You’ve probably seen it and perhaps struggled to understand the craze. CBD, or cannabidiol, a cannabis extract, has made its way up to food, drinks and dietary supplements almost everywhere. The hype has significantly grown in the U.S. in the last five years. However, its legality and benefits remain in a gray area and debated in the country, where 33 states have legalized medical marijuana and 10 have legalized recreational pot.
Last December, a federal farm bill removed hemp-derived products like CBD from the list of controlled substances but the Food and Drug Administration still hasn't cleared CBD for use in foods or for making health claims.
On May 31, the FDA held a hearing in which its acting commissioner, Norman Sharpless, said that “CBD and THC cannot lawfully be added to a food or marketed as a dietary supplement.” The agency has opened a public docket for people to comment on how to regulate CBD products until July 2. As of June 19, there were already 2,000 comments, which included many testimonials about CBD's benefits.
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Meanwhile, companies like Walgreens, CVS and Rite Aid are selling CBD products in some states and the Vermont-based company Ben and Jerry’s is looking to bring CBD-infused ice creams to the market.
Here’s what else you need to know about CBD:
What is CBD?
CBD, or cannabidiol, is an extract that comes primarily from the hemp flower but can also derive from marijuana plants.
“Cannabis is a broad term referring to the herb that can be grown with various composition/ratios of over 100 biologically active chemical compounds called phytocannabinoids,” said Dr. Tyler Gaston, a neurologist from the University of Alabama at Birmingham’s Epilepsy Center.
CBD is the second-most known cannabinoid after tetrahydrocannabinol (THC), the psychoactive compound in cannabis.
CBD products are usually categorized as "isolate," "broad spectrum" or "full spectrum." Isolate means that the cannabidiol molecule has been separated from the other compounds. Broad spectrum contains all the cannabinoids except THC and full spectrum has all the cannabinoids, including some trace amounts of THC.
Does CBD get you high?
Neither version of CBD products get you high. “It has no psychoactive or high producing effects,” according to Gaston. The “high” effect is caused by THC.
So what does CBD do?
In the last five years, as CBD products have proliferated, claims from consumers who use it for its “properties” have increased too. Many products labeled as “CBD-infused” also claim to improve people’s general wellness.
The executive director of the National Hemp Association, Erica McBride, said that CBD “is good for all sorts of wellness issues like pain management, neuropathy, and it has anti-inflammatory properties.”
But a consensus in the scientific and medical communities does not exist due to the lack of regulation from the FDA, which has only approved one medicine, Epidiolex. The prescription medicine is used to treat seizures associated with two particular epilepsy syndromes that are typically diagnosed in childhood -- Lennox Gastaut and Dravet Syndromes.
In Europe, Sativex, a product containing CBD, has been approved to treat spasticity in multiple sclerosis.
“While there are significant interest, large amounts of anecdotal data and many studies underway for these other conditions, the only high quality scientific data we have currently is only for this one particular product (Epidiolex) in the treatment of seizures in those two particular epilepsy syndromes,” explained Gaston with the University of Alabama.
For 31-year-old Omar Pérez, an urban planning PhD student in Southern California, CBD has helped him "survive."
Born and raised in Puerto Rico, Pérez started using CBD to treat his anxiety shortly after starting his doctorate studies and after Hurricane Maria obliterated Puerto Rico, where his family lives, in September 2017. But he kept using it to relieve his pains and inflammations.
"I recommend CBD to everyone. Your body feels loose, relaxed and without pain when you use it. It's like walking out of a nice and warm jacuzzi," he told NBC.
How is CBD consumed?
CBD comes in many shapes and forms. From oil to dietary supplements, creams, tinctures and as additions to coffee and cocktails, the variety is rich. The most popular, according to McBride with the National Hemp Association, are infused drinks and edibles. And restaurants are taking notice.
The National Restaurant Association and the American Culinary Federation surveyed 650 chefs and found that 3 out of 4 considered CBD-infused food as a hot trend for 2019.
CBD isolates are used in drinks because they are water soluble.
Tinctures and oil extracts, meanwhile, are oil based and, therefore, not water soluble.
Typically, people who use CBD tinctures add a few drops under their tongues or to their food and drinks, while CBD oils are consumed through vaporizers.
Will CBD show on a drug test?
The isolate molecule does not have THC at all. “Therefore, there is no risk for consumers who are taking an isolate product to ever fail a drug test,” McBride explained.
“Full spectrum is considered to be more effective because all the cannabinoids work together in the body and result in the entourage effect, whereas just isolating the CBD molecule may not provide the same benefits as a full spectrum product,” McBride said.
Full spectrum products contain THC, but McBride said they have no more than 0.3% of it, the legal limit of this cannabinoid in a product.
Still, McBride said that if a person were to consume a full spectrum product every single day for a year at some higher doses, "it's conceivable that enough THC builds up in the body to be detected in a drug test."
Is CBD legal?
This is where the discussion turns gray. CBD is currently unregulated, although it has really become popular in the last five years with the passage of Congress’ 2014 Farm Bill that allowed states to pass hemp legislation and conduct hemp trials. “That was the start of the blooming industry that we see today,” McBride said.
With the passage of the 2018 Farm Bill, hemp and its derivatives on a federal level were taken off the list of controlled substances.
But regulation at a federal level is still lacking, with rules and laws a "long way out," according to Doug Farquhar the director of the environmental health program at the National Conference of State Legislatures (NCSL).
"The states are much more able to react to these nuances, but right now it makes it a little bit more difficult because they can't react to regulation that's just not there," he said.
Mindy Bridges, a policy specialist also with the NCSL, said that since the 2014 federal farm bill, the USDA is trying to catch up with some states that are already growing hemp. However, "the USDA will not come up with a regulation plan at least until the fall," she said.
Bridges said that state and federal laws, including the FDA and the USDA, "are trying to catch up with each other."
Since CBD laws and regulations vary from state-to-state, travelers are paying the consequences.
Back in April, Hester Burkhalter, a 69-year-old grandmother from North Carolina, was arrested in Disney World after a guard found a bottle of CBD oil in her purse at a security checkpoint. She also tested positive for THC and was detained for 15 hours.
Burkhalter, an arthritis patient, uses the product as recommended by her doctor in North Carolina.
Meanwhile, in Texas, Lena Bartula, a 71-year-old grandmother and artist, was arrested at the Dallas-Fort Worth International Airport after police officers found CBD oil in her travel bag. She spent two nights behind bars before a grand jury decided to drop her case.
Bartula, still affected by those two nights in jail, says she'll never pack CBD again when she travels and is advising every CBD user she knows to do the same.
"I have warned everyone I know, because most people my age, with my kinds of aches and pains, do take this," she told NBC Dallas-Fort Worth. "They rely on it."
The FDA has said CBD is not legal for use in food, drinks and supplements until they figure out a system to regulate the products.
Again, the only approved CBD product is Epidiolex, which is available by prescription. And yet, the FDA can’t authorize a dietary supplement to be in the market if the active ingredient is already a prescription drug, McBride said.
“The time is now for them to figure out the regulatory path forward," she said.
McBride said the industry as a whole is supportive of and in need of regulation.
Both Dr. Gaston and McBride agreed that there are two main issues in the discussion on CBD: the lack of regulation that makes the situation vary from state to state and the inconsistency in content and labeling of these products, where what is listed on the label is different from what it is actually in the product.
“There have been two studies published on artisanal products and their content. In one of these studies, only 40% of the online-purchased CBD products were correctly labeled for content. This obviously has huge potential implications,” said the neurologist.
Last February, NBC Miami's investigators purchased 35 CBD products from seven different companies and had them tested in a laboratory. The investigation found that 20 out of the 35 had less than half of the amount of CBD advertised on the label, and some had no CBD at all.
Chris Martinez, the president of Evio Labs, which ran the tests, told NBC Miami that "patients are being duped."
Where to buy CBD?
Given the unregulated market and the wide variety of products out there, CBD-infused products are easy to find since they’re almost everywhere.
For this reason, the executive director of the National Hemp Association tells consumers to be skeptical and informed before purchasing any product. “Unfortunately, this is the challenge. It’s tremendously difficult for consumers to be able to differentiate a quality product from a non-quality product, which is part of the reason regulations are desperately needed,” McBride said.
She made the following suggestions for consumers who want to buy CBD-infused products:
- Buy from trusted stores or retailers.
- Ask these stores or retailers for the product’s certificate of analysis.
- Look for a product that’s been made in the United States. That helps to ensure it’s a quality product.
- If buying online, many retailers make the certificate of analysis available. Look for the source of the product.
McBride understands the biggest problem is that a lot of products don’t contain as much CBD as they claim to and the problem is more a matter of what the consumer is paying for rather than an issue of safety.
“Certainly, it’s an unregulated industry and consumers need to be mindful of where they’re purchasing their products,” she added.