nutrarisk.com e ABCs of CBD for Insurance Agents HOW RETAIL AGENTS CAN GROW THEIR BUSINESS WITH CANNABIDIOL (CBD) WHITE PAPER OCT 2018 The ABCs of CBD for Insurance Agents: How Retail Agents Can Grow Their Business with Cannabidiol (CBD) Within the rapidly expanding cannabis market, a new category of products is experiencing an exciting increase in popularity: Cannabidiol or CBD compounds. A recent report by Hemp Business Journal predicted the CBD market would grow globally from $202 million in 2017 to $2.1 billion by 2020.1 CBD is one of the many compounds found in the cannabis plant. Unlike marijuana, CBD oil, a popular extraction from cannabis, has many therapeutic uses. This paper will explore the history of medical marijuana and CBD oil, how people use CBD oil, some of its health benefits, some precautions and how agents can enter this rapidly emerging market. Insurance agents with little or no experience in “nutraceuticals” such as CBD oil can benefit from learning about its tremendous potential to relieve pain and lessen symptoms of various illnesses like diabetes and Alzheimer’s. More importantly, the manufacturers, retailers, cultivators and all the industries supporting CBD production and sale will require insurance. It seems likely that if your agents have not considered writing for this growing market, they soon will. Knowing about medical marijuana—its uses, benefits, side effects, safety concerns, drug interactions and legality—will help you better serve clients in this emerging market. 2 Copyright © 2018. Worldwide Facilities, LLC. All Rights Reserved. History of CBD Twenty-nine states plus the District of Columbia legalized medical marijuana while nine states and the District of Columbia legalized recreational marijuana. It is likely that more states will follow these leaders, especially since the financial returns have proved to be so compelling. In addition, the FDA approved Epidiolex, a brand of CBD or medical marijuana, on June 25, 2018. While the approval is for two seizure syndromes—Lennox-Gastaut and Dravet—in patients two years of age or older, it is the first federally approved use of medical marijuana in the United States.2 What is Marijuana? Manufacturers make marijuana by cutting and drying cannabis sativa or the hemp plant, which contains delta-9-tetrahydrocannabinol (THC). THC causes the symptoms of euphoria typically associated with cannabis use. Cannabis also contains, according to various sources, anywhere from 66 to 120 cannabinoids (medical marijuana substances). Most cannabinoids do not produce the “high” effect of THC.3 The FDA has approved another cannabis-derived drug, Marinol, a synthetic form of marijuana. Cancer patients use Marinol to treat nausea and appetite loss. Yet another cannabis product, called K2 or Spice, is an illegal synthetic marijuana that has been linked to a number of “serious side effects, including seizure, psychosis and even death,” according to CBS News.4 Studies show marijuana itself may be harmful. Smoking marijuana recreationally may increase the possibility of developing certain conditions, such as gum disease, acute memory loss, testicular cancer and psychosis in young adults. In addition, regular, longtime users may become dependent or even addicted. To be certain that these risks exist, however, researchers need to conduct further study. 3 Copyright © 2018. Worldwide Facilities, LLC. All Rights Reserved. A Brief History of Medical Marijuana In 2700 B.C.E. Chinese doctors made a cannabis tea for gout and malaria.5 Some historians posit that the anointing holy oil described in Exodus and used in Biblical lands around 1450 B.C.E. contained cannabis. In 200 B.C.E., ancient Grecian healers used it for earaches. For physicians in the Middle Ages, it was a medicinal herb, and Queen Victoria used cannabis as an extract in alcohol during the 1840s. The late 1700s in the United States saw marijuana seeds and roots suggested for skin inflammation.6 However, by 1937, 23 states outlawed marijuana, and in 1970, the federal government made it a Schedule I drug. Schedule I drugs are classified as the most dangerous and include heroin. Today, medical marijuana is legal in 29 states, and the FDA has approved one form, Epidiolex, making that form legal in all states. What are the Various Types of Medical Marijuana? Another name for medical marijuana is cannabinoid, which is a chemical compound. The cannabis plant synthesizes its cannabinoids naturally, but does not on its own produce THC or the cannabinoids. Producers must activate THC and cannabinoids, usually by applying heat.7 Researchers have studied only a few of the known cannabinoids with CBD being the most commonly known. Other well-known cannabinoids, in addition to CBD, include those listed below:8 CBN (Cannibiol) CBC (Cannabichromene) CBG (Cannabigerol) CBGV (Cannabigerivarin) THCV (Tetrahydrocannabivarin) 4 Copyright © 2018. Worldwide Facilities, LLC. All Rights Reserved. CBDV (Cannabidivarin) CBCV (Cannabichromevarin) CBD may be the most widely used cannabinoid. Many of these cannabinoids provide reported medical benefits. The main benefit of a cannabinoid over marijuana or THC is that the user does not experience a high. Some marijuana growers have developed CBD strains that have a higher than usual level of cannabidiol. CBD may relieve anxiety, depression, some forms of childhood epilepsy, pain and inflammation. It also may protect an injured brain. Popular brands include Charlotte’s Web, Harlequin and Cannatonic. Growers produce all other cannabinoids listed above from CBG, which reduces pain and inflammation, acts as an antibacterial and antifungal and protects the brain. CBN is an “accident.” It occurs when growers store THC incorrectly, exposing it to excessive heat or light for a very long time. CBN may fight bacteria, increase appetite and relieve pain, convulsions and agitation. Studies show that CBC has antibacterial and antifungal effects. It may also act as an antidepressant, improve acne and relieve diarrhea.9 Because CBD may be the most widely used cannabinoid, we will discuss it in more detail than the other cannabinoids. How do Cannabinoids Work in the Human Body? The human body produces its own natural cannabinoids. Thus, humans have inborn cannabinoid receptors: CB1 and CB2. These receptors operate in your central nervous system (CNS) and your peripheral nervous system (PNS). CB1 functions throughout your body, but mainly in your brain and CNS. CB1 influences all the functions of your brain, including coordination, emotion, reasoning and hunger. THC, the version of marijuana that produces a “high,” attaches to CB1 receptors. 5 Copyright © 2018. Worldwide Facilities, LLC. All Rights Reserved. The PNS consists of the nerves and nerve cell clusters, the parts of the nervous system outside the brain and spinal cord. The other type of receptor, CB2, operates in the PNS. Scientists used to think that CBD attaches to CB2, but research shows that CBD does not attach to either CB1 or CB2 receptors. Instead, it causes the body to produce more of its own cannabinoids.10 To sum up, cannabinoids work in our bodies in two ways: 1. THC affects us directly when it attaches to our CB1 receptors, producing the feeling of a “high.” 2. CBD causes our bodies to produce more of their own cannabinoids. CBD produces some proven medical benefits. In addition, CBD might benefit other conditions, but that conclusion needs more research.11 We will begin an in-depth discussion of CBD by looking at the product that the FDA recently approved, Epidiolex. What is Epidiolex? The British company GW Pharmaceuticals developed Epidiolex and ran its three-year drug trials from September 2013 through September 2016. GW Pharmaceuticals describes Epidiolex as a “pure CBD” plant extract, a thick, sticky liquid packaged in droppers.12 The FDA approved the drug in patients two years of age or older on June 25, 2018, for two syndromes: Lennox-Gastaut and Dravet. However, according to FDA chief Scott Gottlieb, “This is an important medical advance. But it’s also important to note that this is not an approval of marijuana or all of its components. This is the approval of one specific CBD medication for a specific use.”13 Epidiolex is 98 percent CBD and two percent other cannabinoids. Patient studies show a high rate of success. Studies show that Epidiolex reduces seizures in children by 84 percent, and 11 percent of those children studied no longer suffered seizures. Seizures in 42 percent of those children reduced by 80 percent, 6 Copyright © 2018. Worldwide Facilities, LLC. All Rights Reserved. and seizures for the rest of the children in the study reduced 25 percent to 60 percent. Other studies report similar good results. “CBD offers parents and children alike unprecedented hope,” according to Medical Marijuana, an online resource for medical marijuana information. However, the side effects of Epidiolex can be very serious. They include liver problems, appetite loss, vomiting, fever, fatigue, jaundice and various forms of psychological distress. These types of side effects would of course be of concern to product liability carriers. How do People Use CBD? Most CBD comes as oil, so manufacturers will frequently call their product “CBD oils.” People use these oils in many forms and concentrations. Form Description Concentrations/Doses Tinctures A mixture of cannabis and alcohol, From 20 – 80 mg to vegetable glycerine, or even vinegar 100 – 1000 mg that is usually mixed into a drink, a meal or taken straight Edibles Easy to take, difficult to accurately Varies dose Patches Easy to take, difficult to accurately Varies dose Gums, Easy to take, difficult to accurately Varies Lozenges, Mints dose Oral Sprays Quickest technique 1 – 3 mg, 2 - 3 sprays orally Topicals (Balms, Use for pain, inflammation and Dosage varies Salves) topical skin issues. Apply as any other body care product. Vape Juice CBD enters blood stream almost Accurate dosing difficult immediately. Research the ingredients to avoid dangerous vape juices and be aware of unregulated sellers.