Years ago, I was a leukemia patient and bone marrow transplant recipient confronting an extremely difficult decision: Do I continue down an uncontrolled, life-threatening spiral caused by "wasting syndrome" (persistent and potentially fatal weight loss), or do I try an unproven, unregulated, illegal and potentially toxic approach — cannabis?
My oncologist was reluctant to make a recommendation due to the lack of credible information, not to mention safety and legal concerns. But, as a scientist with decades of experience at both research-based and generic pharmaceutical companies, I chose to roll the dice.
I opted to try "medical" cannabis based on anecdotal reports from my hematologist, colleagues and friends, despite my anxiety over inhaling an — at the time — unregulated substance with no evidence-based science to support its use, nor assurances against harmful contaminants. I was fortunate then, and subsequently opted to serve as commissioner on the Maryland Medical Cannabis Commission, in an effort to ensure no one else would have to take such a gamble in deciding on a treatment.
Both my career and my experience as a patient have given me a unique perspective as to how cannabis and cannabis-derived products, like cannabidiol (CBD), should be regulated. CBD, a cannabis plant extract that doesn't cause intoxication, is now being touted as a potential fix for everything from anxiety to inflammation. It's added to lotions, oils and gummies and even sold as an additive for your coffee.
But regulators are beginning to recognize the dangers inherent in our current "anything goes" environment of unregulated CBD products: The Food and Drug Administration held a day-long hearing on the issue last week.
A 2017 paper in the Journal of the American Medical Association (JAMA) highlighted the lack of quality and consistency in CBD products, which poses risks to consumers. Manufacturing standardization in compliance with good manufacturing practice is one of many critical needs. Experts are calling for the creation of a national standard for CBD, while others focus on label standardization and the need to incorporate into the CBD category rules that currently regulate dietary supplements, foods and cosmetics. I strongly agree with these experts.