January 1, 2020

Keeping an Eye Out for CBD

Medical marijuana has seen much attention over the last few years, but very few have discussed the rise of cannabidiol (CBD) products that are derived from marijuana.

While there are certain FDA-approved drugs containing CBD, such as Epidiolex, there has been an explosion of CBD-containing products that have not undergone any clinical trials, yet they are still marketed for various indications. Particularly relevant to workers’ comp, some of these indications include:

  • Pain
  • Muscle spasms
  • Anxiety and depression
  • Sleeplessness
  • Opioid dependency
  • PTSD
  • Brain injury

CBD products are, in theory, supposed to lack tetrahydrocannabinol (THC), the compound responsible for the euphoric effects of marijuana, and offer various clinical benefits. However, depending on sourcing and quality, this may not in actuality be the case, and some CBD products could inadvertently contain THC.

But even if CBD products contained no THC, the belief that CBD products are not euphoric has led members of the public to assume that these products are safer, despite a lack of clinical evidence. While initial research does indicate that CBD can offer certain clinical benefits for particular medical conditions, more research is necessary to clarify those benefits against potential risks.

Unfortunately, the public’s misconceptions have been inappropriately marketed by certain manufacturers of CBD products. The FDA is aware that some companies appear to be marketing products containing cannabis and cannabis-derived compounds in ways that violate the law.

The FDA displayed concern that the marketing of these products could put the health and safety of consumers at risk, by claiming to prevent, diagnose, mitigate, treat, or cure serious diseases, influencing patients not to use approved therapies. And though the FDA has issued warning letters to companies selling unapproved CBD products, the agency does not have a policy of enforcement discretion with respect to any CBD products.

This is especially alarming considering the explosion of CBD products available on the market; CBD products are not just found in smoke shops, but in health food stores, corner markets, gas stations, and even in CVS and Walgreens, and they are available in a myriad of formulations such as oils, capsules and pills, and other edibles such as gummies and candies, or topicals, sublingual picks, vape pens, bath bombs, pet treats, coffee, ice cream, energy drinks, beers and protein bars, vaginal suppositories, and much more.

But how does this impact workers’ comp?

Unbeknownst to the claims and medical professionals teams, not only could patients be using CBD products to treat pain, muscle spasms, and other common ailments associated with an injury, but patients who are adhering to their workers’ comp therapy could be using CBD products for unrelated concerns.

CBD lotions to cleanse the skin are popular, as are smoothies that claim to offer digestive benefits; the number of trendy applications for CBD is skyrocketing, and with such limited clinical understanding regarding the impact of these products, patients could be exposing themselves to a variety of risks.

It is unknown how CBD may interact with common workers’ comp medications, and it is not known how much CBD is safe to consume daily, especially if patients are using multiple CBD products. For instance, a patient may apply a topical CBD lotion, then consume a CBD smoothie or candy, then use CBD oils and soaps, making it difficult to ascertain the total consumption associated with various CBD products.

Claims professionals have limited visibility into CBD use, and as the popularity of these products continues to grow, clinical science could potentially reveal significant concern that payers may need to take note of.

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