How Safe Are Your CBD Products?

An interview with Jahan Marcu and Jan Roberts

The International Research Center on Cannabis and Mental Health (IRCCMH), along with the Cannabis Chemistry Subdivision of the American Chemical Society, recently released a report about the safety of unregulated CBD vape products commonly found in gas stations and health food stores. Dispense Magazine talked to the report’s authors, Jahan Marcu and Jan Roberts, to get all the details.

Jahan Marcu, Ph.D. is a renowned cannabis researcher and author. Jan Roberts is head of a healthcare system that has 16,000 client visits a year. Together they founded IRCCMH when they recognized a gap between what was happening in the lab and what was happening with patients. Both are passionate about destigmatizing cannabis and exploring how cannabis can be used therapeutically. Their goal is to build an organization that blends advocacy, research, and education.

They sat down with us to talk about their organization and the warning report they issued about over-the-counter CBDs.

DM: Why is the term “mental health’ in your organization’s title? Is it because mental health professionals tend to only see cannabis through the lens of addiction?

Jahan: One thing that has become readily apparent in the literature is that finding lasting harm from using cannabis is exceedingly difficult. And differences that are found her often not significant, meaning no different than random occurrences.

What is unfortunate is that despite the decades and decades of research going back to the 1960s looking at brain scans and IQ tests, we still are not much closer to detecting or predicting when cannabis will be helpful or identifying those vulnerable individuals. That should be the goal of the research – knowing when it’s useful and when it is not.

DM: It must be frustrating to talk to mental health professionals who balk at the idea of recommended cannabis but have no trouble prescribing opiates.

Jan: Or benzos! Anytime I have a patient who’s on Xanax or even Klonopin, my antenna goes up just because I know it’s so physically addictive, and most people don’t know it. I would much rather see a patient utilizing cannabis in a therapeutic way.

Jahan: I think that people who are seeing all use as being negative or all use as abuse are envisioning people consuming massive amounts of THC and not thinking about the other factors that mitigate the side effects or prevent intoxication.

DM: Let’s talk about your report. How did you do your research? How did you come to these conclusions?

Jahan: We started probably more than a year ago working with our colleagues asking a very simple question about CBD products that were commercially available. Do they match the label in terms of contents, what is expressed to be in there?

We found that there was roughly a 70 percent chance that the label would be significantly different than what was in the product. While we are in the process of designing the next round of research which would actually look at contaminants, these researchers at Virginia Commonwealth University (VCU) looked at some very specific products — these vape cartridges which seem to be sold outside of a regulated market. If you’ve either been to a gas station or a hobby store and seen CBD products sold next to lighter fluid, that’s where they got these products. They found that they have synthetic cannabinoids in them.

DM: Did they mostly just test the vape cartridges?

Jahan: Yes. It was a very targeted study for those inhaled products.

We were reading online reviews talking about how great the CBD products made them feel, or how bad they made them feel in these subjective reports of intoxication. Well, that doesn’t make sense for a CBD product.

There are all these little pieces that had us scratching our heads. One was in Utah. They had 200 ER visits with severe anxiety and other issues. That doesn’t make sense! Is it a drug interaction? Other CDCs in other states were reporting people showing up to the ER with these products. It wasn’t making sense! Like CBD plus inhaling it equals hospitalization. What’s the missing piece?

DM: You found THC and a synthetic cannabinoid.

Jan: Yeah. Some of them had percentages of THC that would have actually popped a drug screen. Consumers don’t know what they are getting is essentially what we’re saying. Both Jahan and I are passionate about advocacy, so we started to talk about this and we both agreed at the same time that we need to do a consumer warning. This is something that people need to be aware of.

DM:  If THC is in there, that could possibly be because they don’t know how to do processing, right?

Jahan: Potentially, yeah.

DM: But with these synthetic cannabinoids… That’s not an accidental thing or could it be?

Jahan: It’s hard to say where it originated from. The people who are doing the packaging could have just bought a stock oil from someone, and put it in there for product differentiation. When the market gets saturated, people might try some crazy things for product differentiation. I do not think this is a contaminant like, “Oops, we have left too much THC in the during the harvesting and processing,” or, “It fell out of the ceiling,” or, “Oops, someone sneezed and now there’s a bunch of synthetic cannabinoids in there.” It seems to be an intentional adulteration of product for the purposes of having some sort of product differentiation. That is the most diplomatic way I can say it.

DM: What other kinds of toxins did you find? Solvents? Heavy metals? Pesticides?

Jahan: That is a great question. This group of researchers at VCU did not find those things but we have a proposal in place with some of our research colleagues to start looking in different states at their CBD products for those things.

One of the things we want to do is make sure the methods being used for looking at these contaminants are validated by a third-party and to look at things that aren’t necessarily required by regulations like certain solvents, certain additional heavy metals, or some of these synthetic cannabinoids.

Jan: My concern is that most people using this are looking for some kind of relief from mental health issues. They could be utilizing something that’s actually exacerbating them.

DM: The things that people should be most worried about are over the counter vape cartridges, right? Should people be worried about gummy bears? Do you have enough data yet?

Jahan: There isn’t a lot of data on synthetic cannabinoids being orally ingested or applied to the skin. They are primarily consumed through inhalation. Think very critically about the products that you are inhaling, looking at the packaging is extremely critical in terms of being able to know where it comes from.

One of the big red flags that any consumer can use is if there are fake certification seals. They’re not from a certification organization, it just says “Certified” To what? By who?

Jan: We all agree that the best practice is to know your source. Get it from a dispensary that is more regulated than just buying it from Amazon or another vendor.

DM: You said there have been 200 emergency room visits reported in Utah. What other kinds of reactions are being reported in other states?

Jahan: We were able to find over 2,300 incidents involving these compounds since 2017. Many of them show up for five non-fatal intoxication effects. The main five are severe anxiety, confusion, psychosis, tachycardia, and psychomotor agitation.

DM: Are these primarily short-lived? Are there lingering problems or is it just a one-time occurrence?

Jahan: Well if you are the user, it can seem to last forever.

Jan: The data is really out on that. We don’t even know what the long-term effects can be.

Jahan: You’re kind of spinning The Wheel of Fortune. Is it going to land on two minutes? Two hours? Tomorrow? With the synthetic cannabinoids, we don’t know. When you synthesize a drug, it’s never one hundred percent pure. When you buy a supplement at the grocery store it’s 95% pure.

There are some unknowns in terms of what happens to these drugs over time. It is confusing as some effects last for 15-20 minutes then dissipate, while others are much more potent.

DM: When you say synthetic cannabinoids, these are substances that actually engage with the endocannabinoid system, attaching to the CB receptors. But the material is not actual marijuana, right?

Jahan: Correct. It might be stimulating receptors we don’t know about but if it stimulates CB1, boom! It’s synthetic marijuana.

DM: Have you found any deaths that have occurred from these substances?

Jahan: We have not been able to find any deaths that occurred because of any of these substances alone. Usually, there are other narcotics or drugs involved.

Jan: We don’t know much about the drug interactions either.

DM: If someone already has a damaged immune system or is fighting off other conditions such as cancer, this can be even more troubling.

Jan: Well if you have PTSD for example. You’re already hyper-vigilant. You’re already anxious. You are already struggling with flashbacks and stuff like that. If you’re ingesting something like this, it can actually exacerbate the condition.

DM: You made a good point in your release that the good, decent, honest CBD companies and the industry in total are suffering from these kinds of things.

Jan: Absolutely. That’s why we support legalization and regulation. One of the concerns we had was that these findings would lead to more restrictions as far as attempts from the federal government to keep it illegal. There are good products out there and we want consumers and patients to understand that you have to know where it’s coming from. Don’t just try it because you found it on Amazon or at your coffeehouse.

Jahan: I think it’s an opportunity for companies to differentiate themselves. It’s a chance for them to say, “Hey look, we know where it’s coming from. We have these certifications. We follow these standards.”

There are a lot of good CBD manufacturers and companies out there, and I don’t want to see them bear the brunt of the backlash. I encourage the industry to issue similar statements– that they don’t condone this type of behavior– and even issue recommendations for companies to distinguish themselves.

DM: What can the consumer do if one wants to buy CBD products out there on the free market?

Jahan: One is to educate yourself and think critically. I like to think about it as asking annoying questions.

Jan: I’m concerned about the gummies, mints, and chocolates that are out.  Health food stores, coffee shops, and Bob’s gas station don’t understand the reality behind what they’re selling.

Jahan: Another simple thing the consumer can do is to compare labels. Other regulated products, even the can of tuna fish at the dollar store, have seals like “dolphin safe,” a website, or 800 numbers to call. It’s legitimate packaging with a trademark.

If you are a registered patient accessing it through proper channels, those products come fully labeled.

DM: Here in Pennsylvania, we don’t have recreational use; we only have the medicinal program. If we buy cannabis that was grown in our state, through a regulated system, there is very little chance of these problems cropping up, yes?

Jahan: Yes, I think there is very little chance of those things cropping up. But Pennsylvania patients might say, “Well the local dispensary doesn’t have the products. I’m going to drive across the border.” I know Pennsylvanians are used to driving to New Jersey for a wine they can’t get their state!

DM: Final question. Are you an advocate for CBD alone in general? Or does the research show that it is best combined with THC?

Jahan:  I’d say yes and no is the scientific answer. I think it depends on what condition you’re looking at, what administration route will be used, and also whether or not the person’s polypharmacy.

Overall, based on the literature that I have read and the research I have done, CBD seems to enhance the ability of THC. I would say that THC, CBD, and other compounds from the plant seem to enhance, have additive, or even synergistic effects.

The first research study I ever did was actually looking at the impact of combinations of cannabinoids on brain cancer cells. Ever since then, I’ve thought strongly about this issue. The greatest potential is in the combinations and ratios of these products working together.

 

IRCCMH is working on an educational piece about CBD as well as launching a research journal and hosting a conference on the subject in the near future. Their release is available at irccmh.org/press-releases.