CHABA: Is it Right for Your Practice? The CBD Marketplace and Opportunity

Verséa Holdings, Inc. WSCA Leadership Level Corporate Partner

The CBD (cannabidiol) market is arguably reminiscent of the mid 1990s internet boom. When the bubble burst a multitude of businesses were eliminated from the market because simply placing “dot com” in your business name was not a sound strategy and the market became skeptical of the true value these companies presented. Nevertheless, many companies were able to prevail during those heady times and they all have one thing in common – a valuable product that was able to scale. Consequently, our lives have improved with innovations made with internet applications and internet-based businesses.

Chiropractors in Washington are allowed to use and sell certain CBD products in their practices, provided they meet the statutory definition of Cannabis Health and Beauty Aids (CHABA) outlined in RCW 69.50.575.* Although chiropractors can only use CHABA and not the full range of CBD products on the market, for the purposes of this article, we will use the terms CHABA and CBD interchangeably.

The CBD marketplace is analogous to the early “dot com” marketplace. As a healthcare provider you have a unique opportunity to participate in the CBD market, but not without discerning the legitimacy and value of sustainable CBD brands versus those looking for short-term gains.

While there are CBD brands that are having flashes of commercial success, many are marketing directly to consumers and consequently their rhetoric and claims of unsubstantiated therapeutic benefits will capture the attention of federal regulators such as the Food and Drug Administration (FDA) and the Fair-Trade Commission (FTC), ultimately putting these companies out of business.

The hemp-derived CBD

market is legal, but lacking in the oversight of manufacturing and marketing practices that helps ensure consumer safety.

20 www .chir ohealth.or g The CBD Product Landscape

Before discussing the CBD opportunity, it is important to understand the current landscape of this market.

The Regulatory Environment

Since the United States Farm Bill passed in 2018, hemp, the variety of cannabis sativa containing virtually no THC (below 0.3% by dry weight), is no longer classified as an illicit drug like its cousin marijuana. Despite not yet classifying CBD products as a dietary supplement (sometimes colloquially called a “nutraceutical”) or a drug, the FDA maintains a position of enforcement against any “claims” of efficacy and safety made by CBD companies. Prior to the passing of the 2018 U.S. Farm Bill, a trend of increasing global utilization of cannabidiol for therapeutic purposes had already begun.

The Bandwagon

Since hemp prohibition ended, we have seen a proliferation of so called “CBD brands” on the market, currently at approximately 3,000+ and counting. Many involve one producer filling bottles for the masses to brand, label and sell. The rush to make a quick dollar has been more than obvious with “CBD Sold Here” banners littering the landscape. Multi-level marketing groups, individuals, corner stores and gas stations are all finding their way into the market. Are these outlets reliable, sustainable and more credible places for your patients to buy CBD from than you?

• The National Institute on Drug Abuse (NIDA) previously cited there is a scientific basis for the medical use of CBD.

• Interest from the National Institute of Health (NIH) and other agencies to study natural, isolated and synthetic versions of CBD and other cannabinoids was on the rise.

• The public and private sectors’ quest to identify non-addicting treatments to address pain, other conditions and the opioid crisis started.

The Product Challenges The American Medical Association conducted a study, recently published in the Journal of the American Medical Association, in which they found that of the 84 CBD products they purchased and lab tested, 69% of them stated information on their labels that did not match what was actually in the product! For some, the THC content was above federal limits of 0.3%. For others, the actual CBD content was significantly less than what was stated on the label, which could negate any potential clinical response. Contamination is also a concern in the CBD market.

The term “pharmaceutical grade” and the acronym “GMP” (i.e., Good Manufacturing Practices) are routinely thrown around by CBD brands. Many producers claim to, but are not really, sourcing and manufacturing products in a way that aligns to pharmaceutical standards. Did you know that there are different manufacturing practices for food and pharmaceuticals?

Next time you are out shopping, ask your local store selling “pharmaceutical grade” CBD if they know what a pharmacokinetic study (PK) is. Their expression will be priceless. Validated controls, Tmax, and