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CBD is all the rage among patients. It’s launching their physicians into uncharted territory


(Stat) – Corner-store cannabidiol “scares the bejesus” out of Dr. Jacqueline French.

French, a neurologist at New York University’s Langone Health, tries to steer her patients away from sprinting to the neighborhood bodega to buy versions of the hemp derivative that’s better known as CBD.

She, like so many other doctors around the country, is torn — on the one hand, there’s scant guidance for how to treat a patient with a CBD supplement, and there are few reputable sellers who can guarantee what they’re selling. There’s not nearly as much science behind those products as with a typical prescription medicine. On the other hand, there is one FDA-approved drug based on CBD, fully cleared based on the agency’s rules for safety and efficacy, with dosing information at least for the patients who have the two types of epilepsy it treats.

“The last thing that you can do is tell them, ‘Don’t do it,’ because that doesn’t work. You can say, ‘Here’s what I know, and if you decide in any case to do it, please let me know,’” French said. “You have to keep them in the discussion and go with them the best that you can. … The buzz and the intensity of the desire of people to take it is so great.”

French, like so many other doctors around the country whose patients are clamoring to try the supplement, is in uncharted territory.

More than half a dozen neurologists and other physicians around the country spoke with STAT about the difficult decisions and even headaches that CBD — sometimes a supplement, sometimes a drug — and its booming popularity have created for the medical community. Should they encourage a treatment that may not work but also may not hurt their patients, if it gives them hope? Or should they reject any treatment out of hand that hasn’t been proven effective?

For those doctors that do decide to “prescribe” CBD, there’s a whole new set of questions. How can they help a patient get a safe product in a largely unregulated market? How does a doctor dose CBD? And exactly what should that doctor monitor after the patient starts treatment?

“It is [as] if suddenly Prozac was a dietary supplement,” French said.

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