CBD comes from cannabis plants called hemp that are specifically grown with high levels of CBD and low levels of THC. Cannabis plants grown with high levels of THC are usually called marijuana. CBD comes from oil that is extracted from the cannabis plant. That oil can then be ingested as a liquid, a capsule, a gummy, or inhaled through vaping. It can also be added as an ingredient in such products as lotions and skin patches.
There is currently 1 CBD treatment approved by the U.S. Food and Drug Administration (FDA) called Epidiolex, which is used to treat a rare and severe form of epilepsy in children. There are not currently any FDA-approved CBD medications for treating cancer or side effects of cancer treatments.
What is CBD?
There is much about CBD that is still unknown. It has largely gone unstudied because, until 2018, it was considered a schedule I drug by the U.S. Drug Enforcement Administration (DEA). A schedule I drug is a drug that has been declared illegal by the DEA because of safety concerns over its potential for abuse and because there is no accepted medical use for it. Then, in September 2018, the DEA updated CBD’s status to become a schedule V drug. Schedule V drugs have a lower potential for abuse and are deemed to have some medical use.
It is also important to note that some studies have shown that CBD might interfere with how your body processes cancer drugs, called a drug interaction. This might make cancer treatments more toxic or make them less effective. More research is needed on these effects, too. For these reasons, always tell your oncologist if you’re thinking about using CBD before you take it.
There have been some studies that show that CBD, alone or together with THC, may relieve pain, insomnia, or anxiety, but these studies were not specific to people with cancer. While no studies to date have shown that CBD eases these side effects specifically in people with cancer or people receiving cancer treatment, some people with cancer have reported benefits in taking CBD, such as helping with nausea, vomiting, depression, and other side effects. According to ASCO guidelines, your doctor may consider prescribing cannabinoids for chronic pain management if you live in a state where it is legal. However, ASCO guidelines state that there is not enough evidence to support the use of cannabinoids for preventing nausea and vomiting in people with cancer receiving radiation therapy or chemotherapy.
Dr. Hou: We need more research to assess the safety and effects of CBD. And we need to take a closer look at potential herb-drug interactions, which is especially important for people receiving chemotherapy.
Cannabis, also known as marijuana, is used to treat some symptoms related to cancer. It’s made from the flowers, leaves, and resin (sticky chemical) of the Cannabis sativa plant.
New York State is the latest to legalize the recreational use of marijuana for adults.
What do we know about how CBD works?
Dr. Raghunathan: While legalization and regulation may change the accessibility and/or quality of all cannabis products, it doesn’t change the lack of scientific evidence. Unfortunately, we still don’t know enough about the benefits of these products for people with cancer. There is a lot of research happening in Canada and Australia because regulations around its use there have changed. It will be interesting to see what comes out of that. In the meantime, you and your doctor should discuss the potential benefits and harms of using anything with cannabis for medical purposes.
The law also establishes retail licenses, opening the door for dispensaries selling marijuana online and in retail stores.
Dr. Raghunathan: The new law allows New Yorkers 21 and over to have up to three ounces of marijuana for recreational use. Using and selling marijuana are both legal, except in schools, workplaces, or in cars. The law also allows New Yorkers up to 24 grams of concentrated cannabis products, including products containing CBD, which is one of many chemicals extracted from the cannabis plant. CBD is different from delta-9-tetrahydrocannabinol, also known as THC, which is another chemical extracted from the cannabis plant.
Dr. Raghunathan: CBD is not psychoactive in the same way that marijuana is. It doesn’t act on the cannabinoid receptors in the central nervous system, which is how THC works. However, it is possibly psychoactive because it works on serotonin receptors, and anything that affects mood is psychoactive. CBD has been studied in mice and seems to affect sleep-wake cycles. But CBD can be unexpectedly psychoactive and sedative because it’s not well-regulated. Studies have shown that some products that claim to be pure CBD actually have THC and other dangerous contaminants, such as opioids.