Whether it’s at Williamsburg Drug Company, Olde Towne Pharmacy or The Prescription Shoppe, local pharmacists have taken notice of the nationwide fascination with CBD oil and stock the popular alternative remedy.
Henry Ranger, who owns the Prescription Shoppe in James City County’s Courthouse Commons shopping center, said he first heard about the effects of CBD oil while working for a larger chain pharmacy that didn’t stock the product. He said he was unable to begin exploring the growing industry until he opened his own business.
Ranger said he reviewed the available studies and located pharmaceutical-grade CBD oil manufacturers. Meanwhile, customers of all ages asked about trying it out to help with a number of medical issues, including anxiety, inflammation and joint pain.
“It just has so many different benefits and it’s been an absolute game-changer,” he said.
What is CBD oil?
Cannabidiol, also called CBD, is a component extracted from the cannabis leaf, but is separate from tetrahydrocannabinol, better known as THC, the psychoactive component in cannabis that causes a high. In other words, the oil produced from CBD can’t get you high, as Riverside Health System Vice President and Chief Pharmacy Officer Cindy Williams explained.
“CBD is a component of cannabis or hemp,” she said. “It is one of the non-psychoactive ingredients, THC tends to be the psychoactive ingredient, and so there’s a couple of different ways that CBD oil is available legally within the state of Virginia.”
Reading that CBD comes from hemp may raise some eyebrows, but it was made legal last year as part of the 2018 Farm Bill that was adopted last December by Congress.
According to a statement put out in April by FDA Commissioner Scott Gottlieb, M.D., the Farm Bill defined a new category of cannabis classified as “hemp,”meaning that it contains a maximum of 0.3% THC on a dry weight basis. The bill also removed hemp from the Controlled Substances Act.
Now CBD oil legally is allowed to be manufactured and sold so long as it contains that same low concentration of THC; it is available for purchase online and over the counter at pharmacies. Virginia has also put processes in place to allow for the legal cultivation and extraction of hemp and hemp-based CBD, Williams said.
According to reports by CNBC, NBC News and Forbes, CVS, Walgreens and Rite-Aid sell topical CBD products such as creams and balms at stores in select U.S. markets, but not in Virginia.
The FDA statement also notes that CBD products cannot be added to food or drinks, and haven’t been approved to be marketed as dietary supplements because they haven’t been subjected to the necessary FDA testing.
Possible side effects from CBD oil include fatigue, drowsiness, diarrhea and abdominal pain, according to Williams and pharmacy owners. They also warned that CBD could have negative interactions with medication. Patients interested in trying CBD oil are encouraged to consult a pharmacist, who can help determine the right dosage amount. Lisa Genakos, marketing and community outreach coordinator at Williamsburg Drug Company, said that taking too much also can result in drowsiness.
When asked why she thinks CBD oil is gaining popularity nationally, Williams said she believes that patients who were worried about the addictive properties of using opioids or other medications for issues including anxiety or pain relief see the oil as an effective natural remedy.
“They’re seeking what is perceived to be a more natural way to treat some of these things,” she said. “I think the flip side of that is we need more research and we need more control over the quality of the products that are being marketed just to make sure the public is being protected from that side as well.”
Genakos said that after a car accident left her with a broken back, she began taking percocet to manage pain, but the opioid left her in a “drug fog.” She chose to try CBD oil, and continues to take it daily to manage pain from herniated discs that resulted from the accident.
“I was taking percocet which is opioids, and that was preventing me from being able to work more than my broken back was,” she said. “Within 10 days, I was off the percocet and the muscle relaxers, (the CBD oil) was taking care of my pain and my head was clear.”
CBD is in a “grey area”
Although the FDA takes legal authority over CBD oil usage in the U.S., Williams and pharmacy owners agree that the product exists in a sort of grey area, and is still widely unregulated.
“This is probably my biggest concern right now: there’s very little oversight on the products that are available commercially,” Williams said.
Kelly Kale, owner of Olde Towne Pharmacy on Longhill Road, said she has followed studies on its effectiveness for years, but waited to begin stocking CBD oil until she could be sure that she could legally sell products that were pharmaceutically tested and proven to be safe.
She has continued to warn her customers to use only pharmaceutical-grade CBD products, despite the availability of similar products online.
“I want them to be on pharmaceutical-grade products, because we can guarantee from bottle to bottle and from batch to batch that it’s exactly the same product every time,” Kale said. “What you’re receiving off the internet, lord knows what’s in it.”
How it’s used
Common CBD products at area pharmacies include oil and capsules that are taken by mouth, as well as CBD balms and topical gels. While they said cannabidiol won’t have the same effect for everybody, local pharmacy owners agreed that an overwhelming majority of their customers have told them it helps alleviate issues including pain and anxiety.
T.W. Taylor, owner of Williamsburg Drug Company, explained that CBD works because it can accelerate the function of cell receptors throughout the body that make up a network called the endocannabinoid system. Those receptors help to regulate functions including digestion, immune function, memory, mood and pain, Genakos said.
“You have receptors all over your body that take the CBD and use it to help your body feel better,” Genakos said when asked how she would explain the process to a new patient.
Despite studies and anecdotes from users that pharmacy owners said show how CBD can help patients, Williams warned that it still hasn’t been heavily studied, and that there’s little medical research to validate its effectiveness.
“There is emerging data, but it’s very limited and it’s far from conclusive, and a lot of that is because there just haven’t been well-designed, randomized control trials to determine whether the products are effective and in some cases safe, because they’re not without side effects,” she said.
On the other hand, Taylor said he feels confident about its effectiveness after seeing studies done by Ananda and other groups, and hearing about how it has helped his customers.
“If somebody has pain, inflammation, anxiety, those things, it’s actually malpractice for me not to help them with something that can help them, especially when I have something that’s safe and effective. It has no abuse potential, there’s no danger to society and it helps eight out of 10 people,” he said. “I don’t have a single drug that’s that good.”
Lance Zaal, who owns King of Clubs Brewing Co. in the Williamsburg Premium Outlets, said he began using CBD oil to help with back pain after hearing about it from friends. Although it doesn’t completely take the pain away, he said it helps, and he still takes it on occasion.
“I’m still productive and I try to stay active in the gym so I don’t want anything that alters my ability to do what I normally do, so it helps me to focus on that because it takes away a little bit of the pain,” he said.
Arriaza can be reached at 757-790-9313 or on Twitter @rodrigoarriaza0.