Nearly Half of CBD Oils Are Mislabeled

By Pat Anson, PNN Editor

CBD oils derived from hemp are increasingly being used to relieve painful conditions. Studies have found the oils effective in treating migraines and fibromylagia, and recent research found that a proprietary blend of CBD oil helped relieve symptoms in 9 out of 10 people suffering from chronic pain.

But a new study at the University of Kentucky College of Medicine found that nearly half of the CBD oil products tested in a lab were mislabeled. Of the 80 CBD oils purchased online or in retail stores, only 43 had concentrations of cannabidiols that were within 10% of their label claims – an accuracy rate of just 54 percent.

One oil had a CBD concentration that was 159% higher than its label indicated. Another oil had only 17% of the CBD it was supposed to have.

“As most consumers are using CBD products as therapeutic treatments for some types of medical condition, the dosing is important when considering the potential for CBD accumulation, elevation of liver enzymes, and drug-drug interactions,” lead author Erin Johnson reported in the Journal of Cannabis Research.  

“The findings reported here emphasize the continued need for clear and consistent regulation from federal and state agencies to ensure label accuracy of CBD products and subsequent enforcement. These results also indicate the need for continued development of good manufacturing practices and testing standards.”

In a separate analysis of the same CBD oils, Johnson and her colleagues found that most contained trace amounts of THC (tetrahydrocannabinol), the psychoactive substance in cannabis. Five of the 21 CBD oils that were labeled "THC Free" contained detectable levels of THC.

"THC is not allowed at the Olympics. It's not allowed in many sports organizations. But athletes use CBD because it helps them recover, and it helps them with different facets of their training," co-author Shanna Babalonis said in a press release. "So I think that one of the key takeaways from this work is to say that the public needs to question whether there's THC in their CBD products."

The two studies are certainly not the first to find that cannabis products are often mislabeled. They point to a continuing problem since passage of the 2018 Farm Bill, which legalized hemp under federal law. Although hemp contains only trace amounts of THC, cannabis companies have found ways to tweak its chemical composition to produce concentrated levels of delta-8 THC, which has a mild psychoactive and intoxicating effect.

The FDA considers delta-8 THC to be an unapproved drug, but because it comes from hemp – a legal substance – its regulatory status is unclear. Recently, the FDA sent the first warning letters to five cannabis companies, not for mislabeling, but for making unsubstantiated medical claims about delta-8 THC.  

Until the FDA or individual states confront the widespread mislabeling of CBD products, industry insiders say it’s likely to continue. 

“The mislabeling of Delta-8 products is not surprising but is a result of poor quality controls that are present through the category. Delta 8 can be unsafe for people to use, especially if it not labeled. This is due to the psychoactive component of Delta 8,” said John McDonagh, CEO of CBD producer NextEvo Naturals.  

“Some states have started to regulate Delta 8 to take it off the market. The FDA is limited as it doesn’t have sufficient enforcement resources, so the best solution for now is for states to take action.”

Study Finds Cannabis Oil Effective in 9 out of 10 Pain Patients

By Pat Anson, PNN Editor

Medical cannabis improved symptoms in 9 out of 10 chronic pain patients taking oral formulations of cannabidiol (CBD) and tetrahydrocannabinol (THC), according to a large new study in Colombia.

The observational study, the largest of its kind in Latin America, is the first clinical peer-reviewed evidence on the effectiveness and safety of cannabis products made by Khiron Life Sciences. Over 2,100 patients with a variety of chronic pain conditions self-reported their symptoms after taking CBD and THC oil-based formulations at a Khiron clinic in Bogota.

The findings are published in the peer-reviewed journal Frontiers in Pain Research.

"We believe these findings to be generalizable across patient populations, considering that our results are extremely well-aligned with those reported by researchers working with similar clinical populations in nations with long-standing medicinal cannabis access programs, such as Israel and Canada," lead author Guillermo Moreno-Sanz, Global Scientific Director of Khiron Life Sciences, said in a press release.

While most previous studies only looked at the short-term effects of cannabis ingested through a variety of different methods, this study focused on the safety and efficacy of cannabis oils for up to 26 weeks. Most participants were female, with an average age of 59 years.

Patients received cannabis oils composed primarily of CBD (30mg CBD/2mg THC) or a more balanced formulation (14mg CBD/12mg THC). 

Key findings in the study include:

• 92.5% of patients reported some degree of improvement in their chronic pain.

• 75% reported moderate or robust reduction in chronic pain

• 72% reported no adverse side effects

The degree of improvement was similar between both formulations, although males reported less effectiveness in the first 4 weeks of treatment.

Most side effects were mild, such as somnolence (13%), dizziness (8%) and dry mouth (4%), and faded away after 12 weeks of treatment. No serious adverse events requiring hospitalization or medical intervention were reported.

"This study, based on Khiron's medical products, is critical to reassure physicians and health insurance providers of the efficacy of medicinal cannabis to treat chronic pain. The global impact and economic burden of chronic pain in our society, mounting medical evidence will increase access to cannabinoid-based medicines worldwide." says Alvaro Torres, Khiron CEO and Director.

Khiron Life Sciences is a medical cannabis company based in Colombia. Its products are sold in Colombia, Peru, Germany, UK and Brazil, and will soon be available in Mexico.

Recent studies have also found cannabis oil effective in treating fibromyalgia and migraine.

Daily Drop of CBD Oil Reduces Migraine Headaches

By Pat Anson, PNN Editor

A CBD oil formulated for migraine sufferers significantly reduces the number of migraine headaches, according to a survey conducted by Axon Relief, a Utah-based company that makes a line of therapeutic CBD products.

“Our goal was to put out a CBD oil that is specific for people with migraine and to get feedback from them. There is a lot of anecdotal evidence that it works, but we haven’t seen any clinical data really behind it. And so this is kind of a first effort of ours to get some directional data on how effective this is,” says Ben Rollins, founder of Axon Relief.

Axon’s CBD Oil is made from pure hemp seed oil and has about 30mg of CBD per dose, a stronger than average dosage of cannabidiol. It contains no extra flavors, colors or THC (tetrahydrocannabinol), the psychoactive ingredient in cannabis, and is tested by a third-party lab.

The company asked new users of its CBD oil to take the Headache Impact Test (Hit-6™) both before and after a 30-day trial period. The questionnaire asks participants about the frequency and severity of their migraines, and how it impacts their daily lives.

Of the 105 customers who participated in the survey, 86 percent said a daily dose of the CBD oil reduced the impact of their headaches. On average, they also had nearly four fewer headache days per month.

The number of participants with chronic migraine – daily headaches – fell from 15 at the start of the study to 10 after the trial period, a 33% decline.

AXON RELIEF IMAGE

“Since the '90s I've been on constant high doses of carbamazepine and gabapentin. The periodic pain breakthroughs were only controlled by hydrocodone,” one user said. “What a change CBD Oil has made: no more carbamazepine or hydrocodone, and only half the gabapentin -- and far better pain control.”

Another participant said the CBD oil “significantly helped with my chronic migraines. If taken at onset, I can rely on it to take the edge off relatively quickly."

Previous studies have found that inhaled and ingested cannabis help reduce migraine pain.  A recent study of nearly 10,000 people in the U.S. and Canada who used a migraine tracking app found that 82 percent who used cannabis believed it was an effective pain reliever.    

A 2017 study conducted in Israel found that combining THC and CBD in a 200mg oral dose reduced pain by 55 percent in a small group of migraine sufferers.

And a 2016 study at the University of Colorado found that inhaled and ingested cannabis significantly reduced the number of migraine headaches. Inhalation appeared to provide the fastest results, while edible cannabis took longer to provide pain relief.

Axon Relief will soon be introducing an extra strength version of its CBD oil, which will contain about 100mg of CBD per dose. The company is also releasing a new dietary supplement in capsule form that combines CBD with magnesium, CoQ10 and riboflavin – ingredients recommended by the Migraine Trust. 

Pain and Anxiety Reduced in First New Zealand Cannabis Patients

By Pat Anson, PNN Editor

A study of the first patients prescribed medical cannabis after it was legalized in New Zealand in 2017 found that cannabidiol – the non-psychoactive ingredient in marijuana -- significantly improved their chronic pain and anxiety.

Researchers at the University of Auckland analyzed the health records of the first 397 patients prescribed cannabidiol (CBD oil) at a cannabis clinic in Auckland. The patients live with a variety of chronic pain conditions, including fibromyalgia, osteoarthritis, rheumatoid arthritis, neuropathy, multiple sclerosis, migraines and cancer.

Participants were asked to rate their pain, anxiety, mobility and depression before taking CBD oil and four weeks after starting treatment. The CBD doses ranged from 40mg/day to 300mg/day. The recommended daily dose was at least 100 mg.

Patients with non-cancer pain reported significant improvement in their pain, mobility, anxiety and depression. Some also said they slept better and their appetite improved.

Patients with neurological symptoms experienced no improvement with any symptom, and patients with cancer only reported improvement in pain.

Most patients said they were satisfied with CBD oil, with 70% reporting it was good, very good or excellent; while 30% reported no benefit.

Adverse side-effects, which included sedation and vivid dreams, were reported by about 10% of participants, with two patients (0.8 percent) reporting a worsening of a pre-existing condition.

“The study has limitations due to drop-out and other factors, but the findings are consistent with other evidence and underline the need for more research to allow us to fully realise the therapeutic potential of medical cannabis,” said Professor Bruce Arroll, senior author of the study and head of the Department of General Practice and Primary Healthcare at the University of Auckland.

“Our findings show that CBD is well-tolerated in most patients and can markedly ease symptoms in a range of hard-to-treat conditions, and that there are people keen to access this and self-fund the medication.”

Some patients chose not to take CBD oil because of its cost. Patients had to pay $300 (US) for 2500 mg of CBD oil, $150 for an initial consultation, and $75 for a follow-up.

“Our evidence of CBD’s potential benefits in treating pain and anxiety, if corroborated by future clinical trials, suggests we may need to consider subsidising medical cannabis,” said co-author Dr. Graham Gulbransen, who operates the cannabis clinic in Auckland. 

Because the study was observational and relied on patients self-reporting their symptoms, it did not establish a cause-and-effect relationship. It’s also possible the improvement in symptoms was due to a placebo effect.

The findings are published in the British Journal of General Practice Open (BJGP Open).

How CBD Helped End My Insomnia

By David Eaton, Guest Columnist

Due to a decrease in my opioid pain medication (to fall within the CDC guideline), my pain level increased to the point that I was unable to sleep. Of course, lack of sleep affects your overall health and so I began a downward spiral and needed something to break that cycle.

My son, who has been suffering acute pain from scoliosis in his neck, was having similar insomnia issues. He tried CBD oil and recommended that I do the same.

I knew little about CBD, so I talked to the very knowledgeable and helpful manager of a local CBD store. His recommendation was that I begin by researching CBD myself and then talk about it with the doctor at my pain clinic -- advice that impressed me as being very responsible.

After spending a day or two reading online articles, including some here on Pain News Network, I ran the idea past the physician’s assistant at my pain clinic.  She thought it was a great idea and asked me to try it before my next appointment with her in 4 days.

I placed another call to the manager at the CBD store and he recommended starting with a CBD infused "candy bar." My wife went there the next day and paid $25 for a white chocolate, peach and hazelnut flavored candy bar containing 120 mg of CBD.

DAVID EATON

The chocolate bar was scored in such a way that it can be divided into 4 servings, each with 30 mg of CBD. The manager’s suggestion was for me to try a single piece the first night and then take one and a half sections the following 2 nights. So that's what I did. 

Prior to trying the CBD, I had experienced a lot of pain-induced insomnia and found it difficult to sleep for more than an hour at a time.  It was not uncommon for me to wake up 10 times during a 12-hour effort to sleep. 

Most people do not realize how important a good night's sleep is to your health and well-being.  After my insomnia got severe, I installed an app on my phone (Sleep as Android) to track how much I slept each night.

After taking my nighttime meds and my last "dose" of CBD chocolate, I fell asleep around 8 pm.  According to the sleep app, which amazed me by its accuracy, I slept until 3 am, waking up feeling very rested and refreshed.

I decided to stay awake long enough to write this article before going back to sleep at 4 am. I slept until 10:45 that morning.

In all, I got about eleven and a half hours of deep sleep over the course of about 13 hours!   

As far as I am concerned, the use of CBD to reduce my pain and promote relaxation is an overwhelming success. I will be investing in a bottle of CBD oil on my next trip to town. 

David Eaton is disabled by chronic pain caused by degenerative disc disease, migraines and arthritis. He lives in Georgia.

Pain News Network invites other readers to share their stories with us. Send them to editor@painnewsnetwork.org. 

The information in this column is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.