The CBD industry’s explosive growth is quickly outpacing science, but with the passage of the 2018 Farm Bill, research has begun in earnest, and more is being known about the benefits of this now common cannabis compound and its uses.
Alice O’Leary-Randall has been on the forefront of the medical cannabis movement ever since her late husband, Robert C. Randall, became the first person in the U.S. to legally receive medical cannabis. Now the editor-in-chief of Mary’s Medicinals publications, O’Leary-Randall frequently writes and speaks on the issue. Here, she outlines some common CBD myths, as well as what current research suggests about the therapeutic properties of CBD, drug-to-drug interactions and best clinical practices for medical professionals.
Cannabis Business Times: What are some common CBD myths that have been dispelled through research?
Alice O’Leary-Randall: I think the most common one that I hear is that you can use CBD because that way you won’t fail the drug test at work. That’s a big one, and that is not true. There’s just enough THC in there that if you’re using it on a regular basis, like taking capsules every day or something like that, the THC can build up in the liver and thus into your bloodstream eventually and can skew a drug test.
The idea that CBD can heal things. Realistically, CBD treats symptoms. It doesn’t heal disease. I think that’s really important for people to understand that distinction.
CBT: What is currently known about CBD and drug-to-drug interactions?
AOR: There’s a growing amount that’s known. The good news is that CBD is a relatively benign substance, and that extends to the drug interactions, as well. But there is always that one individual who has really different reactions—contraindicative reactions—to drugs. I have a friend who looks at the word THC and she’s high. Give her a little bit of THC and she just becomes a mop—it’s amazing to me. But similarly, prescribed medications to her are also a really big issue because they just don’t react in the same way as they do in other people.
So, it’s a really good question because not only are we still on the cutting edge of finding out how CBD interacts with other medications, but there’s also a whole lot that isn’t known about medications that are already available. It’s a two-way street; it demonstrates our lack of knowledge on both fronts.
CBT: What does current research suggest about the therapeutic properties of CBD?
AOR: It’s a really exciting area because there’s a lot of research going on—not here in America, sadly, but certainly in Israel, Europe and Brazil. I think what we’re finding is this cannabinoid, like so many cannabinoids, has properties that can be tailored to the individual to make it an extraordinary medication.
If this science pans out where they’re looking down into the submolecules of humans and how drugs interact with those submolecules—if that research pans out with what the suppositions are—we’re going to have really incredible medicine in the next 20 to 30 years. A physician will be able to pick a little bit here, a little bit there, take a little bit of CBD, a little bit of CBG, a little bit of THC, and make a tailor-made concoction for the individual. I think that’s what’s most exciting in terms of cannabinoid research in general. People are really getting down to the smallest snippets, and there’s even something inside of us that they call “snips,” these tiny little things that collect cannabinoids and can have a tremendous impact on your health.
The problem is, we’re all a little different, and we’ve already known that cannabis affects everybody a little differently. CBD is no different. It has some very broad properties, such as anti-inflammatory, which are being supported by current research coming out of Israel, primarily, and to a certain extent, Germany. But it also has this deeper potential that I think is going to be really, really exciting in coming years.
CBT: What are some best clinical practices that doctors should implement regarding CBD?
AOR: I think there are two categories of clinicians that we have now. There are those who understand cannabis, who have embraced it wholeheartedly, or they’re not embracing it and they’re sick of their patients coming in the door and saying, “Well, doctor, I’ve been hearing about this CBD stuff from my friends,” and their answer is usually, “Well, go to the clinic,” if you’re lucky enough to live in a state that has a medical cannabis clinic.
If you’re lucky enough to have clinicians who are embracing it, the most common practice for cannabis clinicians in today’s world is you start low and you go slow. It’s almost becoming singsong at this point—everybody knows it. But it’s really important because a medical cannabis patient’s approach to using cannabis is 180 degrees from the recreational user. The medical cannabis patient doesn’t need high THC content, for the most part. There are some that do, but for the most part, they don’t. And cannabis clinicians understand that. They understand that they can start with very small amounts and get as effective relief as they want from it, or as the patient wants from it.
I think one reason that a conventional doctor has yet to educate himself or herself relative to cannabis [is because he or she] still has that Cheech and Chong vision in his or her head, that this elderly patient sitting in front of them is going to be high as a kite on THC. They don’t understand that that really is not necessary. You can get a therapeutic effect with the smallest amount of cannabis in some cases, and that’s true to CBD as well, if it’s well-produced CBD. That’s an important thing that needs to be brought out here—we’re talking full-spectrum CBD and not juiced-up hemp oil, if you will.
If you’re lucky enough to have a cannabis clinician, use them because your regular doctor isn’t there yet, for the most part.
CBT: What do you hope attendees will bring back to their business from your session at Cannabis Conference 2020?
AOR: I would hope that the attendees recognize that there is help out there for the medical cannabis patient, and it would be really nice if the industry as a whole, from the cultivator up through the dispenser, embraces that. The American Cannabis Nurses Association, as well as the Society of Cannabis Clinicians, are two racehorses available to the industry that are not being well utilized. I think this is probably going to be my big point more than anything, that the medical cannabis industry needs to start partnering more, in my opinion, with those clinicians who are actively engaged in treating patients and who want to help patients pick out the proper medication for them. There’s a ton of American Cannabis Nurses who would love to be affiliated with dispensaries, be available as a hotline or be available in the dispensary one day a week [or] two days a week to consult with patients and help them tailor their medical cannabis experience, but the dispensaries haven’t been real open to that, and that needs to change. There needs to be more cooperation between the industry and the clinicians.
Editor’s Note: This interview has been edited for style, length and clarity.