Effectiveness, legality, risks… What you need to know before testing CBD

CBD. Three letters for a small molecule that has been rising, which has been rising since 2018. Taken from the cannabis plant, it stands out from its cousin, THC (the main active molecule of cannabis, editor's note), by promising to solve many ailments without rendering addict or cloud the consumer's brain. From sleep to stress to painful periods, CBD offers its benefits. And the success does not weaken, according to the 1700 French shops which market it in various forms: e-liquid, herbal tea, chewing gum, spray, oil, chocolate bar, lollipop, sparkling drink.

Singer Mika recently invested in the company Divie, dedicated to CBD, and even palaces are getting into it. The Shangri-La in Paris thus offers a cannabidiol oil massage. But if the molecule has a positive image, its composition, its legislation and especially its impact on health, question. We take stock.

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Discovered in the 1960s

It is a chemical molecule called "phytocannabinoid", extracted from the flowers of certain varieties of cannabis, all from the Cannabis sativa family. It was discovered by the Israeli chemist Raphaël Mechoulam in the 1960s.

In practice, “this molecule activates the body's endocannabinoid system (set of cell receptors and molecules, editor's note) and other systems involved in inflammation, the transmission of pain and emotions, such as the receptors at serotonin”, specifies Nicolas Authier, psychiatrist specialized in pharmacology and addictology.

Unlike THC (or delta-9-tetrahydrocannabinol), also present in the plant, CBD has no euphoric effects, and is not a narcotic. “By its mechanism of action, however, it remains considered a psychoactive, much less powerful than THC, but which still acts on the psyche”, nuances the psychiatrist, also president of the temporary specialized Scientific Committee on therapeutic cannabis.

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Is it legal?

Yes and no. In reality, a legal vagueness remains, concerning the sale of cannabidiol. Until last year, “France complied with the decree of August 22, 1990, which limits the exploitation and use of hemp to fibers and seeds only”, reports master Eveline Van Keymeulen, associate within of the Healthcare & Life Sciences practice of Latham & Watkins. Clearly, as CBD is found in flowers and these are prohibited, any consumption was strictly prohibited in France.

But this ban was deemed illegal by the Court of Justice of the European Union (CJEU) in November 2020. The reason? The Court pointed out that according to the current state of scientific knowledge, CBD did not appear to have "a psychotropic effect or a harmful effect on human health".

This is why on December 30, 2021, the government published a new decree to revise the one deemed illegal. The latter authorizes the production of hemp extracts on an industrial scale, but prohibits consumption in their raw form (leaves and flowers). Clearly: you can buy a cosmetic product based on CBD extracts, but it will be forbidden to smoke a joint or buy CBD herbal tea.

But it was without counting on a new twist. Monday, January 24, the Council of State sided with the defenders of the sector and temporarily suspended the government decree. "There is a serious doubt about the legality of this general and absolute prohibition measure because of its disproportionate nature", specifies the authority in a press release. Pending an in-depth examination of these points raised, the case remains to be followed for the time being.

What is the risk to the consumer? “Without an immediate test to differentiate CBD from narcotic cannabis, if a consumer is caught by police in possession of CBD flowers (even potpourri), they risk being prosecuted for narcotic use, and to receive an immediate fine of around 200 euros, explains the lawyer. For the time being, however, it is less likely that he will be prosecuted by the courts.

What about oils to put under the tongue, drinks, chocolates and other food variations based on CBD? "All food supplements remain a priori prohibited, pending the end of the evaluation of the European Food Safety Authority (EFSA) and the authorization by the European Commission by the end of 2022 or the beginning of 2023", specifies master Eveline Van Keymeulen.

In conclusion, today only one type of product is legal in Europe: "Cosmetics (cream, serum, balm, lubricant, editor's note) containing CBD extracts without a trace of THC", concludes the lawyer.

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What are the benefits?

On the health side, according to Laurent Chevallier, nutritionist and botanist, CBD represents a promising molecule for the treatment of certain pathologies. "More than 10,000 studies have been carried out around the world," he reports. Some argue that it can limit involuntary muscle contractures, which is interesting for the treatment of multiple sclerosis and neurological conditions such as Parkinson's. The doctor adds: “To a lesser extent, athletes could use it to limit inflammation, pain and thus avoid the use of opioids. Effects on anxiety and depressive processes have also been highlighted.

But beware of overpromising. “The only scientifically validated indication of CBD concerns drug-resistant epilepsies, nuance psychiatrist Nicolas Authier. For the rest, no well-conducted study has demonstrated other virtues in humans. It is not because the substance clings to a receptor of pain or emotions that it will necessarily generate beneficial effects.

However, testimonials from users of “wellness” CBD mostly report soothing, relaxing sensations. On the forums, we talk about stress reduction, easier falling asleep, and relief from migraines, body aches, and even painful periods.

To explain this, health professionals do not rule out the possibility of a placebo effect. “It is part of a ritual, like verbena herbal tea that you take before going to bed,” illustrated Pascal Douek, a doctor specializing in medical cannabis, in a previous article.

On the cosmetics side, among the supposed properties of the molecule for external use, dermatologist Nina Roos mentions "a possible relaxing impact on the muscles of the face", and therefore a beneficial action on so-called "dynamic" wrinkles, such as those on the forehead. . “Potentially antibacterial, CBD could also be suitable for acne-prone skin,” adds the doctor. Assumptions, but no scientific confirmation of magnitude.

Is there a health risk?

Yes. In the event of misuse, there are two main risks. “Digestive disorders – diarrhea for example – and neurological disorders such as drowsiness”, lists psychiatrist Nicolas Authier. In other, rarer cases, CBD can have an effect on the liver. “This is also one of the reasons why a blood test may be recommended by the general practitioner”, adds the psychiatrist.

In addition, be careful, “there are dozens of drug interactions with this molecule, underlines Nicolas Authier. It can modify the elimination of other drugs at the level of the liver. It is the responsibility of the seller to inform his customers about these risks and interactions. The doctor also advises against the use of CBD for pregnant women and children.

How to choose and consume it?

In the absence of a regulated market, health professionals deplore a lack of transparency on the composition of oils, sprays and other CBD-based products. "You do not have the exact certainty of what you consume, neither on the CBD content, nor on that of THC", alarms Dr Laurent Chevallier.

To protect yourself as much as possible from undesirable effects, psychiatrist Nicolas Authier lists the major red flags to which you must pay attention before going to the checkout. The impossible promises in particular. “There is always THC, we can never completely remove it from the finished product, he insists. Be careful, too, when the seller or the website puts forward many therapeutic claims: it is strictly prohibited. And to conclude: "If the brand does not inform you about the risks of drug interactions or about the potential risks, everything suggests that it is not well informed and therefore lacks seriousness."

The doctor advises to turn to oral oils, easy to handle and to dose, which are swallowed or ingested under the tongue. He also recommends reading the label carefully and choosing the simplest formula possible. Clearly, it should read “CBD flower extract”, potentially mixed with another vegetable oil.

The flowers consumed in the form of a joint with tobacco are strongly contraindicated because of the carcinogenic and cardiovascular risks associated with combustion. “If you are mildly addicted to cannabis, you can reduce the risk by vaping it,” he suggests.

In addition, according to the psychiatrist, herbal teas from cannabis flowers rich in CBD are of no interest, since the molecule does not mix with water. On the other hand, it is infused in fatty substances, such as milk.

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Regarding the dosage, Nicolas Authier invites the consumer to follow the principles recommended in the event of self-medication with conventional drugs, ie 5 to 7 days of use. “We have to wonder if this product is really effective and if there are other non-chemical substances that could help us,” he notes.

In the cosmetics department, dermatologist Nina Roos recommends paying attention to the traceability of products and favoring those from the European Union. “The CBD extract level should be among the first five ingredients on the label,” she says. The shorter the list, with organic products and without coating agents, the less allergen risk there will be.

To have a more concentrated active ingredient, the specialist suggests turning to serum or a mixture of vegetable oils enriched with CBD. "Shampoo or soap, on the other hand, have no interest since the active ingredients will be rinsed automatically with water," she corrects.

In any case, the dermatologist advises people prone to psoriasis or eczema not to use it, and recommends that non-pathological skin types first test the product's tolerance on a bend in the elbow and observe a any reaction for three days, before applying it to the face or body. It is better to carry out this test in the evening, “certain active ingredients contained in this type of product can be photosensitizing”, adds the doctor.

*Originally published on December 12, 2021, this article has been updated.

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