Nearly 70% of all cannabidiol (CBD) products sold online are either over or under labeled, according to a Penn Medicine study published this week in JAMA. The study was supported by funding from the Institute for Research on Cannabinoids (IROC).
Penn Medicine researcher, Marcel Bonn-Miller, PhD, an adjunct assistant professor of Psychology in Psychiatry and the lead author on the study, believes the mislabeling of cannabidiol products is a direct result of inadequate regulation and oversight.
"The big problem, with this being something that is not federally legal, is that the needed quality assurance oversight from the Food and Drug Administration is not available. There are currently no standards for producing, testing, or labeling these oils," Bonn-Miller said. "So, right now, if you buy a Hershey bar, you know it has been checked over; you know how many calories are in it, you know it has chocolate as an ingredient, you know how much chocolate is in there. Selling these oils without oversight, there is no way to know what is actually in the bottle. It's crazy to have less oversight and information about a product being widely used for medicinal purposes, especially in very ill children, than a Hershey bar."
CBD is widely used to treat adults with a variety of health conditions, and young children with rare seizure disorders.
For a month, Bonn-Miller and his team of researchers conducted internet searches to identify and purchase CBD products available for online retail purchase that included CBD content on the packaging. The team purchased and analyzed 84 products from 31 different companies.
Lab testing of the products found that more than 42% of products were under-labeled, meaning that the product contained a higher concentration of CBD than indicated. And 26% of products were over-labeled, meaning the product contained a lower concentration of CBD than indicated. Only 30% of CBD products purchased tested to have CBD content within 10% of the amount listed on the product label.
While there are no studies showing CBD can be harmful in high doses, products containing too little CBD may not have the desired therapeutic effect, while too much CBD will give an inaccurate picture of effectiveness from product to product.
"People are using this as medicine for many conditions (anxiety, inflammation, pain, epilepsy)," Bonn-Miller explained. "The biggest implication is that many of these patients may not be getting the proper dosage; they're either not getting enough for it to be effective or they're getting too much."
According to Bonn-Miller, a number of products also contained a significant amount of THC, which has been shown to cause cognitive impairment and other adverse health effects. "This is a medication that is often used for children with epilepsy, so parents could be giving their child THC without even knowing it," he said.
In a previous study, Bonn-Miller and colleagues analyzed cannabinoid dose and label accuracy in edible medical cannabis products and found similar discrepancies. He hopes this and future studies will call attention to the impact of inconsistent cannabis product labeling. "Future research should be focused on making sure people are paying attention to this issue and encouraging regulation in this rapidly expanding industry."
Business experts estimate that the market for CBD products will grow to more than $2 billion in consumer sales within the next three years. While interest in this area continues to grow, little has been done to ensure regulation and oversight of the sale of products containing CBD. The primary reason for this is that CBD is currently classified as a Schedule I controlled dangerous substance by the DEA, despite having been legalized for medicinal use in many states. Thus, many people do not have access to stores that sell CBD products and instead rely on online retailers to purchase CBD products.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In the fiscal year 2016, Penn Medicine provided $393 million to benefit our community.