CBD: Pharmacist’s Friend or Foe?

Unless you live under a rock, you probably know that CBD (cannabidiol) has been the hot topic of conversation in 2019.  With the recent legalization of marijuana in several states, many companies have jumped on board to market the benefits of its counterpart (CBD) in health and wellness.

To be clear, CBD and THC (marijuana) are not the same thing.  While both are derived from the cannabis plant, CBD does not have the the same psychoactive effects as THC, so will not make you "high".  This is a very common misconception in the general public - CBD is NOT medical marijuana!  

Many of you know that I am a pharmacist by trade, so I am going to put on my white coat for a minute and give you my personal take on the CBD debate.  *These views are mine alone and not a reflection of my profession or employer*

It is becoming more and more common for us to hear patients using some sort of CBD product as part of their daily routine - creams, capsules, gummies, oils, you name it! Most pharmacies sell it in my community and you can even walk into the local gas station and buy it along side your coffee and donuts!

Whether you're a supporter or a skeptic, the research on the benefits of CBD has shown promising results.  The FDA even jumped on board with their recent approval of the epilepsy drug Epidiolex - this is currently the only FDA approved pure CBD product on the US market. 

CBD has hit the healthcare industry hard and the pharmacy profession has been on the front lines.  I was just at a conference a few weeks ago and there were no less than six different CBD vendors present to represent their products to community pharmacies.  Despite the debate about it's legality, It is safe to say the CBD industry isn't going anywhere anytime soon.

The biggest hesitation for me as a pharmacist comes down to the lack of regulation and variance in the different products on the market.  Not knowing how much CBD:THC is actually in the product, lack of dosing guidelines, and the possible cumulative effects can be a scary situation for a pharmacist to wade through.

Simply stated, CBD is marketed as a supplement NOT a drug.  Many people I've talked to view it just like any other vitamin and don’t pay much attention to the quality of the product they are buying. The fact is, CBD does have a high potential for drug interactions and dose and quality can definitely make a difference!

CBD acts on an enzyme in our body that is responsible for metabolizing a lot of the medications that we take.  When you take CBD with these medications, it can either increase or decrease the amount of medication in your body which can lead to serious side effects or lack of efficacy of the medication. 

This is where the scary part comes in for my profession... Most people don’t even think to mention CBD as part of their medication list and there's no way to cross reference the product even when they do.  All interactions need checked "by hand" to a generalized list of medications that have the potential to cause a problem. This opens up a can of worms for us pharmacists since we can’t counsel you on risks we don’t know exist!

With that said, here’s a list of a few common medications to look out for when you’re thinking about using any CBD product:

Antidepressants

Blood pressure meds

Statins

Antibiotics

Antivirals

Antipsychotics

Antihistamines

Blood thinners 

If you are taking any of these types of medications, it is best to ask your doctor or pharmacist first before you start using CBD.  We may be able to guide you in the right direction for a quality product or tell you how you can take your medications along with your CBD to help avoid potential interactions.  

I am 100% a believer in the benefits of CBD.  I personally suffer from some chronic pain issues and CBD has worked quite well for me.  Studies have shown several health benefits of CBD ranging from relief of anxiety and chronic pain to management of epilepsy and Multiple Sclerosis.  Some companies are even marketing it for your pets!  

As true as these claims may (or may not) be, the lack of regulation makes separating fact from fiction rather difficult for the consumer.  The CBD Awareness Project is a great website to help answer your questions and clarify some of the information you are hearing. If I had one take away, I just urge you as a consumer to educate yourself and involve your healthcare provider in your care.  Do your research before you buy!

For more information, visit here for a list of certified CBD brands and reviews. 

That's what I have for you this week Off the Bench!

Stay tuned next week as I continue with my CBD series.  Can CBD play a role in ending the opioid epidemic in Athletes?

 

Nicole Hasson, PharmD

Eat. Train. Live.

Leave a Reply

Your email address will not be published. Required fields are marked *