Growing acceptance of medical marijuana has spurred aggressive marketing of CBD (cannabidiol), a non-intoxicating cannabis derivative that‚Äôs being added to things like skin cream, candy, and dog snacks.
While a CBD-containing drug was recently approved to treat two severe forms of epilepsy, there‚Äôs scant evidence for other health claims.
Nevertheless, marketers are promoting¬†CBD to treat everything under the sun ‚ÄĒ anxiety, depression, neurological diseases, heart disease, addiction, diabetes, pain, sleep disturbances, migraine headaches. You name it.
Last fall the FDA issued warning letters to four companies that illegally marketed CBD as a cure for cancer, Alzheimer‚Äôs, and other serious diseases, noting the products haven‚Äôt been shown to be safe or effective.
It cited blatant fabrications, such as CBD ‚Äúmakes cancer cells commit ‚Äėsuicide.’‚ÄĚ
‚ÄúThe deceptive marketing of unproven treatments may keep some patients from accessing appropriate, recognized therapies to treat serious and even fatal diseases,‚ÄĚ the FDA said.
New outlets should be pushing back against these absurd and potentially dangerous health claims, which continue in spite of the FDA‚Äôs admonitions, and some are. But others have been shamelessly showcasing CBD products and passing along positive testimonials with little or no scrutiny.
University of Alberta law professor and medical debunker Tim Caulfield called it an ‚Äúupside down‚ÄĚ version of Reefer Madness, the 1936 propaganda movie that so exaggerated the ill effects of marijuana as to become an object of satire.
In this case, it‚Äôs claims of a benefit and assurances of safety that are being wildly embellished.
‚ÄúThe CBD craze is a classic example of how media and marketing hype can build around a new idea,‚ÄĚ Caulfield said via email. ‚ÄúCBD has gained traction in popular culture ‚Äď in part due to the broader discussion about the legalization of cannabis.‚ÄĚ
An example is Fox News‚Äô Proponents of pot-infused coffee tout ‚Äėmedical and health‚Äô benefits, which gave free rein to the proprietor of a CBD-laced coffee business to tout his product for quelling anxiety, preventing cancer, and even removing plaques in the brain associated with Alzheimer‚Äôs.
The story didn‚Äôt mention the lack of science to back those claims or limited data about CBD‚Äôs potential side effects.
Forbes‚Äô Spas Take Treatments To New Highs With CBD Oil also grossly inflated the evidence, saying CBD ‚Äúoffers a myriad of potential health effects. Research shows that CBD helps ease anxiety, reduces inflammation, and might be an effective treatment for acne, among dozens of other promised benefits.‚ÄĚ
A better effort was NBC Today‚Äôs CBD oil is on the rise: What to know about the marijuana ingredient, though it started off by displaying an array of CBD products along with a comment from a social media user calling the substance ‚Äúa lifesaver if you‚Äôre someone who deals with chronic pain.‚ÄĚ
The show‚Äôs medical contributor, Roshini Raj, M.D., did offer cautions about limited research and lack of regulation and mentioned CBD isn‚Äôt legal everywhere. But her general take was positive, saying CBD ‚Äúdoes have some therapeutic properties‚ÄĚ and ‚Äúa lot of potential‚ÄĚ with ‚Äúrelatively few‚ÄĚ side effects.
Raj signed off by quipping that she would take a CBD-laced gummy bear ‚Äúfor the road.‚ÄĚ
Some journalists have jumped at the chance to try out CBD products for themselves,
We‚Äôve criticized first-person reporting on trendy and unproven remedies. Anecdotal evidence ‚ÄĒ even from a journalist ‚ÄĒ doesn‚Äôt constitute proof that something works. A perceived benefit could reflect a placebo effect or the natural course of the condition, and only a randomized controlled trial can prove a treatment‚Äôs effects.
Food site Epicurious provided advice on how to cook with CBD oil while misinforming readers that CBD has been ‚Äúshown to combat‚ÄĚ an array of illnesses, and Bon Appetit offered a shameless¬†endorsement of CBD strips as a remedy for stress:
Noting that ‚Äúmany consider (cannabis products) solid sources of antioxidants and beneficial amino acids,‚ÄĚ a Glamour reporter wrote she was able to ‚Äúget the buzz around CBD beauty‚ÄĚ after a week of using personal care products containing the ingredient.
At least a reporter for The Oklahoman acknowledged the futility of relating her own experience swigging CBD-laced water, in a story that laudably cautioned about limited data.
‚ÄúI took two sips (one with an Excedrin for my tension headache) and almost immediately felt my anxiety abate. Which could well have been because I was focusing on what would happen next, rather than on all the things I¬†had been worrying about. As I sipped it throughout the day, I felt calmer than usual, but I have absolutely no proof whether the difference was the CBD, or the way my thoughts ran.‚ÄĚ
Other reporting admirably refrained from hype.
The Atlanta Journal-Constitution attempted to explain the growing appeal of CBD: Without legal way to buy marijuana, Georgians turn to CBD.
It highlighted confusion between CBD and another marijuana compound, THC, which does produce a high, and linked to an evidence review for journalists published by Harvard University‚Äôs Shorenstein Center on Media, Politics and Public Policy, which calls evidence on CBD ‚Äúmixed.‚ÄĚ
The Journal-Constitution was also the only outlet we saw in a scan of recent coverage that mentioned the price of over-the-counter CBD, saying vials cost $30 to $300 in a local store.
The Canadian Press wrote CBD marketing ‚Äúhas run wildly ahead of what scientific studies have proven,‚ÄĚ and some parents have given the substance to children with autism spectrum disorder ‚Äúdespite a dearth of scientific support for any benefit and in the face of concerns over detrimental effects on the developing brain.‚ÄĚ
Another critical look came from Consumer Reports, which noted that a 2017 report¬† by the National Academies of Science, Engineering, and Medicine ‚Äúcould identify only three small published randomized trials‚ÄĒthe gold standard for medical research‚ÄĒthat looked at just CBD. And for none of those conditions‚ÄĒanxiety, smoking cessation, and Parkinson‚Äôs disease‚ÄĒwas the evidence strong enough for the NAS report to conclude that CBD clearly helps.‚ÄĚ
It also made the important point that while CBD appears to pose little risk of abuse, its safety is unclear. In short-term studies, CBD has produced at least some side effects including tiredness, diarrhea, and changes in appetite and weight.
A 2017 review also highlighted a need for larger and longer-term studies on CBD‚Äôs safety,
And there‚Äôs more reason for caution. A recent evidence review published in Canadian Family Physician cited ‚Äúpervasive‚ÄĚ pro-industry bias in cannabis research, exacerbated by poor news reporting.
Two co-authors of that review, researchers Joey Ton and Danielle Perry of the University of Alberta, said via email that a surge in CBD use ‚Äúcould lead to unexpected side effects or medication interactions that we do not know of at this time due to limited evidence in the literature.‚ÄĚ
While some news stories have advised people to talk their doctors before using CBD, they said doctors ‚Äúhave many questions themselves regarding the use of CBD and whether the claims are correct.‚ÄĚ
Some reporting sidestepped that evidence gap, advising consumers only to vet CBD products for quality.
Bon Appetit‚Äôs Before You Buy CBD Oil Online, Ask These Questions called CBD ‚Äúthe thing that will deliver us, and our dogs, from stress, pain and anxiety,‚ÄĚ while offering such cautions as: ‚ÄúIf you‚Äôre worried about whether your kale is organic, you should take the same approach to CBD.‚ÄĚ
Similarly, CNHI News Service‚Äôs The story regarding CBD oil: How do you know what to buy? warned of ‚Äúscammers‚ÄĚ who sell ‚Äúa rip-off product.‚ÄĚ
In other words, these stories seemed to say, go ahead and buy an unproven product, as long as it‚Äôs pure and organic.
This spate of news coverage follows the FDA‚Äôs approval in June of a CBD-containing drug called Epidiolex, which used with other drugs in clinical trials reduced seizures in some patients with two rare forms of epilepsy.
The FDA cautioned Epidiolex might cause severe liver injury and carries other risks common to epilepsy medications, including suicidal thoughts.
It‚Äôs possible that ongoing research will find other uses for CBD.
‚ÄúTo be honest, I suspect there will be applications for this product,‚ÄĚ Caulfield said. ‚ÄúBut it is a complex chemical and we simply do not have a robust body of evidence right now.‚ÄĚ
Almost certainly CBD will fall short of the bloated expectations. It‚Äôs worth noting that other heavily promoted additives like probiotics and antioxidants have been researched for years without showing health benefits for the average consumer.
For now, journalists can serve the public by backing away from the gummy bears and skin cream and provide a counterweight to the wishful thinking that takes hold when there‚Äôs a vacuum of robust science.