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Q&A: Three Questions for Sanjay Gupta on CBD

On Sunday, CNN will air Gupta’s fifth documentary about cannabis as medicine. Cannabis Wire caught up with Gupta to learn more about his thoughts on the so-called CBD craze and forthcoming FDA regulations.

Published on Sep 27, 2019 6:50AM EDT Q&A

Co-founder of Cannabis Wire.

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In 2013, long before most Americans had heard of the now-popular cannabis compound called cannabidiol, or CBD, CNN’s chief medical correspondent Sanjay Gupta wrote an op-ed called “Why I Changed My Mind on Weed.” The piece was released with a documentary called WEED, which focused on a young girl in Colorado named Charlotte Figi. Her seizures from epilepsy were reduced when she consumed a high-CBD cannabis oil produced from a type of cannabis that was later named after her, Charlotte’s Web.

Since then, Gupta and CNN have produced several more documentaries in the series, for which Gupta has traveled the world to learn how cannabis research is unfolding in places like Israel, and what lessons could potentially be considered here in the US, where the federal government still does not classify cannabis as medicine while more than 30 states have. And on Sunday, the fifth installment will air, called WEED 5: The CBD Craze.

The timing makes sense: the 2018 Farm Bill signed into law just under one year ago legalized hemp across the US, and CBD is abundant in hemp. Cannabis Wire has been closely following the proliferation of CBD products, and the debate among the Food and Drug Administration, the hemp and CBD industries, state regulators, and other stakeholders, as the FDA prepares to unveil its regulations for the booming CBD product industry. (Catch up on all of Cannabis Wire’s CBD-related coverage here.)

Cannabis Wire co-founder and editor Nushin Rashidian caught up with Gupta to learn more about the latest documentary, and his thoughts on forthcoming FDA regulations that will determine the future of the so-called CBD craze.

“I don’t think it should just be pharma route,” Gupta said about the CBD regulations under consideration by the FDA, which will determine whether the compound can be in food and supplements, or only in pharmaceuticals.

(This interview has been edited for length and clarity.)

Nushin Rashidian, Cannabis Wire: What is the central thesis or focus of WEED 5?

Sanjay Gupta: I think the big focus is all that has happened right before the Farm Bill and now after the Farm Bill, and the consumer confusion around CBD in terms of legality. People have referred to this as a CBD craze sort of time period. We wanted to try and look at what has happened over the last couple of years and to try and make sense of that for the consumer.

Rashidian: Looking back to 2014, people were just learning about Charlotte’s Web, and now I can’t turn a corner in Manhattan without seeing CBD somewhere, mainstream stores and otherwise. Has any aspect of how CBD has taken off surprised you? Did you see this coming? What’s your general feeling about how prevalent CBD popularity is?

Gupta: For people following it over the last couple of years, it’s been a pretty abrupt turnaround, that’s what they feel like. They couldn’t say the word, they didn’t know what CBD was exactly around that time, 2013, 2014. And now, as you say, it’s available everywhere. I think there are some concerns with that, frankly. When we talked about Charlotte, when we were representing that work, it was always around the medicinal aspect of this: Why couldn’t this be studied like any other compound? What were the barriers to that?

There was enough evidence, I think, real evidence, some of it from other countries, that would at least make the research around this seem to have a pretty good path forward, and yet it wasn’t happening. I think when it suddenly became much more available on the botanical or supplement side without any significant regulation around it we were concerned. And I think some of those concerns have born out that you could have some of the bad things happen, you could have some unscrupulous actors enter the scene, and people even getting sick. So there was concern with how this has gone forward.

The idea that cannabis is a medicine—there’s now not only data behind it but an FDA-approved drug behind it—it’s still very much true. And that sometimes it can work when nothing else has, that’s very much true. But how this has unfolded over the last couple of years has caused a lot of confusion.

And I’ll say one other thing. I think the CBD thing, CBD as a compound, sort of became a convenient political narrative. You know, it’s the stuff that you don’t necessarily have to inhale, it helps little kids with seizures. It wasn’t hard to rally behind, but that was never the complete story either. And the idea that somehow, maybe unintentionally, I don’t know, the other compounds in cannabis, including THC, have been sort of re-vilified through all this I think is also real. I don’t want to assign intent to that but I think the outcome is what it is. It’s like, “Well, we’re supporting CBD.” CBD is not cannabis. CBD is not the entire plant. And there are potentially medical benefits from the rest of the plant.

Rashidian: The FDA has an interesting challenge right now. The FDA is under pressure from industry. There are people who want this compound in foods. There are people who want this compound in supplements. There are people who want this compound on the shelf for people to consume. At the same time, cannabidiol is part of an approved pharmaceutical. CBD does things to the body. What do you make of the challenge facing the FDA right now, as they have a decision to make on CBD regulations in the next few weeks. People want this. It’s already on shelves. But it’s a prescription drug. How do you think about that, as a doctor?

Gupta: There’s plenty of supplements out there and the supplement market has been pretty unregulated. And I think that that’s been a concern aside from from CBD. When we think about regulation, I would say that there’s three phases to trialling these things from a pharma standpoint, which is: one, to prove that it’s safe, two, to prove that it’s effective, and three, to see how it compares to other existing therapies. I don’t know that I would necessarily say that CBD has to receive the same sort of approvals as pharma by any means. I think that’s not practical. It’s very expensive and that would certainly make it not available to people more widely.

But I do think it needs to be shown to be safe, so at least the first phase of that. We were at some of the FDA public hearings that they had back in May, and I think that was issue number one. There are some unscrupulous actors in this space. These people, whoever they are, I mean, when they say it’s the Wild West, that’s what it sort of looks like, because they’re taking advantage of the absence of regulations to pump out cheaper, sometimes entirely synthetic, and sometimes dangerous products in the market.

I think that consumers have to be able to know if they’re buying what they think they’re buying, and it’s a legitimate product. And I think there needs to be education. What about the impact on the liver? What about the impact on you if you take the other medications, like a statin medication or some other medication that’s also metabolized by the liver? People should be knowledgeable about that. But I think the question you’re asking, and I’ve thought long and hard about it: I don’t think it should just be pharma route. I think both routes can exist, pharma and the artisanal-slash-botanical-slash-supplement route. As long as you can give people some confidence that what they’re buying is what they think it is, and that it’s safe.

On Sunday, CNN will air Gupta’s fifth documentary about cannabis as medicine. Cannabis Wire caught up with Gupta to learn more about his thoughts on the so-called CBD craze and forthcoming FDA regulations.

CBD ENDORSED BY DR. SANJAY GUPTA ON CNN FOR SEIZURE DISORDERS

I have previously written about using cannabis for seizure disorders. I thought I would share some of my recent experiences and some knowledge I have gained in particular as Dr. Sanjay Gupta will be sharing his views and experience with Cannabidiol and seizures. This is a new position for Dr. Gupta that he will share with the public this Sunday evening on CNN at 8 PM PDT. Be sure to tune in and read on to read some of my own recent experiences with rich CBD oils/extracts in childhood seizures.

To begin with, overall, the efficacy of rich CBD dosed extracts to help treat seizures, particularly in treatment resistant seizure disorders, is well established. I have seen two children, under the age of 7 in the past two weeks alone, where their seizures, both having 3-4 grand mals per day, go to having less than one limited seizure per week. Can you imagine how this changes the life of the child as well as parents and other family members? It certainly always places a big smile on my face.

The ratio of cannabinoids and dosing is clearly somewhat debated. I know that groups in Colorado are using a CBD dose of 1 mg per pound. I think this is pretty excessive for most kids and have spoken with one mother whose child was becoming sedated. Remember, although CBD may not be psychoactive, the whole plant version of CBD with all the other cannabinoids and minor cannabinoids makes the medicine somewhat psychoactive – particularly in higher doses.

The average daily dose I have seen work very effectively for most kids is around 12-15 mg of whole plant CBD per 24 hours in divided doses. I have seen some exceptional responses even at doses of 6 mg whole plant CBD per day.

There are also some reports where CBD is either not so effective or becomes less effective for some reason. In some of these patients it is probably prudent to add some THC to their daily dosing as it has been reported to help. I would always VERY slowly increase the daily THC by 1 mg every two days.

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