Self-reported Cannabidiol (CBD) Use for Conditions With Proven Therapies

Abstract

IMPORTANCE Use of cannabidiol (CBD) has markedly increased in the past 5 years, concurrent with marketing claims that over-the-counter CBD can be used to treat almost any health condition. However, the reasons why individuals use CBD remain unclear. OBJECTIVE To assess whether individuals are using CBD for diagnosable conditions that have evidence-based therapies. DESIGN, SETTING, AND PARTICIPANTS This case series assessed claimed treatment applications reported by CBD users in public testimonials shared on the Reddit forum r/CBD. The r/CBD forum was selected because it includes a large, naturally occurring sample of 104 917 registered individuals who publicly discuss their experiences using CBD. All r/CBD posts were obtained from January 1, 2014, through August 31, 2019. A random sample of posts was drawn (n = 3000) and filtered to include posts in which self-identified CBD users testified why they take CBD (n = 376). EXPOSURES Self-reported use of CBD for medicinal purposes. MAIN OUTCOMES AND MEASURES Cannabidiol testimonials were divided into 11 subcategories corresponding with the condition's medical subspecialty and 2 subcategories corresponding with wellness benefits. Posts were allowed to receive more than 1 label. RESULTS Of the 376 posts labeled as testimonials, 90.0% (95% CI, 86.8%-92.8%) of testimonials claimed that CBD treated the individual's diagnosable conditions. Psychiatric conditions (eg, autism or depression) were the most frequently cited subcategory, mentioned in 63.9% (95% CI, 59.0%-69.1%) of testimonials, followed by orthopedic (26.4%; 95% CI, 21.8%-31.1%), sleep (14.6%; 95% CI, 11.3%-18.5%), and neurological (6.9%; 95% CI, 4.4%-9.6%) conditions. Testimonials also claimed that CBD treated gastroenterological conditions (3.9%; 95% CI, 1.9%-6.1%), as well as addiction, cardiological, dermatological, ophthalmological, oral health, and sexual health conditions (<2.0% each). By contrast, just 29.5% (95% CI, 24.8%-34.2%) of testimonies claimed any wellness benefit, with most citing mental wellness (eg, "quieting my mind") (29.5% [95% CI, 24.2%-34.4%]); 1.4% (95% CI, 0.3%-2.8%) claimed a physical wellness benefit (eg, "exercise performance"). CONCLUSIONS AND RELEVANCE The findings of this case series suggest a need for regulation of factors associated with CBD being used to treat diagnosable conditions, engagement of health care professionals with patients on their potential CBD use, and implementation of public health campaigns that encourage the public to seek treatment advice from health care professionals regarding evidence-based therapies.

Availability and Promotion of Cannabidiol (CBD) Products in Online Vape Shops

“…We identified two vape shops that made explicit health claims about CBD’s effectiveness for treating anxiety, inflammation, pain, and stress, which are not FDA-approved uses of CBD. The claims we identified are consistent with findings of a recent analysis of user testimonials on the largest social media forum devoted to discussing CBD that found that psychiatric (e.g., anxiety) and orthopedic (e.g., joint pain) conditions were the most commonly reported medical reasons for using CBD [ 9 ]. Such unsubstantiated claims may increase use of CBD products, prolong illnesses with existing effective treatments, and expose consumers to both known and unknown health risks without conferring any of the purported benefits.…”

“…While the pharmacological profile of CBD suggests that additional therapeutic applications of CBD could eventually be approved by the FDA, the public may already perceive that CBD is an effective therapeutic for many health conditions that it may never be approved to treat [ 8 ]. This is of particular concern when patients are substituting CBD for other proven effective treatments–prolonging illnesses that could otherwise be alleviated [ 9 ].…”

“…Since CBD products can come in numerous forms and not just vapes (e.g., capsules, edibles, topicals, and tinctures), we documented the forms of CBD that vape shops allowed visitors to mail-order on their websites. Finally, because CBD products have been marketed extensively with unsubstantiated health claims [ 4 , 9 ], we also conducted a content analysis to determine whether the vape shops made any health claims about CBD products.…”

CBD-enriched cannabis for autism spectrum disorder: an experience of a single center in Turkey and reviews of the literature

“…CBD use is not devoid of health risks; known risks include liver damage, adverse effects on the male reproductive system, potential drug interactions that may be associated with adverse events or diminished efficacy of approved therapies, and additional unknown health risks. However, the pharmacology of CBD has not been well studied; thus, little is known about both the potential therapeutic benefits and the hazards of short- or long-term use (Leas et al 2020 ). According to our study, restlessness was the only mild side effect seen in some patients which was resolved on making some doses adjustments.…”

Selling cannabidiol products in Canada: A framing analysis of advertising claims by online retailers

“…Unsupported claims pose a concern for those using CBD for medical purposes, who may accept the accuracy of such claims and spend significant amounts of money on these products for potentially little benefit [31][32][33]. This is especially concerning in situations when CBD is purchased to improve or treat life-threatening illnesses among patients who may forego evidence-based treatments [34][35][36]. The spread of unproven and, in many cases, false claims, contributes to the spread of misinformation.…”