Consumers are not protected when buying CBD products

The market for CBD (cannabidiol) products in the U.S. is expected to grow from $2 billion in 2018 to as high as $20 billion in 2025. CBD comes in a staggering array of different products, and some are selling for as much as $60 per fluid ounce. Claims include that it reduces stress and anxiety, relieves severe pain, boosts cognitive function and lowers blood sugar levels.

But because CBD products other than the drug Epidiolexâ are not regulated by the FDA or any other agency, purchasing CBD products is a dicey proposition, said Igor Koturbash, MD, PhD, associate professor and vice-chair, Department of Environmental and Occupational Health in the UAMS College of Public Health.

Other than Epidiolexâ, which is approved to treat several rare forms of children's epilepsy, no CBD products have been proven to be effective in clinical trials. Koturbash said because of the lack of regulations, consumers don't know the CBD strength in the product they purchase, or whether it contains the psychoactive ingredient tetrahydrocannabinol (THC). Consumers also don't know if the products contain pesticides, fungi and other contaminants.

"The consumer is not protected," Koturbash said. "You can overdose on both CBD and THC. And how many people will stop after one or two gummy bears? Very few products available contain the amount of CBD on the label. Usually it is a very low amount. Sometimes it is a higher amount. One of the products we saw had seven times more CBD than claimed.

"Some of the CBD products contained as much as 45 percent THC, which means if you take that CBD, you are going to be impaired. And you are guaranteed to fail a drug test."

Korturbash said one of the most important things for physicians and healthcare providers to know, at this very moment, is that the hype about CBD is just hype. With so many people taking CBD products, it is important for healthcare providers to ask about it.

"Several studies including those in our lab show CBD can have a strong potential to interact with over-the-counter and prescription drugs," he said. "Physicians need to be aware of that and know if patients are taking other medications and advise people to be very careful and cautious about it because of the potential for drug interactions. Physicians need to be aware of any prescription drug patients are taking with CBD. In the best-case scenario, CBD may just negate the impact. In the worst case, there is a potential for negative health impacts affecting the efficacy of the drug."

Some people swear that topical CBD oil helps them with pain in the knees and other joints. But Kortubash said the problem is experts don't know much in terms of how much CBD has been absorbed into the skin.

"It depends on the amount of the CBD you use in that topical and the quality of that topical," he said. "There is very little knowledge of how much CBD applied on the skin can be absorbed. So, it is very hard to assess potential for topical CBD."