September 19, 2018

Coca-Cola may launch a cannabis-infused 'wellness beverage.' Is that a good (or legal) idea?

Daily Briefing

    Coca-Cola is exploring the cannabis-infused beverage market with an eye toward creating a "functional wellness beverage"—but it's unclear whether such a product would be legal in the United States, and medical professionals caution that cannabidiol's (CBD) purported wellness benefits are largely unproven.

    Just updated: Your cheat sheets for understanding health care's legal landscape

    Coca-Cola's plans

    According to a BNN Bloomberg report, Coca-Cola is interested in CBD-infused drinks as a possible means of treating inflammation, pain, and cramping.

    Coca-Cola spokesperson Kent Landers said the company is "closely watching the growth" of beverages infused with cannabidiol (CBD) "as an ingredient in functional wellness beverages around the world." Landers added that the market is "evolving quickly" and emphasized that "[n]o decisions have been made at this time."

    What does the law say?

    One roadblock is that it's not entirely clear whether companies can legally sell CBD in the United States. Currently, the U.S. Drug Enforcement Administration views CBD as a Schedule 1 drug, meaning it's entirely illegal. However, hemp—which is a variety of the cannabis plant regulated by the U.S. Department of Agriculture—also contains CBD and can be legally sold, provided it contains only a very low amount of THC, marijuana's active ingredient.

    Since the Department of Agriculture tests only for THC and not CBD in hemp, some companies are able to sell hemp-derived products they say contain CBD, according to Sara Jane Ward, an assistant professor of pharmacology at the Temple University Lewis Katz School of Medicine.

    Kris Kane, president of 4Front, a firm that advises companies on cannabis law, said it's not likely Coca-Cola would develop a CBD-infused beverage in the United States in the current legal environment. He expects the company will instead develop the product in Canada first, readying it for the United States in the event that federal law changes. "I can't imagine they're doing it just for the 35 million people in Canada, they clearly have an eye on the U.S. market," Kane said.

    Bonnie Herzog, an analyst with Wells Fargo, said she estimates the cannabis-infused beverage market to become a $50 billion annual market in the United States.

    What does the science say?

    But would a "wellness beverage" that contains CBD actually lead to better health? Proponents of CBD say it helps fight anxiety, depression, pain, and stress—but there's little research to back up the most extravagant of these claims.

    What is well-supported is CBD's effectiveness in treating rare seizure disorders in children and epilepsy, according to the World Health Organization (WHO). There's also some evidence to suggest that CBD can help with anxiety, according to Robert Carson, an assistant professor of neurology and pediatrics at Vanderbilt University. "In children, especially those with autism spectrum disorders, this may manifest as improved interactions with others."

    Other, more limited research has shown CBD has potential in treating Alzheimer's disease, cancer, psychosis, and Parkinson's disease, according to WHO. David Shurtleff, the acting director of the National Center for Complementary and Integrative Health, said if CBD is "proved effective for anxiety, depression, and panic disorder, it may have other effects as well that could be useful and beneficial." Shurtleff cautioned, however, that "this is a really early stage."

    So why, in spite of such limited evidence of effectiveness, has CBD attracted such widespread enthusiasm? Jordan Tishler, a physician at Harvard University and CEO of InhaleMD, which specializes in cannabis therapeutics, trumps the hype up to the placebo effect. He explained people often take CBD with the assumption that it will help them so "they're going to get some perceived benefit because that's the way the placebo effect works, and then they go and trumpet this."

    There's also little research into potential risks of CBD. The most commonly reported side effects are minor, such as dry mouth and dizziness, but Tishler noted CBD is metabolized by the same enzyme that metabolizes other medicines, which could cause the levels of other medications already in a person's system to rise—potentially to fatal levels.

    The bottom line: "Please be open with [your] physicians regarding what [you] are taking," Carson said (Skerritt/Giammona, Bloomberg, 9/17; Miller, U.S. News & World Report, 3/1; Murray, MSN, 10/27/17; Hafner, USA Today, 9/17; Isidore, CNN Money, 9/17).

    Just updated: Your cheat sheets for understanding health care's legal landscape

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