Dr. Nicole Saphier: CBD’s safety is uncertain – There may be unknown risks from chemical in marijuana

You’ve likely seen or heard ads on the Internet, radio, TV and print publications touting the benefits of cannabidiol (CBD) – a chemical found in cannabis (marijuana) plants. Unlike the tetrahydrocannabinol (THC) in marijuana, CBD is non-psychoactive, meaning it doesn't cause the "high" associated with marijuana consumption.

The use of CBD has increased over the last several years. In fact, you can find CBD-containing products just about everywhere.

Today CBD is the trending element in the growing field of cannabis research. But despite being widely promoted in dietary supplements, foods, cosmetics and animal wellness products, it has only been approved by the U.S. Food and Drug Administration (FDA) for use in one prescription medication to treat two rare and severe forms of epilepsy.


This limited approval for the use of CBD is largely due to the fact there is not much information available about it, including its effects on the body.

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Earlier this week the FDA published a revised Consumer Update regarding the safety of CBD-containing products. It also issued warning letters to 15 companies for illegally selling such products, in violation of the federal Food, Drug and Cosmetic Act (FD&CA).

The warning letter was issued because under the FD&CA, any product (other than a food) intended to treat a disease or have a medical use in humans or animals is considered a drug.  Since only one drug for seizures has been properly vetted with proven health benefits and declared safe, no other products can legally be marketed as such.

However, marijuana and products derived from marijuana are being sold in different states under different laws, despite the continued status of marijuana as illegal for most uses under federal law.

In some states so-called “medical marijuana” is legal, and getting a medical prescription for the drug is relatively easy. And some states have legalized recreational marijuana use as well, with varying restrictions. Federal authorities have not sought to stop the sale of marijuana and marijuana products in states that have legalized such sales.

Before the creation of the FDA in 1906, companies were free to market drugs in the U.S. without government regulation, resulting in the sales of drugs that were sometimes useless and sometimes harmful – even deadly. The FDA was created to test drugs to ensure they were safe and effective before they could be legally marketed.

There are plenty of question marks surrounding products containing CBD because of just the small amount of scientific tests that have been conducted on the chemical. In most cases, we just don’t know if these products are safe and effective.

CBD products may prove to be a vital advancement in medicine. However, we are still lacking the evidence that it is efficacious for certain conditions and safe to use.

Pure cannabidiol has demonstrated health benefits in small, limited research trials. Researchers have found it reduces inflammation, anxiety, insomnia, neurological disorders and other common ailments. But more extensive research is needed to validate these findings. 

It’s important to keep in mind that the CBD available for sale commercially may not be pure. And without proper vetting by the FDA, we may be subjecting people to harm by allowing unchecked consumption.


Although many reject the notion of government regulation and want to continue to use CBD products, safety remains an important issue yet to be resolved. There have been reports of some CBD products containing harmful contaminants, such as pesticides and heavy metals.

Additionally, we don’t actually know the most effective dose of CBD for medical conditions other than seizures.

The biggest concern I have as a physician (and mother) is that people, including adolescents, will use CBD without discussing it with their doctor first.  Although the risk of direct harm from using these products is likely small, there is a greater harm that could be caused by undertreating many medical conditions.

In other words, if a person believes CBD is treating his or her particular ailment, the person may not get safe and effective medical treatment that could do a better job.


If you are a believer in CBD or looking to try it as an alternative therapy in conjunction with prescribed medical treatments, make sure you are consulting your physician first to discuss whether it is something to be considered.

Until the FDA looks closely at each individual product and medical scientists further study long-term efficacy and safety profiles, there may be unknown risks.  So if you are going to consume CBD do so with caution and not in large quantities.