the author never did criticize marijuana, just CBD. The placebo effect is lovely, until you find out that a supplement you are taking contains ground up dust, lead or worse, as if often found in supplements.
33
@John Jones
I also use CBD for arthritis in my hands, although I limit my use to evenings, which now allows me to sleep through the night. I use an online brand lotion derived from hemp which specifies the amount of CBD contained per dose. I have also tried a 10% lidocaine lotion from the drug store - one that my 80-something year old mother uses nightly, despite the warnings to only use it for a few days at a time - which also worked, but seemed to wear off much faster. As a mid-fifties late baby boomer/Gen Xer (depending on whose definition is used), I know many, many people my age and substantially older that have smoked pot for decades without having any worse ailments than their contemporaries who have not. While I am also skeptical about the current craze for CBD in everything from cosmetics to beer, it's working for me, and I don't really foresee some horrible side effect coming to light in further studies.
10
Yes, but he deserves to be criticized for prematurely declaring CBD to be a placebo without the necessary scientific evidence needed to do so.
12
Friedman runs straight off the the rails when he tries to moralize from "a few small randomized clinical trials" which provide "insufficient evidence."
If there are no conclusions to be drawn, then don't draw conclusions. That's what science tell us, and that includes negative conclusions.
People's attitudes and immediate needs are a different matter. Walk around any drugstore and ask yourself how many of unguents, ointments, pills, sprays, jellies, powders, syrups and nostrums have medical efficacy. One more won't tilt the balance. But let's wait for the evidence before we sneer.
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I too was confused by Friedman’s conclusion that CBD “looks more like a placebo”, given that he just told us there hasn’t been enough research to draw conclusions.
We need politicians with the courage to reverse our irrational anti-marijuana laws. Only then can we have verified dosages, meaningful research, and useful recommendations. Until then, even if it’s a placebo and it makes people feel better, what’s the harm?
28
@hquain
Eh, it's probably cynical self-interest on his part.
So many people think psychology is bunkum and psychologists are frauds just taking your money.
I disagree completely. I have a BA in Psychology from a good school.
But I'm sure the same people who support Trump are suspicious of psychology. God knows Trump could use a long stint on a psychiatrists couch.
Maybe Dr. Friedman will offer. LOL
5
Mr Friedman writes: "Still, the explosive popularity of CBD is way ahead of any evidence to support its efficacy — or reliable reassurances that it has no serious adverse effects. Where is the healthy skepticism when we need it?"
The reliable reassurances that it has no serious adverse side effects can be shown by pointing to the millions of people who have smoked or eaten marijuana products for years without serious adverse side effects.
With respect to the content and quality claims, well, anytime you take something, you should educate yourself before doing so. There are numerous sites that examine and rate CBD products, including important information on the process used to extract the oil.
I wish Mr. Friedman had taken a more balanced view. As it is, it sounds suspiciously like the 'anything cannabis related is bad' themes that we've heard so often over the years.
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@Dom.
I hope the Times will let me say again that there are a few proven interactions between CBD and widely used pharmaceuticals. With very little research having been done, it’s not insignificant that dangerous interactions have already been found. Being careful with CBD is a matter of life and death.
@ADN: Cut out the pharmaceuticals. CBC is non-toxic.
@Carl Hultberg
That can be a particularly dangerous viewpoint. Here is one pharmaceutical you can’t cut out if you need it.
https://www.hindawi.com/journals/crit/2016/4028492/
CBD is saving children and adults' brains from epileptic seizures. That, alone, should cause our government to make both hemp and marijuana based products (not only pharmaceuticals) fully legal, in whatever form the imagination creates.
CBD is helping millions with all kinds of ailments and terrible pain.
CBD is helping those with cancer after treatment regain their appetites.
CBD and THC are valuable for a very large number of uses, whether inhaled, ingested or transdermally.
Research has been suppressed for decades by our government. We have real results now from the few years of experience of some courageous parents who took their children to Colorado and the other states that have legalized marijuana.
If you want proof, talk to the doctors of all those patients. They know.
Those are real experiences.
As for the Trump administration, they're trying to find excuses to ban hemp products. Those are legal now and doing a whole lot of good for a whole lot of people. It burns to see them in action after Trump, during his campaign, was all for legalizing these substances to help those who have a medical need. He signed the legislation but the FDA wants it only to be legal for the expensive Big Pharma product that is now out but not so much for the rest.
Shameful.
---
FDA casts shadow on hemp win, calling CBD products illegal
December 23 entry
Things Trump Did While You Weren’t Looking
https://wp.me/p2KJ3H-2ZW
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@Rima Regas
While I sympathize and am deeply suspicious of Big Pharma, how many doctors can one person actually ask? Even more confusing, depending on the part of the country in which you live, doctors vary widely in their opinions on CBD and THC. This is why reasonable, controlled studies should be done and the results made widely available in both scientific journals and popular publications. Who is to say which bit of anecdotal evidence is accurate?
13
@Ray Zielinski
Ask any neurologist or neurosurgeon with VNS patients.
Ask any oncologist.
Ask any rheumatologist.
For starters.
12
@Ray Zielinski
I have and 1 in 26 Americans has seizures.
8
I have friends who take CBD cream for joint pain (a small amount goes a long ways) and swear by it. I use it myself for arthritis in my fingers and knee, and I'm probably the biggest skeptic of medications you can find. I'm not speaking about oral CBD, only the cream from a local store that makes it in their shop. I'd be skeptical of purchasing it on-line. You can call it a placebo if you want, for me and many of my friends it works and beats the alternatives...… that are, by the way, sold by Big Pharma at inflated prices.
25
@Steve
I have rather painful arthritis in my left hand, especially in my fingers. I use CBD cream before practicing my harp and - voila. I still wasn't very good at the piece my teacher had given me, but playing it didn't hurt.
8
I really wanted the CBD oil to work for my low back pain. I had first tried the topical cream with no success but I was very hopeful that the digestible oil recommended by a friend was going help.
So after consulting with two CBD sales representatives, I purchased a small bottle and followed their instructions.
Unfortunately after 3 weeks of the recommended 4-6 drops under my tongue nightly, I experienced no relief.
I thought of purchasing a second bottle and upping the dose but decided that the product is too pricey.
The problem is that no one really knows the correct dosage for the different ailments each user is treating. It's all hit and miss. The 1st sales rep suggested 4-6 drops a day for my back pain but the general research online suggested 20+ drops a day.
So bottles containing 100 drops only last 5 days and cost an average of $50. At minimum $300 a month, it's pretty expensive to experiment with the product to see if it works. A higher concentration of cannabidiol oil costs even more.
The majority of people with whom I spoke received no relief for their various issues either from the topicals or digestibles. And now reading that many tested products do not contain the levels of CBD they advertise makes me less likely to experiment further. I would have liked to make this work but it's just too iffy and too expensive.
13
@JM. I love near Seattle and pretty much have the same experience as you. After reading this article I now realize there needs to be a THC/CBD ratio. Before I was asking for as low THC as possible.
IF I go back to our local 4/20 store I'll definitely pay more attention to the ratio.
5
@Jane and @JM,
I hope you don't mind a suggestion: you might investigate kratom (mitragyna speciosa) as an alternative. It's a pain relief plant product like CBD, but not hyped nearly as much. Does wonders for my chronic joint pain (noticeably more than CBD) and much easier on the wallet at $70/kg, which is 1-2 months of doses
@JM part of the problem is that you are looking for drops to fix a low back problem. While in the long run CBD can help you, you also need a physical therapist who can treat you and show you exercises that can help you identify weaknesses you may not be aware of. CBD can complement a full wellness program but you cannot expect to be the solution for everything.
3
Schedule 1 drug or not, a vast majority of the population has tried or regularly uses marijuana, whether covertly in the past, medically, or now, increasingly, recreationally. Unless Pharma can control access and price, it seems very unlikely that there will ever be many gold-standard clinical trials. However, there are other qualitative/quantitative research methods that could be applied to people who use CBD/THC for relief. Statistical methods are fine where they can be applied, but careful in-depth case-studies will assuredly reveal much of value.
13
The jury is out on a lot of different pharmaceutical interventions, but the battles rage on. For a while we knew that Antidepressants might only have been placebos with lots of side effects, but tons of people kept taking them anyway. Now we find that a major study says that they do seem to have "moderate" effectiveness for clinical depression (and the press is all over that, no doubt supported by the well-funded PR people at pharmaceutical corporations), but that leaves a ton of questions about the millions of people who've been prescribed anti-depressants for off-label diagnoses (I, for instance, was prescribed them after my mother died -- but grief is not the same thing as clinical depression....hmmmmmm -- I wonder what the studies say about SSRI's and grieving?). I think people need to be able to make their own decisions based on empirical evidence as much as possible -- if I find that CBD gummies help considerably with premenstrual cramps and anxiety -- and I have no significant side effects from them and trust my supplier (an organic-savvy company from Vermont), I think it's okay for me to keep taking them -- placebo or not. They're certainly less addictive than any of the psych meds usually prescribed for premenstrual anxiety and cramps -- and they have no noticeable side effects.
23
I use CBD oil for my agonizing neuropathy. It helps me tremendously. I look forward to the day that medical research catches up to my own experience.
296
Same experience here. My itchy, burny feet are soothed almost immediately after massaging CBD salve into them, allowing me to sit comfortably and to sleep. I am so grateful that it is legal here in Oregon.
51
Thank you, Barbara Thomas.
The dismissiveness of some toward cannabis is pathetic.
51
I am 70 and about to have spine surgery for stenosis in my lumbar vertebrae. Every body part below my waist was seriously in pain. I'm using about 30 mg of CBD oil a day in capsules and I'm almost pain free in my lower body.
At the same time I happen to have a sinus problem and CBD oil dosen't work to relieve that pain - I'm taking the standard antihistamine and decongestant meds.
My experience is that CBD is actually effective - not a placebo - for certain types of chronic pain.
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@westford
Some medical conditions are more responsive to the placebo effect than others, including chronic pain.
8
@westford - FWIW, two docs proposed fusing the bottom 5 vertebrae in my 73 yr old spine to treat severe stenosis. One honest doc said, "I won't guarantee fusion will eliminate your pain. The only thing I'll guarantee is that you'll lose flexibility." In desperation due to the intolerable pain, I scheduled the surgery anyway.
Serendipitously, right before surgery I learned about Vertiflex spinal inserts . I had two inserted in outpatient surgery, walked out of the doc's office, realized almost immediate pain relief and had minimal post-surgical recovery.
One year later, I'm again hiking 4-5 days/wk in rugged southern UT canyons, able to do pretty strenuous outside work (as long as I'm mindful) and have full flexibility with manageable pain levels. I take an occasional ibuprofen, stretch daily for about an hour. I'd recommend checking out the Vertiflex inserts to see if they're applicable for you. Peace…
10
@westford you should try acupuncture...my 84 yr old father had terrible pain from stenosis...had many epidurals etc. that only gave him temporary relief. I convinced him to try my acupuncturist...within a month he had tremendous relief and was questioning that he ever had stenosis to begin with.
2
My wife has used CBD to treat chemo-induced nausea for several years. She found that 100% hemp-derived CBD was useless. However, she did get relief in a formulation of 8:1 CBD:THC, and even more so at 4:1, which nonetheless did not get her high. Whether it is the combination of the two that works, or simply taking a little THC regardless of the presence of CBD, I can’t say. But I can say with certainty that it worked better than the conventional anti-nausea medication she was prescribed.
184
@eyesopen That's because THC is better for nausea and pain. CDB on the other hand gives a relaxing effect and is a good anti-inflammatory.
32
@eyesopen
I had the same experience. For months, I bought and tried straight CBD to help with chronic migraine - no relief. Switching to a low dose of THC was the only bit of relief I have found from cannabis.
Cannabinoids need further serious research, as do the medical possibilities of currently prohibited psychedelics, like MDMA, psilocybin, LSD, and others. But we are living in an anti-intellectual age, a time when our government ignores and often disdains basic science and research. Whether CBD has therapeutic uses or is a placebo, we need facts to help inform us.
58
I have nerve damage after hand surgery. A dose of CBD oil allows me to flex and supinate my hand about 10 degrees more than I can without it. My PT and I have measured and tested.
50
@Marc Have you tried a capsule that has no CBD oil as a control, ideally without you or your PT knowing whether you ingested CBD or placebo on a given day (a double-blind test)?
1
@Marc
A "dose" of how many miligrams?
@Marc: You are obviously an anecdotal placebo dupe. (joke) Glad you feel better!
1
Individuals need to educate themselves and take control of their health.
Find a cannabis class at your local community college taught by a doctor or nurse or other therapist who has taken it upon themselves to learn about cannabis. I have learned not to depend upon allopathic physician's help as they are too tied to big pharma.
There are also cannabis support groups where you can learn what is working for other cancer patients, individuals with Parkinson's and more.
Cannabis use is just like nutritional advice, don't bother asking your doctor for advice on using food as medicine, they know zero. There is no money in cannabis for allopathic physicians just like there is no money in teaching your patients the basis of healthy eating.
50
@Helen Elder
I fail to see that being allegedly tied to "big pharma" is that much worse than peddling remedies that don't have the stated ingredient at all or the quantity claimed of the stated ingredient.
If people haven't yet been told about the benefits of healthy eating they are indeed seeing egregiously ill-qualified professionals, or, more likely, refusing to pay attention. In the second decade of the 21st century, healthy eating is not exactly a trade secret.
4
@parthasarathy Consider reading Helen Elder's comment with more nuance. Clearly not every doctor is clueless about nutrition - she recommends classes taught by medical professionals. I use Kaiser Permanente and their tagline is to "thrive". They promote healthy eating and exercise. Yet when I ask my perfectly fine physician what she can tell me about acupuncture for weak kidneys she has no information. She suggests avoiding aspirin and ibuprofin, but no one knew enough to either direct me to a nutritionist or tell me there are easy fixes for vegetables that have compounds that are hard on the kidneys.
Nutrition is complex, and Ms. Elder is correct that our medical system is not structured to include it. Insurance rarely includes payments for nutritional consultations.
Besides, it is almost more than a person can do just to stay on top of pharmaceuticals.
It is a problem that many items do not have the correct amount of listed ingredients, so for the time being, it would seem that "know your source" is good advice.
7
Suzanne,
I’d give acupuncture a try as I think it is known for helping with kidneys. It helped in our case. Our 10 year old daughter had quite serious kidney issues due to lupus. We added weekly acupuncture to help with arthritic pains from the illness. It helped with that, but turned out to help with her kidneys. She was being tested more frequently due to being at an NIH research project. Over about 6-8 months, where nothing else was changed in her medications, her kidney labs steadily improved. After about a year the kidney issue was considered somewhat “mysteriously” resolved. I say mysteriously because doctors didn’t credit the acupuncture for the improvement. She’s 28 and has had no further issues.
1
There is so much about cannabis we don't know. But the Federal Schedule I assignment has essentially prevented research on one of the oldest medicinal plants on the planet.
I have used medical marijuana now for a number of years and use it to treat both severe osteoarthritis and a sleep disorder (kill two birds with one stone as it were). To me, it is a wonder drug and has allowed me to get my hands functioning again with much less pain which, but the way, kept me up and night.
But I had to guess product and dosage - balancing out the analgesic effects against the psychotropic effects which last longer with edibles - so it would be wonderful if there were double-blind studies on effectiveness, efficacy, dosage and type if cannabinoid involved.
But until we change our policies, this is just not going to happen.
318
First of all, if the use of CBD oil is a "placebo effect" it is nonetheless truly healing in that the reported subjected experience of pain was reduced. That's a win, whatever the reason. And the side effect profile for marijuana and CBD substances is thought to be milder than many other chemicals used for pain relief--opiates in particular. Second, extant information suggests that it is vital to study marijuana and CBD oil in a scientific, systematic way so that we can acquire the data necessary to form an educated opinion about this pros and cons of this drug.
74
Once marijuana is no longer a Schedule I drug, real research can be done. No valid answers or statements can or should be made until we have good double blind research studies which cannot be done until that time.
140
@md4totz Most of the CBD oil is from hemp. Unless you live in a state where marijuana is legal you can't get marijuana CBD without a prescription.
The CBD oil that helps children with epilepsy comes from marijuana CBD. Hemp has very little THC unlike marijuana. Also marijuana and hemp have different types and level of CBDs.
5
@md4totz Two people said it helped their dog's pain.
If your point is there needs to be serious medical scientific studies at the federal level of marijuana to evaluate their use and efficacy, I agree.
351
I also agree. But I want similar studies on the Placebo effect and identification of the comparative effectiveness of placebos with ALL proprietary drugs. Placebos have no side effects. If the placebo effect can be induced predictably it warrants research. Problem: you can’t patent placebos.
9
@Brad The government via the FDA has their collective heads in the sand.
1
@Brad - If you are going to demand studies of cbd, then the same standard should apply to vitamins and innumerable other supplements that are freely available OTC. Remember when everyone was taking vitamin c for colds, and eating fish oil for heart disease. Where were you demanding studies of these?