Hemp derived cannabidiol (CBD) has been a hot topic in the media. The big issue now is the legality of these products and lack of support or even guidance from state Veterinary Medical Associations, Veterinary Medical Boards, and certainly the AVMA. Here is what you need to understand.
The professional veterinary associations and regulatory bodies have many reservations regarding MANY of the products we use in clinic daily - you just don't hear about them the same way the cannabis narrative has gained traction. In 2018 the DEA de-scheduled hemp-derived CBD. Hemp-derived CBD is very different from "marijuana" (which is often called “cannabis” in legislation) derived CBD. CBD from hemp is not a controlled substance and is legal to be transported in all 50 states. With that said, the de-scheduling did punt oversight of hemp-derived CBD products to the FDA; the FDA, in turn, has made some very clear statements regarding what is legally allowed to be sold. Hemp CBD products for animals, depending on their labeling and marketing, are considered an animal supplement or nutraceutical (not a dietary supplement) that are legal at the federal level and in most states.
Enforcement in states is almost non-existent and specific to the manufacturers, not veterinarians. You may have read that the FDA expressly prohibits CBD in dietary supplements: this is true, but only in regards to human supplements NOT animal supplements. The FDA does not regulate animal supplements or nutraceuticals. A human dietary supplement is differentiated in both the law and FDA categorization (for more information see the 1996 interpretation of Dietary Supplement and Health Education Act).
You may have also seen that there are no FDA-approved cannabis products for veterinary species. The FDA regulates and approves animal products that are drugs, food, and/or medical devices. The FDA acknowledges that hemp CBD products can be legal depending on the intended use, how they are labeled, and how they are marketed (See question number 8).
The packaging and marketing of a product determines whether a product is a drug - not the actual use of a product by a veterinarian or consumer. The FDA also does not necessarily consider a product a drug just because it contains an ingredient in an FDA-approved medication. An example of this is fish oil. Fish oil has long been sold as both a human and animal supplement. In 2019, the FDA approved a new "drug" called Vascepa, a highly purified fish oil. Does this make all fish oil a drug that requires a prescription? Obviously not, unless the product label makes medical claims.
Other things not approved by the FDA being used regularly in veterinary medicine:
The use of ANY animal supplement or nutraceutical. The same FDA labeling and marketing rules apply. Glucosamine supplements, milk thistle, Yunaan Baiyao, etc: NONE are not FDA approved.
Stem cell transplants and in-hospital stem-cell collection kits.
Laser therapy. Manufacturers are encouraged to follow the FDA's laser manufacturing guidelines.
MOST pharmaceuticals on your shelves are not approved for animal use!
For example: Have you ever looked at the label on your bottle of ketamine? It says that it is only approved for humans, non-human primates, and cats. Yet we use it in numerous species. Ketamine may be administered for indications outside of its FDA-approved indications and species, consistent with medical standards and regulations, per state veterinary practice acts and AMDUCA law. Careful practice of evidence-based medicine supports its use by appropriately trained veterinary professionals. The important thing to remember is, because most of the drugs we use are not FDA approved for our specific species, nor for the reasons or conditions for which we want to use them, there is potential for legal exposure if an adverse reaction were to be reported to a state veterinary governing board ("VMB").
A VMB can reprimand a DVM for using any drug that is not labeled for that specific species or indication. Do they do this often? No, just like VMB’s rarely reprimand a licensee for using supplements in general.
When it comes to supplements/nutraceuticals and decreasing liability concerns, it may be best to use a product that has been clinically researched in the event an adverse reaction occurs. This way the practitioner could provide evidence that they, in fact, were attempting to maintain a “standard of care”.
In the end it is critical to look at your state’s hemp (CBD) specific laws. We mean actually READING the law yourself, not just listening to what someone at the VMB or VMA office has to say about the law. It has been our experience that there are stark differences in verbal advice given compared to what is actually stated in law.
We also discourage veterinary premises from carrying any hemp CBD product that makes blatant label claims (i.e., "treats pain", "reduces seizures", "cures cancer", etc.). And please DO NOT carry or recommend any marijuana product.
The AVMA now acknowledges that discussion of hemp or marijuana research with clients within the bounds of a valid VCPR is reasonable, with the exception of recommending these types of products. The AVMA also does not fully endorse recommendations of other animal supplements/nutraceuticals.
The Veterinary Cannabinoid Academy does support the recommendation of hemp products but not marijuana products, even in states where medical or recreational use is legal, until laws are in place to better protect veterinary practitioners.
Suggested language to record cannabis conversations in the medical record:
"Owner inquired about hemp CBD product. Provided harm reduction counseling."
"Owner purchased XX product. Suggested dosing based off recent studies."
"Recheck appointment in 3-6 months for serum chemistry monitoring."
"Owner asked about XX product. Reviewed COA and provided harm reduction counseling. Owner elected to use product at XX dose for ECS support."