Heads Up About CBD Oil: Risks That Aren't on The Label

Dangerous synthetics. THC that shouldn’t be there. Low levels of the active ingredient. Concerns about pesticides and heavy metals. In part 3 of our report, what studies show about the hidden side of this popular product.

Person turning dial that reads "risk"Don't be lured by the hype surrounding CBD oil and all the product claims. Dangerous synthetics, low levels of the active ingredient and traces of pesticides and heavy metals are among the hidden risks being uncovered by research on this unregulated substance.

CBD oil is hot. Fueled by enthusiastic claims—some research-backed, others questionable—that it’s a natural remedy for an enormous variety of medical problems, sales soared to $190 million in 2017 and are expected to reach $646 million by 20221.  

But recent reports have turned up a dark side that experts say consumers can’t afford to ignore.

CBD oil is extracted from marijuana or from hemp plants. The selling point: It’s full of cannabidiol, a marijuana component that has some proven (and many unproven) therapeutic properties but won’t make you feel high. It’s legal in at least 47 states according to the National Organization for the Reform of Marijuana Laws (NORML). But online sales make it available everywhere. And lack of federal regulations mean labels on over-the-counter CBD oil products won’t tell you how much CBD is inside—or whether it contains ingredients that shouldn’t be there.

“The best way to find safe, reliable CBD oil is to contact the manufacturer or seller and ask to see the lab reports,” says Eileen Konieczny, RN, past president of the American Cannabis Nurses Association and author of the book Healing with CBD: How Cannabidiol can Transform your Health without the High (Ulysses Press, September 18, 2018). “You want to make sure the product contains the amount of CBD on the label and no synthetics, pesticides, heavy metals or THC— the marijuana component that makes people feel high. A responsible company will make this information available to you. A company that won’t is questionable.”

Taz Bhatia, MD, an integrative medicine physician from Atlanta, Georgia, and author of the books Super Woman RX and What Doctors Eat, agrees. “I think using manufacturers that are submitting to testing or pharmacies that are trying to carry CBD and have done some vetting may be more of the answer.”

Studies and lab tests have uncovered these problems in some batches of some over-the-counter CBD oils purchased in stores and online:

Dangerous synthetic cannabinoids. In May, researchers from the Utah Department of Health2 reported that CDB and hemp oil products containing a synthetic cannabinoid were the likely cause of 52 CBD-related poisonings in Utah between October 2017 and January 2018. Users reported altered mental states, vomiting, seizures, unconsciousness and hallucinations after vaping the oil or taking it internally, according to a headline-grabbing study in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. The researchers say that because CBD is largely an unregulated product, consumers cannot tell whether the product they’re buying is from plant sources or has synthetic origins. They called on the US Food and Drug Administration to regulate CBD.

This spring, the US Army sent out a similar warning when 60 people turned up at Womack Army Medical Center in Fort Bragg, North Carolina, and the Naval Medical Center at Camp Lejeune, North Carolina, with similar symptoms. In April the Army banned the use of CBD and other hemp products. “Soldiers are prohibited from using hemp or products containing hemp oil and are also prohibited from using synthetic cannabis, to include synthetic blends using CBD oil, and other THC substitutes ("spice"), or any other substance similarly designed to mimic the effects of a controlled substance,” the Army Public Health Center announced in an alert bulletin. “Although some vape oils may contain CBD oil, CBD, THC, and/or synthetic cannabinoids, many vape oils do not disclose that they may contain illegal and/or potentially hazardous substances to include synthetic cannabinoids.” 

In October the Army issued another related health alert warning soldiers about the dangers of vape oils containing unknown substances including CBD oil.3

THC. When researchers analyzed 84 CBD oils, tinctures and vaping products from 31 online companies for a November 2017 study4 published in the Journal of the American Medical Association, they found that 21% contained THC. “The THC content observed may be sufficient to produce intoxication or impairment, especially among children,” they noted. “These findings highlight the need for manufacturing and testing standards, and oversight of medicinal cannabis products.”

Too much–or too little–CBD. In the same study, just 30% of CBD samples contained the cannabidiol level listed on the label or advertised on the company website. Another 26% had lower levels than advertised and 43% had higher levels. When ConsumerLab.com analyzed5 nine CBD and hemp liquids and supplements for a February 2018 review, the independent product-evaluation company found levels ranging from 2.2 to 22.3 milligrams per serving. “You can't rely on listed amounts of "cannabinoids" to tell you how much CBD is in a product,” the group noted online. And FDA checks in 2015 and 2016 found cannabidiol levels as low as 1% of the amount listed on the labels of some products—prompting a spate of warning letters to CBD businesses.6

Concerns about pesticides and heavy metals.  Hemp–widely used to make CBD–is also widely used to clean up soils contaminated with heavy metals and pesticides, Konieczny notes. Could those chemicals end up in CBD oil? While the nine products tested recently by ConsumerLab found no arsenic, lead or cadmium, concerns linger due to reports of lead and arsenic in some hemp oils in a 2017 study.7

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