By Emily Ledger
Cannabis-based products have gained increasing recognition in both the medical and wellness sectors in recent years, with the common cannabinoid huge attention among the scientific research community and the general public alike.
CBD, also known by its unabbreviated name Cannabidiol, has become the star ingredient in a baffling range of products in the UK. The retail CBD market has not only grown to include edible products like chocolate, gummies, and drinks, as well as skincare and beauty products but more traditional wellness items such as CBD oils and capsules.
The CBD used in the production of items such as these is classed by UK and EU regulations as a food supplement. This means that they are moderated by the Food Standards Agency and are not considered, nor should they be labelled as, a medical product.
On the other hand, CBD is also used in medical products such as Epidyolex – the use of which is highly controlled with access only permitted through the prescription of a specialist clinician. But what is the difference between these two classes of CBD products?
Perceived Benefits of Over-the-Counter CBD Products
The success of the CBD industry, both in the UK and in many other countries around the world, has been largely spearheaded by anecdotal evidence in combination with the findings of limited clinical studies. Many users have raved about the products’ potential to ease anxiety and stress, aid in sleep, and even help with pain and muscle recovery.
While anecdotal evidence is relatively strong in this respect, there are few clinical studies to back up the perceived benefits of CBD. Research into the cannabinoid is on the rise, however, it is important to note that these trials are carried out with carefully controlled cannabis extracts at much higher doses than you would get in high-street products.
While over-the-counter CBD products may well provide individuals with relief from some symptoms such as those previously mentioned, the manufacturers are restricted from making any sort of medical claim. This is because the products have not been subjected to any medical assessment or research. It is also important to remember that CBD affects everyone differently, so while one person may experience impressive relief from CBD products, another might not notice any difference at all!
Standards and Testing of Pharmaceutical-Grade CBD
In contrast to over-the-counter (OTC) CBD products, cannabidiol-based medical products are subjected to a number of manufacturing and licensing standards.
Prior to being approved as a medicine in the EU and UK, pharmaceutical products must pass European Medicines Agency pharmaceutical authorisation. This means that the medicine and pharmaceutical company must be compliant to ‘Good Laboratory Practise’, ‘Good Clinical Practise’ and ‘Good Manufacturing Practise’.
In addition, the manufacturers must submit information regarding the product and results of clinical trials for assessment by the European Medicines Agency. These assessments consider the chemical and physical properties of the product, the benefits reported by patient groups and potential risks and side effects associated with the use of the product. Risks and side effects are also continuously monitored following the authorisation of the medicine.
CBD Products: Pharmaceutical-grade Vs Retail
In contrast to pharmaceutical CBD-based products such as Epidyolex, CBD products such as oil tinctures and edibles that are easily available over the counter or on the internet are not subjected to clinical trials or pharmaceutical-grade testing.
Reliability of OTC CBD Products
Furthermore, while laboratory testing of these products is often available – to guarantee the cannabinoid content and ensure that you are getting what you pay for – many products available online and in high street shops have been found to be incorrectly labelled in the UK. For example, a study carried out by the Centre for Medicinal Cannabis in June 2019 found that almost half of products tested incorrectly stated the CBD content. One of these products actually contained no cannabidiol at all.
Having said this, it is important to clarify that there is a large number of high-quality, reliable CBD brands currently operating in the UK. Moreover, the incoming Novel Foods deadline for certification in March this year will likely eliminate much of the low-quality brands operating in the sector.
Strength and Dose of CBD
Another of the most significant differences between CBD products bought over the counter and those that are only available through prescription is the strength and recommended dose. A starting dose of Epidyolex, prescribed for the treatment of intractable epilepsy, is 2.5 mg/kg, increasing to 5 mg/kg after one week. For context, each ml of Eidyolex solution contains 100mg of CBD.
In contrast, OTC CBD products often contain much lower levels of cannabidiol that has not been rigorously tested. These products often come with dosing recommendations that don’t come close to the doses used for medical purposes.
While a huge number of people may have experienced some positive effects having used OTC CBD products, it is important to remember that they should not be used as an alternative to medicines designed for serious health conditions. Although current research has found that CBD is not harmful at moderate or even high doses, you should not exceed dosage recommendations laid out on each CBD product.
If you are seeking medical help with the use of CBD or other cannabinoids, you should discuss with this with your doctor.