2019年9月24日 星期二

The NIH Would Finally Like to Figure Out if CBD Actually Works


Moody’s Medicinals CBD water

Ethan Miller/Getty Images

Cannabidol, a compound found in marijuana that doesn’t get you high, is everywhere these days (it is also questionably legal, but that doesn’t seem to be stopping many people). Online recipes tell you how to spike your desserts with CBD, whether you’re making banana cream pudding or donut holes. Trendy workout studios offer CBD seltzer as a post-class refresher. Casper, a mattress company, recently started hawking CBD gummies to, according to the advertisements, help their customers sleep. There’s CBD mascara, CBD sports bras, CBD lotion, CBD dog treats, more CBD human treats, CBD bath salts, and on and on.

But does all that CBD … do anything? It hasn’t yet been proven. “The science is lagging behind the public use and interest. We’re doing our best to catch up here,” David Shurtleff, deputy director of the National Center for Complementary and Integrative Health, told the Associated Press last week. He was commenting on news that the government will be funding nine research grants looking into CBD and other similar compounds in pot, totaling $3 million. One of these studies involves CBD pudding’s effect on pain—depending on the data, it will either help curb the rampant rise in spiked desserts (and CBD oil and honey), or it will allow the skeptical among us to finally indulge with good evidence validating our choices. The market might have gotten ahead of itself on this one, but surely carefully done science will eventually prevail.

Just kidding! When it comes to consumer goods, science prevails basically never. Every drugstore and health boutique in America is filled with a little chemistry that is then overlaid with a lot of folklore. We buy aluminum-free deodorant because a long-debunked internet rumor once told us that aluminum on our armpits was bad. We use charcoal teeth whiteners that, even though their star ingredient does work in certain stomach detox protocols, may just be scraping away at your tooth enamel. We pour money into vitamins promising stronger nails, despite the fact that they only—maybe—work for the few people with an active biotin deficiency. And if you’ve ever made a New Year’s resolution, you know that the world of diet and exercise abounds with recipes and regimens that promise the world, woefully underdeliver, and persist even when science fails to confirm their magic.

The new studies will look specifically at how CBD might act as a pain reliever, with an eye toward figuring out whether it can serve as an alternative to opioids for people with chronic pain, according to a statement from the National Institutes of Health. The road to final answers here will be long, with most of the studies constituting basic research on how CBD interacts with receptors, or how it affects rodents—studies that can shine a light on how CBD might work in humans, but won’t prove anything about how CBD affects us. The results from this work will be nuanced and deployed into a world already replete with marketing slogans and money-grubbing; it stands almost no chance.

When it comes to consumer goods, science prevails basically never.

The problem is that science rarely delivers a clean and definitive ruling that something doesn’t work, particularly when it might work in a number of circumstances. I know from reading dozens and dozens of papers over my career on the science behind consumer goods that no study will ever directly say a product is a woeful waste of money—just that it didn’t pan out when deployed in a particular manner. In that pudding study the NIH is planning, folks with lower back pain will have some CBD pudding (or some regular, control pudding), and then hop in a brain scanner so scientists can see what’s happening.

Even if it finds no difference between the pudding-eaters, it won’t be able to rule that CBD doesn’t help pain. It will only be an incremental step at understanding whether CBD might help one small aspect of pain for some people. That’s the most a paper or expert can really say when they have no affirmative evidence: It didn’t work this way, but that doesn’t mean it doesn’t work for anything. Science, by design, leaves room for unexpected possibilities. That is the right way for science to operate because single studies often miss things, the work is iterative, and in the end, it’s the broader body of research that matters.

And no matter the outcome, the study will do little to curb people selling CBD products. If the pudding does do something, CBD oil brands will have a paper to add to their marketing arsenal. If the special puddling doesn’t do anything for people with chronic pain, it will be easy to ignore; manufacturers can easily word claims about products’ benefits vaguely enough to avoid out-and-out false advertising. But more importantly, once something is in the public imagination as being useful, it’s hard to oust it. CBD has benefited from early studies that suggest legitimate uses from pain management to anxiety to insomnia. It doesn’t matter much that these are typically small, and often in rodents. There’s also the simple fact that it comes from marijuana; that it would do something positive seems logical, in the same way that buying face creams boasting antioxidants seems logical, even though they may only wind up being present in trace amounts. One only really has to note that a product has CBD in order to sell it.

Still, research into CBD is valuable, perhaps wildly so. Where it will be very useful is in actual medicine, helping doctors understand if they can or should advise patients with lower back pain, or other ailments, to use CBD, and in what amounts. It will also help journalists bent on debunking wellness trends make ever-more informed recommendations on how savvy consumers should spend their money. CBD already has a number of fans: It’s worth untangling what portion of those people might be directly benefiting from the compound versus benefiting from the placebo effect. But when it comes to the larger marketplace, science simply can’t catch up to CBD. The trend will need to wane on its own terms—probably when another miracle ingredient comes along to oust it.



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