A new preprint study under review shows how the CBD products market is shaping the consumption of prescription drugs in Italy.
The local availability of cannabis flowers, as known as light cannabis led to a significant decrease of dispensed boxes of anxiolytics by 11.5%, a reduction of sedatives by 10%, and a reduction of antipsychotics by 4.8%. Also, the study found a reduction of consumption of antiepileptics (- 1.5%), antidepressants (-1.2%), opioids (-1.2%), anti-migraines (-1%).
To conduct the study, Italian researchers used a unique longitudinal dataset recording monthly drug sales and mapping the local market availability of retailers selling CBD flowers. They matched the data of 106 Italian provinces from January 2016 to February 2018. CBD product data was acquired using web scraping on the sites that map their online presence in the reference period. Data on prescription drug sales were obtained by the Italian association of pharmacy owners Federfarma and by the Italian national health system.
CBD In Italy
Since the CBD market popped up in Italy in 2017, the number of dispensed drugs sales decreased by approximately 1.6% on average. Researchers considered seven categories of drugs: opioids, anxiolytics, sedatives, antimigraine, antiepileptics, antipsychotics, and antidepressants.
The study links the reduction of consumption of these prescription drugs with the recognized or advertised clinical effects of CBD. The accessibility to these products encouraged some patients to try CBD for relief instead of consuming prescription drugs.
Italian cannabis law entered into force in 2017 and allowed farmers to cultivate cannabis plants with a THC level below 0.5%.
However, cannabis law doesn’t regulate the sale of cannabis flowers. On the one hand the sale of cannabis flowers is not allowed, but on the other hand it isn’t forbidden.
This lack of regulation created a legal loophole, so Italian CBD companies and retailers started to sell cannabis flowers with THC levels below 0.5%.
This legal loophole created a new market; it has given jobs to more than 10,000 people and started up about 1,500 companies with a turnover of €150 million in 2018.
Italians have started to recognize the benefits of CBD and use it for several purposes. CBD flowers have also attracted new consumers that were using prescription drugs. According to the study, they may have found in light cannabis a more effective treatment than traditional drugs.
However, the study highlights some critical issues to take into consideration.
Self-medication with CBD products can be an alarm bell for lawmakers as people may not follow expert advice.
Additionally, the current cannabis law needs clarity about the sale of CBD flowers as the lack of regulation of the Italian cannabis market puts retailers and companies in danger.
Furthermore, the substitution of prescription drugs with CBD products highlights the lack of access to legal medical marijuana. The large-scale availability of CBD flowers may also lead to substitution patterns not clinically indicated, according to the study.
Using CBD flowers for medical purposes may not be as beneficial for the health of patients because the quality control is different from medical marijuana…and people still tend to confuse CBD cannabis with medical marijuana.
Access to medical marijuana is not always easy and the rules to apply for a program vary from region to region. As most of them pertain to chronic diseases, they don’t include pathologies such as anxiety and depression. Hence, patients may find relief with CBD flowers, which are less expensive and don’t need a prescription.