According to the National Restaurant Association, one of the top food trends is infusing foods and beverages with CBD.

If you’re not familiar with CBD, it stands for cannabidiol, one of the active ingredients in cannabis. The primary active ingredient in marijuana is THC, or tetrahydrocannabinol. Although both are varieties of the cannabis plant, there’s a significant difference between marijuana and hemp. Marijuana contains more THC, which is the psychoactive component that can account for as much as 40% of the total cannabinoid content. Hemp has more CBD with only 0.3% THC or less. CBD is not psychoactive and has been used for centuries to manage pain, anxiety, insomnia, and epilepsy. CBD is found in a wide variety of foods and beverages, from coffee and juices to muffins, jelly beans, snack foods, and ice cream.

Why the high interest in CBD-infused foods and beverages?

CBD is often used to help manage anxiety, and some studies show that CBD may help people fall asleep and stay asleep. CBD is also used to treat chronic pain, although more human studies are needed to substantiate these claims.

Legal obstacles with CBD-infused foods and beverages

The 2018 Farm Bill removed hemp from the Controlled Substances Act, meaning it is no longer a controlled substance under federal law. That legislation led to the FDA recognizing three hemp seed-derived food ingredients as generally recognized as safe (GRAS), meaning they can be legally used in foods.

Hulled hemp seed, hemp seed protein powder, and hemp seed oil don’t contain CBD or THC and are currently sold as supplements or as food ingredients.

There’s one major legal obstacle to infusing CBD into foods and beverages: the Food and Drug Administration (FDA) maintains that it is illegal to sell CBD in foods or supplements across state lines because there isn’t enough research on safety. While the FDA recognizes the significant interest in CBD-infused foods and beverages, consumer health and safety is their primary concern. Even though it’s illegal to sell CBD-infused products across state lines, many foods and beverages are available online. There’s concern that these products may contain unsafe ingredients or that people may be influenced by marketing to use these products instead of more traditional medicine, which could lead to very poor health outcomes. In fact, a study published in the Journal of the American Medical Association in 2017 found that of the 84 different CBD products available online tested, 43% were under-labeled, 26% were over-labeled, and 31% were accurately labeled. THC was detected in 21% of the products tested.

To add another wrinkle, some states passed legislation making CBD-infused foods and beverages legal. Colorado allows all parts of the hemp plant to be added to foods, while Missouri allows CBD to be added to alcoholic beverages. On the opposite side, California, Georgia, and New York City banned adding CBD to foods, waiting for FDA approval.

As it stands currently:

The FDA requires any cannabis product (hemp-derived or otherwise) that’s marketed claiming therapeutic benefits to be approved by the FDA for its intended use before it can legally be marketed and sold via interstate commerce. Both foods containing added CBD or the psychoactive compound THC as well as dietary supplements that contain CBD or THC, may not be marketed or sold via interstate commerce.

There are many unresolved questions regarding the cumulative exposure to CBD if people access it across a broad range of consumer products and the intended benefits of CBD in such products.

There are also questions about the amount of CBD in foods and beverages that won’t interfere with prescription medications. The FDA will continue to issue warning letters to companies making unsubstantiated claims for products containing CBD on social media websites and online stores.

Our recommendations:

Exercise caution with any food or beverage infused with CBD. It is currently impossible to accurately know the amount of CBD in foods and beverages, and there are no scientifically recommended safety levels.

References:

1. National Restaurant Association. What’s Hot Culinary Forecast? https://restaurant.org/research/reports/foodtrends published 1-10-19; accessed 8-12-19.

2. Harvard Health Publishing. Cannabidiol: what we know and what we don’t. Peter Grinspoon, MD. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 updated 6-5-19; accessed 8-12-19.

3. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18–041. doi:10.7812/TPP/18-041

4. U.S. Food and Drug Administration. FDA Regulation of Cannabis and Cannabis-Derived Products: Questions and Answers. https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-questions-and-answers current as of 4-2-19; accessed 8-13-19.

5. Healthline News. FDA Puts the Brakes on CBD-Infused Snacks at the Supermarket. More Research Needed. Bob Curley. https://www.healthline.com/health-news/ice-cream-and-other-foods-that-may-soon-be-infused-with-cannabidiol published 6-10-19, accessed 8-12-19.

6. The New York Times. CBD is Wildly Popular. Disputes Over Its Legality are a Growing Source of Tension. Timothy Williams. https://www.nytimes.com/2019/05/06/us/cbd-cannabis-marijuana-hemp.html published 5-6-19; accessed 8-13-19.

7. Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708–1709. doi:10.1001/jama.2017.11909

8. U.S. Food and Drug Administration. FDA Statement. Statement from FDA Commissioner Scott Gottlieb, M.D., on new steps to advance the agency’s continued evaluation of potential regulatory pathways for cannabis-containing and cannabis-derived products. https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-new-steps-advance-agencys-continued-evaluation current as of 4-2-19; accessed 8-14-19