Counseling Pearls for CBD

The popularity of cannabidiol (CBD) is on the rise, but many patients still have questions and concerns: Is it legal? Will I fail a drug test? What’s the right product for my specific situation? Read on for 10 counseling pearls pharmacists can provide to give patients peace of mind about wading into the CBD waters.

1. Discuss factors that may lead to a positive drug test.

Failing a drug test can have widespread consequences. Review with patients whether the product is full spectrum, broad isolate, or isolate, as well as the THC levels—if any—contained in the product. Frequency of use can also impact drug test results, so be sure to review how the product should be dosed.¹

2. Ask about substance and lifestyle use when discussing dosing.

Use of ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can enhance CBD activity.² Methamphetamines and other ADHD medications of similar pharmacologic quality may require a larger dose, as methamphetamine alters the receptors used for CBD.

3. Stay educated.

Keep up-to-date on the latest CBD research or consider taking a continuing education course.³ Many companies that manufacture CBD products have a variety of educational blogs, videos, and other materials to keep pharmacists and pharmacy staff are knowledgeable.

4. Create an environment where patients feel comfortable disclosing CBD use.

Fostering an open environment increases the likelihood of getting an accurate, total medication history from the patient—and reduces the likelihood of negative health outcomes due to the interaction of CBD with other medications or lifestyle factors.⁴

5. Discuss expectations.

Patients who have exceptional results are often the biggest proponents of CBD, but not all patients will experience the exceptional. Although CBD can be used to treat a variety of conditions, the efficacy of CBD isn’t the same for all of them.⁵

6. Determine what condition the patient will be using CBD to treat.

Not all forms of CBD will effectively help with all conditions. Creams and lotions work best for dermatologic concerns, while a tincture might work best for mental health needs.⁶

7. Encourage a “start low and go slow” approach to dosing.

Patients will likely want to maximize effect when starting, but more CBD does not always equal better results. Discuss the concept of optimal dosing and explain that a dose beyond the optimal range for a person will actually lead to reduced efficacy.²

8. Be knowledgeable about your state’s CBD laws.

Patients may be concerned about whether their CBD consumption can lead to legal trouble.

9. Know what products (if any) contain delta 8.

Delta 8 is a THC-containing substance found in hemp, colloquially referred to as “weed light.”⁷ Because it’s derived from hemp, delta 8 products exist in a legal gray zone. Certain states, such as Illinois, Kentucky, North Dakota, Oregon, and Vermont, have laws specifically addressing the legality of products with delta 8.

10. Serve as a knowledge source for parents looking to use CBD for their children.

CBD use in children isn’t as common as use in adults.⁸ Some parents may want to turn to CBD to address problems like hyperactivity, anxiety, or sleep problems. But because research on pediatric CBD use remains limited, pharmacists can serve as a valuable source of accurate information on CBD and its pediatric uses.

References

1. Does CBD show up on a drug test? [Yes, it can] Reference. Ananda Professional. Published February 4, 2022. Accessed August 18, 2022. https://anandaprofessional.com/blogs/learn-about-cbd/does-cbd-show-up-on-a-drug-test
2. How much CBD to take [10 step dosage guide]. Reference. Ananda Professional. Published February 4, 2022. Accessed August 18, 2022. https://anandaprofessional.com/blogs/learn-about-cbd/how-much-cbd-to-take-10-step-dosage-guide
3. Faast L. Selling CBD in the pharmacy. News Article. Published September 22, 2021. Accessed August 18, 2022. https://www.drugtopics.com/view/selling-cbd-in-the-pharmacy
4. Bemben NM. CBD oil and medical marijuana: pharmacists need to know the high points. Reference. Wolters Kluwer. Published May 19, 2019. Accessed August 18, 2022. https://www.wolterskluwer.com/en/expert-insights/cbd-oil-and-medical-marijuana-pharmacists-need-to-know-the-high-points
5. Ceasrine L, Peachman RR. 6 tips for safe CBD use. News article. Consumer Reports. Published September 7, 2018. Accessed August 18, 2022. https://www.consumerreports.org/cbd/safe-cbd-use/
6. Grinspoon P. Cannabidiol (CBD): 2hat we know and what we don't. News Article. Harvard Health. Published September 24, 2021. Accessed August 18, 2022. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
7. Is CBD Oil Legal in 2022? [+ Delta-8 THC]. Reference. Ananda Professional. Published February 4, 2022. Accessed August 22, 2022. https://anandaprofessional.com/blogs/learn-about-cbd/is-cbd-oil-legal
8. Hester M. Looking at CBD use in pediatrics. News article. Contemporary Pediatrics. Published March 11, 2022. Accessed August 18, 2022. https://www.contemporarypediatrics.com/view/looking-at-cbd-use-in-pediatrics