Vast Majority of Medical Cannabis Products Sold Online are Mislabeled

Lack of federal oversight for cannabidiol products sold online could lead to adverse events among patients who take the products for conditions such as cancer.

The use of medical marijuana has been explored to treat numerous conditions, including epilepsy, pain management, and cancer. Limited evidence suggests that cannabidiol (CBD)—a derivative of marijuana that does not cause euphoria—has the potential to treat disease without causing dependence.

Studies have highlighted the potential of CBD to treat a rare pediatric seizure disorder and patients have shared testimonies of how the drug has helped treat other conditions.

Despite growing interest in CBD, the drug is still tightly controlled and not available in many retail stores. Patients may have to turn to online retailers to access CBD products, but a new study published by JAMA suggests these products may be exposing patients to potential harms.

The study found that nearly 70% of CBD products sold online were over or under labeled. The authors hypothesize that the mislabeling is the result of improper regulation, according to the study.

“The big problem, with this being something that is not federally legal, is that the needed quality assurance oversight from the FDA is not available. There are currently no standards for producing, testing, or labeling these oils,” said lead author Marcel Bonn-Miller, PhD. “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 [CBD] 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.”

In the study, the researchers identified and purchased 84 labeled CBD products online from 31 companies.

The authors discovered that 41% of the products contained a higher concentration of CBD than was labeled, meaning it was classified as under labeled, according to the study. Another 26% of the products had a lower concentration of CBD than the label indicated.

Only 30% of the products contained CBD within 10% of what the label indicated, according to the study. While too much CBD may cause adverse events, too little could cause negative clinical results.

The authors said that the significant variability may make it difficult for patients to achieve treatment goals.

“People are using this as medicine for many conditions (anxiety, inflammation, pain, epilepsy),” Dr Bonn-Miller said. “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.”

Notably, some products also contained a high level of THC, which is responsible for the euphoric feeling associated with marijuana and can cause cognitive impairment, according to the study.

“This is a medication that is often used for children with epilepsy, so parents could be giving their child THC without even knowing it,” Dr Bonn-Miller said.

A previous study of the CBD content of edible medical marijuana products showed similar discrepancies, according to the authors.

These findings highlight the need for regulated labeling of CBD products to mitigate potential adverse events, according to the authors.

“Future research should be focused on making sure people are paying attention to this issue and encouraging regulation in this rapidly expanding industry,” Dr Bonn-Miller concluded.