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What’s the deal with CBD?

Pot for Spot goes mainstream

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Perplexed or annoyed by the consideration of medical marijuana in veterinary medicine? I was. As a veterinarian who finds controlled substances a total pain to manage, I was put out by the prospect of one more item I had to oversee meticulously. More than that, the constant barrage of questions my clients were asking exasperated me.

Does it work? Can I just give my pets some of my own? Can I blow smoke in their faces or bake dog treats with pot in it?

Sigh. Where to start? I had no idea. So a few years ago I started to do some digging. The result is this column, which I hope you will consider in the spirit it’s offered: With the intent of improving veterinary patient care.

The truth about CBD

As many of you know, our pets are highly sensitive to the principal psychoactive component of marijuana, the THC molecule (tetrahydrocannabinol). (This evidence is incontrovertible in dogs but less available for cats.) This sensitivity, however, does not apply to the nonpsychoactive CBD (cannabidiol) molecule this plant also contains.

CBD is a component of both the marijuana plant and its close cousin, the hemp plant. Almost all of the CBD oil used in medicine is sourced from hemp.

CBD’s safety profile has been studied in dogs at Colorado State University (conclusion: safe) and research into its efficacy in seizure disorders is currently underway there. A mountain of anecdotal reports also identifies osteoarthritis, inflammatory bowel disease, allergic skin disease, appetite stimulation, and nausea relief (among others) as other potential areas of study.

High-level evidence on efficacy is scant, to be sure, but CBD oil is considered safe and effective by a growing number of veterinary practitioners who aren’t your typical devotees of alternative medicine. I fall squarely into that camp. Count me among the converted.

But here’s the thing: It’s technically illegal. If I recommend it or sell it, what’s my exposure?

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CBD and the law

Hemp is among the lowlier plants on the planet. This shrubby plant has a rangy, spiky—dare I say, weedy—appearance. Not much to look at.

For all its humility, hemp has some status in the human world. It’s been used for millennia in the manufacture of textiles, paper, and rope. In fact, the oldest known relic of human industry is a swatch of hemp fabric. Almost 10,000 years later, we still use the stuff for all its original purposes, but we also distill oil from it for fuel, food, plastic composites, cosmetics, and nutraceuticals, and now medicines.

The one thing hemp cannot do? It can’t get you high. Nevertheless, since 1937 the Controlled Substances Act has classified this plant as a Schedule I drug.

Why? Hemp has the unlucky distinction of sharing a genus with the marijuana plant. Though it claims a mere 0.3 percent THC (and can’t even remotely get you stoned), this plant has been just as off-limits to farmers, sellers, and buyers in the U.S. as any other Cannabis plant.

Sure, you can go to Whole Foods and buy some hemp-based products, but those you can eat (like those delicious hemp seed chocolate bars I’m addicted to) are technically illegal.

So if a behemoth like Whole Foods is willing to sell them, it’s clear that no one really enforces the law at this level. I mean, with an opioid crisis threatening to tear the roof off our healthcare system’s rickety house of cards, who’s got the time to chase down minivan-driving soccer moms as they exit the parking lot?

Pretty much everyone sees the uselessness of this kind of legislation, anyway. Even Senator Mitch McConnell, a staunch antidrug Republican, wants to change the law banning hemp farming. He introduced a Senate bill last month to do just this. It would make farming industrial hemp legal and take hemp off the Controlled Substances Act’s playlist altogether.

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Hemp is currently farmed in the U.S. after the 2014 farm bill allowed hemp farming for “research purposes.” Despite the “investigative” limitation, this law effectively signaled the U.S.’s lack of interest in prosecuting any hemp cases and opened the door for those who wanted to sell and use hemp-containing products, like medicinal CBD.

Ever since, the trickle of CBD products into the mainstream has swelled. But is it legal? Not yet. Not until McConnell’s bill passes. Which it’s expected to, thereby making comestible hemp derivatives, like CBD oil, 100 percent legal to keep on your pharmacy shelves.

But what about states like Florida, where laws have been passed to allow medical marijuana use? Or like Colorado, where even recreational marijuana is allowed?

Here the law gets even fuzzier. The Drug Enforcement Administration doesn’t seem to like the direction this whole thing is taking. Though it’s clear the DEA doesn’t have the resources to enforce the antihemp policy (by prosecuting CBD sales or defending court challenges), it’s gone out of its way to remind us that CBD is still illegal under federal law.

So what’s a veterinarian to do?

All this brings me back to us, the veterinarians who believe that CBD is a safe and effective addition to our current treatment protocols. How are we to approach and manage the situation?

For my part, I’ve chosen to flout federal law in favor of patient care. Most of the patients I’ve medicated with CBD oil have thrived. After recommending it to hundreds of patients (I carry it in-house now), I’ve not yet observed an adverse reaction. Sure, some patients have balked at its delivery, but that’s about it for negatives.

Still, not all CBD oils are created equal. Do your research. Chat with veterinarians on Veterinary Information Network and in your vicinity. Talk to the pharmacist in charge at the company whose products you choose to recommend to be sure there’s no THC at all in the product. Follow all these recommendations and you can rest easy knowing that you’re offering a product that meets a high standard of care.

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Does that convince you to recommend it? For you to start stocking it, even? Well … sure. That is, if you feel comfortable enough knowing that if the DEA spot checks you, finds it on your shelves, and cites you (seems highly unlikely), you’d have the fortitude to handle the consequences.

For my part the decision is easy. The chances that the DEA would ever charge me (or any of us) are extremely low. I mean, why would they want to make me an example? After all, veterinarians like me only want to improve their patient care … not help pets get high off their inventory. And I daresay Whole Foods is a bigger target if the DEA really wanted to enforce the law anyway.

For those of you who say you’d rather wait ‘til McConnell gets his bill passed, I say that’s OK. But if it doesn’t happen soon, I wouldn’t hold my breath for this or any other administration to regulate my patient care on this one––not when antiquated blue laws, trivial botanical distinctions, and jurisdictional infighting are the only things keeping me from offering my patients a safe and effective therapeutic option.

 

Dr. Patty Khuly owns a small animal practice in Miami and is a passionate blogger at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.

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