Behavioral Sciences: CBD Consumers Can Be Misled

Published in Hopkins Medicine - Fall 2022

When it comes to topical cannabidiol (CBD) products, inaccurate and misleading labeling of CBD content is widespread, according to a new study by Johns Hopkins researchers, which involved testing more than 100 such products using gas chromatography-mass spectrometry.

The study, published in JAMA Network Open, also revealed that some of these nonprescription products contained amounts of delta-9-tetrahydrocannabinol (THC), the main active ingredient in cannabis that can cause a “high” — including some products that claimed to be free of THC. The team further found that some of the CBD products made therapeutic claims not approved by the U.S. Food and Drug Administration (FDA).

“Misleading labels can result in people using poorly regulated and expensive CBD products instead of FDA-approved products that are established as safe and effective for a given health condition,” says study lead author Tory Spindle,assistant professor of psychiatry and behavioral sciences at the school of medicine.

To date, the FDA has only approved one prescription CBD product to treat seizures associated with rare epilepsy disorders. It also approved two prescription THC products for nausea and vomiting associated with chemotherapy, and for loss of appetite and weight loss associated with HIV/AIDS.

CBD and THC are the most commonly known compounds in the plant Cannabis sativa. A key difference between the two is that THC can produce a psychoactive “high” effect at high doses, whereas CBD doesn’t, according to the National Institutes of Health’s National Center for Complementary and Integrative Health.

Under the Agriculture Improvement Act of 2018 (the Farm Bill), CBD products that contain less than 0.3% of THC are not considered federally illegal substances. This has made CBD products particularly popular and widely available to consumers virtually anywhere, but it also makes it difficult for the FDA to address unapproved claims and mislabeling. However, Spindle notes, “Recent research has shown that people who use CBD products containing even small amounts of THC could potentially test positive for cannabis using a conventional drug test.” This has not been determined for topical CBD products, but the authors are currently studying it.

“The variability in the chemical content and labeling found in our study highlights the need for better regulatory oversight of CBD products to ensure consumer safety,” says Ryan Vandrey, professor of psychiatry and behavioral sciences and the study’s senior author.

Such regulation, the authors believe, would ensure CBD products meet established standards for quality assurance so consumers can make informed decisions about product selection and are not misled by unproven therapeutic or cosmetic claims. The study authors also caution that people should check with their health care practitioner before starting any CBD regimen.

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