Dear suckahs,

It’s been a terribly exciting time here in the 802 for people who care about cannabis. As of September 2017, possession of limited concentrations of CBD oil became legal in all 50 states. And next, in January 2018, Governor Phil Scott signed a bill into law legalizing limited use of marijuana, which allows users 21 and over possession of 1 ounce of marijuana, or if you choose to grow it yourself, “2 mature or 4 immature marijuana plants per housing unit.” As of July 1st, 2018, Vermont dropped all criminal penalties against anyone who fit this criteria. Our state rejoiced, resplendent with the local newspaper showcasing a front page, full-color photo of some slob smoking the biggest joint ever, probably comprised of both of his extremely mature plants at once. And the meantime, there’s been an explosion of CBD oil coffee drinks, alcoholic beverages, smoothies, chocolates, honey straws, et cetera at food and beverage establishments in the area.

It’s very hard for suckahs to not get carried away by all this delirious momentum, because suddenly, we’ve seen shops and businesses sprouting up all over the state touting CBD oil and CBD oil-containing products, portrayed as cure-all for everything…anxiety, aches and pains, dry skin, blah hair, mental clarity, better focus, muscle recovery, skin clarification, and insomnia, to name just a few. The product spin is that CBD is a previously undiscovered, revolutionary new compound that will save the world. And as a PT operating in the middle of it all, I sometimes have the sensation that I’ve been abducted by aliens and brought to some crazy CBD-infused planet, because my conversations in the clinic frequently go like this:`

Me: So, how are the exercises going?
Client: Well, I haven’t tried those yet, but I’ve been using CBD oil!

People come in talking like they’re pharmacists, about different strains and different dosages and how applied, topically versus orally versus other methods I’m not comfortable discussing. Frankly, I’m totally uncomfortable with all of it. I’ve never been the life of the party. The closest you’ll ever get to cannabis in my clinic is an occasional Dead set on my Sonos system. And no one’s getting any better, or even noticing any difference at all in their symptoms after using the CBD oil, and they keep on coming to PT.  But many keep using it because CBD oil is legal now and it’s everywhere and it’s from a plant, so might as well get on board, right?

Well, my dearest, most adorable suckahs, I hate to be the downer PT who ruins all the fun. I totally get how all of this can be so confusing. CBD oil must be good for us and do something useful, because otherwise why would it be legal, and why are so many businesses selling it and promoting it and so many people using it? The answer, my beloved suckahs, and I truly hate to sound so jaded and cynical because it’s really not the kind of person I am. The honest truth as to why we have this product on our hands is cold, hard CASH. Yes, I hate to break it to you. Act 86 was pushed through largely because it was portrayed as a viable solution to the state’s economic woes. Even our governor seemed a little skeptical, as upon signing the bill, he immediately urged the Vermont legislature to please turn its attention to “more significant issues faced by Vermonters in their daily lives.” And alert entrepreneurs seized the moment to create a need and fill it and capitalize on the en masse suckahdom of an epidemic of people seeking a quick fix to all of life’s woes.

But this isn’t the first time that false claims about the efficacy of trendy products has incited suckahs everywhere to waste their money. Hi everyone, cellulite cream, tea tree oil, oat bran, fidget spinners, the Ab Enhancer?

Please permit me to give you a quick version of the science. The human brain, immune system and organs contain neuroreceptors known as cannabinoid receptors, also known as “opioid receptors.” Endocannabinoids, which are neurotransmitters naturally produced by our bodies, bind to the cannabinoid receptors known as CB1 (located in your brain and several organs) and CB2 (located in your immune system), to regulate processes like mood, appetite, pain, and memory. Supporters of cannabis legalization love to throw what is now often referred to as the “endocannabinoid system” in our faces as evidence that we were all created to sit around and smoke cannabis. LIES! Like us, plants are living organisms too, and have their own set of cannabinoid receptors and endocannabinoids. But we are not plants, and we have a different molecular structure;  therefore, plant neurotransmitters do not affect us the same way that they affect plants. We’ve seen this kind of scenario with soy estrogen, which has turned out to be largely a dud as a treatment for menopausal symptoms in women, but has caused lactation in some children given soy milk as a substitute for dairy.

Even if you actually are a plant, I’m sure you see where this is going. There are over 100 endocannabinoids in cannabis, but there are only two that we care about right now at the center of the CBD debate and for the purposes of this discussion. Tetrahydrocannabinol, abbreviated THC, binds to our CB1 and CB2 receptors. This is the component of cannabis that produces the “get high” feeling. It is due to the effects of THC that cannabis, from the cannabinoid-producing flower plant family Cannabaceae, has been used for centuries as a psychoactive drug, dating back to the 3rd century BCE to induce trances, for mystical travel, celebrations and other fun usage. It also is the active ingredient in medical marijuana, medically prescribed to alleviate severe pain in chronic or end-of-life situations, and also as an appetite stimulant for patients receiving chemotherapy or other appetite-suppressing treatments.

The other endocannabinoid produced by the cannabis plant is cannabidiol, abbreviated CBD, which is intended to be the active ingredient in CBD oil. Here’s the problem, suckahs–CBD does not actually bind to human CB1 and CB2 receptors, which is the sole operating mechanism by which neurotransmitters do their thing. Binding to neuroreceptors is what they do to regulate the human body. So what does CBD actually do for us, you ask? Because plant CBD does not bind to human receptors, the answer at this moment in time is that pure, untainted CBD actually does nothing for us.

The lack of any decent research out there supports not only the science, but also my clinical evidence that CBD does nothing. A cursory search online uncovers very little real research. The true research out there shows little to no evidence whatsoever for the efficacy of CBD oil. What support there is consists primarily of conjecture-based articles, presenting evidence for the efficacy of CBD as ”some people believe…” or “users frequently say…”  These articles often are found on websites that require you to input your age before you are allowed to read anything which, just saying, in general are not a reliable source of accurate information.

I know, my poor suckahs, you don’t want to hear this because you spent so much money on this bogus product and that shit is expensive, like $64 for 1.5 fluid ounces! And here’s something else very important to know. Depending on where you purchased your CBD oil, you may think it’s working because you might feel some THC-like effects. Fake research will tell you that this is because “CBD does not bind to CB1 and CB2 receptors, but may trick the receptors into a chemical reaction.” Impossible. We’re talking about proteins mechanically binding to other proteins here, and proteins aren’t gullible and they don’t have thoughts. Unlike our brains, apparently.

Here’s the very real reason why some of you might feel some THC effects, and it’s not necessarily a placebo effect. It’s because your expensive CBD oil is junk quality and was improperly distilled, and therefore actually contains some traces of THC. That’s fine if you’re OK with being exposed to THC, but I definitely would NOT use it on your kids. And if you’re one of the people trying to explain that you’re taking CBD because “it doesn’t get you high but has all the other benefits,” and you’re feeling some benefit, rest assured you’re most likely getting ALL the benefits of THC whether you like it or not, including a positive THC urine test for the next 30 days at least. Important stuff to know if you’re facing a drug test for a potential job, health insurance, or any other reasons.

Thank our state and our nation for rushing headlong into an easy money industry without establishing standards. We have no uniform standards or process for measuring purity of CBD. We have no idea what a safe dosage of CBD or THC is. We have no idea what a toxic dose might be. And the CBD pushers are taking advantage of an unaware and vulnerable consumer base that is desperate for a quick fix for pain and other ailments, by pushing a product that at best is useless and at worst could be dangerous.

Yes, it’s from a plant, so it’s all natural and natural is good, right? Please allow me to remind you that there are many potent plant-based pharmaceuticals, such as codeine and morphine, as well as plant-based street drugs such as cocaine and heroin. These drugs bind to our cannabinoid, a.k.a. opioid receptors as well.

You may have read about one new FDA-approved CBD-containing drug, Epidiolex, which was approved to treat two very rare and very severe forms of childhood epilepsy that are unresponsive to other medications. If you read the fine print, you will learn that 1) Epidiolex was fast tracked (a process in which a drug is allowed to skip steps in the FDA approval process to make it available sooner for a special use); 2) it also was granted orphan drug status, in which FDA drug approval is based on research results provided by a sponsor requesting approval of the drug for a unique condition. In this case, the sponsor was GW Pharmaceuticals. 3) GW Pharmaceuticals guarantees that the CBD oil in the drug is 99 percent pure, and contains less than 1 percent of THC. For all we know, this THC dosage administered at regular intervals could have neurologic effects on children. Big pharma strikes again.

To be clear, I don’t have a problem with any of this. I can’t blame any parent for being willing to try absolutely anything that might possibly work for a child with severe, untreatable epilepsy, just as I can’t blame anyone in severe, chronic or end of life pain for using THC. I would do the same thing in both situations. But let’s all just fess up that the active ingredient here is most likely THC, not CBD, because even the FDA notes in the Epidiolex filing briefs that CBD does not bond with human cannabinoid receptors. And then let’s establish a safe threshold dosage of THC for children and adults for medical usage.

Back to the original subject: Given the fact that we have established neither purification standards or practices or any efficacy whatsoever for pure CBD, nor safe or effective dosages of THC, I do not believe that the general public should be muddling around with these substances over the counter quite yet. No one should be self-medicating with random doses at will for any and all conditions. The ones I blame for this situation are those who are profiting by pushing these products on an unsuspecting population.

So in case I’ve been unclear, my recommendation on CBD oil is to skip it. Don’t be a suckah, save your money. I’m all for continuing research. Who knows, maybe in the future a study will prove that CBD has a really useful benefit, like removing coffee stains from big Irish teeth, or rapidly deodorizing a car after someone left a piece of cheese under a car seat. Hey, I’m open-minded. But at this moment in time, it’s nothing but really pricey hogwash.

I love you all and I’ve been a suckah too. In the past, I have taken supplements from health food stores designed to help me with my training that did not agree with me, and as a result I am very cautious about supplements that promise amazing results. I write this stuff because it is my job to not only help you to heal, but also to help protect you. There are no quick fixes; therefore I want you to be skeptical of people trying to sell you one, and also steer clear of products that claim to cure a wide range of ailments. It’s a confusing world out there filled with conflicting health advice. Don’t believe all you read, or all that your well-intentioned friends tell you. Take good care of yourself through common sense measures, and with assistance from trained health professionals, neither of which cost $64 for a 1.5 fluid ounce bottle most of the time. Value your body and your brain and don’t be willing to expose yourself to just any substance until you know more about it. Be well.

Kathleen Doehla, M.S. P.T.