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The ongoing debate about medical marijuana's benefits has increasingly highlighted the importance of specific cannabinoid constituents. Proponents tout the benefits of cannabidiol (CBD) — and in conversations with me about the potential risks of marijuana use, my patients frequently reply, “Oh, I don't use tetrahydrocannabinol (THC) products, I use ones with cannabidiol.” In an analysis of commercially available CBD products, investigators assayed the CBD content of 81 preparations (oil, tincture, vaporization liquid) purchased online and compared the cannabinoid content (determined by averaged triplicate high-performance liquid chromatography) with that on product labeling.
Measured CBD content ranged from 0.1 to 655.3 mg/mL (median, 9.4 mg/mL), while the labeled range was 1.3 to 800.0 mg/mL (median, 15.0 mg/mL). Applying a ±10% allowance standard for herbal products, 43% of products were underlabeled, 26% were overlabeled, and 31% were accurately labeled. Vaporization products were the least accurately labeled and oil the most accurately labeled. THC was detected in 21% of samples, cannabidiolic acid in 15%, and cannabigerol in 2%.
Bonn-Miller MO et al. Labeling accuracy of cannabidiol extracts sold online. JAMA 2017 Nov 7; 318:1708. (http://dx.doi.org/10.1001/jama.2017.11909)
Comment
This analysis is consistent with a previous study showing poor correspondence between actual and labeled THC content of edible products (JAMA 2015; 313:2491). Overlabeling could cancel any potential clinical benefit, whereas underlabeling may be of less concern, given that CBD has neither abuse potential nor adverse effects at higher doses. Still, unanticipated THC content could pose a variety of risks, especially in children. These findings highlight the need for better testing standards and regulatory oversight.