CBD (cannabis oil or hemp oil) is a key component of the cannabis plant. It doesn’t trigger the psychological effects associated with tetrahydrocannabinol (THC), a psychoactive drug, and isn’t associated with addiction. It can be sold through retail outlets as a food supplement as long as this is without any medicinal claims.

In August 2019, the UK’s Centre for Medicinal Cannabis (CMC) announced the release of a new Cannabinoid Industry Quality Charter to help foster a legally compliant, socially responsible and innovative cannabidiol (CBD) industry in the UK. This followed the CMC’s study in June 2019, which revealed that, at £300 million, the UK CBD market was much larger than previously estimated. 

CBD (cannabis oil or hemp oil) is a key component of the cannabis plant. It doesn’t trigger the psychological effects associated with tetrahydrocannabinol (THC), a psychoactive drug, and isn’t associated with addiction. It can be sold through retail outlets as a food supplement as long as this is without any medicinal claims.

Although more research is required, there is some clinical and anecdotal evidence that CBD oil may help in sleep disorders, anxiety and arthritis, and many community pharmacies are now stocking the non-medicinal products. However, there is currently confusion around the legal status of CBD oil and the legal threshold for the presence of THC. One of the key recommendations in the CMC study was the formation of a cannabis-related kitemark to give consumers trust in the available products, instore and online. 

A £1bn market by 2025

According to the CMC, six million adults have used CBD oil in the UK. The market is estimated to be worth almost £1 billion per annum by 2025, equivalent in size to the current entire UK herbal supplement market. Although the manufacturers can’t make any medicinal claims, customer curiosity is driving growth. 

EOS Scientific recently launched its luxury CBD-infused body and skincare range, Ambience Apothecary, into Boots. This follows a series of successful CBD-infused products under the EveryDay Ambience brand, already retailing in Holland & Barrett. 

“We conducted national research earlier this year looking into the attitudes towards holistic remedies, with a specific focus on using holistics to help alleviate mental health issues,” says Simon Manthorpe, CEO of EOS Scientific. “Alongside statistics finding that 38 per cent of Britons would indeed use CBD oil to help with their mental health, we found that almost a quarter – 24 per cent – of Brits would prefer to use holistics than prescribed medicines. This clearly shows the growing enthusiasm in the UK, helping these new trends emerge.”

Several health charities have published educational materials in response to the growing interest, but without any official guidance they are unable to make recommendations. Versus Arthritis, for example, has added advice on CBD oil to its complementary treatments website information, specifically stating that there isn’t enough evidence to recommend its use in musculoskeletal pain. 

However, DragonflyCBD research has shown that two out of three consumers worry about the potential impact of taking painkillers for problems such as pain and lower back pain. 

Authoritative guidance needed to stay safe

According to the CMC, most UK consumers are buying CBD oil products online, despite the wide availability in pharmacies, health food stores and supermarkets. More awareness and information in-store would help to ensure that consumers are buying reputable, safe and effective products from community pharmacies, alongside appropriate advice. 

“A growing number of pharmacies are selling non-medicinal CBD products,” says an NPA spokesperson. “Currently the evidence about the long-term effects of these products is limited and the regulations are complex. We would welcome more research and authoritative guidance that makes it easier for manufacturers, healthcare professionals, retailers and consumers to make informed choices, keeping everyone on the right side of the law and safe from harm.”

The quality of products varies significantly in the UK. Blind testing of 30 popular UK CBD products by the CMC demonstrated that many of the products on the market didn’t contain what was indicated on their labels. Only 38 per cent of the products were within 10 per cent of the advertised CBD content and 38 per cent had less than 50 per cent of the advertised CBD content. One product contained zero CBD. Almost half of the selected products had measurable levels of THC, making them technically illegal in the UK. Further analysis of these results is ongoing and will be published as part of a fuller analysis of the data in a peer-reviewed journal.

DragonflyCBD was one of the products tested by the CMC and, says marketing manager Nikki Warner-Green, it passed. “The company manages every step of the production process,” she says. “Dragonfly Biosciences has its own laboratory for extractions and processing. A national press advertising campaign will run in September and the Autumn for DragonflyCBD, supported by pharmacy POS including, posters, display packs, shelf wobblers and consumer leaflets.”

We would welcome more research and authoritative guidance that makes it easier to make informed choices

Canabidol products have been designed to meet the standards required by the pharmacy sector. Steve Batchelor, marketing manager at Canabidol and British Cannabis, says that education is key for this emerging market. “There are three things that every pharmacist and patient should have knowledge of before they select the product to stock,” he says. “Is it safe? Is it legal? Is it as described? The responsibility of the pharmacist should be to stock the purist and most transparently tested product possible. With CBD being a new area to many, it is also important for a pharmacist to be well informed around the possible delivery methods (from sublingual to vaporised, topical, oral and edible) and to research other key areas like bioavailability and drug interactions.”

Tips for sourcing products

Safeguarding customers is, of course, vital, so it is important that pharmacists source and recommend safe, consistently high quality products that adhere to stringent production requirements. Jonathan Hartshorn, CEO of CBD health and wellness company Satipharm, says that pharmacists should look for products made under controlled conditions, such as the Good Manufacturing Practice, and full ISO certification. “Understandably, customers interested in trying CBD for the first time will be looking for trusted products which deliver a consistent amount every time,” he says. “When discussing use with customers, pharmacists should look to recommend products which deliver a reliable dose with clinically proven bioavailability. Though oil products are popular forms of CBD, delivering a consistent dose is difficult. In addition to difficulties in dosing, the bioavailability of CBD oil has been shown to be very low, at around five per cent; as such, our Gelpell technology is clinically proven to deliver more than three times higher bioavailability than CBD oil.”

Linked articles on the legal status of CBD can be found here and here