Talking to Your Doctor About CBD

Talking to your doctor about CBD

As cannabidiol (CBD) and other cannabis-derived products gain more widespread acceptance, an ever-increasing number of people are considering how CBD oil can fit into their regular health and wellness regimen.

Especially if you have pre-existing conditions or are already on prescription medications, it is important to consult a medical professional before beginning use of any new wellness tool or supplement. 

Finding the Right Doctor to Discuss CBD Use

Odds are that you already have some experience with the physicians in your area. You may even have already developed a relationship with a doctor whom you know to be reliable, knowledgeable, and trustworthy. However, not all physicians are experts when it comes to CBD and other hemp-derived products. That’s largely due to the decades-long prohibition on research and formal cannabis treatment — the effects of which are likely to linger for years to come.

If you already have a primary care physician (PCP), consider calling their office to ask about their experience with and knowledge of CBD treatment. Better to know in advance whether your PCP is equipped to address your concerns.

If you do not already have a PCP, or if your PCP is not up-to-speed on the current research in CBD, then be sure to look into other physicians in your local area and/or healthcare network. In fact, some physicians specialize in cannabis or medical marijuana-related therapy. Odds are that medical practices such as these will be well-read on current and developing research into CBD’s therapeutic applications.

As always when looking for a new physician, be sure to read up on their interests and focus, how long they’ve been practicing, and other topics. Reading reviews from the physicians’ other clients can also be a valuable and important step; just as in any other profession, not all physicians are equally qualified.

Key Consideration: CBD Drug Interactions and the “Grapefruit Test”

For anyone already taking prescription medications, this is one of the most important things to discuss with your doctor. CBD use, on its own, has been shown to have few if any significant side effects. However, it does have the potential to interfere with certain prescription medications. Conveniently, it does so in precisely the same way as a much better known substance: grapefruit.

If you are currently taking any prescription medications, be sure to carefully inspect their label and dosage instructions. If you find any warnings about interactions with grapefruit, then odds are that CBD will interfere with the effectiveness of that medication.

To be safe, it is always best to explicitly discuss this topic with your physician before using CBD or other cannabis-derived products. Even if your physician is not aware of current research on CBD specifically, asking them about the “grapefruit test” is a good way to be certain. After all, this interaction has been thoroughly researched, well-documented, and is widely understood throughout the medical community.

Some of the most common medications with which CBD and grapefruit interfere are as follows. However, note that this is far from an exhaustive list. You should absolutely talk to your doctor about the grapefruit test before starting CBD treatment.

Common CBD Drug Interactions:

  • Cholesterol medications, including atorvastatin, lovastatin, and simvastatin (pravastatin does not interact with grapefruit)
  • Blood pressure medications, including felodipine, nifedipine, nimodipine, and nisoldipine
  • Heart arrhythmia medications, including amiodarone
  • Antidepressants and anti-anxiety medications, including buspirone and sertraline
  • Medications for use following organ transplants, including cyclosporine and tacrolimus
  • Allergy medications, including fexofenadine
  • Erectile dysfunction medications, including sildenafil

What to Consider Before Your Appointment

Come up With a List of Questions and Concerns

If you’re considering adding CBD to your wellness routine, odds are you still have a few questions and concerns about how it can affect you. Indeed, that’s one of the most important reasons to consult your physician before starting any new drug, supplement, or other addition to your routine. Whether you’ve already taken the time to learn about CBD’s effects, benefits, and more or if you’re just starting your research, it’s important to come up with a few goals for your discussion with dear old Doc. What, simply put, are you trying to learn?

Some of the most important considerations include the following:

— Be able to explain your interest in CBD. Are you hoping that it can help treat pain, anxiety, sleep disorders, or some other condition?

— Consider asking which types of CBD products might be most appropriate for your specific needs. Oils, topicals, vapes, and more all have different bioavailability and therapeutic potential. 

— Similarly, full spectrum vs broad spectrum or CBD isolate products may interact differently with your needs and treatment goals

— How will CBD interact with any pre-existing conditions?

— What medications are you already on, and can CBD interfere with any of these? As a quick reference, you can ask your doctor whether any of your medications can be safely taken with grapefruit. See the section on this topic, above, for more in-depth info.

Whatever your reason for asking your doctor about CBD, it pays to be prepared. The more you know, and the better questions you ask, the better your doctor will be able to help you navigate the sometimes complex world of CBD treatment.

CBD Legality and Stigma by Jurisdiction

Following the passage of the 2018 Farm Bill, the manufacture, sale, and use of CBD is technically legal in all U.S. states and territories. However, that’s not to say that it’s achieved full and widespread acceptance yet. 

Depending on where in the U.S. you are, you may encounter some amount of pushback relating to CBD use — including, unfortunately, from some physicians. Because of CBD’s relationship with cannabis, which was legally prohibited and stigmatized for decades in the U.S., there is still great misunderstanding and prejudice related to CBD use, and a number of jurisdictions have made efforts to restrict its local availability.

As such, it’s a helpful step to check local regulations on CBD use. Again, CBD is officially legal in all 50 U.S. states, but even though local restrictions may not have the effect of outlawing CBD, they may be a good indicator of what sort of reaction/level of stigma you might expect. If you live in such a jurisdiction where CBD and cannabis are still highly stigmatized, it’s a sign that you may meet with some resistance.

The international CBD situation can be even more complex. Regardless of where you are in the world, the state of medical research on the effects and effectiveness of CBD is still somewhat murky. While some countries have formally legalized all CBD use, and some others have allowed for prescriptions of CBD and other cannabis-derived drugs (see, for instance, Sativex, Marinol/Dronabinol, and Epidiolex), many have not. It’s important to be aware of the legal status and regulation of such products before discussing with your doctor.

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