July 25, 2022: Cannabidiol (CBD) products made from hemp have become more popular in recent years. But how much can you trust what the label says, compared to what’s actually in CBD patches, creams, and lotions?
A team of researchers decided to find out. They purchased 105 hemp-derived CBD topicals (products designed to be applied to the skin) from physical stores and online sites.
Of the 89 labels stating the amount of CBD, for example, 24% matched what was inside; 58% of the products had more CBD; and the remaining 18% contained less.
Additionally, more than a third, 35%, of the topicals tested contained delta-9-tetrahydrocannabinol (THC), including some that claimed to be THC-free.
THC is the compound in marijuana that is associated with “being high.” But hemp products can contain 0.3% or less of THC, and all of the products in this study met the regulation.
People should “be wary of cannabinoid products available in retail stores. The products may not contain the amounts of CBD or THC that are advertised,” says lead study author Tory R. Spindle , PhD.
The to study was published in JAMA Network Open on July 20.
It can be deceiving
CBD topicals are over-the-counter (OTC) products, so they are not regulated by the FDA in the same way that prescription drugs are. But at the same time, the agency does not allow OTC products to make claims about health benefits.
“The health claims that are made about the products, which are often very expensive, may not be supported by clinical research,” says Spindle, a researcher at the Johns Hopkins Cannabis Science Laboratory in Baltimore.
He and his colleagues found that 28% of the 105 products made a therapeutic claim, primarily to help relieve pain and inflammation. And 14% say it helps improve the quality or appearance of the skin.
“This study really highlights that the current regulatory oversight of cannabinoid products is not enough,” says Spindle, who is also an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.
More hemp-derived CBD products are appearing on store shelves and online due to the Agriculture Improvement Act of 2018. This law, better known as the Farm Bill, removed hemp and hemp products from the United States List of Controlled Substances.
Take heart, consumer
Despite the concerns uncovered in the study, the CBD industry appears to be improving, says Adam Friedman, MD.
“The good news is that in the last couple of years, with this incredible explosion of CBD-heavy or CBD-only products coming to market thanks to the Farm Bill, there seems to be better quality assurance,” he says. Friedman, professor and chair of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, DC.
“Labeling is improving, but there is still a lot of work to be done as there is still under- and over-labelling,” he says.
The study authors cite concerns about the ingredients in these products being absorbed through the skin, entering the body and causing other effects, such as liver toxicity. But Friedman says most of these CBD topicals are unlikely to penetrate deeper than the top layers of the skin.
“These are renowned researchers who have published extensively in this space, including on this topic. This is a reputable journal. The design is strong and the limitations are few,” says Jamie Corroon, ND.
He found it interesting that products were mislabeled regardless of whether they were sold in brick-and-mortar stores or online. Also, as for the finding that products containing THC were within the legal maximum of 0.3%, “that’s surprising and shows good manufacturing practices,” he says.
Since these THC CBD products are applied to the skin, the risk of deterioration “is exceptionally low,” says Corroon, a licensed naturopathic doctor and founder and medical director of the Medical Cannabis Education Center in Del Mar, CA .
“The thing about hemp-derived topical CBD products is that they are generally safe, accessible, relatively affordable, and many people are reporting positive experiences using them,” he says.
Bad apples?
Friedman agreed with Spindle and colleagues that the mislabeling and health benefit claims of some CBD products are troubling.
“Companies that mislabel and make inappropriate claims … hurt the entire field.”
“There is enormous potential for this area, particularly in dermatology, where we are looking for specific topical agents to use CBD,” Friedman says. When manufacturers mislead about CBD products, it “undermines the credibility of this field.”
The researchers purchased about half of the CBD products at brick-and-mortar stores in Baltimore and the other half online in July and August 2020.
To find the exact amounts of CBD, THC, and other cannabinoids in each product, the researchers detected chemical signals for each ingredient of interest using a method called gas chromatography-mass spectrometry testing.
Applying more research
Spindle and colleagues are examining the short- and long-term effects of topical cannabinoid lotions, creams, patches, and other products.
“We need to understand what these products do,” he says, “and whether there are factors such as product formulation that may influence their effects on the user.”
An unanswered question is whether topical CBD products could change drug test results required for employment or other reasons.