ASA in the News

By Lisa Esposito for US News & World Report

Scrutinize the label. You need to know precisely what's within the container. Having this information speaks to the product's purity, quality, consistency and safe use. All this should all appear on product labels, according to "Patient's Guide to CBD: 2019," a downloadable report from Americans for Safe Access, a nonprofit group with the goal of promoting legal, safe use of medical cannabis.

MAYBE YOU'RE A CUSTOMER who's curious about CBD-infused products such as tinctures, capsules, sprays, lotion, waters, sodas or gummy bears. You've heard claims of pain-relieving, anxiety-reducing, anti-inflammatory, sleep-enhancing and other purported healing properties, and you wonder if products containing cannabidiol, or CBD, can help you.

Research on the safest, most effective use of CBD is still emerging. Even so, with major retail chains climbing on board, health and wellness products with CBD are getting easier to find. And if you're interested in trying them, you're not alone. In a survey conducted by CreakyJoints, part of the Global Living Foundation, more than half of arthritis patients surveyed had tried medical marijuana and CBD products in addition to their prescribed medications to cope with symptoms like chronic pain.

CBD is related to marijuana, but there are important differences. Both involve chemicals found in cannabis plants. THC, which primarily comes from marijuana, has psychotropic properties – it gets you high. In contrast, CBD, which is mostly derived from the related plant hemp, doesn't have this psychotropic effect.

"We weren't entirely surprised that so many people living with chronic rheumatic and musculoskeletal conditions have tried such products for what they considered medical reasons," says Benjamin Nowell, director of patient-centered research at CreakyJoints. "With the proliferation of unregulated CBD products in the U.S., people have greater access. However, there is currently no definitive way to compare different brands or types of CBD products, due to the dearth of high-quality clinical studies evaluating their safety, effectiveness and appropriate dosing."

At a Retailer Near You

Stop in at a CVS Pharmacy in Maryland: Adjacent to standard heat wraps and sports creams, across the aisle from keto snacks, an entire display is devoted to topical products containing CBD, a chemical found in cannabis plants.

In the CVS display and nearby shelves, you can pick up CBD "Relief & Recovery" spray from Sagely Naturals at $27.99 per container or $14 per ounce. Or you could try PlusCBD Oil hemp balm, among several other brands of CBD-based topicals.

In addition to Maryland, CVS has introduced topical CBD products in Alabama, California, Colorado, Illinois, Indiana, Kentucky and Tennessee, according to a statement reported in March by CNBC, which noted the stores will not be selling CBD-containing supplements or food additives. Walgreens also announced plans to sell topical CBD products at stores in select states, according to another March CNBC story.

Throughout Pennsylvania, gas station/convenience store chain Sheetz is selling CBD products, including topical rubs and patches, tinctures, vape pens, oral pouches, capsules and pet products. All will be kept behind the counter, and proof-of-age identification will be required from all customers, who must be 18 or older, according to a May 25 company press release.

A slew of other retailers are reportedly considering entering the market. And of course, you can order CBD products online. If you're shopping on the internet, you can easily check product information in the moment. However, buying CBD items through an established retailer, whether in-person or online, could give you an added layer of product vetting.

Shifting State Regulations

Keep in mind that CBD regulations vary state by state. In Florida, for example, a bill authorizing the state's new hemp program went into effect on July 1. The Florida Dept. of Agriculture and Consumer Services is drafting rules to regulate and oversee the program, says Maxwell Flugrath, a department spokesperson.

Florida Agriculture Commissioner Nikki Fried has created the state's first-ever Director of Cannabis position to oversee the program, Flugrath notes. "Once the state hemp program rules are adopted, our department will be able to begin testing cannabis products for safety and quality, and can begin enforcing the adopted standards to ensure consumers can trust what they're ingesting," he says. State laws around CBD products are in flux, with individual legislatures still sorting out regulations. For more information, check out your own state government's website.

CBD Buyer's Tips

As a health consumer, you need to consider a product's quality and purity. These expert tips outline how to go about buying CBD products and what to look for on the labels. (Hint: It helps to have your mobile device handy when you walk into the store.)

Come prepared. "Prior to going to the store to purchase any CBD-containing product, consumers should consider researching CBD and cross-referencing their findings with whatever disease or ailment they are concerned with," says former Surgeon General Dr. Richard Carmona, who serves on the advisory board for Kadenwood, a "seed-to-shelf" consumer CBD products company that's launching a CBD topical cream called Level Select later this month.

Understand exactly how to use the CBD product. How do you take the CBD? How much? For how long do you take it? What are the risks and benefits? If the answers aren't clear from the product's label or your previous fact-finding, then it shouldn't go into or onto your body.

Ask your doctor. "What's most important is that patients who are considering trying these products seek guidance from their physician and health care team," Nowell says. Health care providers would be able to monitor CBD product use, he adds, and could also offer alternative wellness recommendations that are better supported with evidence to date. Doctors or pharmacists can discuss side effects and potential drug interactions with any medications you're taking.

Scrutinize the label. You need to know precisely what's within the container. Having this information speaks to the product's purity, quality, consistency and safe use. All this should all appear on product labels, according to "Patient's Guide to CBD: 2019," a downloadable report from Americans for Safe Access, a nonprofit group with the goal of promoting legal, safe use of medical cannabis. Check your CBD label for the following:

• Identity (like dietary supplement) to understand what it's meant for.
• Cannabinoid content. CBD from hemp contains only trace amounts of THC, at most.
• Net quantity. Quantity is expressed with measures such as weight or numerical count, so you can compare with other products.
• Batch lot or control number.
• Production or expiration date.
• Instructions for use. For instance, is this a sublingual CBD tincture that should be taken under the tongue?
• Dosing guidance. With a CBD balm, cream or lotion, do you slather it on your skin or use a small amount? (Research on safe, appropriate dosing is still in early stages.)
• Appropriate warnings and contraindications for use. Also, check with your doctor about possible interactions with any prescription medicines you take.
• Storage instructions.

Check for FDA warning letters. Some products marketed as containing CBD have been actually been found to contain little or none with testing. The Food and Drug Administration keeps a running list of firms (and their purchase websites) to which the FDA has sent warning letters about questionable CBD products.

Look for independent testing. "Are the products third-party tested?" is a key question for consumers to consider to determine which brands are safer than others, says Dr. Kristine Blanche, owner and operator of Integrative Healing Center in Long Island, New York. On manufacturers' websites, you can look for a Certificate of Analysis, or COA, showing test results. Done by an independent laboratory, COA testing includes analysis for contaminants and measurement of CBD and THC levels, providing an extra level of quality assurance. You should be able to download the COA online, and the retailer should be willing to share it.

Beware of hype. "Watch out for cure-all claims," says Michael McGuffin, president of the American Herbal Products Association, a trade group. 
"Federal regulations prohibit food or supplement products from being marketed to cure or treat any disease. If you see a company making disease or other questionable claims, it should raise a red flag."

Seek contact info. Federal regulations also require that product labels display information on how to contact the company, McGuffin says. "If the label doesn't include company contact information, don't buy it," he says.

Consider your information source. To ensure you're getting accurate information on CBD, rather than unsubstantiated advertising, testimonials or anecdotes, turn to nonbiased, scientific sources such as the National Institute on Drug Abuse or the Mayo Clinic website, Carmona says.