Medical Marijuana: The State of the Science

The Complex Regulatory Issues Surrounding CBD

The legal status of CBD is complex on both a federal and state level. CBD can be extracted from two sources: from Cannabis sativa (along with many other phytocannabinoids) or from industrial hemp, which can contain no more than 0.3% THC.^[172] CBD is legal in the 23 states and the District of Columbia where cannabis products are permitted for medical use. In these states, medical authorization is required to purchase CBD, as is the case for all cannabis products. However, finding a CBD product is often extremely challenging in these states, because dispensaries have recognized that their profitability is dependent on their ability to provide consumers with high-THC concentration, euphoria-producing products. Tragically, as CBD mitigates the euphoria associated with THC, dispensaries in states where they are minimally regulated have little interest in selling high-CBD concentration strains, and typically charge more for strains high in THC.

Although its federal legal status is still questionable, the Agriculture Act of 2014 authorizes states to permit hemp cultivation for research purposes, again provided that the THC content is no greater than 0.3% by weight.^[173] Growing industrial hemp has been illegal without a US Drug Enforcement Administration (DEA) permit under the Controlled Substance Act, but it can legally be imported; imports of hemp seeds increased from 92 metric tons in 2005 to 2272 metric tons in 2013.^[174]

Currently, there are 11 states where medical marijuana is not legal, but low-THC (~0.3%–3%)/high-CBD (~5%–15%) concentration cannabinoid products have been legalized for clinical research and treatment. Some of these states restrict the sources of CBD-rich products and specify the diseases for which they can be accessed for treatment, whereas others do not.^[175]

Despite state regulation, CBD has become readily available over the internet, with one website (http://cannabisoilforsale.net/) claiming that hemp-based CBD products "are fully legal in all 50 states when sold as nutritional supplements." This claim is based on a unanimous decision by the Ninth Circuit Court of Appeals, which determined that the DEA "cannot regulate naturally-occurring THC not contained within or derived from marijuana, i.e., non-psychoactive hemp is not included in Schedule I. The DEA has no authority to regulate drugs that are not scheduled, and it has not followed procedures required to schedule a substance. The DEA's definition of 'THC' contravenes the unambiguously expressed intent of Congress in the Controlled Substances Act (CSA) and cannot be upheld."^[176]

Irrespective of the ambiguity of the law, hemp-based CBD products are available and being used and probably will become progressively more accepted by patients, healthcare providers, and federal and state governments.

Cite this: Michael E. Schatman. Medical Marijuana: The State of the Science - Medscape - Feb 06, 2015.

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