LAWRENCE — Before starting his CBD company, Chris Brunin researched the competition, the labs they used, the products they sold.
He checked out ingredient suppliers and organic hemp farmers. He took everyone’s pitches with a heapful of salt.
“The hemp industry is like the Wild West and Wall Street had a baby,” said Brunin. “You have to vet everything and everybody … to make sure you’re not getting messed with or lied to.”
Brunin advises consumers to do the same. Ask to see lab results. Ask how much actual CBD — not just, say, hemp seed oil — is in a bottle. Comparison shop. Is it overpriced? Often, he says, it is.
Kansas legalized CBD, the cannabis extract cannabidiol, last summer. Since then, the state that came late to this multi-billion dollar industry has seen the number of CBD vendors skyrocket.
Spas and massage parlors don’t want to miss their piece of an ever-expanding pie. Last month, Dillons supermarkets rolled out non-edible CBD offerings — balms, lotions and the like — in its Kansas grocery stores with pharmacies.
But as Americans turn to CBD in search of help for everything from migraines to insomnia to cancer, scientists and regulators worry that some companies market unproven health claims, and that others sell products with inaccurate labels. What’s more, even though the products shouldn’t get you high, some might still make you flunk a drug test.
Meanwhile, people who see medical promise in CBD fret about incompetent or unscrupulous manufacturers tainting an industry that activists fought to legalize. Kansas is one of just four states with exceptionally tight laws on all things cannabis.
“Honestly, I’m scared for people,” said Lisa Sublett, of medical cannabis proponents Bleeding Kansas Advocates. “I don’t trust the stuff at your gas station, sorry. You really have no idea what’s in the bottle.”
She recommends consulting The Patient’s Guide to CBD, a 50-page primer from Americans For Safe Access that explains labels, lab analyses and more.
Done right, advocates say CBD products can change an ailing person’s life.
Scientific studies suggest they’re right — at least for people with certain rare epilepsies, and maybe for others. But the vast majority of anecdotal claims piling up about CBD’s medicinal qualities don’t have backing from clinical trials to prove they’re more than sales pitches and the power of placebo.
“There’s some real value here,” Mayo Clinic physician Brent Bauer said. “But we have to do a lot of work to kind of chip away at the rough edges and find out: How big is the diamond? Is it one carat or is it 40 carats?”
Definitive scientific studies will take time. A few intriguing leads include possible benefits for treating anxiety and pain.
Ask for lab results … but know they can be wrong
Quiet Trees, Brunin’s small-batch company, lives in an unassuming 1,500-square-foot lab-and-packing facility in southwest Lawrence.
Shelves line the walls with clear plastic boxes full of bath bombs, vaping mixes and gummy bears. A big blue barrel holds 55 gallons of organic hemp seed oil from Kentucky. A small crew in white lab coats produces, packages and ships products daily to customers — mostly retail shops — in a half dozen states.
One of the shortest routes the products take lands them at CBD of Lawrence. It sits on Massachusetts Street, the heart of the college town’s boutique and local shopping.
There, customers eyeing a bottle of tincture or packet of vape cartridges can whip out a smartphone and scan QR codes on the packaging. That takes them to a Google Drive copy of third-party chemical analyses by a lab in Massachusetts that tests the materials Quiet Trees uses.
Pharmacist Dustin Hothan wants that transparency. The co-owner of CBD of Lawrence says he won’t stock anything without independent lab results.
He pores over product reviews online, looking for any quality complaints about the CBD capsules, beverages and more on the shelves of his store.
Still, Hothan once got a tip that a product he stocked contained detectable amounts of THC, the compound in cannabis that can get you high, or, in smaller, non-intoxicating doses, still make you fail a drug test even weeks after discontinuing use.
“So we sent it off for testing,” he said. “It turned out, it did contain THC.”
The label had promised otherwise. The original lab results, too. Hothan dropped the product.
How can mistakes like these happen? Lab quality varies. The quality of manufacturers in this rapidly ballooning industry does, too. Even the best-intentioned retailers must figure out which names to trust, homing in on labs and brands that prove themselves.
All retailers great and small
Nationally, market analyst Brightfield Group estimates the value of the U.S. CBD industry multiplied seven times over in 2018. In a new report this month, it pegs the market at nearly $24 billion by 2023.
After all, national retailers have joined the action. Customers not drawn to vapes and tinctures will find new takes on old products, Brightfield says. Anti-aging creams. Dog treats. Bottles of multi-vitamin.
The state of Kansas tracks neither the value of CBD sales in the state nor the number of vendors. One hemp advocate guesses the compound is now available at hundreds of locations statewide.
Kelly Rippel, co-founder of Kansans for Hemp, has mixed feelings about that.
“There’s got to be an understanding from all institutions that it can’t be stigmatized anymore,” he said. “But it has to be done in a way that is going to protect public health.”
In reality, neither the state nor federal government check the contents of the tinctures, vapes and more flooding Kansas stores.
The sole FDA-approved use is Epidiolex, a CBD drug that proved itself in clinical trials as a treatment for rare types of epilepsy.
As for the booming wellness market, the FDA wants answers to questions about the effects of taking CBD long-term, and about product safety and reports of contamination by pesticides or heavy metals.
“We are looking into this,” the agency said in a recent consumer update.
It has tested a small number of the vast array of CBD products and found contents don’t always match labels. The agency issued warnings, too, to companies caught claiming their products can save people from cancer, Alzheimer’s, diabetes and more.
Scientists at the University of Pennsylvania and other institutions bought more than 80 CBD products online and found fewer than a third were accurately labeled.
CBD levels were off, and some products that claimed not to contain THC actually did.
Legal quandary and quagmire
Vince Sanders, CEO of national CBD retailer American Shaman, would love to talk about what his products do. But the risk for drawing ire from federal regulators held him back in a recent interview.
“Honestly, up until relatively recently, I said a lot of stuff I probably shouldn’t have in retrospect,” he said.
American Shaman recently pulled down thousands of testimonials from its website, Sanders said, to avoid any potential legal liability.
The Kansas City-based CBD heavyweight with franchises in about 25 states, and dozens of shops across Kansas, kept only nebulous phrases on its home page.
“Positive effects.” “Pain management.” “Beneficial qualities.” CBD “helps in recovery from conditions,” the site says, but doesn’t specify any.
Yet, Sanders said in the interview: “There’s overwhelming evidence of what CBD does. … I can’t say it. I wish I could.”
“They work very quickly,” he said. “If you find some relief during the 15 minutes or so you’re there, then you have a good idea.”
Indeed, the National Library of Medicine’s online research database, PubMed, offers a dazzling array of CBD articles, but far too few clinical trials to back the wide-ranging claims about the substance’s abilities.
Much of the work involves animals and petri dishes, or small-scale trials. CBD shows some promise for helping with pain, anxiety, and even schizophrenia, says Bauer, of the Mayo Clinic. But benefits in studies often came only with exceptionally high doses of CBD — and sometimes side effects.
The fact that “natural” substances can cause problems gets lost at times amid excitement for herbal remedies. St. John’s Wort shrub can help some people with depression, for example, but also messes with birth control.
Bauer, who founded and directs research at Mayo’s program for integrating alternative medicines such as acupuncture into health care there, recommends against CBD for young children, pregnant or breastfeeding women, and patients taking many medications. CBD can screw up dosage levels of certain prescriptions. Talk to your doctor if you plan to take it.
THC vs CBD
State laws bar Kansans from getting marijuana legally. So is CBD just a poor substitute?
Studies show CBD and THC work differently and have different potential medical benefits, says Mallory Loflin, a psychiatry professor at the University of California-San Diego who specializes in cannabis research. CBD also has a diffuse, lighter effect.
“You need a much bigger dose,” she said. “We don’t start seeing differentiation from placebo in clinical trials for things like anxiety until you get up in the 300- to 600-milligram range.”
That could mean an entire bottle of CBD oil a day, depending on the bottle, but studies with such high doses also give some patients diarrhea. Anecdotally, CBD vendors and consumers often say smaller doses work, but clinical data is lacking.
A vigorous placebo effect complicates research of both cannabis extracts. The risk? That trials can fail, even when the extracts work.
“You’re hearing that cannabinoids are so helpful for so many different conditions — people already believe they’re going to work,” Loflin said. “If everyone's cured, I can’t compare groups because both groups were cured.”
Loflin is also leading a new Veterans Affairs Administration study in San Diego on the effects of CBD for treating post-traumatic stress disorder. She worries that in today’s absence of settled science, patients don’t know what to get. Some studies point to taking low doses of THC for certain chronic pain, for example, while others suggest going the CBD route — possibly with a little THC, but not with higher doses — for anxiety and other mental health issues.
She studied veterans self-treating with cannabis products in California, where both THC and CBD are legal. Most picked what was likely the wrong treatment for their conditions. Some weren’t even sure what they used.
“Which frankly terrified me,” she said. “Because the effects of CBD vs THC are about as alike as chalk and cheese.”
Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service. You can follow her on Twitter @Celia_LJ or email her at celia (at) kcur (dot) org. The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on the health and well-being of Kansans, their communities and civic life.
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