Understanding the Legal and Ethical Implications of Using CBD for Cancer

Understanding the Legal and Ethical Implications of Using CBD for Cancer

Cannabidiol (CBD), a non-psychoactive compound derived from the cannabis plant, has garnered significant attention for its potential therapeutic benefits, particularly in managing symptoms associated with cancer and its treatments. However, the use of CBD in oncology raises complex legal and ethical questions that patients, healthcare providers, and policymakers must navigate.​

Legal Landscape of CBD Use in Cancer Treatment

Federal Regulations

In the United States, the legal status of CBD is primarily governed by the 2018 Farm Bill, which legalized hemp-derived CBD products containing less than 0.3% tetrahydrocannabinol (THC) at the federal level. This legislation aimed to distinguish hemp from marijuana, facilitating the growth of the hemp industry and the availability of CBD products. However, this federal legalization does not extend to all cannabis-derived products. CBD products exceeding the 0.3% THC threshold remain classified as marijuana under federal law, rendering them illegal at the federal level.

State Regulations

Despite federal guidelines, the legality of CBD varies significantly across states. As of 2025, 39 states have legalized medical marijuana, and 24 states plus the District of Columbia have legalized recreational marijuana use. These state-level decisions create a patchwork of regulations, leading to confusion among patients and healthcare providers regarding the legality and availability of CBD products for cancer treatment.​

FDA Oversight

The U.S. Food and Drug Administration (FDA) has not approved any CBD products for the treatment of cancer or its symptoms, with the exception of Epidiolex, a CBD-based medication approved for certain types of epilepsy. The FDA has issued warning letters to companies marketing unapproved CBD products with unsubstantiated claims to treat or cure cancer, emphasizing the importance of rigorous scientific evaluation to ensure safety and efficacy.

Ethical Considerations in CBD Use for Cancer

Informed Consent

Patients considering CBD as part of their cancer treatment regimen must be provided with comprehensive information about its potential benefits and risks. Given the limited clinical evidence supporting CBD's efficacy in cancer care, healthcare providers have an ethical obligation to ensure that patients are fully informed and not misled by unproven claims.​

Access and Equity

The legal variability of CBD products creates disparities in access, particularly for patients in states where CBD remains illegal. This inequity raises ethical concerns about fairness and the right of all patients to explore potential therapeutic options.​

Regulatory Oversight

The lack of FDA-approved CBD products for cancer treatment underscores the need for robust regulatory frameworks to ensure that any cannabis-derived therapies are subject to rigorous scientific scrutiny. Ethically, it is imperative that products marketed for cancer treatment undergo clinical trials to establish their safety and efficacy, protecting patients from potential harm.​

Conclusion

The intersection of CBD use and cancer treatment presents a complex landscape of legal and ethical challenges. While emerging research suggests potential benefits of CBD in managing cancer-related symptoms, the absence of FDA approval and the variability in state laws complicate its use. Ethically, it is crucial to prioritize patient safety, informed consent, and equitable access to ensure that CBD is used responsibly in cancer care. Ongoing research and policy development are essential to clarify the role of CBD in oncology and to establish guidelines that protect and benefit patients.

References:

U.S. Food and Drug Administration. FDA Warns Companies Marketing Unproven Products Derived from Marijuana That Claim to Treat or Cure Cancer. 1 Nov. 2017, www.fda.gov/news-events/press-announcements/fda-warns-companies-marketing-unproven-products-derived-marijuana-claim-treat-or-cure-cancer.

Holland, Kimberly. “CBD for Cancer: Can It Help People Cope?” Healthline, 6 June 2022, www.healthline.com/health/cancer/cbd-for-cancer.

Smith, Amy. “Is CBD Oil Legal in All 50 States?” Investopedia, 12 Jan. 2024, www.investopedia.com/marijuana-legality-by-state-4844504.

Whiting, Penny F., et al. “Cannabinoids for Medical Use: A Systematic Review and Meta-Analysis.” JAMA, vol. 313, no. 24, 2015, pp. 2456–2473. doi:10.1001/jama.2015.6358.

Blessing, Esther M., et al. “Cannabidiol as a Potential Treatment for Anxiety Disorders.” Neurotherapeutics, vol. 12, no. 4, 2015, pp. 825–836. doi:10.1007/s13311-015-0387-1.

Shannon, Scott, et al. “Cannabidiol in Anxiety and Sleep: A Large Case Series.” The Permanente Journal, vol. 23, 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553.