The Allen County Board of Health is exploring plans to craft guidance for physicians and patients regarding the use of CBD oil.
A researcher, two physicians and a pharmacist addressed the board Monday during a discussion related to the hemp-based product that has been advertised as a remedy for pain, sleeplessness and other ailments. The Indiana General Assembly legalized CBD oil during its 2018 session. In the state, CBD oil derived from hemp is legal, meaning it has less than 0.3% THC, the psychoactive chemical found in marijuana.
Dr. Rudy Kaschmann, a retired neurosurgeon, told the board he became interested in the subject after he was given the Indiana State Department of Toxicology report on CBD.
Kaschmann said reports indicate some products sold to the public are impure. Other chemicals found in CBD oil, Kaschmann said, could interact with prescription medications a patient is taking.
“There are many other cannabinoids in there, and they haven't studied their interaction,” Kaschmann said. “So that's unpredictable.”
Others who spoke Monday said that although some issues have been found, there are also indications that CBD oil can be effective in certain situations. More data, they said, is needed on the substance, which can be found at a range of retail stores, including CBD shops, hair salons and gas stations.
Brian Henriksen, director of research of the Fort Wayne Medical Education Program, said CBD oil has compounds that can have adverse drug reactions, but they're compounds that are also found in some kinds of food.
Other concerns involve the lack of regulation on CBD products, Dr. Daniel Roth, of Summit Pain Management, told the board. It's important to note, however, that the products sold at retail establishments can vary significantly from those recommended by a doctor, especially when it comes to total THC and CBD content.
Additionally, if doctors are going to recommend a CBD product to patients, the product needs to be reputable and there needs to be a mechanism in place to understand the amount of active ingredient in each bottle, Henriksen said.
Roth added that he thinks CBD could have a role in harm reduction, especially when it comes to opioids and benzodiazepines. It's important that patients be monitored by a doctor while using the substance, he said.
“Essentially, I think with appropriate monitoring, (CBD oil) can be a very effective tool at managing pain, anxiety and sleep issues,” Roth said.
Henriksen said it's also important to note that the many products that have been tested so far are fake and there isn't enough peer-reviewed research available to “prospectively look at these outcomes.”
“We need iterative, well-thought-out, well-researched and well-studied projects that are interinstitutional to understand how these compounds will affect the health of our community,” Henriksen said.
Allen County Health Commissioner Dr. Deborah McMahan said she hopes the Fort Wayne Medical Society, the Regional Mental Health Coalition and the Allen County Board of Health can come up with a consensus statement to release to the public that addresses the substance's legality and the evidence surrounding how effective it is.
“What we'd like you to do is make sure you do it at least with the knowledge of your physician, if not under the guidance,” McMahan said. “But what we need to do before we have people going to their doctor is educate the doctors.”