Background: Recent legislative change has allowed increased access to cannabis products in many jurisdictions. In some locations, this includes over-the-counter (OTC) and/or online access to products containing cannabidiol (CBD), a non-intoxicating cannabinoid with therapeutic properties. Here we compared the availability of CBD products and the associated legislative and regulatory background in nine selected countries.
Methods: Accessibility of CBD products was examined in the USA, Canada, Germany, Ireland, United Kingdom, Switzerland, Japan, Australia, and New Zealand as of May 2020. Regulatory and other relevant documents were obtained from government agency websites and related sources. Relevant commercial websites and some physical retailers were visited to verify access to CBD-containing products and the nature of the products available.
Results: A range of CBD products appeared to be accessible without prescription in seven out of nine countries reviewed. Australia and New Zealand were the exceptions where clinician prescription was required to access any CBD-containing product. CBD products commonly available without prescription included oils, gel capsules, purified crystal and topical products. The daily recommended doses with orally administered non-prescription products were typically well below 150 mg and substantially lower than the doses reported to have therapeutic effects in published clinical trials (e.g., 300-1500 mg). The legal foundations enabling access in several countries were often unclear, with marketed products sometimes failing to meet legal requirements for sale. There was an obvious disparity between federal directives and available products in both the USA and European countries examined.
Conclusions: There are a variety of approaches in how countries manage access to CBD products. Many countries appear to permit OTC and online availability of CBD products but often without legislative clarity. As consumer demand for CBD escalates, improved legislation, guidelines and quality control of CBD products would seem prudent together with clinical trials exploring the therapeutic benefits of lower-dose CBD formulations.
Keywords: Access to treatment, Cannabidiol, Cannabinoid, Cannabis, Government regulation, Medicinal cannabis
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of Competing Interests IM has acted as a consultant to Kinoxis Therapeutics, is on the Medical Advisory Board of BOD Australia, and has received honoraria from Janssen. His research is funded by the Lambert Initiative and the Australian National Health and Medical Research Council (NHMRC). He, together with JA, are inventors on several patents relating to novel cannabinoid therapeutics. JA has served as an expert witness in various medicolegal cases involving cannabis and in 2018 was a temporary advisor to the World Health Organization (WHO) on their review of cannabis and the cannabinoids. His research is funded by the Lambert Initiative and the Australian National Health and Medical Research Council (NHMRC). RC provides consultancy to the medical cannabis industry. DC is the Medical Lead for the Centre for Medicinal Cannabis (UK), an organization that is funded by manufacturers of cannabinoid medical products, and has received funding in undertaking this work. NG provides consultancy on prescription to non-prescription reclassification of medicines, and, since this paper has been written has provided consultancy on CBD availability without prescription. Other authors report no competing interests.