The use of CBD oil is becoming more mainstream and a variety of wellness products now proudly boast of being infused with CBD. While you can buy these products right off the shelf, there’s no straightforward way to measure their efficacy.
Below, we’ll clear up the confusion about CBD oil, explain what it is, how it’s used, potential drawbacks, and how Medicaid deals with the use of this increasingly popular product.
What is CBD oil?
CBD oil is made from cannabidiol, an oil found in the Cannabis sativa plant. Cannabidiol has long been used as a natural remedy in folk medicine.
While these plants are also used to produce marijuana, CBD oil is not the same thing since it does not contain THC. Therefore, it is non-intoxicating, meaning it is not psychoactive and cannot get you “high” from CBD oil. This is part of what attracts people to the use of this oil.
CBD oil is made by soaking the plant’s flowers, leaves, and/or stem in ethanol or high-proof alcohol and then diluting it in a carrier oil. These carrier oils can include coconut, hemp seed, and medium-chain triglyceride (MCT) oil.
You can take CBD oils orally and can even be added to food and drinks. Depending on the carrier oil, some CBD oils are formulated to be used topically by applying them directly to the skin.
More recently, CBD oil has been found to provide multiple health benefits.
Uses for CBD oil
While CBD oil is often used to treat chronic pain in combination with THC oil (which does have psychoactive properties), it can be used on its own as well. It interacts with the body’s cannabinoid receptors to release neurotransmitters in your brain.
As a result, CBD oil has shown some promise in the treatment of the following:
Pain
Living with pain can seriously decrease a person’s quality of life. While more research is required, people do use CBD oil to manage pain, inflammation, and overall discomfort related to health issues. CBD oil is a particularly attractive option because it is not addictive. It also absorbs into the bloodstream quickly, meaning it may be able to alleviate pain faster than a pill.
Anxiety
We don’t know how CBD affects the brain, but researchers suspect that it can influence serotonin production. As you may know, serotonin is a neurotransmitter that plays a role in mental health, and decreased serotonin levels can lead to anxiety. According to a survey of over 5000 CBD users, over 60% of them took it to address their anxiety symptoms, although research has been inconclusive.
Depression
Because CBD is thought to alter serotonin levels, researchers are investigating its use in the treatment of depression as well. Selective serotonin reuptake inhibitors (SSRIs) are the most common pharmaceutical treatment for depression and work in much the same way. While there have been no trials testing it on humans yet, according to a review study, CBD appeared to act faster than conventional antidepressants.
Insomnia
Insomnia has many causes, but because CBD oil can be used to treat pain and ameliorate the effects of anxiety, it is also thought to have beneficial effects on sleep. In addition to insomnia, CBD is also being tested on people who suffer from REM sleep behavior disorder and excessive daytime sleepiness disorder.
PTSD
PTSD sufferers have been claiming the CBD helps with their symptoms for years, but so far the research that’s been published has been done on rodents. But it stands to reason that CBD may help in emotional memory processing because this is controlled by the body’s endocannabinoid (eCB) system. The Department of Veterans Affairs is currently funding its first study on CBD, though they are pairing it with psychotherapy.
Addiction
Because CBD is not addictive, it’s a much safer alternative to marijuana for treating patient symptoms. But it has also been studied in treating addiction itself and has shown promise in helping to modulate the various neuronal circuits involved in drug addiction. For example, a double-blind study of 42 recovering heroin addicts and found that CBD cravings and anxiety, both of which can lead back to drug use.
Cancer-related symptoms (such as nausea and vomiting)
Because CBD can stimulate appetite, reduce nausea, and relieve pain, cancer patients have turned to it to improve their quality of life. Note that the research does not show that CBD helps cure the cancer itself, it only helps patients deal with symptoms.
Acne
CBD oil is becoming a more and more common ingredient in beauty products. But there is some evidence that this is more than just a fad. Dermatology researchers are still investigating, but it seems likely that CBD oil may help reduce acne thanks to its ability to influence the production of sebum (an oily substance) produced by the body. While we don’t yet understand the molecular mechanisms at work here, evidence suggests that the topical application of CBD may also be useful in the treatment of eczema, psoriasis, pruritis, and inflammatory conditions.
Because CBD oil can be purchased in most states off the shelves or on the Internet, there is a large amount of anecdotal evidence attesting to its efficacy in treating other ailments, such as arthritis. You may find testimonials on message boards or social media attesting to the value of CBD oil for medical use. But it’s important to remember that these claims have not been scientifically verified. Of course, if you’re able to purchase CBD oil in your state, the decision is ultimately up to you whether or not you want to try it.
CBD oil has also shown some promise in treating neurological disorders such as epilepsy, Parkinson’s, and multiple sclerosis, but the research is ongoing. It’s also possible that CBD oil can help reduce high blood pressure, which could lead to better heart health. But more high-quality research needs to be done before these health claims can be verified.
Many of the studies conducted on CBD oil have been small or performed only on animals. That’s why it’s important to talk to a licensed medical practitioner before attempting to treat yourself with CBD oil.
In addition to the lack of definitive clinical research, there are also side effects to consider before investing in CBD oil treatments.
Side effects of CBD oil
While both the chronic use of CBD oil as well as taking it in high doses (of up to 1500 mg per day) are generally well tolerated by humans, its use also carries some risks.
Possible side effects of CBD oil can include:
· Diarrhea
· Changes in appetite and weight
· Fatigue
· Drowsiness
· Irritability
· Lightheadedness
· Dry mouth
· Low blood pressure
· Other gastrointestinal issues
CBD can have other unintended consequences as well, especially if you are taking medications. For example, if you take opioids, benzodiazepines, antipsychotics, antidepressants, antihistamines, or other substances that cause drowsiness, such as alcohol, you may experience more sleepiness or fatigue. Taking CBD alongside stimulants can cause decreased appetite. If you use the product while taking heartburn drugs, it could also increase your chances of experiencing diarrhea.
You should also be careful if you suffer from cardiovascular disease and are using blood thinners. CBD can increase the effects of these drugs. That’s why it is vital that you speak to your doctor about using CBD oil if you’re on other medication.
CBD oil risks
The main risk associated with CBD oil is that is it typically marketed as a supplement and is therefore not regulated by the FDA. That means there is no official quality control. It’s important to find a trusted source of any CBD product, including CBD oil. You’ll want to look for one that lists all ingredients on the label, can show independent tests of its purity, and has a good reputation.
Keep in mind that there have been cases of counterfeit CBD oil being sold. And a 2018 study found that less than one-third of products marketed as CBD actually contained the amount of active ingredients listed on the label. Some also contained THC despite claiming that they did not. Some CBD users report having failed drug tests after a CBD product they bought online contained more THC than the label indicated.
In 2020, the U.S. Food and Drug Administration issued warning letters to companies selling products containing cannabidiol (CBD) in ways that violated the Federal Food, Drug, and Cosmetic Act (FD&C Act). These letters addressed the illegal marketing of products that claimed to treat medical conditions.
Doctors have also expressed concern that people will turn to alternative and unproven treatments like CBD oil in lieu of appropriate care.
Will Medicaid cover CBD oil?
No, Medicaid does not cover or help defray the cost of CBD oil since it is not approved by the FDA to treat medical conditions. Even if it is prescribed to you by a physician, neither Medicaid nor any other insurance will help cover its cost.
CBD oil is still considered a Schedule I substance under the Controlled Substances Act (CSA), because it is a chemical component of the cannabis plant. While it has a low potential for abuse, more studies are required before it can be approved for the treatment of other conditions and covered by insurance.
Exception where Medicaid will cover CBD
There is only one exception to the FDA’s current refusal to cover CBD products and that is a CBD medication called Epidiolex. This drug was approved by the FDA in 2019. It’s a prescription medicine used to treat seizures associated with Lennox-Gastaut syndrome and Dravet syndrome, which are two rare and severe forms of epilepsy.
Unless a patient has a diagnosis for one of these serious conditions and a prescription for Eipdiolex, Medicaid will not help pay for the use of CBD oil.
Outside of the US, a prescription drug Sativex, which uses CBD as an active ingredient, has been approved for muscle spasticity associated with multiple sclerosis as well as for cancer pain. But that has no bearing on US patients or their insurance coverage.
The future of CBD oil and insurance coverage
The FDA has acknowledged the growing public interest in CBD oil and other CBD-infused products and has vowed to look into safe research on its use for medical treatment.
However, this is complicated by the Agriculture Improvement Act of 2018, which removed cannabis and its low-THC derivatives from the definition of marijuana in the Controlled Substances Act (CSA). However, this only applies on the federal level. That means states still have jurisdiction over whether or not to prohibit these products from being sold. In addition, the law preserved the FDA’s responsibility for such products.
While there have been more animal studies showing the promise of CBD in treating certain medical conditions, legal issues still make human trials difficult. This holds up the research process. And until more research on humans can be done, it’s unlikely the FDA will approve more CBD-related treatments in the near future.
The cost of CBD oil
CBD oil can be expensive. An analysis of 856 oils from 263 companies found that the average cost of pure CBD oil (that claimed to contain no other cannabinoids or THC) cost is roughly 10 cents per milligram. It’s very important that you pay attention to the total milligrams listed on the bottle as the study also found that some products on the market contained so little CBD that the price came closer to 80 cents per milligram.
In conclusion, while CBD oil seems to be largely safe, the cost can push it out of reach for many people without the help of Medicaid or other insurance. Until CBD oil moves from “promising” to “proven,” you can expect to pay for it out-of-pocket in all but the one very specific case mentioned above.