Jan. 8, 2024 – They’re not regulated by the federal government, at least not yet, but a substantial number of Americans reportedly use hemp-derived alternative cannabinoid products.
Some take them to manage pain, others to help improve their sleep. Known more commonly as CBD, delta-8, CBG, and CBN, these products have flooded the marketplace.
Users interviewed for this story recommend caution and encouraged others to find a reputable source or brand and sticking with it.
So how many American adults are using these products?
“We were surprised that over a quarter of Americans used these emerging cannabinoid products in the past year,” said Kevin Boehnke, PhD, a research assistant professor in the Department of Anesthesiology and the Chronic Pain and Fatigue Research Center at the University of Michigan in Ann Arbor.
Boehnke was senior investigator in a study that examined how often and why Americans used these products.
Younger adults and those living in states where cannabis use was prohibited by law were more likely to use CBD, delta-8 THC, and others. These “emerging cannabinoids” contain less than 0.3% THC (the compound in marijuana that makes one “high”) and are currently legal under federal law.
The research reveals almost 12% of adults reported using delta-8 THC in the past year, more than 5% used CBG, and over 4% used CBN. The public health study was published online in December in the journal JAMA Network Open.
Also, more than 21% of people reported using CBD in the nationally representative survey. So, Bill Gould, a 47-year-old real estate agent and songwriter in Temecula, CA, is in good company.
Gould uses CBD in gummy, liquid, or topical forms to help manage his migraines. He also reports better relief using topical CBD to treat "guitar elbow," which is akin to tennis elbow but for musicians. “Compared to other times I have had strains, it definitely seems to help better,” he said.
Gould is concerned about labeling transparency and whether products are the same from brand to brand.
“Some of them are made with [animal-derived] gelatins, some of them are not gluten-free, some of them have an enormous amount of sugar in them. If you have food allergies or dietary preferences, you really have to pay close attention,” he said.
Marsi Thrash, a 54-year-old lobbyist who lives in a suburb of Charleston, SC, agreed. “I buy CBD from very reputable places. I buy it from the local compounding pharmacy, and I've never had any problems,” she said.
The concerns come in part from a young and crowded marketplace where the major players have not yet emerged, she said. “There are so many different brands out there, so many different products.”
“I see all sorts of CBD brands and products. It's definitely overwhelming,” said Jay Valter, a 52-year-old attorney working in the financial sector in Philadelphia.
Concentrations of CBD and THC also differ among products. Regarding the hemp-derived, less than 0.3% THC product, “I would like people to know that you can get it, it's functional, and it doesn't get you loaded,” Gould said. In contrast, products that contain 1:1 concentration of CBD and THC “will get you buzzed” and are more likely found at dispensaries or in clubs versus health stores.
Navigating the Delta
Thrash has tried CBD gummies, but tincture drops placed under her tongue work better and faster for her. She has aches and pains from an autoimmune condition, and the CBD is “very helpful in calming that down.”
Thrash also has a hard time sleeping, and generally, prescription sleep aids leave her with a drowsy hangover the next day, making it more difficult to function. “CBD is the most workable,” she said.
Delta-8 THC, in contrast, is not a good sleep option for Thrash, even though its widely available in drinks and in vape pens in her part of South Carolina. “I don't care for it because it literally sends me into ‘Alice in Wonderland’-type dreams.”
But Valter prefers delta-8 THC to help treat his joint pain and as a sleep aid. “The THC gummies did the trick for me, but the problem was I would often wake up [feeling] stoned,” he said. “That was not particularly ideal.”
He tried different delta-8 products, “and I really like the one I’m using now. It really does the job, and I don’t wake up with any after-effects.” Valter also occasionally uses a topical CBD gel or tincture to ease joint pain.
Better regulations are needed to help protect consumers, said Boehnke, the researcher from the University of Michigan. “This is especially true for delta-8 THC products, which reportedly cause similar effects to delta-9 THC, the compound people generally refer to as THC.”
Stopping for Gas, Beef Jerky, and CBD?
Valter also recommends caution when selecting a cannabinoid product. “I think there's a lot of junk on the market, for sure, especially in terms of CBD,” he said.
Thrash is willing to pay more to get CBD from a more reputable source. “I'm very leery of the $5 stuff you can buy in a gas station. I wouldn’t buy it. Maybe it is the exact same thing – and I'm just getting hoodwinked for a hundred bucks. I don't know.”
“But I want to buy from the person who can tell me exactly where it came from,” she said.
Unlike prescription medications with precise labeling of ingredients, “with the CBD products, there are so many companies making it,” Gould said. “I don't buy janky products from people.”
With no required laboratory testing for safety of these products, such as for contaminants like pesticides, solvents, or heavy metals, Boehnke also urges caution. Likewise, there is no verification to prove these products contain the cannabinoid type and quantity that are on the label, he said.
Also, many cannabinoid products can be purchased online, where minimum age requirements are difficult to enforce, Boehnke said.
An Argument to Relax More Laws?
“The most important finding is that when cannabis is legal in some form in a given state, it tends to reduce or eliminate consumer desire for delta-8 THC products,” said Ethan Russo, MD, a board-certified neurologist and psychopharmacology researcher in Vashon, WA, and founder and CEO of credo-science.com. “This is a clear indication that liberalization of the laws must continue and expand to reduce the public health dangers of synthetic unregulated products.”
Russo, who was not affiliated with the study, said the compound delta-8 THC is not the problem, “but rather its manufacture and production.” All the commercially available delta-8 THC products are synthetically produced from excess stock of CBD, he said. “Virtually none are pure, most often contaminated with a host of other synthetic molecules about which we know little or nothing as to their possible toxicology,” he said.
Likewise, he said there is little scientific evidence to support the benefit of cannabinol, or CBN. Also, he said CBN is a breakdown product of THC, and “its presence on the market is largely a function of providing the industry an outlet and income stream for old, degraded cannabis that is otherwise unsellable.”
On the other hand, Russo said, tetrahydrocannabivarin (THCV), or delta-9, and cannabigerol, or CBG, “are very promising” as therapeutics “and deserve greater attention.”
Russo and colleague Carrie Cuttler, PhD, an associate professor at Washington State University, recently finished a randomized controlled trial of CBG for anxiety “with very positive results. We hope to publish that soon.”
Asked where he would like to take the research next, Boehnke said, “This is a first small step. We’d like to understand how people use these products, why they use them – for example, for medical versus nonmedical reasons – and health outcomes associated with their use.”