In this report, researchers reviewed 16 previously published studies testing the use of various cannabis-based medicines in the treatment of chronic neuropathic pain and found some evidence that cannabis-based medicines may help with pain relief and reduce pain intensity, sleep difficulties, and psychological distress. Side effects included sleepiness, dizziness, mental confusion. The authors concluded that the potential harm of such medicines may outweigh their possible benefit, however, it should be noted that the studies used a variety of cannabis-based medicines (e.g. inhaled cannabis and sprays and oral tablets containing THC and/or CBD from plant sources or made synthetically), some of which are more likely to result in these side effects than products without THC.
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In 2019, the European Commission announced that CBD and other cannabinoids would be classified as "novel foods",[85] meaning that CBD products would require authorization under the EU Novel Food Regulation stating: because "this product was not used as a food or food ingredient before 15 May 1997, before it may be placed on the market in the EU as a food or food ingredient, a safety assessment under the Novel Food Regulation is required."[86] The recommendation – applying to CBD extracts, synthesized CBD, and all CBD products, including CBD oil – was scheduled for a final ruling by the European Commission in March 2019.[85] If approved, manufacturers of CBD products would be required to conduct safety tests and prove safe consumption, indicating that CBD products would not be eligible for legal commerce until at least 2021.[85]
Food and beverage products containing CBD were introduced in the United States in 2017.[52] Similar to energy drinks and protein bars which may contain vitamin or herbal additives, food and beverage items can be infused with CBD as an alternative means of ingesting the substance.[53] In the United States, numerous products are marketed as containing CBD, but in reality contain little or none.[54] Some companies marketing CBD-infused food products with claims that are similar to the effects of prescription drugs have received warning letters from the Food and Drug Administration for making unsubstantiated health claims.[55] In February 2019, the New York City Department of Health announced plans to fine restaurants that sell food or drinks containing CBD, beginning in October 2019.[56]
Preliminary research indicates that cannabidiol may reduce adverse effects of THC, particularly those causing intoxication and sedation, but only at high doses.[21] Safety studies of cannabidiol showed it is well-tolerated, but may cause tiredness, diarrhea, or changes in appetite as common adverse effects.[22] Epidiolex documentation lists sleepiness, insomnia and poor quality sleep, decreased appetite, diarrhea, and fatigue.[2]
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