Show Notes - Episode 16: CBD

00:52 - Tiffany welcomes listeners and Bridget to the show

01:10 - Bridget Seritt founded Canna Patient Resource Connection, an organization that collects comprehensive patient information for therapeutic use of cannabis products

03:20 - Today’s topic will focus on CBD 

04:07 - Conversations will focus on the patient experience. Bridget is not a doctor and cannot prescribe medication. You should take information back to your health care provider and discuss treatment options with them.

05:59 - The widespread availability of CBD products is confusing for patients and doctors

06:50 - Prior to 1960, all hemp products were legally classified as marijuana. Definition was changed in response to industrial lobbying.

07:19 - The only difference between hemp and marijuana is the level of THC in it. 

07:28 - Federal definition of hemp is a plant that contains .3% or less THC.

10:24 - There are no standard definitions for broad spectrum, full spectrum, and isolate. But generally, full spectrum CBD contains all the cannabinoids, terpenes, and THC. Broad spectrum removes as much THC as possible. 

11:45 - THC is the part of cannabis that produces an intoxicating effect.

15:15 - Information about CBD is primarily available online and is generally being circulated by people who want to sell CBD or have a political agenda. It may not be accurate.

17:42 - One site Bridget reviewed claimed CBD was legal in all 50 states, but it failed to mention any potential legal problems it could create for people

19:16 - CBD was removed from the schedule of controlled substances, but it was transferred to the regulatory authority of the FDA which considers it a “drug product.”

19:37 - The 2018 Farm Bill that legalized hemp also contained a clause that said the bill did not prevent states from regulating further. So unless state laws have been modified to remove CBD from their own controlled substances list, you could be violating state law even if it is federally legal. 

21:34 - Using CBD would be a felony drug violation in South Dakota, even though it is totally legal in some other states.

23:24 - Always check with local municipalities for laws and regulations before beginning to use CBD.

23:40 - Canada allows all adults to use CBD, but they will not allow anyone to import it across the border.

24:10 - CBD isolates are legal in Idaho, but only ones made from hemp seeds and stalk. But CBD cannot be made from hemp seeds and stalk.

25:20 - In the United States, each state has a legal loophole that makes it illegal to give CBD to minors unless you participate in a state registry program. The Canna Patient Resource Connection has worked with four families recently who were in trouble with Child Protective Services for giving CBD to their child.

26:30 - In the US, mandated reporters, including teachers and doctors, are required by law to report you to CPS if you tell them that your child is taking CBD.

30:18 - The Arthritis Foundation surveyed people and found that over 70% were either interested in using CBD or already using it, so there is a lot of demand for accurate information about CBD.

34:19 - Very few patients experience relief immediately from taking CBD. It usually takes consistent use over time to see results.

37:12 - Cannabis has different effects at lower doses than it does at higher doses. Low doses tend to be more stimulatory, while higher doses tend to be more sedative.

37:38 - Some people may experience intoxication, so begin CBD therapy or increase your dose on a day when you do not need to be alert in case you experience a sedative effect.

40:48 - Oral CBD helps alleviate inflammation and neuropathic pain. Oral varieties are most comparable to extended release medications.

41:39 - Inhaled CBD via vaping is primarily recommended for acute symptoms.

42:39 - Vaping does not involve smoke or burning plant materials, and it is safe from reputable sources. Probably best for people with extreme nausea that do not have lung issues.

43:13 - Topical CBD products that include complementary essential oils are best. Entourage effects with topicals and essential oils are the most effective preparations for pain management.

46:07 - “Edibles” are a form of oral CBD where food is infused with CBD.

47:10 - Be wary of any commercial CBD infused products until you have researched them and seen lab testing. Most products infused with CBD are not going to be therapeutic.

47:59 - Avoid purchasing CBD from sources that you have not researched because there is no regulation currently in the US. Companies do not have to tell you what is in their product.

49:09 - Before you buy from a company, make sure that companies are batch testing every batch for THC content, solvent residues, heavy metals, and contaminants.

49:43 - Hemp is used to decontaminate soil. It will absorb many contaminants from the soil, so it is critically important that your CBD supplier be testing every batch for ground contaminants and heavy metals. Organic farming methods will not mitigate this risk.

51:18 - Always ask where a company is sourcing their hemp, and try to find a company that is using clean growing practices with local sourcing.

55:57 - Also ask what part of the plant is processed. You don’t want something from seeds or stalks. Ideally you want CBD sourced from flowers and some of the leaves.

53:48 - Look for a CBD that tells you how many mgs of CBD are in each mL of tincture, caplet, etc. so that you can regulate your dose for therapeutic purposes.

55:14 - Every oral drug that is metabolized by the cyp450 system will have some kind of drug interaction with CBD. 

55:22 - CBD also cancels out some drugs completely, independent of the aforementioned liver action.

55:35 - CBD will cause some drugs to have a stronger effect than intended.

55:53 - CBD does interact with opiate receptors, so always consult a pharmacist before taking any opiate with CBD due to the potential for a toxic effect.

56:50 - Just because CBD comes from a plant doesn’t mean it is safe to use in every situation.

57:20 - CBD for aiarthritis diseases should be used in conjunction with prescribed medications, not as a substitute for DMARDs or Biologics.

58:55 - Most doctors and nurses have not received any formal training on therapeutic uses for cannabis. 

1:01:43 - In states with legal medical cannabis programs, you can find a physician with cannabis training, and they should really be involved in your care decisions if you want to use therapeutic CBD.

1:03:09 - Visit the Canna Patient Resource Connection at keepitlegalcolorado.org for more information about therapeutic CBD use.

1:04:01 - Visit aiarthritis.org/podcast to continue the conversation about AiArthritis and CBD.

1:04:19 - Tiffany and Bridget will be hosting a Facebook event where you can ask questions about CBD. You can access that @IFAiArthritis on Facebook under the Event tab.

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