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Comment by ryanmercer | Hacker News Reader

>People are super thirsty for CBD,

Because you can't open social media without seeing music artists, actors, comedians, strength athletes, social-media-only-famous people shilling for one company or another with sponsored posts.

>it is very effective for many people.

Placebo is a hell of a drug. There is no credible, replicable, evidence that CBD does anything for anyone, and it's done nothing for many people duped into buying it, it's likely acting as a placebo. It's all n=1 posts, "my friend's uncle has cancer and took some and man it changed his life", SEO advertorial blogs and 'press releases', forum posts etc.

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There is no credible, replicable, evidence that CBD does anything for anyone

There are studies that show it is reasonably effective for some intractable forms of epilepsy

https://www.nejm.org/doi/full/10.1056/NEJMoa1611618

Indeed there is an official licensed medicinal version called Epidolex and the FDA recently approved it https://www.fda.gov/newsevents/newsroom/pressannouncements/u...

(however this often gets overblown somewhat by the pot lobby, so I share your concerns about snake oil in general)

Maybe a more accurate statement is the efficacy of the doses available for retail purchase.

The paper you cited used “cannabidiol oral solution at a dose of 20 mg per kilogram of body weight”

So for a young adult of 50kg this is 1000mg/day.

Amazon’s maximum dose I could find is 1000mg for $50 [0]. So to get these kinds of benefits someone would need $1500/month.

I would like to see more studies at the kind of doses these retail doses marketed to grandmas (mine in particular).

[0] https://www.amazon.com/Natural-Hemp-Drops-Relief-Essenzia/dp...

So you went from

>Placebo is a hell of a drug. There is no credible, replicable, evidence that CBD does anything for anyone, and it's done nothing for many people duped into buying it, it's likely acting as a placebo.

To "it works, but it's too expensive." Ok.

I never said that.

Well you're right. I assumed it was the same person, my mistake.

Thanks for the response.

Yes, it is expensive. I don't know what to tell you other than you are wrong. If you look at your own statements, you will see you stated unequivocally that CBD isn't effective.

Now you are backpedaling saying its expensive. Yes, it is expensive. And I promise you it's not hard to see that it absolutely works for some people. If you understood how well cannibinoids fit into our brains, this may not surprise you.

Having looked into pricing and done quite a bit of research, the cheapest I have seen for pills is 50c for 25mg. But this is still $600/month for a 1000mg dose.

I think most people are taking less than this. But still 300-600mg is expensive. But, its not much more expensive that other "mediciine" that needs to be taken every day.

You might be confusing me with someone else. I never said equivocally or unequivocally that cbd wasn’t effective. I said at retail doses it’s not effective because it’s different than what the study says.

A $600/month otc treatment is not realistic. I’m really familiar with retail cbd use. I don’t think it’s harmful. But these retail offerings are not advertising 1g/day doses and instead include droppers and market small doses.

I haven’t read any studies that show these low doses having the anecdotal impact.

If it absolutely works for some people, then we’ll have RCTs and published results for us both to discuss. That will be great.

There’s lots of expensive medicine. There’s also medicine that’s dirt cheap ($6/month metformin, $3/month ssris, etc).

With research cbd will be very affordable as well. Because now, it’s only available in the doses in the referenced papers to rich people. Which is nice, but if it is as amazing as folks feel it is then prices really need to come down.

Apologies. I thought it was the same person.

However you are wrong that a $600/month otc treatmnet is not realistic. It's certainly not ideal, it's certainly out of the financial range of many people. .

And certainly there are people right now spending $600/month for CBD because it works.

Prices will definitely come down, and I agree they "need" to. I suspect we will have synthesized CBD quite soon). Minus the black market, and then minus the hype, and then plus the increase in production, prices have a long way to go down.

Assuming the stuff is actually safe, I've seen 1000MG for $15.

Please share that link. That would still put the price at $450/month.

I don’t know of anything that shows a risk or danger.

To what extent has it been properly studied? If you're asserting it's a placebo effect, shouldn't that mean you have significant proof no other effect is involved?

I haven't tried it, but I have friends with chronic pain that prefer it to both opiates and OTC painkillers and have for years. That certainly could be placebo, but having seen them cycle through a variety of approaches and stop on CBD, I'd be surprised there's absolutely no effect.

> If you're asserting it's a placebo effect, shouldn't that mean you have significant proof no other effect is involved?

Thats not how scientific research into drugs works. The null hypothesis that you hold by default is that the substance being studied has no effect. The purpose of research is to demonstrate that an effect exists and until that has been shown the null hypothesis is held to be true.

https://info.umkc.edu/drbanderson/null-hypothesis-testing/

Perhaps you could try assuming that I knew about the null hypothesis already and still wrote what I wrote.

there is credible, replicable, evidence that CBD is effective for a number of problems. You do need to be an expert in drugs and scientific literature to appreciate this. I don't generally use appeal to authority, but this is a case where I am knowledgeable (20+ years in drug discovery, interest in CBD) and have read enough literature to see that there is enough evidence to pass the necessary bars.

Repeating the same reply near verbatim doesn’t make it any more untrue, it just proves to other readers you have an agenda to push.

I absolutely have an agenda, that of the scientific method and skepticism. Show me peer-reviewed, widely accepted, research that supports that CBD is a miracle panacea, you can't, it doesn't exist.

What does exist is lots of link-farm SEO ad copy, people claiming on forums that along with their mega-dosing iodine and salt lamps they've seen drastic changes in their cancer/aids/anxiety/pain, and then gobs and gobs of people claiming anyone that says CBD isn't a cure-all 'has an agenda to push' and/or is being paid 'by big pharma'.

Most sellers of CBD oil are outright committing fraud with claims they make, they have paid influencers (that often don't disclose clearly they are doing a paid endorsement), with fake reviews and almost certainly with armies of fake advertorials on forums.

If CBD does have valid medical benefits, it's almost certain that it will not have anywhere near the current alleged number of applications.

> Show me peer-reviewed, widely accepted, research that supports that CBD is a miracle panacea

That's clearly a strawman: nothing is a panacea. But here are some links from the first page of Google when I searched for "CBD research":

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189631/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/

Each have dozens or more citations and are from reputable scientists at large universities. If your agenda is "the scientific method," hopefully that Google search helped.

We should regulate CBD so that salespeople don't make absurd claims about what it can or can't do. But claiming that it's on par with megadosing iodine or salt lamps is pretty uneducated.

Citing a part of the first paper's Conclusion:

> Until data from well-designed clinical trials are available and reliable, and standardized CBD products that are produced using GMP are available, caution must be exercised in any consideration of using CBD for the treatment of epilepsy. In the meantime, based upon promising preliminary data, further clinical research should be wholeheartedly pursued.

Citing a part of the second paper's Conclusion:

> Human experimental findings support preclinical findings, and also suggest a lack of anxiogenic effects, minimal sedative effects, and an excellent safety profile. Current preclinical and human findings mostly involve acute CBD dosing in healthy subjects, so further studies are required to establish whether chronic dosing of CBD has similar effects in relevant clinical populations. Overall, this review emphasizes the potential value and need for further study of CBD in the treatment of anxiety disorders.

So the second one says it seems good for acute dosing. Both say more research has to be done. Let's hope this is being done in the near future.

> Both say more research has to be done. Let's hope this is being done in the near future.

Things have changed some in recent years, but it’s still very difficult to do accredited scientific research when something is a scheduled narcotic.

You are not arguing in good faith. WHile I agree with the statement, "Most sellers of CBD oil are outright committing fraud with claims they make", the legitimate scientific establishment has demonstrated several valid applications. The scientific community never claimed it was a cure-all.

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