CBD

Is CBD a Miracle Cure or a Marketing Scam? (Both.)

Cannabidiol is caught between two worlds.

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Jennifer Aniston uses it for anxiety. Podcast host Joe Rogan applies it for elbow pain. You can buy dog treats infused with it, as well as facial scrubs and hand lotions, tinctures, and vaporizer cartridges. It's used as an ingredient in cocktails, beer, and gummy worms. It's sold at Amish markets and at fancy boutiques and at prepper depots. In October, it received the ultimate blessing for a trendy new cure-all: It was the subject of a multipart special on daytime basic cable hosted by Dr. Oz.

"It" is cannabidiol, or CBD, a compound contained mostly in the flowers of the female marijuana plant but also in the burlier hemp plant—both strains of Cannabis sativa. Like tetrahydrocannabinol (THC), CBD attaches to receptors throughout the body. But unlike THC, it doesn't alter perception or sharpen the appetite. Instead, people who use pure CBD report feeling calmed and relaxed. As Aniston recently told Us Weekly, "CBD helps with pain, stress, and anxiety. It has all the benefits of marijuana without the high."

But alongside all the celebrity buzz and bright marketing claims, there is another, more inspiring type of story about CBD: Children wracked by dozens of severe epileptic seizures a day who are suddenly well, their desperate parents weeping in relief. Although there is a near-complete absence of data concerning casual, low-dose use in lollipops or scented skin creams, a growing body of scientific evidence shows the efficacy of large doses of pure CBD for treating certain dire medical conditions.

The growing universe of CBD products—powerful cures and spa-day fun alike—is threatened by overzealous regulators, some of whom insist that CBD be classed among the most dangerous drugs. That means the people who stand to benefit most—the sickest and most desperate CBD users—remain at grave risk.

CBD, then, is caught between two worlds: the medical reality of its effectiveness in large doses on the one hand, and the popular image of a tasty, calming, faddish cure-all on the other.

Cannabis for Kindergartners

The story of today's CBD resurgence starts in 2011, when Paige Figi of Colorado put her 5-year-old daughter, Charlotte, in hospice care. Doctors thought she had a few weeks left to live, a few months at most.

For most of Charlotte's brief life, Figi and her husband had been on a fruitless quest to alleviate the violent seizures their daughter suffered as a result of Dravet syndrome, a rare and incurable form of epilepsy whose sufferers have a life expectancy of about eight years.

By the time Charlotte turned 5, her parents had tried just about every treatment available. Yet Charlotte still needed a feeding tube to eat and was debilitated by seizures that came on at all times of day and night.

"We did vitamins, acupuncture, gluten-free, dairy-free, keto, all raw and organic," Figi says. "We tried every pharmaceutical drug on the market except ones that were dangerous to children. You're just sort of throwing darts aimlessly."

Even after all those failures, there was one more thing Charlotte's parents wanted to try. During the hundreds of hours Figi spent researching Dravet syndrome, she came across studies from Israel and Europe that showed that CBD worked as an anticonvulsant and could possibly keep Charlotte's seizures at bay.

Figi wanted to administer CBD to her daughter. She found translators so she could talk to physicians and researchers in Israel and France. From these distant mentors, she learned how to extract CBD from marijuana, how to dose it, and how to test its purity.

The only remaining obstacle was finding a doctor who would recommend giving a cannabis derivative to a kindergartner. While federal law is shifting all the time, in 2011 CBD was illegal. As a compound that could be derived from cannabis, it was classified as a Schedule I drug, meaning it had no accepted medical use and a high potential for abuse. It was therefore illegal to manufacture, possess, sell, purchase, or consume. Even in pioneering Colorado, then home to a very liberal medical marijuana system, giving CBD to a small child was a tough sell.

"I was terribly nervous," Figi says. "The 'red card' doctors"—physicians who specialized in approving people for the state's medical marijuana program—"were all opposed." Eventually, Figi convinced a small team of physicians across several institutions to review Charlotte's case and sign off on giving her CBD, making her the youngest medical marijuana patient in the state.

After 18 months, Figi stepped forward to announce that her daughter was free of seizures and no longer taking any medication aside from CBD. Sanjay Gupta, a physician and talking head, flew to Colorado to meet the Figis and eventually created a series of CNN specials on medical marijuana that sparked national interest in Charlotte's case.

In the years since, parents of epileptic children have moved their families to Colorado in order to gain access to reliable and legal-to-administer CBD. Following Paige Figi's advocacy, several red-state legislatures legalized CBD while leaving marijuana itself and other cannabinoids illegal.

CBD doesn't "cure" Dravet syndrome; it only treats the most dangerous symptoms. Dravet patients will still have drastically shorter lives than average, and not all of them will respond equally well to CBD, because every patient is different. But there is no longer any question among medical professionals that CBD works as an anti-epileptic drug.

'Pure CBD Gumdrops'

During the same period that Charlotte was undergoing treatment, CBD found its way into a variety of nonmedicinal products, from $13 bath bombs advertised as providing pain relief and "mental clarity" to essential oil combinations that retail for as much as $60 an ounce. This year, CBD made an appearance at In Goop Health, the conference hosted by actress and wellness entrepreneur Gwyneth Paltrow, as part of a panel devoted to the health effects of marijuana and associated products. Once you know what it is, you start to see it everywhere. It served as a punchline in a recent New Yorker "Shouts and Murmurs" column and earned a shoutout from Paul Nassif, a star of the reality TV show Botched.

"CBD was isolated in 1940, and for decades nobody cared," says Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws (NORML) and an early proponent of researching CBD's medical utility. "I have been doing this work since the mid-1990s, and for the first decade or so, nobody but a wonk would talk about CBD." Now, however, the number of CBD questions Armentano receives at NORML is "almost overwhelming."

Among cannabis policy analysts and the people who report on drug policy, Armentano has a reputation for possessing an almost encyclopedic knowledge of marijuana research. When we talked in October, he expressed irritation at shady actors promoting CBD for applications that haven't been studied and for hawking CBD health products that contain so little of the active ingredient that they may as well be sugar pills.

"The idea that it's going to be in this balm or that balm, I don't know what the scientific basis for that is," Armentano says of lotions that claim to contain CBD. "The people who are talking the loudest about CBD don't have a scientific background. They are marketers and advertisers, and they have done a hell of a job."

Which is a shame, because CBD does work quite well for some things and, with additional research, may turn out to work quite well for others. In an email, Armentano pointed to peer-reviewed research suggesting that, in addition to epilepsy, CBD holds promise for treating cancer, diabetes, inflammation, migraines, and even schizophrenia and substance abuse.

"Holds promise" is the key qualifier. Many makers and marketers of CBD products have latched onto these glimmers of efficacy to promote watered-down products that may or may not contain actual CBD (in addition to other cannabinoids) in varying doses. This kind of sloppy extrapolation is a regular occurrence in the nutritional supplement industry, where compounds frequently make the leap from lab to bottle with little or no input from clinical researchers. A lot can get lost in translation, such as the minimum dosage required for a compound to be effective or the best route of administration.

"Even if products do contain what they advertise," Armentano says, "the dosing is very low compared to what's used in clinical trials." A recent migraine clinical trial, for instance, used 200 milligrams of CBD daily. A highly rated and reviewed one-ounce bottle of hemp oil I found online delivers 8.33 milligrams of CBD per serving and contains a total of 30 servings. A person would need to consume nearly a bottle per day to achieve the therapeutic effects seen in peer-reviewed CBD studies.

Curious as to whether Armentano was exaggerating the extent of this problem, I then looked at the label information of more than a dozen highly reviewed CBD products marketed to adults. Not one of them contained even half the dose of marijuana-derived CBD recommended for a child suffering from seizures. But some of these products did sound tasty and look chic: An elegantly boxed candy described itself as "pure CBD gumdrops…made by hand in small batches from five simple ingredients: natural fruit essences, gelatin, citric acid, sugar and the finest full-spectrum phytocannabinoid-rich CBD extract."

While they're probably delicious, each piece of candy contains only 20 milligrams of CBD, according to the packaging. That's one-tenth the amount used in the adult migraine trial and one-fifth the minimum dose required by a child with Dravet syndrome. At $60 for a box of nine doses, the boutique gumdrop is more like a slice of rum cake than a shot of rum. Various CBD products available on Amazon contain roughly the same amount or a few milligrams more per dose—still nowhere close to the therapeutic doses used in research.

This is not nitpicking. Dosing is an essential aspect of getting specific therapeutic results for specific ailments. Several studies have shown that CBD has a "bell-shaped dose-response curve," as one Brazilian report notes. In that study, which tested CBD as a treatment for anxiety in adults, 57 men were divided into four groups and given three different doses of CBD, plus a placebo. The group that received 300 mg of CBD had the best results, while the placebo group, the 150 mg group, and the 600 mg group fared much worse. There is, in other words, a sweet spot.

While the compound is gaining acceptance as a life-changing medicine for the chronically and terminally ill, its explosive popularity as a hot new luxury self-care product rests on shaky ground. And it's not clear how many consumers (or sellers) have a clue what they're doing.

'Hey, What About This Product?'

Sometimes the therapeutic and recreational markets get tangled up. The twin issues of provenance and purity are of special concern to people who are genuinely sick yet still unable to obtain CBD through traditional medical channels.

Not all Dravet syndrome sufferers will respond equally well, because every patient is different. But there is no longer any question among medical professionals that CBD works as an anti-epileptic drug.

"I get thousands and thousands of messages a week from parents sending me pictures or asking me, 'Hey, what about this product? What about this product?'" says Sebastien Cotte, whose son Jagger has a rare and terminal neurological disorder called Leigh syndrome. Like Paige Figi, Cotte has become a sherpa for parents of children with rare diseases. He speaks around the U.S. about finding CBD products that are safe and tested for contaminants.

"I don't give anything to Jagger that I don't see the lab report for," Cotte says. "His immune system is so compromised, if there's a family of mold or E. coli in a product, it could kill him." It makes Cotte particularly nervous when parents ask him about CBD products they've found in places like gas stations, which he calls "a horrible place to buy a product for your kid."

Yet it's hard to blame consumers for feeling baffled. The "green rush" that started in 2012, when Colorado and Washington state legalized recreational cannabis, has attracted the energies of not just good Samaritans, scientists, and honest entrepreneurs but also hustlers, scam artists, and people who don't know much about what they're selling.

"There's no question that the explosion of CBD products is creating serious confusion, and consumers are left to try to sort the wheat from the chaff without a lot of help," says Taylor West, former deputy director of the National Cannabis Industry Association, now with Cohnnabis, a Denver-based marketing agency that works with marijuana companies. "It'll get worse before it gets better."

Pulling CBD from hemp rather than the marijuana plant has become a flashpoint inside the cannabis world. While the two are in the same family, hemp is a heftier strain. It's used to make fabric and rope, not drugs. You can't get high smoking hemp or make edibles from it. While it does contain trace amounts of cannabidiol, all of the clinical research into CBD to date has used derivatives of the marijuana plant, not hemp.

"No one talked about CBD being derived from hemp until a few years ago, when people thought it might be a potential loophole," Armentano says. That "loophole" is hemp's debatable classification under the Controlled Substances Act (CSA). The law's definition of "marihuana" excludes "the mature stalks" of Cannabis sativa, along with any "derivative" of the stalks, "oil or cake made from the seeds," and the seeds themselves if they have been sterilized to prevent germination. In addition to those exemptions, a 2014 federal law allowed limited cultivation of "industrial hemp," defined as Cannabis sativa with a THC content of "not more than 0.3 percent on a dry weight basis." The 2018 farm bill allows even broader cultivation of hemp based on the same definition.

Over the last several years, the Drug Enforcement Administration (DEA) has attempted to clarify its position. In May 2018, the agency released an internal directive informing staff that "products and materials that are made from the cannabis plant and which fall outside the CSA definition of marijuana (such as sterilized seeds, oil or cake made from the seeds, and mature stalks) are not controlled under the CSA." That would seem to suggest that CBD made from hemp containing less than 0.3 percent THC is not a controlled substance. But as researcher Jamie Corroon and attorney Rod Kight noted in an October 2018 paper for Cannabis and Cannabinoid Research, while "these statements clarified that CBD derived from a source other than cannabis was lawful, they did not specifically state that CBD from industrial hemp was lawful."

Hemp's murky legal status doesn't necessarily make it a good source of CBD. "Many lower-quality producers use hemp oil imported from overseas," West explains in an email. The vast majority of CBD products available on sites like Amazon, for instance, use CBD derived from hemp, and many vendors are not clear about where that hemp was grown.

Perhaps more important, potential buyers may not have a clear idea of what to look for. "High-quality CBD producers need to understand that there is very little education in the general populace about CBD," West says. "Market research from BDS Analytics tells us that most consumers don't even know the difference between CBD and THC. That's how basic the knowledge gap is between those of us living in the hemp/cannabis bubble and the outside world."

West thinks there are several ways to provide clarity to consumers, including putting more information on product labels, creating a third-party testing group, and sharing lab results with sellers and buyers (although this last option requires lab testing, which is not cheap).

"I'm actually brainstorming with a couple other parents to see if we can try to start some kind of Consumer Reports, but for cannabis," says Cotte, Jagger's father. "It's so needed. There's a new CBD product coming out every day, brands I've never heard of, stuff from Europe and China. Sometimes it's full of toxins."

Toxins is a buzzword among crunchy hypochondriacs, but Cotte is talking about the very real risk posed by drugs sold in black or gray markets. A random CBD product you buy on Amazon or at your local head shop is unlikely to contain a contaminant such as illicit fentanyl, but it might not contain what the label claims, either. In late 2017, more than 30 people were admitted to emergency rooms in Utah after consuming "Yolo CBD oil." The Centers for Disease Control and Prevention later reported that the bottles actually contained a synthetic cannabinoid called 4-CCB. This dangerous, lab-made drug, meant to mimic the effects of THC, caused seizures and vomiting. What's more, the Yolo bottles contained no actual CBD.

A 2018 paper in Medical Cannabis and Cannabinoids, published by the European academic house Karger, highlighted this information asymmetry. Consumers know only what they see on the label and in most cases have no third party to help them make decisions. As a result, the paper's authors warned, consumers are ignorant of the "residual presence of toxic solvents used during the extraction procedure" and do not know whether a formulation contains heavy metals absorbed from soil, excessive pesticides sprayed on the plants themselves, or non-CBD drugs designed to give users the sense that the product "works." In 2016, the Food and Drug Administration (FDA) tested 13 different CBD products and found that only two of them contained the amount of CBD listed on the label.

Aside from the incident in Utah, very few products marketed as containing mostly or exclusively CBD have proven to be harmful. But the available data suggest the market has been flooded with crappy products created by companies, both foreign and domestic, hoping to cash in on the hype.

'From the DEA's Perspective, CBD Is Still a Schedule I Substance'

Even for CBD products that are made and dosed correctly and that do work, there's an additional hurdle. With a single exception, this entire product sector cannot legally market itself as medically better than the hyped placebos it's competing against.

According to the Drug Enforcement Administration, CBD, whether it's derived from the cannabis plant or the hemp plant, is illegal. This seems to conflict with the clarification the agency published in May 2018, but it's consistent with what DEA Spokesperson Melvin Patterson told Men's Health in October 2018: "From the DEA's perspective, CBD is still a Schedule I substance."

While many producers of hemp-derived CBD insist otherwise and do in fact operate with relative impunity when compared to people who grow cannabis, the DEA doesn't formally recognize the distinction, and many retailers don't either.

That point was driven home to me by a cashier at a local pet store, who rang up my CBD-infused honey sticks (made in Colorado and said to help pets relax) separately from the bag of salmon treats I was buying for my cat. I paid for the salmon treats with my credit card but paid for the CBD with PayPal. The latter transaction was described to PayPal as involving an artisanal good, with no mention of CBD.

A new federal farm bill could soon remove CBD's classification as an illicit drug. But until such legislation goes into effect, the only CBD formulation considered legal by the DEA is Epidiolex, an oral spray that the FDA approved in June 2018 for the treatment of Dravet syndrome, Charlotte Figi's disease, and Lennox-Gastaut syndrome, another rare form of epilepsy. Both conditions cause frequent and potentially deadly seizures in infants and children.

Two months after the FDA approved Epidiolex, the DEA announced it had moved the medication from Schedule I to Schedule V, the least regulated category of controlled substances. Schedule V contains drugs that have demonstrated medical value and are unlikely to be abused or lead to addiction.

This is how federal regulators and law enforcement agencies want drug makers to do things: Submit a new drug application, go through clinical trials, and wait for approval before you take your product to market. It is a highly detailed, highly specialized, and highly bureaucratic process that costs millions of dollars and takes years to complete. But if you do it right, the federal government gives you permission to sell your drug in the United States.

Joanna Andreasson

The reclassification of Epidiolex from Schedule I to Schedule V is a testament to the hard work and ingenuity of GW Pharmaceuticals, the British firm that holds the patent on the drug. But its approval also underscores the mindless dogmatism that colors federal drug policy.

Epidiolex was developed using cannabis grown in the United Kingdom because the Department of Justice (which includes the DEA) for decades has blocked medical marijuana development in the U.S. by refusing to license private growers of research cannabis. The only federally legal source of cannabis is the University of Mississippi's Marijuana Research Project, which grows it under a contract with the National Institute on Drug Abuse. But that cannabis cannot be used to develop pharmaceutical products.

We don't and can't know if Epidiolex works better than the illegally manufactured high-dose CBD products currently used by children like Jagger and Charlotte. It is against the law for any researcher in the U.S. to test a domestic CBD formulation against Epidiolex in a randomized, controlled trial.

It seems like a matter of principle that consumers should know whether a new prescription medication is more or less effective than the medicines they're already using. But it's an even more important question considering the relative cost of FDA-approved drugs.

Phil Nadeau, a biotech analyst with the financial services firm Cowen, projects that Epidiolex will have "an average gross price of $32,500 a year," according to reporting by Stat. At five cents a milligram, the equivalent amount of black-market CBD would cost somewhere between $100 and $400 a month, or $1,200 to $4,800 a year, depending on the patient's dosing requirements. That's a massive price difference, especially since we don't yet know what portion of Epidiolex's cost American insurance companies will agree to pay. Then again, insurers won't pay anything for CBD made in Colorado, even if it works perfectly, because it hasn't been approved by the FDA.

The fact that some consumers will have access to a tested and regulated prescription drug while others will have to rely on a self-regulated market would be less troubling if the FDA were fine with some manufacturers operating outside of its regulatory purview. But the FDA is not fine with this. In the last several years, it has threatened regulatory action against 19 CBD marketers, including the company that grows the strain of cannabis that saved Charlotte Figi's life.

'To Be in Good Standing With the FDA, We Simply Cannot Speak'

The Stanley brothers of Colorado got into the cannabis business to serve Jesus Christ and to help a family member diagnosed with pancreatic cancer.

"We're actually a relatively conservative family," Joel Stanley, one of seven brothers affiliated with the family's cannabis and hemp operation, told the news service Al Jazeera in 2014. "People wouldn't have guessed that we would be in this. I graduated from a Christian school just a few miles away. But the truth is, we grow plants for sick people. What's un-Christian about that?" According to a profile written by Steve Rabey for On Faith, "Jesse Stanley believes God has called his family to pioneer a form of cannabis-based Christian compassion."

Jesse, Joel, and several of their brothers entered the medical cannabis business in 2008. In 2011, they met Paige Figi and her daughter. Together, Figi and the Stanleys developed Charlotte's Web, a low-THC cannabis-hemp hybrid from which the Stanleys created the CBD treatment that stopped Charlotte's seizures. The brothers went on to develop an entire line of hemp-based health products that includes Charlotte's Web. In doing so, they drew the ire of the FDA.

In 2017, the agency sent warning letters to several marketers of CBD products, among them Stanley Brothers Social Enterprises. In the letter dated October 31, 2017, it told the Stanleys they were violating federal law by marketing their CBD products as treatments for a range of diseases, including cancer. The feds had two problems with that: First, CBD had not been approved as a treatment for cancer (or, at that time, anything else) and thus could not be marketed for that purpose. Second, the company could not take advantage of the broad regulatory latitude granted to nutritional supplements because (a) it had claimed to be selling medicine—a no-no for supplement makers—and (b) GW Pharmaceuticals' Epidiolex application had triggered a clause in the Federal Food, Drug, and Cosmetic Act prohibiting the active ingredient in the drug under review from being marketed as a nutritional supplement.

Every year, the FDA sends hundreds of warnings like that one to manufacturers across the United States. What made its letter to the Stanleys so remarkable is that the brothers had created a drug that demonstrably treats the seizures associated with Dravet syndrome but were being told they could not say so.

Someone who knew nothing about Charlotte could be forgiven if he read the FDA's letter and concluded that the Stanleys were charlatans. The company's decision to advertise anti-cancer benefits, as opposed to focusing exclusively on the anti-seizure benefits, didn't help. The FDA is particularly aggressive in going after companies that claim their products cure or treat cancer.

Time and research may eventually show that the company overpromised on that. The CW Hemp website, where the Stanley brothers sell their formulations, currently makes no medical claims about the company's products. Instead, there's a message on the website titled "Tongue Tied for the Right Reasons."

"You might notice something missing from blog posts and our responses to comments on our blog and social media channels," the message reads. "Namely, details about what Charlotte's Web products do for specific health issues. To be in good standing with the Food and Drug Administration's (FDA) regulations, we simply cannot speak about our product in relation to any disease."

'I Get Frustrated That This Isn't Done Yet'

Charlotte Figi turned 12 in October. She doesn't have a feeding tube, and she hasn't been hospitalized in seven years. But her mother still worries. There is no cure for Dravet, and seizures aren't the syndrome's only symptoms.

Paige Figi also worries because she expected families like hers would have won the CBD fight by now. The seeming ubiquity of trendy low-dose CBD products might make it seem like, in fact, they did. But it's not over until the federal lady sings.

"I get frustrated that this isn't done yet," Figi says. "This is like a vitamin, except it's less dangerous than a vitamin. We could've been done with this already. But seven years later, it's still federally illegal."

The idea that CBD is a vitamin, or should be treated like one, is an increasingly popular argument among cannabis reform advocates. Armentano and Cotte both mentioned it in interviews as perhaps the ideal way forward. The FDA could require marketers of cannabis products to undergo facility inspections, and it could enforce strict labeling requirements, as it does with nutritional supplements. But it wouldn't require cannabis products to undergo extensive clinical trials, as it does now.

Several states are already exercising the kind of thoughtful oversight that the feds are not. Despite the Schedule I status of cannabis and its associated compounds, Colorado has a seed-to-sale regulatory system and regularly inspects every aspect of the cannabis and hemp supply chain, including the Stanley brothers' operation.

Treating CBD products like nutritional supplements would, of course, require the FDA to cede some of its power. The agency can entirely prevent a pharmaceutical drug from going to market, because pharmaceuticals are expensive to make and their value is explicitly tied to FDA approval. By comparison, nutritional supplements are cheaper to make and don't require FDA approval before going to market. Nutritional supplement companies are like the turtles in a Mario Brothers game. The FDA can and does bop them, but the ratio of regulators to regulatees favors the latter.

There's some reason to believe the FDA is willing to accept a limited role in the regulation of cannabis products, at least with regard to CBD. In 2018, Marijuana Moment reporter Tom Angell obtained a letter from Health and Human Services Assistant Secretary Brett Giroir to DEA Acting Administrator Robert Patterson (who has since retired) in which Giroir informed Patterson that the FDA did not think CBD should be a controlled substance at all. But if the DEA insists on continuing to treat it like one, Giroir said, it should reschedule CBD from Schedule I to Schedule V. That would put all CBD products—not just Epidiolex—in the least restrictive regulatory category for prescription drugs.

In September, an administrative law judge for the United States Postal Service ruled that CBD that comes from hemp is legal to send through the mail, while CBD that comes from cannabis is not. The farm bill currently under debate could remove hemp and all of its chemical compounds from the Controlled Substances Act.

For now, however, CBD remains in a legal gray area. The Justice Department has chosen to interpret the United Nations Single Convention on Narcotics, a lodestar for federal scheduling decisions, as requiring drugs in Schedule I to be reviewed and reconsidered at the formulary level, meaning one at a time.

While things are easier now for patients and parents than they were seven years ago, the status quo feels unacceptable. Even if federal law enforcement agencies seem mostly uninterested in cracking down on CBD, dangers remain at the state and local level. "I can't tell you how many calls we get [at NORML] about CBD from retailers," Armentano says. "At least once every couple of weeks, we hear from someone raided by local cops for selling CBD products out of a retail space."

This uncertain situation means that both casual and medical users will have to remain wary. Until the market develops a way to self-regulate, buyers must be extra cautious. Here's a rule of thumb: The stuff that's both safe and effective isn't cheap, and you're not likely to find it in a gas station.

As CBD becomes ever trendier and more commodified, it's important not to let it become a punchline. Just as medical cannabis proved a godsend for AIDS patients in the 1990s, well before the boom in semi-bogus medical cards for back pain and anxiety, CBD is truly helping people with seizure disorders who badly need relief.

It could help even more people were the U.S. not decades behind other first-world hotbeds of medical research. Researchers in the United States face cumbersome and antiquated barriers to studying CBD, THC, and other compounds contained in marijuana, in part because the Controlled Substances Act has installed cops and prosecutors as the arbiters of what scientists and doctors can investigate and learn. That decision has likely impacted countless lives for the worse.

"There are people who died waiting for CBD to become legal," Figi says. "There are parents who didn't want to break the law, and their kid died. Now they have to spend the rest of their lives wondering if they could've done something."

Slather on CBD cream and sip CBD tea, if you want to. Give CBD treats to your dog, even! But keep in mind that it's buyer beware. And that behind all the hype there are lives and freedoms at stake.

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  2. Another example of government incompetence for the sake of government. Not a statist alive who would admit of any wrongdoing here; at best, they’d say that any delays are regrettable, but a necessary part of ensuring safe medical environment.

    Government sucks.

    1. Government sucks

      Without government you wouldn’t have any roads, and you wouldn’t have the military to protect you from an invasion, and you wouldn’t have a fire department to stop your house from burning down.

      But sure, government sucks.

      1. You jest my cuddly friend, but it’s CURRENT YEAR, and people still think road building is a necessary function of government.

        1. my cuddly friend

          Keep your man hands off me, rapist.

          1. You wish I’d rape you. 0.0005 BTC you don’t shave your pubic hair, sicko.

      2. Hey dumbfuck. There are private roads and all volunteer fire departments all across the nation.

        1. lol @ private roads. Hey, car wash cunt: the government built and maintains those roads.

          1. Those private roads are more better known as “toll roads”. But don’t let facts get in the way of a good talking point rant.

      3. Sure because we would have flying cars and no enemies and volunteer fire departments.

        1. Haha! Great point!

      4. military to protect from invasion? Maybe you mean no military overseas to provoke attacks upon the U.S.

        There are private fire fighting companies. I suppose without government there would be no pest control or plumbers.

        The streets in front of many if not most homes were put in by private developers. There are private toll roads. In the future, we won’t need roads – we’ll be flying around in aircars if the government doesn’t obstruct it.

        Government doesn’t suck, it stinks.

        1. The difference between a plumber and an exterminator is that they work on a privately owned residence or business, rather than a publicly owned asset used by many people. You don’t get that distinction?

        2. The difference between a plumber and an exterminator is that they work on a privately owned residence or business, rather than a publicly owned asset used by many people. You don’t get that distinction?

    2. Government is like fire; if you are young, healthy, athletic, and skilled it is possible to live without it. You won’t be comfortable, but it IS possible. But, also like fire, you have to watch the government closely, lest it get out of control, and once it IS out of control it is the very devil to get back under control.

      The drug approval system was saved from any possibility of being quick, cheap, and relatively efficient by the failure of the US regulators to approve Thalidomide quickly. They still hadn’t gotten off the pot by the time the birth defects started turning up, and they have been dragging their goddamned feet ever since.

  3. Underlying arguments about choices in medical substances (as in just about every other social-political issue) are some key questions:

    Are people idiots?
    Do people want to be protected from their idiocy?
    Do people want to know they are being protected from their idiocy?
    Do you want to protect people from their idiocy?
    Do you want people to know you are protecting them from their idiocy?

    1. In ze genralz zense, no (yas). Ze du maek mistakies zo und ze wantz tu kno ze will getz helpz wen ze tiem comz. Zo tu perventz zis gov perventz.

    2. If I had a nickel for every time…

      … Probably a trillion times! “Oh, I don’t need all these protections; I would (for example) not do heroin if it was legal. But all those stupid people over there, they NEEEED protection!!! So Big Mama-Dadda (MEEE) and my Big Government Almighty, we need to be the Big Protective Nanny, for all those inferior beings.”

      Not a ONE of them will ‘fess up to being an inferior being who needs the protection!

      1. I do heroin because it’s legal.
        I also go into the women’s bathroom and flip the toilet seats up.

      2. Hah. Forced to watch a Peppa Pig episode with the granddaughter yesterday and the teacher character asked each kid “what do you want to be when you are grown?” Each animal said some different occupation, but all ended with “so I can tell people what to do.” Even the teacher got a little exasperated so I assume the cartoon scripters were mocking the idea that others need to obey “us.”

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    1. Perhaps some of that easy money could be used to buy some better translation software, as the one you use clearly isn’t working. Giving spam a bad name.

    1. #Hangthetraitor

    2. What? Worse than a Secretary of State who routinely violated even the most basic security, probably so she could do pay-for-play deals with all and sundry? You know; the same leather-lunged, arrogant, stupid bitch who ran the most incompetent political campaign in recent memory and GOT us President Trump?

      Go paint yourself purple and moo.

      1. I would take Norman Osborn, Lex Luthor, or even the Red Skull as president before that bitch.

      2. I would take Norman Osborn, Lex Luthor, or even the Red Skull as president before that bitch.

    3. This article is about CBD. What does your link have to do about CBD?

      You’re obsessed dude. You have Trump Derangement Syndrome. Better Putin than Hillary.

  6. “The idea that it’s going to be in this balm or that balm, I don’t know what the scientific basis for that is,” Armentano says of lotions that claim to contain CBD. “The people who are talking the loudest about CBD don’t have a scientific background. They are marketers and advertisers, and they have done a hell of a job.”

    Kind of sounds like the physicians and authorities who initially dismissed CBD as an anti-seizure treatment.

    1. All i know is it works for at least some things. It was very effective as an ontment for my knee recently.

    2. Epidiolex

      Clinical trials and approval for it for two rare conditions known to be resistant to standard therapy. That does not mean the other drugs were not working, it means they had breakthrough seizures and in the controlled studies they were all kept on standard meds they were on.

      Reduces seizure frequency in those patients in the range of about 1/3 or greater. That is significant and very worth it. We won’t talk about cost yet which is high at this point. 30k/ year I saw.

      It is at the beginning after all this wasted time about pot legalization whatever.

      The cost is important for one reason. It is totally legal and common for docs to prescribe off label. Asprin for heart attacks, lidocaine for arrhythmias, those were used off label for decades if they were ever even approved. We all know they work.

      The issue I see is those two drugs were dirt cheap and not FDA scheduled. In a broad sense the open field found other uses which have saved many lives. It is more difficult for docs in practice to recommend something costing so much to say “let’s give this a try”.

      So cheap CBD is easy to get. People can try it on their own and see what works. At some point the evidence will be there one way or the other.

      What the FDA wrote.
      https://tinyurl.com/y759potg

  7. I didn’t read the article and won’t, so someone correct me if I’m off base here. But is Reason truly advocating for oil made from cannibals? This is too far.

    1. Yes, but only from cannibals that freely choose to be pressed into oil.

      1. Mine is forced, at gunpoint, while being held down on top of a pinball machine. While drunken men cheer.

    2. The articles *are* better if you don’t read them this decade.

    3. Only free range, non-GMO cannibals. The other kind is full of glutens and other toxins.

    4. They are advocating allowing people to use their own judgement, with advice. Or that’s how I take it. By taking a hard line against marijuana, the Federal Government has effectively made it next to impossible to do actual research on it’s possible benefits. And there seem to be some. And now the some are emerging anyway, the government’s position means that it is doubly difficult to separate the actual benefits from the hype.

      The treatment of Marijuana as a Schedule I drug has always bee absurd; based initially (as I have read, anyway, and if I’m wrong, please to point me to the data) on a blizzard of the kind of revolting “We gotta keep them goddamned Niggers in line” swill one normally expects from the KKK table at the county fair. Instead, it came from the FDR administration and it has been argued that it was actually for a ‘full employment for redundant Prohibition agents’ measure.

      *spit* (of the Great Progressive Statesmen I loath Woodrow Wilson only slightly more than I do FDR)

      Is smoking Pot a vice? A vice that can potentially ruin your life? Yes! Is there any evidence that the government’s form of intervention against this voce is better than allowing the vice to run unchecked? Not as far as I can see.

  8. Maybe we can apply some of this on progressives.

  9. Considering that we presumably evolved cannabinoid receptors because they conferred an advantage and considering that those receptors are expressed in white blood cells especially, it shouldn’t surprise us if the snake oil salesmen turn out to be right on this one.

    http://en.wikipedia.org/wiki/Cannabinoid_receptor

    Broken clocks, twice a day aside, ethnobotany is taken quite seriously by pharmaceutical companies, and what is ethnobotany if not the collective wisdom of shamans and witch doctors? If snake oil salesman seem more legitimate when they’re from the Amazon, that’s just in our heads.

    How many people alleviated the suffering of their friends and family going through chemo with cannabis before the medical community ever put their official stamp on the wisdom of stoners and Deadheads?

    1. Considering that we presumably evolved cannabinoid receptors because they conferred an advantage . . .

      You get a random mutation. That mutation spreads *if its not disadvantageous* – because those who have it aren’t dying off any faster than those who don’t. It spreads faster if it is advantageous – because those who have it are dying off slower than everyone else.

      But a mutation doesn’t have to be advantageous to stick around and it doesn’t mean that it doesn’t come with some serious negative (like Sickle Cell Trait). And it doesn’t mean that what was advantageous in an earlier environment still remains so.

      1. But a mutation doesn’t have to be advantageous to stick around

        Not quite. Harmless mutations still require resources to persist. There is a cost, however minimal.

        1. Even advantageous mutations require resources to persist. If a mutation provides a benefit that is equal to its resource cost then its neither advantageous no disadvantageous. There will be no selection pressure to keep it around – but neither will there be any to eliminate it.

      2. Sickle Cell has disadvantages if you’re not living in subtropical rain forests that are rife with malaria. My understanding is that the reason Sickle Cell emerged and proliferated was because of the advantages it conferred to those who live in subtropical rain forests that are rife with malaria–they survived long enough to breed where others didn’t.

        Whatever disadvantages might be associated with having cannabinoid receptors expressed in white blood cells, the reason that trait proliferated is presumably because of the advantages they conferred. My understanding is that our bodies evolved to produce small amounts of its own THC like substance under certain conditions–and that’s presumably because of the benefits doing so confers.

        I don’t see any evidence that having cannabinoid receptors was a maladaptation in any way. Whether our common ancestors evolved it or our various ancestors evolved it independently, if the adaptation proliferates to the point that all of humanity has it, it seem fair to conclude that it must have proliferated so widely because was beneficial. We might even go so far as to conclude that it was necessary.

        1. My understanding is that our neocortex evolved that way. It grew to accommodate the advantages conferred by language and religion, and while there still are descendants of a common ancestor that evolved without language and religion like homo sapiens (see chimpanzees), if the neocortex is what separates us from them and no homo sapiens survived into the historical record without language and religion, then it’s appropriate to conclude that homo sapiens wouldn’t have emerged without them.

          If there aren’t any homo sapiens groups that survived into the historical record without cannabinaoid receptors, we might make the same sort of conclusions. Arguing that cannabinoid receptors somehow proliferated to all of humanity without any associated benefits might be a hard argument to win.

        2. I might have added that finding the receptors on white blood cells makes them a likely candidate for conferring advantages associated with survival to the age of breeding.

        3. Cannabinoids and receptors exist in a large number of plants and animals. We make our own endocannabinods. So a similar molecule can have a broad range on effects both within and between species. Take a basic molecular structure, move around a few hydroxy groups and you get a whole different result which may be beneficial or not.

          From an evolutionary point of view this makes sense. You don’t need to reinvent the wheel to use it for different things.

          CBD which is plant derived may have a big effect in mice but little or no effect in humans. We know that the receptors have a different distribution in mouse brains.

          So we do carry around genes from our evolutionary past. Some are functional, some may have little or no effect on function. It seems that the genes that code for the appendix only serve to keep the subspecies homo surgicas generalis employed for example.

          Interesting discussion. In any case there is a lot of hype about CBD and I think it is mostly just that.

          We did try it on our older dog who recently passed. It seemed to help her to move around and be more comfortable. Could be a placebo effect on me. I want it to work so she looked better.

    2. Our bodies produce their own cannabinoids too and they do important things.. So it really shouldn’t be a surprise if a lot of other cannabinoids are therapeutically useful.

  10. God damnit the whole world’s gone crazy. Every where I turn all I hear about is “Oscar De La Hoya! Oscar De La Hoya! Have you seen Oscar De La Hoya?”

    I haven’t cared about Oscar De La Hoya in about 10 years, and the next thing I know, he’s in Congress?

    Hell, I know he’s from Mexico, and that makes him an expert on foreign affairs, but what does he know about policy for this entire country, much less NY? And a woman? With tits? WTF? That’s special, but, Jesus Christ.

    World’s fucked up.

    1. Or any “celebrity” opinion for that matter. Do people really care what Jennifer Anniston thinks about anything outside of the acting profession ? And if they do, why is that?

  11. is threatened by overzealous regulators

    Which product isn’t?

    1. The sex lives of college students?

      1. My dream is to regulate the shit out of some 18 y/o college boys’ lovemaking.

    2. Government Almighty itself!!!

  12. The more people admit to using cannabis derivatives the more the medical community as opposed to the mental illness community studies it.

    Doctors are treating serious side effects more and more.

    Any balanced article should have addressed it.

    https://www.sciencedirect.com/science/
    article/pii/S0074774206780102

    1. Suicide is infinitely more dangerous to human life than pot has ever been, or will ever be, yet we don’t labor under the illusion that harsh laws against suicide will ever put a dent in this problem…

      The laws of Government Almighty aren’t very effective against a LARGE assortment of problems, and are counter-productive, net-net, in a large assortment of problems as well.

      1. Legalizing and calling harmless a substance that causes serious even permanent side effects like mental illness is criminally irresponsible.

        We don’t want our government to be more criminally irresponsible than it already is, for the sake of some extra tax revenue, do we?

        1. “Legalizing and calling harmless” Government Almighty policies by which property is confiscated, and people are imprisoned in places where they get raped and abused, merely because people want to decide for themselves, what kind of “buzz” they want to get, is “criminally irresponsible” as well. Your policies that you advocate aren’t harmless, or kind and gentle. They show no humility, nor mindfulness of unintended consequences.

          You want to outlaw tobacco, booze, overeating, and sexual addiction as well?

          I don’t want freedom for more tax revenue, I want freedom for its own sake, and for maximizing human welfare and learning. Learning something other than “Government Almighty sucks”, which is what we are learning good and hard, right now.

          1. Oh, and besides, I have read that the Netherlands (where pot has been “de facto” legal for decades) has had LOWER youth-pot-smoking than the USA has had, for decades now. “Forbidden fruit” is attractive, and human behavior is counter-intuitive. Government Almighty “solutions” often SUCK MY BIG FAT HIENEY!!!!

            1. Now that mom is doing most of the pot smoking it is not so cool anymore.

              Surrender…surrender…

              1. But don’t give yourself away.

        2. You know what’s criminal? Initiating force which is what prohibition requires.

        3. Rob Misek|1.13.19 @ 2:23PM|#
          “Legalizing and calling harmless a substance that causes serious even permanent side effects like mental illness is criminally irresponsible.”
          Your link was a long ways from even suggesting that, so you’re once again full of shit.

          “We don’t want our government to be more criminally irresponsible than it already is, for the sake of some extra tax revenue, do we?”
          “We” dopn’t want the government to tell us what we may do.
          Fucking slavers like you do.
          Fuck off and die, slaver.

        4. Mr. Meseeks here really thinks,pt is that dangerous? It isn’t. In fact, other than the damage done from inhaling it as smoke, most of the neurological effects are fully reversible in mature adults. Or at leas that’s what most of the more credible studies indicate.

        5. The government does not have that right or responsibility. People can inform themselves and make their own decisions. No one is forced to do drugs. It is criminally irresponsible of government to enforce drug prohibition

    2. Rob, you should really read your own reference, dude – “… the rates of schizophrenia have not increased commensurate with the increase in rates of cannabis use…”

  13. I won’t even consider this a free country until the DEA is dismantled and McAfee is president.

    OT
    You know what goes well with CBD oil other than supple boys? Vidya games.
    I recommend checking out these three titles (some upcoming, some old):
    Metro Exodus
    Stronghold HD
    Zanki Zero: Last Beginning
    And remember to buy a PS4 so you can play the latest Ys game, you fucking losers.

    1. Yes, everyone play the new Ys. If you’re also behind, as I am, we have a PS4 release of the first two Trail of Cold Steel games.

      1. REmake2
        Tales of Vesperia (my current game)
        New sort or No More Heroes next week

        Really, there is a lot happening in games. It’s embarrassing that Reason only let’s Robbie and Suderman stumble in drunk and ramble about Fallout 76 and OoT.

        Get Robbie to review the new Senran game if you want me to donate to your drive.

        1. Hyped for No More Heroes, but I could never get into Tales of *. I’ll have to try again, especially since Vesperia is coming to the Switch this year.
          Oh man, I felt embarrassed for those two, especially Robbie. He really needs to get some better taste. OoT is a fine game and I have fond memories of it, but it’s not the best game ever, and it’s certainly not the best Zelda game ever. (And neither is BotW, just making that clear.) I’d rather watch Heaton play one of the Senran games, and see if he has good taste in girls too.

          1. Tales of * is a crapshoot of a series. Every game is kind of the same, but some are the same but way better. And even then I can’t blame anyone for not liking them.

            Best Zelda is Alundra, btw

      2. I have the Vita releases of those, and I still haven’t played them. Committing to jRPGs is really hard these days. This taste of failure is, what I imagine to be, a regular occurrence for prolific posters on a Libertarian magazine’s comment section. Indeed, it tastes a little “fisty.”

        1. Yeah, JRPGs are 100 hours of me zoning out in a directed manner. It’s hard to find time.

          New Monster Boy was really good though if you missed that one.

  14. We’re witnessing the disastrous results of a Kremlin-controlled foreign policy.

    “The United States is essentially missing in action”: As American forces begin to pull out of Syria, the Middle East increasingly finds a void being filled by Russia, Iran and others. ?@NYTBen?

    It is absolutely unforgivable that Drumpf wants to cut and run from our overseas military commitments. Commander in Chief Hillary Clinton would never do something so cowardly and reckless. That’s why I voted for her in 2016. (Well, that, and also to prevent this country from literally turning into The Handmaid’s Tale.)

    #StillWithHer
    #LibertariansForStayingInSyria

    1. Building walls is inhuman, killing foreigners in their own countries is good government.

      Am I doing this right?

      1. It’s all about opposing Trump. No matter what. He should try and force a an extra trillion do,,ar spending omnibus in the democrats with promises to not cut a dime of existing spending.

        Net result, balanced budget. Out of spite.

    2. Who’s Drumpf? Never heard of any Drumpf.

      Now, there is a President Trump who is getting the U.S. out of all the ill-advised interventionist commitments in the Middle East made by the Bushes.

      All the open borders liberals have become born again warhawks.

      The U.S. needs to have a less adversarial relationship with Russia.

      Better Putin than Hillary.

    3. Commander in Chief Hillary Clinton would never do something so cowardly and reckless.

      No, Angry Hillary would just get us into a nuclear war with the Russians so she could prove she’s tough as any man. Hillary was a nuclear war just waiting to happen. Be glad she lost. I don’t think the Russians had any influence on the election. But if they caused Hillary’s defeat, we should thank them for it.

  15. CBD cured my adrenal fatigue.

    1. Really? I’m interested in hearing more.

      What caused you adrenal fatigue? Too much coffee? If it was too much coffee or some other caffeinated substance, did you quit ingesting your caffeine fix?

  16. “It has all the benefits of marijuana without the high.”

    A new placebo is born

  17. I experimented with CBD and used it to replace the 5mg of Glyburide I was taking for my type 2 diabetes.

    With the Glyburide I was experiencing stool that felt like spiny golf balls. For a year this went on.

    The day I replaced Glyburide with CBD no more spiny golf balls. Immediate relief. And the effect it had on my glucose levels were THE SAME as if I was taking Glyburide.

  18. What kind of shitty “miracle cure” wouldn’t have some scams surrounding it?

    1. It isn’t a ‘miracle cure’. But it has been shown to have varying levels of effectiveness treating certain conditions/symptoms. For myself included.

  19. CBD is one thing but THC is for the make garbage brain.

    1. Not if it’s used topically.

  20. I believe Charlotte Figi started out using regular cannabis that was high in CBD. I also believe the effects of CBD differ depending on the terpenes present just like THC. There is a synergistic effect.

    1. Exactly. THC and CBD are just the two most abundant of a large number of structurally similar molecules in marijuana. Very few, if any, have bern studied. The combined effects of the various materials contributes to the experience in what’s called an ‘ensemble effect.’ This is why each different strain of marijuana gives you a slightly different feeling – the distribution of these many terpenes is different.

      The best research on mj has been conducted in Israel and some in Europe. There are some truly remarkable effects that have been observed.

      1. Importantly, these molecules are very difficult to separate. So ‘pure’ CBD or THC is expensive to produce. Further complicating the problem is that various herbicides and pesticides are also difficult to remove. Getting materials pure enough for medical use and to pass FDA standards is not easy. Some of these impurities can drift over from nearby fields. So med mj will likely be largely grown in greenhouses. Recreational mj may have lower standards.

        1. Actually refining pure THC-A isn’t that hard. Search for THC diamonds.

          1. Sorry, I work in this field. Getting the impurities down to ppm, or for some impurities down to ppb levels needed for med applications, is expensive and low yield.

            THCA at 99% purity goes for $200/g because it’s expensive and difficult (several steps with lots of solvents).

            1. I’ll stick with rec terp sauce.

  21. it doesn’t alter perception…. Instead, people who use pure CBD report feeling calmed and relaxed.

    So, CBD *does* alter perception. “We can’t allow yet another gateway to opioid addiction.” 8-(

    1. It isn’t a euphoric, or a hallucinogen though. Anyone expecting that will be very disappointed.

  22. Didn’t High Times, back in the late ’70s, used to advertise some gadget that was supposed to convert the bad headache-inducing no-high CDB into THC?

    1. While THC and CBD are structural isomers – same atoms arranged slightly differently – the rearrangement would require a lot of energy to break a C-O bond to allow it to happen. Temperatures found in combustion could do it, but not with any selectivity, I.e. you’d get a wide range of products, not just THC. So that gadget was pure bs.

      1. Yes, it appeared to be bs but I do remember when the enthusiastic dope smoker was aware of CBD.
        I kinda recall Car & Driver! (the ’70s in a nutshell) recommending microwaving low-grade commercial weed to increase potency (through altering CBD) as well.

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  24. a compound contained mostly in the flowers of the female marijuana plant

    What about the gender-fluid plants?

    1. The phrase ‘male gender fluid’ actually is more pleasant than many of the alternatives.

  25. Prescriptions serve 3 purposes — 1. For the doctor to communicate to the patient and pharmacist what his RECOMMENDED treatment is. 2. for the patient to prove to a 3rd party payer (insurance) that the treatment is medically necessary IF the patient wants to be reimbursed, and 3. to provide evidence in case the patient sues the doctor for malpractice. If a patient knows what he wants, does not want a 3rd party to pay for it, and does not want to sue the doctor later, then the patient should have a right to choose and purchase his own medication WITHOUT a prescription.

    Doctors must know what they try will be safe and effective for a millions of patients. An individual might want to try something to find out if it is effective for him. He does not have to worry about anyone else. When the individual is dying, “safe” is irrelevant. The risk of not being effective is irrelevant. The rewards of a doubtful treatment being effective are beyond calculation — well worth the “risk”.

    The fact that doctors exist should not mean that individuals should be deprived of our own right to take greater risks and reap greater rewards for themselves than a doctor who must worry about everyone else. Individuals should retain our liberty to make our own decisions.

  26. Can anyone clarify how the DEA and can consider CBD a Schedule I substance when it has NO narcotic/psychoactive properties? Is it some other criteria. Is is to do wit the fact that the plant is banned and not the psychoactive component, THC?

    Can we get rid of the CSA now?

  27. There are few or any quality long term studies that verify the efficacy of CBD used for any purpose. Mostly, the positives or negatives are coming from users. I have used it and it didn’t improve the condition I had intended for its usage. But others have had good success using it for various ailments.

    On the other hand, you can bet Big Pharma doesn’t want something as simple and cost effective as CBD replacing ultra-high cost and profitable drugs. And for sure, we cannot trust the FDA with testing anything. They have been mostly bought and paid for by Big Pharma. Over 50% of all drug studies are never published. It makes you wonder.

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