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CBD: What You Need to Know as a Pharmacist
With demand for CBD at record level, pharmacists need to be familiar with the laws, interactions, and best practices to counsel patients interested in CBD products. While proponents of CBD claim a wide array of therapeutic uses, not all have been proven scientifically, and the products are not without risks—especially with an often-unregulated market of manufacturers. Here’s a quick primer of what you should know as a pharmacist.
When the Agricultural Improvement Act was passed in 2018, it removed hemp from the DEA’s list of controlled substances, opening the door for hemp derived products like CBD at the federal level. However, while CBD has been legalized in over 30 states for medical purposes, not every state has the same laws regarding its sale and use, which can add to confusion. It is highly recommended you know your own state’s laws regarding CBD and how it can be acquired and used legally so you can give accurate information to your customers without risking any legal trouble.
For states where CBD is legal, the most critical advice you can give to patients is to source their CBD products from reputable manufacturers. Since the majority of products aren’t regulated by the FDA, some can contain harmful ingredients like heavy metals and pesticides, or have doses beyond what is recommended. If possible, you should tell your patients to source their CBD products from medical dispensaries because the products there are regulated and tested. High quality manufacturers will also provide a Certificate of Analysis showing the assessment of an independent laboratory for potency and contaminants. Customers can also look for the seal of the Hemp Authority which denotes the legality of the product and the manufacturer’s adherence to standards.
As far as uses, the only medical condition scientifically demonstrated to be helped by CBD is epilepsy. That is not to say the myriad of conditions some claim CBD is useful for are false, simply that their efficacy hasn’t been tested thoroughly enough. Some studies have found that certain doses of CBD may be effective for anxiety, sleep, muscle pain, and depression, but at this point, those treatments are still inconclusive and customers should be made aware of side effects and interactions before pursuing CBD for those issues.
The common side effects of CBD include dry mouth, decrease appetite, lightheadedness, fatigue, dizziness, diarrhea, weight loss, and an increased risk of liver injury with higher doses. Because CBD can be passed through the placenta, pregnant and breastfeeding women should avoid using CBD products. Because CBD is metabolized through the liver, there are quite of few known drug interactions that should be avoided or closely monitored, these include—barbiturates, benzodiazepines, fentanyl, morphine, and propofol. It can also interact and increase the sedative effects of herbal supplements like melatonin and St. John’s wort. This is by no means a complete list, and pharmacists counseling patients should inquire about the drugs and supplements a patient is taking when discussing CBD products with them.
You can find more information and the answers to many questions regarding CBD from this FDA page, right here.