1 Min In Clinical
Let’s get clinical. Follow the links below to find out more about the latest clinical insight in community pharmacy.
Bookmark
Record learning outcomes
In 2021, the cannabidiol (CBD) market was said to be worth £1bn and is projected to reach £1.5bn by 2025 — up 50 per cent in four years, says Regan Saveall, chief executive officer at Dragonfly Biosciences, manufacturer of the Dragonfly CBD brand.
“Awareness has increased and is continuing to increase. People have tried CBD and benefited, and word of mouth is spreading,” he explains.
Cannabidiol, one of 113 naturally occurring compounds found in the resinous flower of the Cannabis sativa plant, has been classed as a novel food supplement, regulated by the Food Standards Agency.
The UK was the first country in the world to regulate the market for legal, orally consumed, non-psychoactive cannabis extracts.
Confusion
There is still some confusion among consumers, however, about the difference between the Cannabis sativa L. plant and Cannabis indica Lam, which typically has high levels of tetrahydrocannabinol (THC) and is used for medicinal or recreational purposes.
“People were confusing CBD with cannabis. They were worried about THC levels in their blood – and potentially losing their jobs if this showed in a blood test – and they were also concerned about CBD being addictive,” says pharmacist Sultan Dajani.
“CBD isn’t addictive and quality CBD products do not contain THC. True, there are some substandard products with THC or even no CBD at all, so choosing a trusted brand is important. Dragonfly CBD is a ‘seed-to-shelf’ brand, with a good reputation and published quality assurance and testing results – so we know that it works.”
“The UK was the first country in the world to regulate the market for legal, orally consumed, non-psychoactive cannabis extracts”
Evidence growing
The evidence supporting CBD use is still in its early stages but is gathering pace. Scientific research on CBD shows promise in a number of areas, ranging from inflammation and immune function to anxiety, mood disorders and other mental health issues.
“Evidence points toward a calming effect of CBD in the central nervous system. Many of these effects seem to be mediated by CBD’s interaction with not only CBD-2 receptors but also the 5-HT1-A receptor, alpha-3 glycine receptors, opioid receptors and others,” explains Dr Tim Bond, chemist and natural health expert from Dragonfly CBD.
“Stress, anxiety and sleep disorders are the top three uses of CBD,” says Regan Saveall. “We know that CBD is a super anti-inflammatory and can help with most ailments where there is inflammation. We have developed creams that people have used for conditions like psoriasis and eczema, and feedback has been very positive.”
Growth areas
“In terms of growth, we are looking at new products for mental health and for the menopause. We believe that CBD can be very beneficial for menopause symptoms. Consumers are much more discernible about what they are taking. They want a natural, healthy alternative option – and this is where CBD can really help.”
To assist consumers wanting to know more about CBD within pharmacy, Deborah Evans at the PAGB suggests that, as there is currently limited evidence of the benefits and side-effects of CBD, it would be helpful for the information that is available to be consolidated and easily accessible.
Sid Dajani recommends a consultation with every customer considering trying CBD for the first time. “People are often looking for reassurance, and I stress that CBD is chemically and physically stable with a good safety profile.
“CBD oil is something that people might want to use throughout the year, and if it works they will be back. If someone didn’t feel they were getting benefit, I might suggest a stronger dose or ask them to take it more frequently. Dragonfly has a wide range of products, with different strengths and different flavours, so we can try to adapt to individuals.”
Dajani believes that CBD could, in time, become regulated – a step he would welcome. “The only people who will fear regulation are those who haven’t invested in testing and [manufacturing] procedures, and those who produce substandard products. As more people use CBD, we need more safeguards in place.”
Which CBD products can be marketing?
The Food Standards Agency publishes a list of CBD products that can be marketed in England and Wales.
The FSA list contains CBD food products which meet the following criteria:
- They were on the market on 13 February 2020
- The FSA received an authorisation application for the products before 31 March 2021
- The FSA has validated the application or agreed that it is sufficiently progressing towards validation.
The list, which is updated regularly to reflect the status of the products in the FSA’s novel foods authorisation process, applies to England and Wales only. Information about CBD products in Northern Ireland can be found in CBD guidance for Northern Ireland. Novel foods regulations in Scotland are covered by Food Standards Scotland.
“We published a list of CBD food products to help consumers make informed choices about the products they buy,” says the FSA. “Products on this list are not formally authorised for sale. They have not yet been fully assessed for safety, but they are linked to applications which are moving through the novel foods process.
“The FSA is not endorsing these products and inclusion on the list is no guarantee that they will be authorised. Products not on the list will not go through any safety assessment and will not be authorised for sale.”
Usage advice
The FSA advises those who are pregnant, breastfeeding or taking any medication not to consume CBD products.
Healthy adults are also advised to think carefully before taking CBD. Some scientific studies suggest CBD can affect the liver if taken at higher doses, but there have been very few studies relevant to levels found in food, says the FSA. As a precaution, the FSA recommends no more than 70mg a day (about 28 drops of 5% CBD) unless under medical direction.
This doesn’t mean that these levels are definitely safe, says the FSA, “but the evidence we have suggests adverse health effects could potentially be seen above this”.
Clinical
In Clinical
Let’s get clinical. Follow the links below to find out more about the latest clinical insight in community pharmacy.