Cannabidiol, cbd as it is better known as. Explain what cbd is. Guest it is a derivative of the cannabis plant. It is an oil extract, previously only available from the plant you grow marijuana from. 2018 farm bill legalized the growing of hemp, which is a form of cannabis that has low concentrations of thc. Hemp become seeing a much more prominent agricultural crop. It can grow in poor quality soil, so you see it grown in lower quality soils. It could be a real opportunity for American Farmers to develop a new crop. Being able to derive cbd from hemp and market it, theres a hemp. Pharmacies growing host what is cbd used for . Guest right now, it is only used for one purpose. It is approved in a concentrated form for the treatment of certain seizure disorders. A lot of Companies Want to put cbd into Dietary Supplements and food. The way the law is constructed right now, that is not legal. All the cbd being put in pet food or different foods for human consumption, all of that is really illegal under current law. How do you devise a regular tray pathway to allow it to be safely put into Food Products . Host how are they able to be put into Food Products if they are l illegal . Guest we took certain Enforcement Actions there were companies claiming cbd could treat all kinds of medical conditions. Sweep those products off the market right now. Debate andot of pressure from capitol hill to try to create a legal pathway for cbd to be allowed into Food Products right now. When Congress Passed the farm legislatorsof thought they were treating a pathway for cbd to be allowed into Food Products, but they specifically reserved those authorities. Host we have a line for those who use cbd, 2027488003 is that number. Otherwise, phone lines as usual. Republicans, 2027488001. Democrats, 2027488000. Independents, 2027488002. Who is most likely to use cbd . Guest a lot of people are using it. It has become popular. Unfortunately, people are using it based on assumption that they will derive some sort of therapeutic benefit. The places where cbd has demonstrated some potential medical applications, certain muscular disorders it is only approved in the treatment of very rare seizure disorders. Its not to say that there wont be other uses, benefits proven for cbd, but right now, theres a narrow set of things where there is reliable science suggesting benefits. In pet food, theres a presumption if your dog cbd while youre at work, when you get home, your dog will be more relaxed. It is a very hokey use of cbd. Host you are concerned about risk. What are the risks . Guest there are risks associated the most obvious risk, liver toxicity. In concentrated forms, you could have liver toxicity. We have examples of that. If you have cbd for breakfast and cbd for lunch and cbd for dinner, you could get acumen live effect a cumulative effect. I saw pretty concentrated forms when people would go online and buy cbd oil, they would get concentrated forms. Has of the cbd being sold high concentrations of thc in it. Host give people a sense of how quickly this has become available and gone to the marketplace. Is this all since the 2018 farm bill or was it something you saw the rise of when you were at the fda . Guest this has been building over time. It was being derived from the cannabis plant. What changed with the farm bill, thcfarm bill legalized low forms of cannabis, otherwise known as hemp, to be legally grown. More farmers will be planting hemp. People want there to be a legal path to allow cbd to be put onto the market for companies who want to put it in foodstuff. The people marketing cbd tend to be Small Companies and some responsible players. The legitimate food Companies Want to be able to put cbd into their products but are holding back. You dont want an outcome where all the legitimate manufacturers are waiting on the sidelines and what you have flooding the market are manufacturers, many of whom are illegitimate. If consumers in Congress Want youo be a pathway supplyput into the food a product that was not previously in the food supply and is sold as a drug. Host we want to talk more about that regulatory pathway. Dr. Scott gottlieb truthful andt misleading. , the dr. Scott gottlieb columnmmissioner of the in the Washington Post about cbd. Phone lines for cbd users, 2027488003. Otherwise, phone lines as usual. Davia is up first out of huntsville. Uses cbd. Go ahead. Caller good morning, dr. Gottlieb. I wanted to challenge you because it sounds like you are really only talking about cbd in the food supply. Im actually recovering from my the head of the Pain Department at university of alabama birmingham highly recommends cbd as an alternative to opiates for pain treatment. , really, whatus are your thoughts on that . Beinge talk about cbd hemp derived or cannabis derived, there are a lot of things and play with that as well as just molecular structure. Guest theres other active ingredients in the cannabis plant, certainly, and in cbd. Cbd is available as a dietary supplement. Dietary supplements are regulated under food regulations. When we talk about something being in the food supply, it is interchangeable with being a dietary supplement as well. The caller is referencing using cbd as a dietary supplement, which is sold online as a dietary supplement. Availablehat is demonstrating uses of cbd as something that can be effective in the treatment of pain is flip. I dont think theres convincing data. A lot of patients are using it in that way and they believe they are deriving a benefit. We want to make it available for that purpose, we should do proper studies and look at the longterm benefits and longterm risks. Host when was there a proper study about this . Guest theres multiple studies underway for the purposes of studying cbd and cbd derivatives for potential applications as a therapeutic. A lot of the studies that are underway look at cbd and the treatment of various neuromuscular disorders, things like parkinsons, potentially. Theres people who think it can be effective in the treatment of pain. The only place where its been demonstrated to be safe and effective is in the treatment of these seizure disorders. It is available in a peer in concentrated form p are and concentrated form. Pure and concentrated form. Host valerie is a cbd user out of new york. Good morning. Caller good morning. I started using cbd six weeks ago for pain in my back because i was desperate. What i would like you to comment on, there are a lot of studies going on right now. People in pain right now are so mesperate ive tried krato i was hoping there would be ystelex. Dies with siste it is very expensive. Guest the caller brings up a larger challenge, a lot of nonopioid alternatives for the treatment of pain. You see people with chronic pain conditions become longterm users of opioids. Kratomim itself itself is a week opioid. It is a larger problem that we dont have effective nonopioid alternatives to treat pain. Lunchhasnt been a free in this space. Every drug has had some kind of liability associated with it, either abuse liability or risks associated with longterm use of the drug. This is a space where we need more active research looking at these new compounds. Believe somens to of these active compounds could potentially be formulated in ways where they could have therapeutic effects for the treatment of pain, but you want to formulate them in ways that you are delivering a precise dose and a responsible concentration, you understand the side effects and the scope of what the effectiveness can be. For the treatment of pain, there hasnt been a lot of literature. There have been studies but not a lot of convincing literature. Host how important is this issue on the realm of issues that the trump fda is dealing with right now . Guest as i was leaving the fda, when i was meeting on capitol hill, this came up almost every conversation i had with congress. I testified twice before congress and i had multiple questions on what the agencys approach was going to be to cbd. There is a desire to see a legal pathway for cbd to be put into Food Products and Dietary Supplements. Farmers want to grow hemp. In order to grow hemp profitably, this is a highmargin derivative for him. Right now, theres no legal pathway to put it into the food supply. You need to properly define the risks and potential benefits. Host what is the time horizon for that happening . Guest the process i outlined in the Washington Post could be immediate. Put in place expectations on what cbd would have to meet to be put into the food supply. It would have to certify how it is manufactured, it would have to be available only in low concentrations, make sure this cbd is coming from a responsible source, it is in a purified form. We will exercise Enforcement Discretion and allow it to be put into the market as long as companies are working toward filing applications, petitions with the fda. You file a new food ingredient application, a petition demonstrating it can be safely used for that purpose, that you can safely put it into a food supply at a low concentration. The onus would be on the manufacturers to get those petitions in. An interim, the agency could to allowiscretion those products that meet certain conditions to help assure safe application. Host mary in ashburn, virginia. A republican. Good morning. Caller good morning, doctor. That im clarify calling about pets and cbd oil because i have no experience with people and cbd oil. I have a very small dog, about 12 pounds. On any given day, shes your normal, average small dog. Whenever theres fireworks going off somewhere or a thunderstorm, she is a woody allen neurotic mess. Just like you, i was extreme skeptical about all the products on the market for dogs and pets who suffer from anxiety because theres so many. I did a bit of Research Online and i purchased some oil i thought, what the heck, if it doesnt work, it doesnt work, but i tried. Within an hour, she doesnt even notice there are thunderstorms. Weve tried everything. Weve tried to those thunderstorm jackets, holding her, swaddling her like a newborn, and the oil actually works for her. Guest theres a lot of cbd being put into pet food. This is one of the biggest categories. It has become so pervasive that i think it will be hard to put the cat back in the bag, pardon the pun. Host are those studies being done . Guest there are not. Literature on the food on the human side can translate to the animal side. Ee far less literature host that information doesnt have to come to the fda . Guest it would be regulated as an animal food or animal drug. Im not aware of a lot of literature going on looking at its application. Its important to keep in mind that a lot of the cbd on the market there have been a lots looking at this of it has high concentrations of thc in it. Some of it has high concentration of thc. You could be sourcing cbd, giving it to a pet, observing a therapeutic benefit because they are taking thc. Host washington. George, an independent. Good morning. Caller i appreciate your show. My comment on the cbd in high school, they taught me marijuana will ruin you for life and mess your mind up. Aboutgton state talked the carnage that would both fall nothing happened. Its been good and our state has made millions and were not putting people in prison for it. My liver got damaged by six aspirin a day. Does the doctor have chronic pain . As he tried cbd . Im not a dope smoker, but im asking him that. Guest i appreciate the question and concerns. Difference between legalization of marijuana and record realization decriminalization. The question of legalization, particularly for recreational use, is a separate question. There are studies that show that longterm use of marijuana affects shortterm memory. Large conducting a experiment in this country by. Aking thc widely available there are going to be longterm effects on developing rains. Kids using thc because of the legalization of these products and the retraction of any stigma associated with the use of these products. Were are valid reasons thought to do that from a Public Policy standpoint. That conversation should be separate from legalization. Host do you think marijuana should be decriminalized nationally . Guest i think we ought to look at decriminalizing it. People are arrested for possession of marijuana and face of other in excess sentences for crimes that are more serious. That is a discussion around decriminalization. Host is that a discussion you had with the white house . Guest no. My domain was largely public health. The conversation was around legalization. You saw states moving to decriminalize these products or legalize these products in ways that were making them thc accessible to use. I do think ultimately we will have to have a federal live coverage, here on cspan. [cheers and applause] f. Vp biden thank you very much. You very, very much for being here to give me this opportunity