The popularity and use of cannabidiol (CBD) has exploded since 2014, and the passage of the federal 2018 Farm Bill that clearly legalized hemp (and the cannabinoids extracted from hemp) has only served to skyrocket use even more. Since January 2019, CBD-rich hemp extracts are available at CVS, Kroger, Bed, Bath & Beyond, and more – not to mention the 2,000+ independent health food stores, doctors’ offices, and dispensaries that have been carrying them for much longer. Over 1,000 hemp CBD companies now exist in the retail sector and it would be a gross misconception to think they’ve all been created equally.
When it comes to CBD and cannabis medicine, the old adage of ‘ask your doctor’ is often a useless recommendation. Most healthcare providers (HCPs) learned nothing about cannabis in medical school, and are incapable of answering patient questions regarding quality, safety, and dosing. This leads consumers to the internet, health food store clerks, friends, and dispensary ‘budtenders’ for information, which often results in mixed information and certainly questionable safety. Hence, it behooves HCPs to educate themselves in this important burgeoning area—and product selection is a crucial place to start.
Hemp CBD vs Marijuana CBD
Hemp and marijuana come from the same variety of Cannabis sativa, Cannabis sativa L. For legal purposes, the defining factor is the THC content. Marijuana can have THC up to 30%, while hemp must contain less than 0.3% THC by dry weight when harvested, making it non-intoxicating. Both contain CBD.
Reasons to Recommend Hemp CBD First
- Unlike marijuana, hemp is federally legal and easily accessible to patients throughout the US in retail stores and online.
- Patients do not have to go to the dispensary for products, which can often avoid conflicting or distracting advice from employees. Some patients have additional reasons for wanting to avoid dispensaries.
- There is little risk of intoxication for patients with hemp. Any full-spectrum product will contain trace amounts of THC, but unless someone takes excessively large amounts (ie: a whole bottle), they should feel no psychotropic effects.
- Hemp is great for the environment! It nourishes the soil, sequesters CO2, and requires 80% less water than indoor marijuana grows. Additionally, hemp does not need grow lights or HVAC systems, both of which use large amounts of electricity - $6 billion in energy costs calculated in 2014 (and that was 5 years ago!). Amazingly, indoor cultivation uses eight times as much energy per square foot as the average U.S. commercial building. It is also worth noting that hemp can be used as food, fabric, fuel, building materials, a durable, environmentally-friendly plastic substitute, and much more. Hemp can be harvested for paper or wood and unlike timber, is ready to harvest about 120 days after its planted.
Top 5 Tips for Choosing Hemp CBD Products You Can Trust
- Sourcing and Farming Practices - Look for a company with ‘seed-to-shelf’ operations that oversees the entire manufacturing process and uses non-GMO globally verified hemp seeds. While ‘Made in the USA’ is a sexy tagline, keep in mind that it has only been fully legal to grow hemp, extract its oils, and ship products made from it across state lines since 2019. While more domestic production can be expected moving forward, many companies will choose to continue importing hemp because of their long history and experience with farmers abroad. In the interim, focus on seed genetics, chemical pesticides/fertilizers used, and extraction methods. These are far better indicators of quality than country of origin.
- Third-party testing for cannabinoid concentration (CBD,THC) and contamination (pesticide/solvent residue, heavy metals, molds, glyphosates, etc.) should be easily accessible via scannable QR codes, online, or by phone. Choose companies that test every batch versus random testing. A batch report that shows what is in your finished product is more telling than an ‘organic’ label. In fact, due to hemp’s new legal status here, no organic certification currently exists for hemp within the United States. Thus, organic labels may be false advertising.
- Gentle Extraction – The preferred method is a chemical-free CO2 extraction to ensure product stability and quality. This “cold” process minimizes thermal degradation of the plant material, while allowing carbon dioxide to naturally concentrate the phytocannabinoids. CO2 extraction is environmentally friendly, non-toxic, and generally recognized as safe (GRAS) by the FDA.
- Full spectrum hemp oil (FSHO) -Choose FSHO vs isolate, distillate, or products labeled “pure CBD” or “no THC.” Full spectrum means it includes numerous cannabinoids, including a small amount of THC in keeping with the legal definition of hemp, plus terpenes, flavonoids, essential fats, plant sterols, vitamin E, and chlorophyll, which also have health-promoting properties. Isolates seem to require much higher doses and have been associated with CBD-drug interactions.
- Labels should include a mg dose of CBD per serving (not just the total cannabinoid content for the bottle) and should reference parts of the plant used, i.e., Hemp Oil (Aerial Plant Parts). Familiarize yourself with AHPA and FDA supplement label guidelines and choose companies that are compliant. Avoid poor quality ingredients like corn syrup and artificial colors/flavors in gummies and liquid products, as well as toxic thinning agents in vape cartridge products, like propylene glycol and ethylene glycol. In fact, given the current spate of severe and even fatal lung disease from vaping, it may be best to discourage that route of administration altogether.
Directing patients to independent resources can also be helpful, i.e., brands certified by the U.S. Hemp Authority https://hempsupporter.com/authorityseals/ and/or recommended by Consumer Labs https://www.consumerlab.com/reviews/cbd-oil-hemp- review/cbd-oil/.
- Clinicians’ Guide to Cannabidiol and Hemp Oils, https://www.mayoclinicproceedings.org/article/S0025-6196(19)30007-2/abstract
- From Phytocannabinoids to Cannabinoid Receptors and Endocannabinoids: Pleiotropic Physiological and Pathological Roles Through Complex Pharmacology, https://www.ncbi.nlm.nih.gov/pubmed/27630175
- Effects of cannabidiol (CBD) in neuropsychiatric disorders: A review of pre-clinical and clinical findings, https://www.ncbi.nlm.nih.gov/pubmed/31601406
- Cannabidiol: State of the art and new challenges for therapeutic applications, https://www.ncbi.nlm.nih.gov/pubmed/28232276
- An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies, https://www.ncbi.nlm.nih.gov/pubmed/28861514