When David Sparer arrived at his Airbnb in Venice, Italy, he encountered an unsurmountable challenge: the spiral staircase. He was debilitated by his arthritis. His friend, the founder of Los Angeles–based cannabis company the Clear, gave him some cannabidiol (CBD) to put under his tongue and on his feet. The next day, Sparer toured all around the city with less pain than he’d had in 10 years on Naproxen, a powerful anti-inflammatory that significantly damaged his liver.
He was converted to the powers of CBD.
Soon thereafter, Sparer gave up his 35-year career and high-profile position at a Fortune 500 company to help expand the Clear. His 28-year-old son, who was diagnosed wtih epilepsy since he was 2 years old, is now taking the Clear’s cannabidiol tincture to manage his seizures. His 88-year-old mother swears by the CBD balm for her arthritic knee. And his brother, who had stage III Hodgkin Lymphoma, found relief from his nausea using the Clear’s products.
“We know the many different conditions that are helped by CBD, but the thing that’s crazy is that this is one molecule,” Sparer said. “It’s really exciting stuff for us to be involved in.”
In recent years, according to Sparer, the Clear has provided its products to two prominent East Coast universities for cannabidiol research: one for a FDA-approved double-blind epilepsy study and one to try to gain some understanding of how CBD works in the brain.
This research follows an easing of restrictions on CBD by the Drug Enforcement Agency in December 2015. Yet the legal status of cannabidiol remains nebulous, much like cannabis itself. The molecule — which is entirely non-psychoactive — is legal in all 50 states but remains federally classified as a Schedule I substance with “no currently acceptable medical use” because it comes from the cannabis plant.
“Marijuana has been around for a long time, but like a lot of other things, once it’s prohibited then it loses the ability to be researched appropriately,” said Ventura Orthopedics pain specialist Dr. Kamyar Assil. “I think we lost many years of being able to use a potential agent that naturally grows out of the ground.”
Assil estimates that 10 to 20 percent of his patients use cannabis for relief, but when he is prescribing medications for arthritis he is limited to Tylenol and nonsteroidal anti-inflammatory drugs such as Naproxen, which can seriously damage organs, or opiates, which have a high potential for abuse. This is why physicians continue to be interested in novel pain treatments such as CBD. But there’s a significant gap between the anecdotal evidence about CBD and the types of large-scale, double-blind studies needed for acceptance by the medical community.
“Unfortunately, the information on the use [of cannabinoids] in rheumatoid arthritis and other types of inflammatory arthritis is quite limited,” said Eric Ruderman, M.D., clinical practice doctor, rheumatology, at Northwestern Memorial Hospital. “They certainly warrant future research, but the existing data doesn’t really support their use at this time.”
Currently, there is only one published, placebo-controlled trial using a THC- and CBD-based oral spray for rheumatoid arthritis, and the data reported was incomplete. There have been a number of studies treating arthritis in rodents with cannabinoids, but these are only the beginning of much-needed additional research. There’s also been talk among multiple sclerosis experts about the potential of cannabis for managing pain, tremors and spasticity, but the studies are similarly preliminary.
The first FDA-approved CBD medication likely will be for epilepsy. GW Pharmaceuticals, a British company specializing in cannabis-derived medicine, is in the last phase of promising, FDA-approved clinical trials for Epidiolex, a CBD oral solution for reducing seizures in treatment-resistant epilepsy patients.
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“I have spent three years pursuing CBD for epilepsy because I saw potential,” said Orrin Devinsky, M.D., of New York University Langone Medical Center’s Comprehensive Epilepsy Center, who is a GW Pharmaceuticals investigator. “There is definitely a huge need for more effective and better tolerated medications.” According to Devinsky, a third of epilepsy patients continue to have seizures that impair their quality of life despite available therapies.
This was the case for Sparer’s son before he began taking CBD. He was experiencing seizures every four to six weeks, which lasted for hours. About four months ago, Sparer's son began taking two drops of CBD oil on his tongue daily. He hasn’t had a seizure since, Sparer says. His doctors are slowly increasing his CBD dose and decreasing his other meds in the hopes that eventually he’ll manage his seizures with only CBD.
This requires precision. This is why, Sparer says, the Clear, unlike some CBD manufacturers, has a team of scientists using specially made equipment that ensures every product is accurately labeled by dose. The company has created all its own protocol as the manufacturing of cannabis products, including CBD oil, continues to be illegal and entirely unregulated in California until Proposition 64 goes into effect on Jan. 1, 2018.
“If we’re going to treat a serious illness, we need to know that the product is good and we need to know the molecule is good to treat that particular thing,” Sparer said. “And most doctors aren’t going to touch anything until the FDA puts their stamp on it — that’s just the way it is.”