The future of alternative medicine: Lets talk about cannabidiol

The use of cannabidiol (CBD) for medical conditions in veterinary medicine-most commonly for pain, anxiety and epilepsy-seems to be the most talked-about area of medical therapy at the moment. And it's no wonder: a recent survey showed that 29% of veterinarians reported they got a weekly inquiry about CBD from their clients. Twenty-seven percent were asked about it monthly and 7% were asked daily.

Yet the same survey showed that less than half of these veterinarians were comfortable talking to their clients about CBD products. Since that survey was conducted, the number of people asking about CBD products has probably grown exponentially, especially after hemp-derived CBD was removed from the Schedule I list in December 2018.

What's the big deal?

First of all-and this is an important distinction-CBD products can come from either hemp or marijuana. Although they may look alike, those CBD products derived from marijuana are still Schedule I and illegal to use. In other words, it can put your DEA license at risk. (In California, veterinarians can legally discuss marijuana use in patients with their clients, but they can't prescribe it or use it in treatment.)

Always ask for the source of the CBD (licensed hemp grower, not marijuana grower) before buying, dispensing or recommending a particular product, should you be inclined to do so. On the human side, dispensers of marijuana-derived CBD are being pursued aggressively in some states-most notably Texas, Ohio and Nebraska.

Federally, CBD oil from hemp with less than 0.3% 19-tetrahydrocannabinol (THC), the psychotropic part of marijuana (and possibly hemp as it contains small amounts), is legal. The real issue is that many states have not caught up with their own legislation regarding the use of CBD from hemp. Some states have been more aggressive in enforcing their laws than others.

On the human side, it's usually OK to dispense CBD as long as it's not dispensed as a drug, no medical claims are made, and it's not part of a dietary supplement or added to food. Of course, in some states, CBD from marijuana is a legal human drug. To make it more confusing, on the veterinary side, animal supplements are not regulated by the FDA, so there's no prohibition on the federal level against using CBD as an animal supplement.

Taking it state by state

The following is a list provided to me by Stacey Evans, JD, an independent legal consultant who works with ElleVet (a provider of hemp products that contain CBD) as well as individual veterinarians. It's important to note that when a state veterinary medical association (VMA) says CBD is illegal or cautions against its use, the association might be wrong. The issue of whether the CBD comes from hemp or marijuana has muddled the declarations of several state VMAs, as has the fact that many prefer to err on the side of caution. This list is accurate as of right now, but it could change at any moment. Please contact your state VMA for any updates.

California VMA cautions veterinarians against selling or administering hemp.

Michigan VMA cautions that veterinarians face increased potential legal risk if there is an adverse event.

Connecticut VMA states that it was told by the Connecticut Department of Consumer Affairs that CBD is illegal for animal use.

Oregon VMA states that it shares with members the FDA's position that hemp products with CBD are unapproved animal drugs.

Illinois VMA provides an AVMA memo about not making any claims that CBD can treat, cure, prevent or mitigate a medical condition or disease.

Oklahoma VMA states that although legal, veterinarians may face increased liability when CBD is used to treat animals.

The following state VMAs have no comment one way or the other: Colorado, New Jersey, Kentucky, Washington, Maryland, Minnesota, Florida, Texas, Louisiana, New York and Pennsylvania.

Want to consider one more layer of legal confusion? A product that doesn't make claims or intend to treat, mitigate or cure a medical condition doesn't automatically become a drug if a client or a veterinarian administers the product to an animal to treat, mitigate or cure a medical condition. Nor is a product a drug just because it contains an ingredient, such as CBD, that's also used in another FDA-approved drug. Such a product is an animal supplement, which the FDA does not regulate.

Once each state government actually passes legislation, most if not all legal issues should be resolved. My advice is to ask your state VMA to push for CBD legislation for animals so you don't accidentally break the law during these confusing early days of CBD use. And for the time being, to be safe, never ever make a claim that it can treat a medical condition or disease or use a product whose packaging makes such a claim.

Dr. Michael Petty owns Arbor Pointe Veterinary Hospital, Canton, Michigan.