Dr. Karen Keough on Prescription CBD Oil vs. Over-the-Counter CBD Products
If you’re looking for CBD oil products, there’s a good chance you can find a store selling some version in just about any direction you travel. CBD specialty stores have popped up throughout Austin with at least eight opening in 2018 alone.
The popularity of CBD oil is due to the vast number of suggested promises it can deliver — everything from easing achy joints to insomnia. Proof that it actually helps these issues is limited, however, there is data that shows it can be effective at managing seizures associated with epilepsy. We’ve seen some impressive benefits among children in our own practice since we began prescribing CBD in 2018. Importantly, the CBD oil used for epilepsy differs from over-the-counter and must be prescribed by a doctor — it’s not available over-the-counter.
So what’s the difference between CBD products you can buy off-the-shelf and ones which must be prescribed?
Child Neurology Consultants’ pediatric neurologist Dr. Karen Keough recently made comments in a story for Community Impact about the differences between over-the-counter CBD and prescription. She stresses that the prescription or medicinal CBD is formulated according to scientific research, where others are not.
Dr. Keough is also chief medical officer for Compassionate Cultivation which is one of only three companies in Texas licensed to produce medicinal CBD.
“This is legitimate medicine, and particularly in the world of epilepsy, it can be exceptionally effective for a small group of kids who try it, and it turns out to be extremely safe,” Dr. Keough said.
Some key differences between doctor-prescribed CBD and over-the-counter products include:
- CBD available in stores is produced from hemp which is an industrial crop in the state of Texas that can be legally grown and then widely distributed. The wide range of over-the-counter products have little quality control, and a large study by the Centers for Disease Control (CDC) showed that some of these products actually did not contain any medication at all.
- Medical CBD, only available with a prescription, is derived from cannabis, not hemp. Its use and distribution is limited and heavily regulated via the Texas Compassionate Use Program (TCUP) because the THC content of medicinal CBD is higher than in over-the-counter products. The regulation and oversight of the TCUP means reliable, high-quality medication.
- While the benefits of over-the-counter, hemp-derived CBD products are based on lots of Internet testimonials, larger scale medical studies show the positive benefits of doctor-prescribed CBD oil on epilepsy patients.
Both retailers who sell CBD products and doctors who prescribe it agree though that there needs to be continued funding and research devoted to the medical use of CBD so that patients can know more about how it will affect them.
This year the Texas Legislature passed a bill that expands the TCUP to many other conditions, including other forms of epilepsy, autism, spasticity due to cerebral palsy and others like multiple sclerosis, and additional progressive neurological diseases. These changes will start within the next month, and many more patients will have access to medical CBD through the TCUP.
Do You Need a Prescription for CBD Oil?
You will find CBD infused into everything from candy to bath salts these days. However, CBD oil is one of the most popular ways of taking the substance. A growing number of companies are springing up offering their take on CBD oil, but the legality of this is somewhat hazy.
In 2018, the updated Farm Bill ensured that the cultivation of Cannabis sativa L. plants containing less than 0.3% THC became federally legal. Following this, hemp was removed from the Controlled Substances Act, and the market exploded unprecedentedly.
Yet, while CBD companies and consumers celebrate this important change, there is just one small catch. The Farm Bill also preserved the rights of the Food and Drug Administration (FDA) to regulate all cannabis-based products under the Food, Drug, and Cosmetic Act. So, while many companies state that their CBD is legal in all 50 states, this is not necessarily the case.
This article explores the confusing laws surrounding cannabis-based medicine and whether you need a prescription for CBD oil. Read on to find out more.
Is CBD Oil Legal?
Technically, the 2018 Farm Bill didn’t legalize CBD or any other cannabinoids. Instead, it permitted the growth of industrial hemp containing a maximum THC content of 0.3%. Therefore, CBD is not a federally legal substance, but hemp is.
Consequently, states are free to set their own CBD laws. In general, most locations follow the lead of the 2018 Farm Bill and tolerate the sale of low-THC CBD products derived from hemp.
However, a couple of states have different rules. In Idaho, CBD products must not contain any THC whatsoever. In Kansas, such items can’t include more than 0.1%. Every other state seems to allow the sale and use of hemp-derived CBD oil with an upper limit of 0.3% THC by dry weight.
To confuse matters, some states have medical marijuana laws that permit patients to access low-THC oil with a doctor’s recommendation. Products can contain more than 0.3% THC in these locations but less than a specific percentage. Let’s find out more below.
Do You Need to Get a Prescription for CBD Oil?
At the time of writing, a significant majority of states have medical marijuana laws in place. If you are lucky enough to live in one of these states, you can apply for a medical card and get access to a whole range of different cannabis-based products.
However, if you are in one of the remaining states, CBD oil may be your only option.
It is not usually necessary to obtain a prescription or a recommendation from a doctor for hemp-derived CBD that contains less than 0.3% THC (see above for exceptions). However, in some states, patients can use CBD oil that contains more than 0.3% THC if they have a medical marijuana card or exception.
For example, in Georgia, the Low THC Oil Registry allows qualifying patients to possess CBD oil with a THC content of up to 5%. In Tennessee, the maximum THC limit is 0.9%.
However, please note that various states’ CBD and MMJ laws change regularly. If you want to know whether you need a written recommendation for CBD oil in your area, we recommend that you contact your local health department for further information.
How to Get a CBD Prescription Legally
Both hemp and marijuana come from the Cannabis sativa L. plant. The main differences relate to THC content and legality, with one dictating the other. While hemp is no longer a controlled substance, marijuana still is.
Any cannabis plant that contains more than 0.3% THC is considered marijuana and is, therefore, federally illegal. Consumers can only use such products in states where recreational marijuana is legal or if they live in a state with a medical marijuana program and have a valid MMJ card.
Obtaining an MMJ card varies depending on where you live. The type of product you can get may also vary.
The MMJ application process varies according to where a person lives. However, in most cases, the process begins with a doctor’s consultation. They ask questions about the person’s health and determine whether marijuana will help them. It is only possible to proceed with an MMJ card application once the individual has received the physician’s certification.
Most states enable patients to apply via an online registry. If their application is approved, the state’s Department of Health sends them a medical marijuana card. Then, they can finally buy CBD products containing more than 0.3% THC, otherwise known as marijuana products.
If the above sounds long-winded, remember that consumers don’t need a prescription for hemp-derived CBD with 0.3% THC or less!
Can Doctors Prescribe CBD Oil?
No. Doctors in the United States are not allowed to prescribe any CBD product. It is the same situation as medical marijuana. Neither CBD nor THC are federally legal substances. Therefore, a physician can recommend CBD oil or MMJ but isn’t permitted to write a prescription for either.
They can also recommend a certain dosage in states where the maximum marijuana limit isn’t set in stone. Some states also permit doctors to recommend increasing a patient’s marijuana dosage depending on the medical condition.
Which CBD Products Are Approved by the FDA?
The only cannabidiol product that the FDA currently approves is Epidiolex. GW Pharmaceuticals developed this medicine. It is approved to treat drug-resistant forms of epilepsy such as Dravet syndrome, Lennox-Gastaut syndrome, and also tuberous sclerosis complex (TSC). As the product has undergone rigorous testing, the FDA has deemed it safe and effective. Sadly, this is more than can be said for other forms of CBD.
Thanks to the illegal status of cannabis for the last century, research into the plant has been severely lacking. Its use as a supplement or food additive is also currently unapproved.
The FDA does allow the use of CBD in cosmetic products, although this is also subject to strict regulations. The actual legality of CBD depends on how it is labeled and marketed, which is where many companies fall foul of the law.
Aside from the dubious legality of many CBD products, customers are presented with another significant problem. Until the FDA fully approves CBD oil as a medicine or supplement, the market will remain completely unregulated. This lack of scrutiny leaves manufacturers free to produce low-quality oils, which at best may have no effect, and at worst, might damage consumer health.
Therefore, if you intend to use CBD, be sure to find a reputable source.
Where Can You Buy CBD Oil Over the Counter?
While CBD oil is widely available online, consumers in select states can purchase over-the-counter CBD at drugstores such as CVS and Walgreens. However, many stores play it safe by only stocking topical products that comply with the FDA’s stringent guidelines.
If you live in a more liberal state, you may also find CBD in specialist stores. There have even been reports of the cannabinoid being sold at gas stations in some states! Whether these products are reliable or not is an entirely different matter, though.
Remember to buy CBD from a reputable brand and not get sucked in by low prices. You get what you pay for in the CBD world, and if the cost of a product seems too good to be true, it probably is.
For some of our top-rated CBD oils, check out this article on the Top CBD Oil Brands for 2021.
All the answers in one post…
Can You Order Cannabis Oil Online Without a Prescription?
The answer is ‘yes’ if the oil in question contains a maximum of 0.3% THC and is deemed to come from industrial hemp. In that case, top-rated brands such as PureKana have you covered as they ship CBD products to most states.
Things get more complicated regarding cannabis oil classified as marijuana products. If consumers can legally buy marijuana in their state, they can purchase it online from a licensed dispensary within the same state. Some dispensaries offer curbside delivery, while others allow online orders for pick-up only.
As marijuana is federally illegal, it remains a crime to transport it across state lines. It doesn’t matter if a person is traveling from one legal state to another. Therefore, ordering high-THC cannabis oil from a vendor in another state could result in federal criminal prosecution.
However, there are cannabinoids offering an intoxicating high that aren’t yet federally illegal. For instance, there is no federal regulation of delta-8-THC, although numerous states have banned it. Delta-8 provides approximately half the level of intoxication as the delta-9-THC found in marijuana. Brands such as Premium Jane are considered among the most reputable sellers of Delta-8.
Further examples of cannabinoids offering varying levels of intoxication that aren’t yet federally illegal include:
If interested in any of the above, Binoid is regarded as one of the most trustworthy vendors.
However, please note that there are calls to ban all of the above federally. Already, there’s a decent chance that for some readers, their state has already made some, if not all, of these cannabinoids illegal. Make sure to check your state’s laws before considering a purchase.
Do You Need a Prescription for CBD Oil? Final Thoughts
Although CBD and cannabis-based medicines are becoming more widely available, residents of certain states may still have some difficulty accessing them. For example, if you reside in a state with a CBD oil registry, you will need to have one of the listed qualifying conditions and get approval from your doctor.
However, most Americans can now enjoy easy access to CBD oil, either online or in retail stores. While this news is undoubtedly positive, it does highlight the need for caution when choosing products. Some brands offer high-quality CBD in a largely unregulated market, while others fail to make the grade.
Until the FDA relaxes its stance on cannabis-based products, this situation is unlikely to change. So, however you get hold of your CBD, be sure to choose a brand that you can trust. Don’t get lured in by flashy packaging or low prices. Instead, look for a well-established, reliable company with positive customer reviews.
Finally, ensure that you are familiar with your area’s CBD rules and regulations. There is a lot of misinformation out there, so do your own research and stay on the right side of the law.