From Allan Frankel, MD, March 12, 2014

Many of us have witnessed in recent years the new “medical cannabis” medications which are supposedly hemp based. (See Assuming that these claims are correct, for some reason all of a sudden companies are selling online CBD capsules just like ordering Viagra online. I can’t get a clear answer as to the legality of this, but according to a very reliable personal source, the FDA has clearly stated it is NOT legal. It is clearly being treated as if it is legal and I don’t have any real issue with this. My issue is that a hemp-based product will be superior for making paper but the Cannabis Plant is superior for medicine. How many people do you know who have gone out of their way to grow hemp to smoke? Maybe not an entirely fair question, but interesting to me.

So, assuming selling very low THC products are legal, who are these products best for?

1. Anxiety and Seizure Disorders are the two primary groups of conditions, at least in my opinion, where a product like this might be good. These groups of patients are generally way better off INITIALLY staying away from THC, although often it needs to be added and you are out of luck. Even with these patients, they will do far better with a cannabis based product offering the “Entourage” of nearly 600 molecules working together in the plant and/or extract of the plant. When I am consulting with regard to extracts, terpene preservation is #1, #2 and #3. Extracting the THC and CBD has become very efficient, but we need to extract more. At least with cannabis, as opposed to hemp, these terpenes are present in large amounts in the plant. So it is always going to yield a more complete plant molecule profile.

2. Pretty much all other patients need THC and Terpenes. For sure, there will be some patients benefitting from CBD in ANY form, so it is worth a try if you have no alternative. Additionally, cannabis based medicine will be less expensive, as even if the CBD cost is the same per mg, all the hundreds of other molecules are there. This results in a far lower dose for nearly any patient, thereby reducing total cost of medicating.

So, although the hemp products will be good for a number of people, losing out on THC and the majority of the terpenes and other precious molecules will ultimately greatly limit the potential of these products.

The age of dosing and “The Entourage Effect” will yield to richer and richer medicines with increased potency and less side effects for individuals. Imagine six different “Charlotte Web” strains. All with the same amount of CBD, all looking very different, some Sativa, some Indica, but EACH having a very different terpene profile. This is where our research is going. Think of it….each strain LIKE Charlotte’s web or ACDC with similar CBD/THC but with varying terpene profiles will be “different” medicines. One is not “better”; they just have different terpene profiles. Don’t you think one group of terpenes and minor cannabinoids might work better than another for a particular patient?

I think so. 

Allan I. Frankel, MD, has a practice in Santa Monica and blogs on the Greenbridge Medical Services site.