What Patients and Doctors Need to Know about the CBD Industry, Part 1
By Luke Terry, MTOM, L.Ac
A New Wellness Industry Emerges: An Overview
The incredible momentum developed by the cannabis industry in the United States, and in particular the closely associated high-resin, cannabinoid-rich hemp and cannabidiol market represents of the most exciting and important developments in the US health care sphere in the last 100 years. The incredible power and potency of the endocannabinoid system in in maintaining vibrant health is finally becoming clear. With that understanding, we can now legally and skillfully access the unparalleled ability for cannabinoid therapeutics to address difficult chronic pain syndromes and other diseases, as well as its significant ability to help us develop deep and resilient well-being.
In hundreds of patients and clients, I’ve seen dramatic and significant improvement in many aspects of health and wellness, and the dramatic rise of the industry gives me hope that through skillful application of powerful and well-made CBD products, we can address many of the chronic and difficult challenges facing health care worldwide.
As a veteran health practitioner, educator, and health writer for almost two decades, and a consultant in the hemp and nutraceutical industry for the past three years, I’m fortunate to have gained deep insider knowledge to this industry. I’m tapping into my industry knowledge from consulting and experience as a functional medicine and nutrition practitioner to produce this series of articles, and many to follow, to help educate the industry and public to clear up confusion and benefit patients, practitioners, and the industry.
The hemp/CBD market developed as an offshoot of the medicinal and recreational marijuana market, both nationally, with the passage of the 2014 Farm Bill, and specifically in Colorado and other states that developed a regulatory framework for this burgeoning industry. The specific legal and regulatory issues facing this industry will be explored in detail in Part 3.
The rapidly expanding, dynamic hemp and CBD industry has taken the supplement and nutraceutical world by storm, with powerful ripple effects moving through specific areas in medicine, including epilepsy treatment and management, pain management, PTSD treatment, and many others.
As a young industry, this market segment is rife with misinformation and misunderstanding at every level, from everyday consumers to producers, practitioners, and regulators.
Let’s start with a review of the plant itself:
High Resin, Cannabinoid-Rich CBD Hemp: A New and Very Different Plant Cultivar Is Born
Today’s cannabis has been bred to be much more potent in a variety of ways compared to its ancestors grown in the last few decades. Selective breeding, first perfected in the underground, pre-legalization era, was utilized by growers to develop more and more potency in both cannabinoids, almost singularly in content, though unique terpene profiles were also developed, as the terpenes, as we’ll see, greatly contribute to a strain’s effects. Breeders competed to grow the most THC-dense flower. International competitions have been held for decades where growers went bud-to-bud for industry honors, both a point of pride and a competitive advantage in the marketplace, where premium strains command high prices.
To give you an idea of this progression, cannabis illegally imported from Mexico by the cartels in the 1990’s contained approximately 4% THC. In 2014, domestic and imported cannabis seemed to average around 12% THC. In Colorado today, legal producers commonly produce strains of cannabis with 20 to 30% THC, and one Boulder grower recently announced a 40% strain. By any measure, a ten-fold increase potency over a few decades illustrates both the power of free-market economics to potentiate innovation, as well as the dedication of breeders to their craft. However high THC strains, while lucrative in their appeal to the niche tastes of high-end cannabis consumers, still leave a lot to be desired from a therapeutic perspective.
When THC levels exceed 20%, dose titration for therapeutic purposes becomes tricky, especially for patients who are naive to cannabinoids or who are otherwise highly sensitive to THC. Moreover, only a few medical syndromes respond singularly to THC’s therapeutic effects. Other cannabinoids, particularly cannabidiol, show much more therapeutic potential, especially when combined with a “full spectrum” of other biomolecules, as we’ll explore below.
In the early part of this century, as cannabidiol began to emerge in the research literature as a very potent therapeutic agent in cannabis, a small group of breeder began emphasizing this cannabinoid. It’s important to note that this form of breeding is not genetic engineering, but the same process that has been used for thousands of years to develop new cultivars of any plant, or even new breeds of domesticated animals. Individual plants that have the desired characteristics are cross-bred, and then off-spring are selected to continue the process. Over time, desired characteristics are strengthened, and unwanted characteristics are suppressed. This is the process that delivered the Teacup poodle from ancient wolf genetics.
With decades of experience, breeders, primarily in Colorado, began selecting for CBD, and rapidly developed strains with 15 to 20% CBD, with some experimental varieties reaching 30% potency. Due to language in the 2014 Farm Bill, as well as state regulations, THC content cannot exceed 0.3% in either the flower tested prior to harvest, or finished consumer products. This is the legal delineation between hemp and marijuana, as we’ll discuss in an upcoming article in this series. This very low THC mandate clearly delineates marijuana products available at dispensaries from the hemp-derived CBD products that are legal nationwide, with a few exceptions.
Another significant distinction is found in the methods of cultivation. Marijuana, almost uniformly, must be cultivated indoors. Because CBD growers can grow outdoors in large-scale industrial farms, CBD growers are not constrained to the high cost and logistical challenge of indoor growing, unlike medicinal and recreational marijuana operations. Outdoor industrial agriculture techniques are being leveraged to grow massive quantities of new strains of high resin, cannabinoid rich CBD hemp flower, a worldwide first. By 2015, vast acreages of high-resin, cannabinoid rich CBD hemp were being grown, primarily in Colorado. In 2016 and 2017, several other states have followed suit.
While significant portions of the outdoor CBD hemp crops were plagued with the typical issues of new and highly experimental crops in a highly regulatory environment, the volume of production increased almost exponentially. The availability of industrial quantities of CBD hemp flower opened the door for development of a wide array of CBD products, leading to the proliferation of products on the market today.
Predictably, in a young industry full of aggressive upstarts and marketing gurus from other industries, often the hype surrounding these products exceeds the deliverable quality of these products. A 2017 industry study showed that fully 70% of the products on the market do not contain the amount of CBD claimed on the product label. Further, most of the 30% of the properly labeled product only contain a small amount of the other beneficial, even necessary cannabis biomolecules required to allow cannabinoid products to effect pharmacological change in patients to their full potential. Much of the true therapeutic potential in CBD hemp is lost in inefficient, wasteful, or shortsighted extraction and processing.
Industry Lingo: Problems with “Full Spectrum” and “Whole Plant”
Like any industry, both the CBD/hemp industry and the medical and recreational cannabis industry are rife with buzzwords and hazily defined concepts. The whole of the industry has been enamored with the concept of the “entourage effect,” describing the synergistic effect of all of the bioactive molecules present in the cannabis plant. Many studies have shown that the cannabis plant contains hundreds of important bioactive compounds, with more being characterized all the time. Further, more studies unequivocally demonstrate the superior efficacy of biochemically diverse cannabis preparations over those with only a few cannabinoids, or even more so over isolated CBD.
As the concept of the entourage effect has spread virally throughout the industry and the public, a few buzzwords have popped up in marketing copy. Some of the most common phrases include the words “Full Spectrum,” to describe a product that allegedly contains a full spectrum of cannabis biomolecules, and “whole plant,” essentially meaning the same thing.
As we’ll see, many of these marketing buzzwords do not adequately describe the product offerings, and only a select few manufacturers offer products on the market that contain the true full spectrum of cannabis biomolecules. Only a carefully designed multi-stage extraction process can ensure the presence of a true full spectrum of cannabis biomolecules, and thus only those processes are capable of delivering products with maximum potency in terms of the entourage effect. Further, poorly designed extraction systems introduce toxic byproducts from synthetic solvents used in extraction, and also damage several delicate biomolecules, changing them into less desirable products. Those toxic contaminants and molecular changes will also be fully detailed in future articles in this space.