More human CBD trials are needed to understand its health benefits

iStock/Tinnakorn Jorruang

A new review on CBD research suggests that more human CBD trials are needed to help us understand the health benefits.

The boom in the use of Cannabidiol (CBD) oils and products has seen many claims regarding the health benefits of using the product. Many patients use the oil to help with many health issues from aches and pains to anxiety, sleep disturbances, arthritis and other chronic conditions.

Since the legalisation of medical cannabis there has been a growing amount of preclinical and clinical evidence that suggests CBD oil is a promising treatment for conditions such as chronic pain and opioid addiction, however there have been few human CBD trials to help understand the safety and efficacy of the product.

Human CBD trials needed to improve our understanding

A review of the latest research, to be published in September in Mayo Clinic Proceedings, has suggest that more human CBD trials are needed before health care providers can say definitely that the product is effective.

Brent Bauer MD, an internist and director of research for the Mayo Clinic Integrative Medicine programme, said: “There are many intriguing findings in pre-clinical studies that suggest CBD and hemp oil have anti-inflammatory effects and may be helpful with improving sleep and anxiety, but trials in humans are still limited, so it is too early to be definitive about efficacy and safety.”

Dr Bauer emphasised that there is reason for concern about a growing number of reports of liver injury in patients who have used CBD products and with a growing patient interest in CBD and hemp oil products, it’s important that clinical research moves ahead to better understand their potential value and safety.

He said: “Careful selection of a health care product is crucial, and though these products do not have Food and Drug Administration approval for therapeutic use, patients continue to ask for them and use them. Physicians need to become better informed about these products, and it’s important that human trials examine issues of efficacy and safety.”

Health professionals should take patient interest seriously

The review concludes that CBD oil products are potentially useful for chronic pain and addiction management and emphasises that physicians should so easily dismiss claims of the oils health products easily – encouraging health care professionals to learn as much as possible and take patient interest seriously.

Dr Bauer said: “We encourage physicians to not disregard their patients’ interest in these products and keep both a clinical curiosity and a healthy scepticism about the claims made. Chronic pain management continues to challenge patients and physicians, and these therapies are a promising area that needs more research.

“For patients struggling with chronic pain, physicians taking time to listen to them and address their questions compassionately but with an evidence-based approach can help them make informed decisions.”

According to the study, the concerns of healthcare professionals is the variety of CBD and hemp oil products, limited regulation of the products, as well as there being no rigorous safety studies on full spectrum CBD oils and limited human CBD trials. Different state laws around the products also adds to the complexity of decision-making for both consumers and physicians.

Different CBD components need to be understood

Co-author Karen Mauck, M.D., an internist at Mayo Clinic, says there are important distinctions between marijuana, hemp and the different components of CBD and hemp oil, and some clinicians may not be aware of them.

She said: “Other than Epidiolex, a purified form of plant-derived CBD which was approved in 2018 for treatment of severe forms of epilepsy, all other forms of CBD are not approved by the Food and Drug Administration but are sold in a variety of formulations, including oral or topical oils, creams, sprays and tablets. They contain variable amounts of CBD, may contain other active compounds and may have labelling inaccuracies. Before using CBD or hemp oils, it’s important to consult with your physician about potential side effects and interactions with other medications.”

Three clinical human CBD trials, enrolling more than 500 patients, have shown that a CBD oral solution taken with other medications halved the number of seizures in 40% of children and young adults with two rare forms of epilepsy. These trials, which were conducted by the British firm GW Pharmaceuticals, convinced the U.S. Food and Drug Administration to approve Epidiolex, a CBD drug made by GW, for sale on the US market.

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