ACVC 2019: Veterinarians: Get involved in the cannabidiol conversation
The cannabidiol (CBD) conversation is in full swing in veterinary practices across the country, and its time for veterinarians to chime in.
A recent survey from Colorado State University showed that about 30% of veterinarians are questioned weekly by clients about CBD. And an informal poll of the audience at the opening Veterinary Crossfire session at this year's Atlantic Coast Veterinary Conference (ACVC) showed the vast majority are receiving regular questions about this issue.
But how do you answer questions and advise your veterinary clients on this issue when the use of these products, even in the human world, is mired in legal confusion? The answer, according to the panelists, is very carefully, and it depends on which state you're in.
Charlotte Lacroix, DVM, JD, founder and CEO of Veterinary Business Advisors, and Robert J. Silver, DVM, MS, CVA, chief medical officer of Rx Vitamins for Pets, kicked off the 2019 ACVC with a spirited discussion on the currently confusing world of CBD use in pets.
Drs. Lacroix and Silver agreed in a few areas, including their view of the 2018 federal Farm Bill, which removed hemp from the Controlled Substances Act. That action was designed to to help speed up the commercialization of hemp, but it has led to more states making CBD use legal in humans, primarily when it's used for therapeutic purposes. However, as far as veterinary use goes, CBD as a therapy remains off limits.
Medication or supplement?
Dr. Silver noted that supplements, which are often used to improve overall health, are not approved by the FDA, so veterinarians could consider recommending CBD as a supplement. But Dr. Lacroix cautioned veterinarians about this thinking.
“If there is an adverse event [related to CBD] and it comes back on you as the veterinarian who recommended it therapeutically, you could be facing a medical malpractice lawsuit,” she said, “and you may not have the malpractice insurance needed to protect you.” She added that in most cases CBD is given to pets not to boost overall health but rather for therapeutic purposes, such as to treat anxiety or epilepsy, and this use is not legal.
Dr. Silver countered that the number of adverse reactions related to CBD in animals reported to the National Animal Supplement Council, which has been looking into this complex issue, has been extremely small-about nine in 16 million (mainly gastrointestinal disturbances). And emerging data show that CBD use in animals can have benefits, he noted, citing a Cornell University study demonstrating that dogs with osteoarthritis who were given CBD had noted pain reduction.
Let the research continue
Both panelists agreed that CBD is in an “evolutionary phase” and that more data are needed.
“It's important to have these clinical studies and encourage companies to invest in the research to establish the safety of [CBD],” Dr. Lacroix said. “It's tempting to get on the band wagon and sell it like everyone else … but our decisions are based in science. The FDA is the administrative agency that demonstrates that a product is safe and effective, and until that has been done, I don't think we can promote these products for therapeutic means.”
Dr. Silver echoed Dr. Lacroix's call for more research, adding that “veterinarians are being left out of the conversation.” He urged attendees to talk with their state veterinary associations to become more involved in these conversations, encourage more research, lobby for clearer direction on CBD use and provide further direction on what veterinarians can and cannot discuss with their patients.