Does CBD oil get you high? 8 things to understand as Virginia marijuana legalization considered

Monique Calello Staunton News Leader

VIRGINIA – News Leader reporter Monique Calello talks with Jenn Michelle Pedini, executive director of the Virginia chapter for the National Organization for the Reform of Marijuana Laws to answer Virginian's most pressing questions on cannabis in the Commonwealth.

Calello: You said the language changes as people get comfortable with those changes, such as low percentages to authorizing full therapeutic-strength products; CBD (cannabidiol) oils to any formulation. Let’s start with basic language.

Do we say CBD and THCA or medical cannabis? 

Pedini: CBD, THCA... People don’t understand what it means and it’s confusing. In the beginning when the law was passed in Virginia in 2015, people started writing about it based on its limited scope. People started writing about it based on Code (Virginia laws).

CBD oil, THCA – those are defined. These cannabinoid contents are there, initially established, to protect patients from snake oil.

Jenn Michelle Pedini, executive director of the Virginia chapter for the National Organization for the Reform of Marijuana Laws (NORML).

Mariah Miranda/Submitted

Now we are getting to the point where the processors are opening, and we are making sure we get everything right. That means making sure patients have access to full therapeutic-strength medicines.

If we aren’t doing that here then patients are going to continue to commit federal interstate drug trafficking or engage with the illicit market.

We have the ability to safely regulate and dispense full therapeutic-strength medical cannabis products. We can do it, so let’s do it.

You can get CBD oil from pharmaceutical processors expected later this Fall, but that’s not all.

CBD oil is a subset of medical cannabis. It’s like saying, "I’m going to go to the store and get milk." Okay, what kind of milk are you going to get? There’s a whole lot of milk to choose from.

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Let’s call it what it is – medical cannabis. Because that’s what it is.

That’s a much broader term than simply saying CBD oil. Medical cannabis can include products like CBD oil, but it’s not limited to that type of product. It’s very narrow to say CBD oil when that does not accurately describe all of the products that this program will include.

CBD oil, number one, implies that it’s oil only, and number two, that there’s no THC. And there is. Virginia’s program is much broader than that.

We won't use percentages for final products anymore because that was very confusing. Percentages are relevant to the pharmacist and extractor.

So we changed all of that with Senator Dunnavant's SB 1557. People understand what therapeutic-strength means. Prior to the senator's bill this year, the medicines were very limited in scope. Prior to being able to deliver full therapeutic-strength, the oils were nonintoxicating.

People are reading: Virginia medical cannabis to expand to full therapeutic-strength products

Does medical cannabis oil get you high?

Pedini: Medical cannabis can be intoxicating to some users in certain amounts. It’s important that we keep in mind that pharmaceutical drugs come with a variety of side effects and intoxication levels. That’s an important comparison.

Hemp oil is rich in anti-oxidants and other nutrients, and has large amounts of CBD (cannabidiols), a compound with significant medical benefits that does not make people feel “high.”

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Is medical cannabis as intoxicating as oxycontin? Of course not. There are a lot of drugs that people take that they substitute with medical cannabis because it’s far less intoxicating and doesn’t come with the same side effects. It doesn’t come with the potential of abuse or overdose or fatality.

So when someone asks if you get high we’re not asking that about other drugs. I think that’s a very inappropriate thing to hang on medical cannabis.

And if it is intoxicating, why does that matter? That standard doesn’t exist for any other drug

Let's look at the example of child with a seizure disorder who is now on a medical cannabis preparation.

Often students are able to use medical cannabis as their rescue medicine for seizures. Prior to using medical cannabis, or they’re not able, their rescue medicine was Diastat, a high dose of valium in suppository form.

Let’s talk about intoxicating! Now that patient will have a choice of a cannabis nasal spray as opposed to a suppository medicine.

Imagine being a 13-year-old child who has a seizure in class. What’s going to be less disruptive for the child? A nasal spray that may at best be mildly intoxicating or a suppository that’s going to be embarrassing, probably feel like being violated and clearly intoxicating.

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We’re not applying the same standard because it comes from a plant someone might  have weird feelings about? What are your feelings about high doses of valium delivered rectally?

This is the current rescue therapy when a child has a seizure in class. The emotional trauma of that has got to be extraordinary. It’s traumatic enough to watch anyone have a seizure.

This intoxication standard does not apply to other medicines.

If you don’t think medical cannabis is appropriate for you and your child, don’t use it. Families are coming together and feel it’s a safer alternative.

If a physician feels that this is an appropriate treatment for a child then that’s between the physician, parent and patient, period. Physicians are in the best position possible to help make these decisions.

If it is intoxicating, how is a student taking medical cannabis oil for back pain supposed to be able to function in class?

Pedini: How is a student who is taking oxycodone for back pain supposed to be able to function in class? If a student is using this medicine it is far less intoxicating.

People generally prefer medical cannabis formulations because they are less intoxicating and have fewer side effects than the pharmaceuticals they were taking otherwise. It’s not going to kill you, and it doesn’t have the same potential for detrimental side effects.

A very small percentage of people have bad feelings about this plant juice. Ninety-four percent of Virginians support doctor-recommended medical marijuana. It is not a controversial subject.

Calello: People are confused about the difference between CBD sold at their local health food store and CBD that will be available at pharmaceutical processors.

What about CBD sold at health food stores?

Pedini: Those products aren't required to meet any consumer safety standards. It's still very much a buyer beware marketplace. Unfortunately, study after study is delivering similar findings – what’s on the label isn't necessarily what’s in the bottle. Multiple studies have shown that products often do not contain the amounts of CBD that's on the label. Many have been found to contain adulterants.

A VCU study recently found products that contain DXM and melatonin. The belief is that the user wants to feel something when they use the product, so the manufacturer adds an adulterant to produce that sensation.

When products aren't regulated, consumers can inadvertently be harmed. For example, cannabis is a bio-accumulator, and if the soil had heavy metals, those could end up in the final extraction. If a crop isn't being tested for mycotoxins, which come from fungi, those could end up in the final product and cause serious illness.

The testing laboratories also need to be regulated. The growers, extractors – they need to have some consumer standards to adhere to. Most everything we put in our bodies is regulated to some degree.
That’s the difference.

Some products might come from states with a regulatory process in place. It’s not to say there aren’t good actors out there. There very well may be. But how is the consumer supposed to know the difference? Who is looking out for the consumer?

Are people finding relief from CBD products sold at health food stores?

Pedini: Is CBD efficacious in therapeutic doses? Yes, for a lot of disorders it is. But are you getting therapeutic doses at the gas station? It’s unlikely.

Consumer safety standards are important for anything you put in your body, period.

Why legislative changes now?

Pedini: Well public policy is not a one and done. If that were the case, we wouldn’t have a General Assembly every year. As you know, we can’t always get everything we want in one swoop, so sometimes our progress has to be incremental. Often we take the approach of, "Let’s do this and see that the sky doesn’t fall and when you’re comfortable with that let’s come back."

What's next for marijuana in Virginia?

Pedini: In the short term, the five facilities in Virginia will open and registered patients will begin accessing their medicine recommended by their doctors.

That should begin in the second half of the year. Before you know it, it will be November elections and we'll head straight into the legislative session in January where we'll continue working on expanding the medical program.

It's important that Virginia soon transition from the affirmative defense model to a state legal model.

At some point we will also need to expand our regulatory structure to both include our vertical licensees and also allow for cultivation and extraction and retail to be licensed separately just as we see in other states. Patients can also expect to see legislation to allow a more robust product offering.

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On the criminal justice side, we'll continue to forge a path forward for the decriminalization (fines not crimes) of simple possession of marijuana.

Will Virginia ever legalize marijuana?

Pedini: Yes, because we should want to take marijuana off the street corner and put it behind the counter where products can be safely regulated and age verification is required.

The policy in place, prohibition, is failing. It's a poor public policy that allows the illicit market to "regulate" marijuana while not providing for providing for public safety or preventing youth access.