Bad Science and Gullible Media
In recent years, CBD has seen a rise in both medical and popular use. Much of this popularity is due to an over-excited industry looking to exploit a cannabinoid that doesn’t cause euphoria for profit by overstating its uses, medicinal and otherwise. Most of the information out there on CBD is not reliable and its health benefits are dramatically overstated as people market unregulated products manufactured poorly and introduced to the public with no sense of its safety or efficacy.
That being said, CBD does have uses in medicine and perhaps in overall “wellness”- whatever that means. Part of the problem lies with how medical cannabis works in general. Cannabis doesn’t work as a medicine like how modern pharmaceuticals do. In modern medicine, we like to engineer powerful single-target chemicals that can be used like sledgehammers to treat a disease. We engineer drugs this way due to our limited understanding of biology, using drugs like hammers and screwdrivers in a biological system too subtle and complex for such tools. This is why most our medicines have a variety of unforeseen side effects and toxicity- we’re trying to use a sledgehammer when an eyeglass screwdriver is required. Cannabis as medicine represents the pinnacle of chemical subtlety and synergy because it is multiple constituents doing more as a set than the sum of the individual parts.
Although there are substantial questions as to how useful CBD or medical cannabis is as a medication, there is relatively little research that is easily accessible to the average reader. For the studies that are done, the media has done a poor job of interpreting it for the public. As a result when a study that comes along that makes an extremely dramatic claim on CBD and its potential for hepatotoxicity, it should fall to the media to look at that study, read it carefully, and to translate its results understandably to the public.
However, just as there are disingenuous people who seek to use CBD for profit like pirates in an unregulated world, there are researchers who publish studies that are equally disingenuous and seek to push the needle back towards prohibition and engage in science so flawed it should never have been published.
This past week, an article titled “Hepatotoxicity of a Cannabidiol-Rich Cannabis Extract in the Mouse Model”, published in the journal Molecules. The media took this story at face value and simply regurgitated what the study said without analyzing the details.
In this study, the researchers gave mice doses of CBD an studied the effects on liver enzyme levels and in necropsy (post-death) imaging. What they don’t state in their research is the fact that their CBD doses are so incredibly, impossibly, and inappropriately high that it makes their results completely meaningless. Without any justification, they proceed to give mice hundreds and thousands of times the dose you would even give a human and proceed to present the results without context to how animal and human dosing has done in the past. The doses they gave to the mice were as follows: “Animals were gavaged (fed via stomach tube) with either 0, 246, 738, or 2460 mg/kg of CBD (acute toxicity, 24 h) or with daily doses of 0, 61.5, 184.5, or 615 mg/kg for 10 days (sub-acute toxicity).” The researchers state that, “These doses were the allometrically scaled mouse equivalent doses (MED) of the maximum recommended human maintenance dose of CBD in EPIDIOLEX® (20 mg/kg).” However, they provide no evidence for how these doses were calculated nor why they are so dramatically different from every other set of dosing parameters of every safety or efficacy study published in humans or animals.
Now to put this in context, the human dosing maxed out for CBD in severe treatment-resistant epilepsy at 25mg/kg/day in early GW Pharmaceutical studies and when Epidiolex was approved by the FDA, it has maximum dosing of 20mg/kg/day. In addition, most animal studies maxed out at around 25-50mg/kg/day for effect and showed little if any hepatotoxicity, except when CBD inhibited the metabolism of other epileptic medications, most especially valproic acid.
This study, on the other hand, took doses that STARTED at 61.5mg/kg/day and went up to 2460 mg/kg/DOSE for the acute effects. This is over 200 times the maximum dose a human would ever be given and, the triglyceride carrier agent would be hepatotoxic at that dose, much less the CBD. These doses are so incredibly, wildly, and insanely outside of the norm of any other published study that I was surprised they were audacious enough to publish such wildly deceptive data and expect the public to digest it.
However, Dr. Koturbash seems to anticipate the criticism and in the media article, Dr. Koturbash is quoted saying, “You have to take into account body size and the metabolism rate. There is a formula where you put in the information and how much of a specific compound to use. Is it perfect? No. But in research we like to say that every model is wrong, but some of them are useful.” Nowhere in the paper does he say what technique or equation he used to determine dose but Dr. Koturbash assures us there is some model involved. He knows the doses used in the study are absolutely absurd and the results of the research are ultimately meaningless, misleading, and outright false but he hopes the media won’t be savvy enough to notice and he’s right.
Because the doses were so absurd and this study’s results were so utterly meaningless, it seems as though these scientists were hoping to squash the popularity of CBD by muddling the conversation with inappropriately stoked fear. Although I can agree that the popularity and widespread unregulated use of CBD is not a good thing for either CBD or medical cannabis as a whole, using deceptive science to fling the conversation off a cliff is not the way to go about it. The media has to become much better at reading scientific papers and translating them to the public. Just because scientific papers speak a complex language with complicated math doesn’t mean they are infallible. A critical reading can expose either honest flaws in technique or, in this case, intentionally deceptive science can be used “Reefer Madness style” to steer the public to a predetermined political goal such as a return to prohibition.
To the researchers involved in authoring this study, we can advance science, medicine, and safety without resorting to trash science and deceptive tactics. To the media, please be careful which studies you give time and attention to and take care to read them and vet them honestly before publishing their “results.”