Cannabis is a hot topic nowadays. Currently, it’s legal or decriminalized in many states across our country. In fact, half of our states have passed legislation permitting medicinal use of cannabis or marijuana in people, under rigorous guidelines. Some states have even passed laws permitting its recreational usage. Understandably, there is increasing enthusiasm regarding its potential medicinal benefits. However, it remains illegal under federal law, which puts veterinarians who believe their patients can be helped by cannabis or cannabis extracts in a potentially problematic position.
Presently, veterinarians must comply with both federal and state laws when it comes to prescribing treatment for their patients. It’s important to understand that even though there are loosening legal restrictions regarding cannabis use in people, they do not apply to its use in animals.
Safety and Efficacy
Marijuana is federally designated as a schedule I controlled substance in the United States under the Controlled Substances Act (CSA) – with the exception of “hemp” (Cannabis sativa L with tetrahydrocannabinol <0.3% dry weight), a type of cannabis that was recently de-scheduled through passage of the 2018 Farm Bill. How marijuana is handled under federal law contrasts with how it is handled under state law.
Separate from scheduling under the CSA, it is important to ensure the safety and efficacy of any product use to treat animals, including cannabis-derived products. Under the Federal Food, Drug, and Cosmetic Act (FFDCA), with which veterinarians must comply, products contained in drugs for animals must be subject to the FDA’s drug approval process. Unapproved drugs for which therapeutic label claims are made are considered “unsafe” under the FFDCA. As such, unapproved drugs may create legal risk for veterinarians who administer, prescribe, dispense, or recommend them.
As cannabis-derived products have become more available, veterinarians have seen increased interest among clients in using these products for their pets. These clients understandably are asking, “Are these products legal, safe, and effective for treating medical conditions in animals?”
Cannabis-derived products that have been suggested as therapeutic agents for use in animals, to date, have not followed the traditional path to FDA approval. Although cannabinoids such as CBD appear to hold therapeutic promise in areas such as the treatment of epilepsy and the management of pain and inflammation associated with osteoarthritis, the available scientific evidence pertaining to their use in animals is currently limited. While findings from a few well-controlled studies have been published, much of what we know is related to anecdotal or case reports.
A study published in 2018 was conducted evaluating a commercial CBD product in dogs with osteoarthritis. Study participants in the CBD treatment group had lower pain scores compared to the placebo group. While favorable, the results suggest that further clinical research on the potential of CBD as a therapy for canine osteoarthritis is warranted. That said, results from a single, small trial is weak and tentative at best. Thus, confident claims of safety and efficacy are hard to establish.
A 2019 study was published regarding the use of CBD in dogs with refractory epilepsy. Only 26 patients qualified for the study having met the stringent inclusion criteria. Nineteen dogs completed the trial. The study provided some evidence that CBD might be useful in refractory epilepsy in dogs. Again, further study is warranted. The study ultimately concluded insufficient evidence to warrant recommending CBD for epilepsy in dogs.
Clinical trials, to date, are important steps in understanding the potential risks and benefits of CBD therapy. Neither of the above-mentioned trials provided strong evidence of clinical benefit for the study participants.
Also of significant concern are recent reports of lab analyses indicating that a substantial portion of products currently available on the market are labelled inaccurately with respect to both the identity and amount of active ingredient found within the product. This is one of the primary reasons why I discourage use of CBD products in my patients.
Toxicity
Veterinary cases of cannabis toxicosis in dogs stem most commonly from exposure to edibles containing cannabis. In these cases, there is frequent exposure to additional toxic ingredients involved – such as chocolate, raisins, or xylitol (an artificial sweetener) which, if ingested, can be fatal. Our feline friends are also at risk and may directly consume the plant material if readily accessible.
There are a wide range of clinical signs that have been associated with cannabis toxicosis. A classic presentation is a depressed or ataxic dog that is dribbling urine. If you know or suspect your pet of having been exposed to any form of cannabis please consult your veterinarian immediately.
Legal Update
Federal and state laws regarding cannabis products are complex, and the legal landscape around these products is evolving. Many of you reading this may be interested in the North Carolina laws regarding CBD and cannabis products. The North Carolina Department of Agriculture and Consumer Services position states:
No products containing CBD, which make medical claims for use in animals, are approved for sale in North Carolina.
Additionally, the FDA states:
As of April 2019, hemp and hemp products may NOT be used in animal feed or pet food in the United States. The 2018 Farm Bill did NOT grant the right to use hemp or hemp products in food for humans or animals. Any CBD products cannot make health claims, including statements that the product may prevent, treat or cure any disease.
Straight Talk
The take-home message regarding CBD and hemp containing products is this… Federally legal or not, a number of these products are out there and readily available. As frustrating as it is to wait for good scientific evidence regarding the safety and efficacy of CBD products, doing so is
ultimately better for our patients than use of insufficiently tested therapies that actually might be associated with adverse effects we did not anticipate or that simply do not work.
I would encourage owners and consumers to be smart shoppers and ask questions before choosing to purchase any product that contains CBD or hemp extract. Find out how the product is manufactured, if the company has purity standards and what the potency may be. Above all, proceed cautiously, be safe and do no harm.
Dr. Scotty Gibbs is the primary veterinarian and owner at Hilltop Animal Hospital in Fuquay-Varina.
