Health

HE A LTH • Summer 2019 13 than scientifically proven, he said. Pacheco attributes CBD's popularity to patients wanting something with- out the side effects and potential inter- actions with other drugs. "People want to try other things," he said. Studies have shown positive effects – for neurological disorders, schizo- phrenia and even psychosis, for exam- ple – but regulators and the medical community are cautious of how much CBD is responsible for those results. Perhaps even worse, the FDA has said CBD products are often misla- beled for how much cannabidiol is actually in them. The FDA has sent nearly 50 warning letters since 2015 for products not accurately labeled. Certain CBD makers have marketed their products saying they have been found to stop cancer cells, reduce withdrawal symptoms or slow the progression of Alzheimer's, claims raising concerns at the FDA. FDA Commissioner Scott Gottlieb said in April he was worried about manufacturers making such major health claims and the FDA is working to put in place new regulations. In Massachusetts, no major regula- tory moves have yet followed the fed- eral changes. Gov. Charlie Baker's administration is reviewing CBD reg- ulations, while the Massachusetts Medical Society hasn't yet issued any recommendations on its use. Unproven, but still popular Even while so much remains unset- tled with CBD's benefits, that hasn't stopped users from turning to it for its supposed healing abilities. A Consumer Reports poll released in April found one out of four adults have tried CBD. An increasing number of retail stores in Central Massachusetts sell CBD, from smoke shops to spas. Turnpike Smoke Shop in Shrewsbury began stocking CBD around eight months ago, with customers saying they helped with was made legal to grow in a new fed- eral farm bill effective in 2020, which for the first time differentiated between hemp and marijuana. The U.S. Drug Enforcement Administration reclassified one can- nabidiol drug from Schedule 1 – those with no legal use, including heroin and LSD – to Schedule 5, a category including far lower potential for abuse, such as the cold medicine Robitussin. That's opened the CBD market, joining with what's become a far more permissive attitude toward cannabis use in general. Last fall, 62% of Americans said they supported legal- izing marijuana, double the percent- age who felt that way in 2000, accord- ing to a Pew Research Center poll. Combined with how many people say they are regularly stressed – 55% experienced stress during a lot of the day, according to a Gallup poll released in April – and it's not hard to see why CBD seems to be everywhere. "I've seen an insane change in some of my customers," said Summi Kharashqah, who works in sales for Amazing Superstore in Northborough. "Even if they want to call it a placebo effect, it still works." A Consumer Reports poll from January shows almost half of those who begin using CBD to replace a medication do so instead of taking an over-the-counter drug like Advil or Tylenol. Potentially more promising for the opioid epidemic, more than one-third said they stopped using a prescription opioid while taking CBD. Unresolved science With a new drug classification for CBD, the f loodgates have opened for research into all kinds of conditions or ailment CBD may treat. The U.S. National Library of Medicine tallies more than 500 ongo- ing studies into CBD: how it affects cocaine addiction, those with autism, cannabis withdrawal, osteoarthritis, graft-versus-host disease, epilepsy, schizophrenia and Crohn's disease. It's a long enough list to make any- one question what kind of wonder drug could cure all of that. "We don't really know the long- term effects of its use," said Dr. Anthony Izzo, a neurologist at Saint Vincent Hospital in Worcester who finds studies are not extensive enough. Izzo finds CBD's benefits to be largely a placebo, something to help patients if they believe it to help but something not known to be harmful. "I don't ever really dissuade patients from using it," he said, "and I never really recommend patients go try it." Dr. Manuel Pacheco, a doctor of psychiatry at Tufts Medical Center in Boston, has similar reservations. Most beneficial claims are more anecdotal Continued on Page 14 A Consumer Reports survey in April found CBD was used most often for reducing anxiety. Why do people take CBD? Reduce stress or anxiety Help with joint pain Fun or recreation Better sleep Reason for using Rate it as extremely or very eective Rate it as slightly or not at all eective 37% 24% 11% 10% 63% 38% 24% 52% 16% 27% 22% 16% Source: Consumer Reports CBD products come in a variety of forms with varying levels of concentration. Daily Less than daily More than once daily Use for general health and wellbeing Use for medical condition 39.7% 56.5% 26.9% 60.3% 43.5% 73.1% For those who use CBD for medical purposes, most use it daily, according to a 2018 online survey with 2,409 respondants. Almost three out of four of those people said they use CBD at least once a day. How often do patients take CBD? Note: Some answers were left blank in survey. Source: "A Cross-Sectional Study of Cannabidiol Users" by Jamie Corroon and Joy A. Phillips

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