April 17, 2019
Judy Beck has tried many painkillers in her decades-long search to alleviate severe pain.
"I was on the gamut of opiates for over 20 years," Beck said. "You name it, they had me on it."
Beck, 66, of Northeast Philadelphia, has battled severe pain from various ailments over the last two decades, including fibromyalgia, lupus and a failed cervical fusion.
Numerous medications only ever relieved about 50 percent of her pain, she said. And oftentimes, the opiates left her walking around "in a fog."
In November 2017, Beck's son, Michael, urged her to try cannabidiol, or CBD, the non-psychoactive chemical compound extracted from cannabis plants, including hemp. Products with CBD have grown into a soaring industry, one that could approach $1.3 billion by 2022.
At first, Beck resisted, figuring CBD would have little effect on her pain. But she eventually relented – and became a big believer.
"To tell you the truth, I have never felt better since I have been on the CBD oil," Beck said. "It's just tremendous. I can't say enough about it."
A variety of CBD products has cut her pain by 70 or 80 percent, Beck said. She has returned to shopping, walking her dog and going out with friends – activities she mostly had eliminated.
She's not alone.
Legions of Americans attribute CBD products to remarkable turnarounds in health. With a lack of scientific studies, anecdotal accounts make up most of the evidence supporting CBD as a therapeutic substance, for now.
But don't discount that growing body of anecdotes, says Sara Jane Ward, a preclinical researcher who has studied CBD for the last 12 years at Temple University's Lewis Katz School of Medicine.
"I think it's really important to listen to these people and to learn what they're saying," Ward said. "We need to try to learn about the different strains. What are people using when they're reporting these positive effects? What, specifically, is the indication that they're saying it's improving?"
Federal restrictions on cannabis have contributed to that lack of scientific research on CBD, though studies on animal models suggests it may have therapeutic value.
Proponents claim CBD helps soothe anxiety, regulate mood and improve sleep – all without the psychoactive effects that can accompany medical marijuana. Others say it suppresses muscle spasms and alleviates inflammation, chronic pain and arthritis.
Meanwhile, the U.S. government mostly has left the CBD industry unregulated, prompting challenges about marketplace transparency and product standards and safety.
No federal agency is tasked with regulating the contents, or the claims, of CBD products. Some products have proven deceptive, containing no CBD at all or illegal amounts of tetrahydrocannabinol – the psychoactive compound better known as THC.
Nevertheless, the industry is growing rapidly and people across the Philadelphia region have turned to CBD products in hopes of remedying all sorts of ailments.
Evan Harden began using CBD products after his workouts following an introduction to the founders of Soothe, a Philly-based retailer.
"It just eliminates the sharp pain; it makes it more subtle. I would say I still have pain, but just not as severe." – Sarah Heffner, CBD user
"It's helped me with my recovery," said Harden, a 30-year-old personal trainer. "It helps me with my mood. It helps me with any type of inflammation or soreness. And sleep."
Harden, a Philadelphia resident, founded The National Bar League, an organization that hosts bar calisthenics competitions. He engages in strenuous physical activity nearly every day – historically without taking many supplements.
Occasionally, Harden said he would use Icy Hot or similar products to soothe aches and pains. But he now prefers the CBD products.
Harden uses Soothe's topical cream and its recovery mix – a powder that can be added to shakes, smoothies and other beverages – to alleviate various aches caused by his workouts. He also has used CBD drops – placed beneath the tongue – to boost his mood and help his sleep.
"I do like the workout recovery (mix) for how I feel after I work out," he said. "I wake up and I feel ready to get after it again."
Similarly, Sarah Heffner uses CBD to battle chronic foot pain that, at its worst, forces her to hobble out of bed in the morning. As a bartender and former ESL instructor accustomed to standing for long periods, that presented a challenge.
"It was getting to the point that I would wake up and I couldn't even get out of bed without my feet really hurting," said Heffner 33, of Philadelphia. "You kind of wobble out of bed. I was so stiff."
About six months ago, Heffner tried CBD for the first time. She purchased a salve at Anthology Wellness in Northern Liberties and began applying it to her Achilles heel before falling asleep. It has helped her walking.
"It just eliminates the sharp pain; it makes it more subtle," Heffner said. "I would say I still have pain, but just not as severe."
Others credit CBD products with helping calm their anxiety.
Kayla, 22, of Montgomery County, began vaping CBD oil last August after an Instagrammer touted its benefits for anxiety. She said she quit taking Prozac and Lexapro, anxiety medications that interrupted her sleep and gave her nightmares.
Kayla, who asked that PhillyVoice withhold her last name due to an ongoing job search, said CBD oil reduces her anxiety when taking tests and driving, among other situations. She said she has had previous panic attacks that sent her to the emergency room. But she hasn't had any since transitioning to CBD oil.
Several times each day, Kayla said she will take a couple of hits of CBD oil from a 200mg vape pen. Each pen generally last her four to six weeks.
"It changed my life," she said. "I used to smoke the Juul. ... I just completely quit that. I'll wake up and I'll take two hits of my pen. I just feel ready to conquer the day."
Success stories like these abound. But there are other people who have used CBD products with little effect.
And in an unregulated industry, where transparency is lacking and products can exceed $75, some wonder whether CBD oil is simply snake oil in disguise.
Three years ago, the U.S. Food and Drug Administration tested several CBD oils. It found that some contained little, if any, CBD while others exceeded the 0.3 percent THC limit. Some did so egregiously.
Late last month, the FDA and the Federal Trade Commission urged three CBD companies to cease making "unsubstantiated advertising claims" on their products. The companies allegedly had touted unfounded claims about their effectiveness in limiting, treating or curing a number of serious illnesses, including cancer, autoimmune diseases and opioid use disorder. (Yet, opioid use disorder was added to New Jersey's list of qualifying conditions in January 2019, as long as the patient is undergoing medication-assisted therapy.)
Still, there is plenty of scientific research indicating that CBD has therapeutic effects, according to Ward. Right now, it mostly remains limited to animal studies.
"By and large, the vast majority of the research out there in that space is extremely positive," Ward said. "There is a lot of enthusiasm from the research community about the therapeutic potential of CBD for the treatment of diseases needing neuroprotection and anti-inflammatory effects and things like that."
Clinical trials on cannabidiol mostly have been limited to those conducted for the epilepsy treatment Epidiolex, the first CBD-based drug approved by the FDA. Additionally, some smaller trials suggest it may help treat anxiety and schizophrenia.
But more studies are needed.
"The majority of human research is still on whole cannabis ... just assessing the long-term effects of chronic marijuana smoking or, more recently, focusing on patients using medical cannabis," Ward said. "There have been lots of studies looking at just THC, but relatively much fewer studies looking at purely the effects of CBD in patients."
A limited number of studies suggests that for CBD to have any effect, it may have to be taken in at least 300 milligrams per dose – way more than the standard dosage listed on many products.
"We know those doses work, but we don't know that those lower doses failed to work," Ward said. "And we don't know the different doses for different indications."
Still, Ward estimated researchers could have a more complete understanding of CBD within as little as five years, thanks in part to the 2018 Farm Bill. Passed in December, it legalized hemp-derived CBD and included provisions for expanding hemp research. To Ward, that makes CBD research "infinitely more doable, fundable, approvable."
"...I steer people toward the medical cannabis. Because I have a very good idea of knowing what's in there." – Dr. Brooke Worster, Jefferson Health
"Then it will have to be motivation from these companies and a desire from the consumer to have this more rigorously tested so that we can answer these questions about safety, efficacy, dose," she said. "My expectation is that there's going to be an explosion (of research) in the next few years."
Before using CBD products, Ward said people should consult their doctors, particularly to ensure it will interact well with any medications they're already taking.
Still, several Philadelphia physicians who certify medical marijuana patients said they strongly favor using medical marijuana over CBD products, partly due to the lack of research.
"People spend a lot of money ordering stuff off the internet and say, 'I don't think this did anything,'" said Dr. Brooke Worster, who runs a medical marijuana clinic at Jefferson Health. "I say, 'I can't confirm that there's actually any CBD in it.' That's why I steer people toward the medical cannabis. Because I have a very good idea of knowing what's in there."
Despite the Wild West vibe of the CBD industry, some companies have attempted to maintain accountability.
Soothe, the Philly-based company, is careful not to make any unsubstantiated claims about its various CBD products, which include edibles, vapes, topicals and tinctures. Management takes the matter so seriously it distributes a set of compliance guidelines to social media influencers touting their products online. Influencers are urged not to claim Soothe products can cure, treat or prevent their ailments. Rather, they are encouraged to say that it regulates mood, alleviates discomfort or promotes gut health.
"We stay away from any terminology that could be misconstrued," co-founder Brandon Bahr said. "That's a huge thing the industry, as a whole, lacks. Ninety-five percent of companies are extremely noncompliant. You literally can't even say the word 'pain.'"
Soothe mostly sells its products online, though Bahr and co-founder Alex Grimm plan to open a retail outlet in the River Wards section of Philadelphia. Unlike many companies, Soothe provides detailed descriptions, including ingredients, and lab testing results for each product.
"We initially got into the industry because we were consumers of cannabis, but CBD in particular," Bahr said. "There was not much research on the market. There was not many ways to prove that a product was good."
"We're having people coming in with serious problems and coming back. It's been life-changing for a lot of people." – Michael Beck, Anthology Wellness proprietor
Soothe began selling CBD products about one year ago. Its gummies proved so popular that a new manufacturer had to be found to keep up with demand.
Demand for CBD products has increased significantly in the last several years. Sales hit $390 million last year, according to New Frontier Data, a cannabis market intelligence company.
And it's not just a millennial trend.
Soothe's sales, for example, are split nearly evenly between millennials and older generations, Bahr said. Millennials tend to use their products for post-workout recovery and stress. Older generations are trying to alleviate discomfort and improve sleep.
Similarly, most of the clientele at Anthology Wellness is middle-aged adults, according to Michael Beck, who opened the Northern Liberties store last fall after cannabidiol dramatically improved his mother's life.
CBD is not a gimmick, Beck said.
"We're having people coming in with serious problems and coming back," Beck said. "They're coming back because it's worked from the beginning. It's been life-changing for a lot of people."
Anthology Wellness sells an array of products, including a tincture, lotion bar, salve and bath soak. The company also posts its lab test results on its website.
Many first-time customers spend as much as 30 minutes in the store, talking with employees who help them find the product that best fits their needs, Beck said.
But the demand for both CBD products and medical marijuana also seemingly emanates from a growing distrust in prescription opioids, according to several manufacturers and medical dispensaries.
"They're starting to see that Western medicine isn't all it's cracked up to be in a lot of situations," Beck said. "They're also seeing people getting prescribed opioids for no reason. This lack of trust between health providers and patients started to build up. It wasn't just the CBD."
Judy Beck had her doubts when she took her son's advice to try CBD.
"In talking with Michael about the oil, I really was so skeptical of it," Beck said. "I thought, 'this is never going to work – not if they have me on all the medications and they're not working.'"
For years, Beck said she took 40mg of Methadone and Percocet – both prescription opioids – up to six times each day for pain relief. She also was taking Flexeril for muscle spasms and Neurontin and Ativan for nerve disorders.
But Beck felt the prescription drugs wearing down her mind and body. At times, she would become confused about her surroundings. Her family worried about her living alone.
So, Beck weaned herself off the drugs over a six-week period while adding a CBD regimen. She said she noticed an immediate reduction in pain. Her sleep improved. And she no longer felt like she was in a stupor.
"She was like a hobbit before where she just sat in a house," Michael Beck said. "Now, she goes down the shore and goes on trips with her friends and stuff like that. It's completely changed her life."
Beck places four to six droplets of CBD oil beneath her tongue each morning, which she said loosens her muscles within a few minutes. She uses nanoparticle CBD oil in her morning coffee, and then adds it to her water or iced tea in the middle of the afternoon. At bedtime, she uses the oil again.
To alleviate muscle spasms, Beck rubs a lotion bar on affected areas. And she uses a salve that she says alleviates a rash she gets when walking people's dogs.
"I would recommend to anybody to give it a try and see," Beck said. "I don't think people realize over the course of all those years, being on the opiates, the destruction it does to your body itself. All people have to do is try it."