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GUEST OPINION: Opioids and CBD — Lawsuits and Addiction

Big pharma has been set ablaze since an Oklahoma court ordered Johnson & Johnson and its subsidiaries to pay $572 million for their role in fuelling the opioid crisis.
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Big pharma has been set ablaze since an Oklahoma court ordered Johnson & Johnson and its subsidiaries to pay $572 million for their role in fuelling the opioid crisis. This trial appears to be the tip of the spear in a budding trend for the government in both the U.S. and Canada to file lawsuits against opioid manufacturers.

There now exists roughly 1,500 similar lawsuits filed in Ohio and one filed by British Columbia’s Attorney General against similar drug manufacturers. 

At trial, Oklahoma argued that the companies and their subsidiaries created a public nuisance by launching an aggressive and misleading campaign that overstated how effective the drugs were for treating chronic pain and understated the risk of addiction.

In response, attorneys for Johnson & Johnson maintained that they acted lawfully as part of a heavily regulated industry.

Cleveland County District Judge, Thad Balkman, ruled in favour of the state commenting that “the opioid crisis has ravaged the state of Oklahoma.” He ordered the companies to pay $572 million to help abate the problem in the coming years. 

With the legalization of marijuana and CBD (cannabidiol) throughout Canada, these opioid lawsuits raise a number of issues, less than a quarter of which I intend to dispense with.  The primary issue I intend to address is, who will be responsible if or if and when we learn that CBD is addictive?

To even address this question, we’ll need to unroot the base of our knowledge regarding the addictive properties of CBD. Now, news networks and top commentators have been constantly telling us that CBD is not addictive. Heck, an article published last month in the Chicago Tribune recommended using CBD to reduce high blood pressure on the basis “it wouldn’t hurt.” 

But hey, who would want to get on the wrong side of Kim Kardashian and Rob Gronkowski?

Two icons who have wrapped their arms around this tree dealing out support in exchange for profit.

Now, I’m not going to say CBD is addictive but we just don’t know enough at this point to say that it isn’t.

The most commonly cited study answering whether CBD is addictive was authored by Shanna Babalonis and published in the March 2017 issue of the Journal of Drug and Alcohol Dependence. Participants of the study were frequent marijuana users who were given various oral dosages of CBD, THC, and a placebo. The study concluded that CBD did not display any signals of abuse liability and THC did.

Now, if you’re like myself, I needed to look up the meaning of abuse liability within the study. Measures of abuse liability included; ratings of high, drug effect, stimulation, blurred vision, energetic, drug strength, heart rate, willing to take again, and mellow.

So essentially, the scientists took a group of frequent marijuana users, then asked them about their drugs subjective experience when using CBD; and, shockingly, the users didn’t report being high on CBD. The study itself sets out a similar limitation, in that: “it is possible that this population was tolerant to the cannabinoid effects produced by CBD and may not be sensitive even to the high dose of CBD tested. It is possible that a higher dose may be necessary to produce measurable effects in this population.”

Lastly, the second last sentence of the study goes on to conclude that: “[I]t currently remains unclear if CBD is safe for long-term use or clinically useful for the treatment of any of the disease conditions currently under investigation.”  But is long-term use a month? A year? Five years? More questions without answers.

So stop believing Cheech and Chong, and your friend who wakes and bakes, that cannabis is not addictive because it could be when used long-term.

Now, I’m not arguing here that marijuana is addictive. Just you can’t have your cake and eat it too. More studies and information are needed before we conclude that CBD is not addictive.

When I’ve raised these concerns with friends, they’ve responded in a half-baked manner saying, “but George, CBD is natural. It can’t be addictive like Captain Cody and other opioids.” Fun fact: opioids are derived from the opium poppy. Further, cocaine, booger sugar or better known as the devil’s dandruff, is derived from the coca plant. Should I go on?

So now that we can agree that there is a chance that CBD might be addictive, who is going to get sued if in 15 years we have a CBD crisis?

Cannabis and CBD producers are already packing a bowl that will fire lawsuits similar to the ones involving the opioid producers. In July, the FDA put out a warning that companies were marketing cannabidiol with unsubstantiated claims that it would treat cancer, Alzheimer’s disease, opioid withdrawal, pain and pet anxiety. The FDA specifically recognized that these marketing campaigns “can put patients and consumers at risk by leading them to put off important medical care.” Think, there is no one tool that can fix every problem in a house, excluding duct tape, and there is no one substance that cures all.

 Notably, only Epidiolex, a purified form of plant-derived CBD, has been approved by the FDA to treat severe forms of epilepsy, all other forms of CBD are not approved by the FDA. Now this may confuse some as medical marijuana is generally used to treat glaucoma and other ailments — CBD and medical marijuana are different. Here, I’m exclusively focusing on CBD.

 In light of the foregoing, we appear to have made out the grounds of argument put forward against Johnson and Johnson. $573 million here we come? But again, opioids were part of a heavily regulated industry. Perhaps, the litigation finger should be pointed toward the government for failing to regulate this product? But, we saw what happened with tobacco and, likely, pursuing the government is a pipe dream.

 The availability of CBD in Canada in conjunction with the unregulated advertising throughout the U.S. and online has created a growing trend of individuals playing Dr. Google who encounter a plethora of information: CBD can be found to assist or cure almost any medical condition. But who is telling us that CBD can cure everything? This advice is likely an individual who slapped a Dr. in front of their name online instead of actually going to medical school.

 Moral of the story, until more human based trials are conducted on the addictive and beneficial effects of CBD, consult your physician regarding your medical condition. And question everything you hear about CBD — it’s a massive industry that is being fueled by larger economic powers than you or me.

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