On December 2, 2022, President Biden signed the Marijuana and Cannabidiol Research Expansion Act into law, removing a regulatory obstacle that for half a century has limited medical research into cannabis-derived compounds known as cannabinoids. This legislation will facilitate research into cannabinoids and their potential health benefits.
This bill is an important first step toward ensuring that consumers have access to legal cannabinoid products whose content, therapeutic benefits, and health and safety risks are known. It is long overdue.
The optimistic sentiment expressed in Congress through the new legislation echoes much of our society’s perceptions regarding marijuana. A generation of people have grown up with widespread access to marijuana that in many circumstances is legal under state law. In fact, data show that Gen Z users prefer marijuana over alcohol.
Although the Marijuana and Cannabidiol Research Expansion Act is crucial on many levels, Olympian Brittney Griner’s incarceration in Russia and recent diplomatic release illustrate that we, as consumers, need to be aware of the wide array of laws surrounding marijuana, CBD, and other cannabinoid products. Understanding these laws will allow us to make informed decisions based on the legality of cannabinoid products, and what we know about their safety.
Understanding Marijuana and Its Legal Status
Marijuana is cannabis that contains more than 0.3% of delta-9-THC, the primary psychoactive cannabinoid that produces intoxicating and impairing effects of marijuana. Products with 0.3% delta-9-THC or less are defined as “hemp.” The Food and Drug Administration (FDA) has determined that many forms of hemp are safe ingredients when manufactured as permitted by law, and these may be used in a wide variety of food products.
Federal law, however, prohibits the manufacturing, distribution, dispensing, or possession of marijuana. It has not been approved as a drug by the FDA, and currently has no accepted medical use under federal law. But state laws are another story. Currently, more than three-quarters of U.S. states have legalized marijuana in some capacity. For adult use, marijuana is legal in 21 states and in Washington, DC. Marijuana is also legal for certain medical uses in 38 states and in Washington, DC.
Typically, the federal government does not enforce federal marijuana law when consumers comply with state law. This is because federal law enforcement focuses its efforts on criminal networks involved in illegal marijuana trade, not on state-authorized activities. In addition, since 2014, Congress has enacted laws prohibiting the use of federal funds to prevent states from implementing their own laws that permit marijuana manufacturing, distribution, and possession. Brittney Griner taught us that traveling abroad with cannabinoids is highly risky.
Marijuana’s Potential Health Effects
Because its illegality under federal law has created difficulty for researchers who want to study marijuana, its complex pharmacology is still not fully understood. However, some research shows that cannabis use can have positive health benefits.
Marcel Bonn-Miller, PhD, a substance use disorder specialist at the University of Pennsylvania Perelman School of Medicine, pointed out that, “The greatest amount of evidence for the therapeutic effects of cannabis relates to its ability to reduce chronic pain, nausea and vomiting due to chemotherapy, and spasticity [tight or stiff muscles] from MS.”
Limited research also suggests that cannabinoids may reduce anxiety, stimulate appetite, and improve weight gain in people with cancer or with AIDS.
Although this research is promising, patients with certain chronic medical (including mental health) conditions may elect to self-medicate with marijuana, that is, use it for therapeutic reasons without having received full information about it. Such use may be satisfying, but it may also increase the risks of adverse effects, drug interactions, and substance use disorder.
The health risks linked to marijuana use may include lung damage, an increased risk of stroke, heart disease, and other vascular diseases. Mental health may also be impaired with use of marijuana, which has been linked to depression, social anxiety, suicidal thoughts, and psychosis. Some evidence also suggests that heavy, regular marijuana use is linked to lack of motivation, social withdrawal, impaired concentration, and compromised occupational achievement. And because marijuana can have depressant as well as stimulant effects on the central nervous system, it has the potential to interact with other drugs, including often-prescribed medications.
Understanding CBD and Its Legal Status
Cannabidiol (CBD) is a compound derived from cannabis and is found in a variety of consumer products. CBD does not have intoxicating effects, but it can cause drowsiness, mood changes, and gastrointestinal distress. FDA-approved prescription CBD is the only legal CBD drug in the United States. Nonetheless, many CBD products of unknown quality are being marketed with medical claims. Under U.S. law, it is illegal to market CBD as a food ingredient or a dietary supplement, but the FDA is only enforcing this law in the most extreme cases of misinformation.
It is necessary for Congress to specify how the FDA should regulate CBD food ingredients and dietary supplements so that these products may be marketed to consumers legally. CBD-containing cosmetic products, such as skin moisturizers, shampoos, and deodorants, are already legal if they are safe and contain 0.3% or less of delta-9-THC.
The Bottom Line
The Marijuana and Cannabidiol Research Expansion Act will go a long way toward ensuring that consumers have legal access to cannabinoid products that contain safe and effective ingredients. New research will help consumers fully understand the benefits—and the risks—of cannabinoid use.
But right now, there are still many unknowns about how cannabinoids could hurt and help people. Scientists will not understand the full picture for many years. In the meantime, consumers must protect themselves, by knowing the law, recognizing the inadequacies of current science, and weighing the risks.
