
Are CBD products still worth the hype?

Summary
CBD products may be everywhere but are consumers and doctors in India accepting them them as truly effective solutions?Ankit Shah* (name changed), a 38-year-old Mumbai-based IT professional, suffers from acute shoulder pain due to a past injury and takes CBD oil (from BOHECO) to relieve pain. He shares that he only takes it on days when the pain is unbearable or on days when he hasn’t slept well. Shah says that he'd recommend CBD products for stress and pain relief and assures that it's not habit-forming. “I only use it on a need-to basis," he says.
Ramesh S* (name changed on request), a 31-year-old Bengaluru-based writer, began using a CBD oil in 2019 to help him get restful sleep after seeing it advertised on Instagram. “I found it greatly improved my sleep and I'd wake up feeling rested," he recalls of the initial days.
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Shah and Ramesh are just examples of consumers in India who are openly embracing CBD wellness products as a natural alternative for managing niggline issues like stress, sleep, and chronic pain.
If one had to trace back the rise of CBD products in the country, in 2018, Uttarakhand became the first state in India to legalise industrial hemp farming, Uttar Pradesh followed suit, and recently, Himachal Pradesh has legalised it. In the same year, the Ministry of AYUSH (Ayurveda, Unani, Siddha and Homeopathy), started handing out licenses for sale of cannabis and derived products— in the form of oils and tablets— for medicinal use. And in 2021, Food Safety and Standards Authority of India (FSSAI) stated that the sale of hemp seeds and related products is standardised under the Food Safety and Standards Regulations 2011.
Since 2018, several direct-to-consumer (D2C) companies like BOHECO, Qurist and Awshad among others that sell CBD oils and pills have come up. CBD or cannabis oil, is said to help those with anxiety, severe migraine and provide relief for patients under palliative care. According to a 2021 report by Market Research Future, the Indian CBD Oil market was one of the fastest-growing in the Asia-Pacific region, indicating that Indians are becoming more open to using CBD oil to tackle pain, anxiety and insomnia.
“In India, consumer behavior towards CBD oil and cannabis at large has transformed significantly since 2013 (when BOHECO started out). Back then, awareness was minimal, and cannabis-based products were largely stigmatized. Today, there is growing acceptance, driven by increased education, healthcare integration, and advocacy from companies like ours," says Yash Kotak, co-founder and chief marketing officer, BOHECO (Bombay Hemp Company). Consumers now understand finer nuances like the difference between CBD (cannabidiol, or the chemical substance found in cannabis) and THC (tetrahydrocannabinol, the primary psychoactive component in marijuana), Kotak observes.
“Regulatory clarity and doctor's trust in the space have further expanded acceptability, even in smaller cities. However, lingering stigma, regulatory challenges, and cost sensitivity remain barriers to widespread adoption," Kotak adds.
CBD: A PAINFREE SOLUTION?
CBD may be used for issues like seizure disorder (epilepsy), anxiety, pain, dystonia, Parkinson's disease, Crohn disease, schizophrenia, diabetes, multiple sclerosis, depression, insomnia and post-traumatic stress disorder (PTSD), explains Dr Manish Pendse, senior consultant physician & diabetologist at Medicover Hospitals, Navi Mumbai. He adds a warning however. “There can be many people who might be tempted to use CBD products without the doctor’s knowledge. But since consuming them can cause side effects like dry mouth, poor appetite, diarrhoea, drowsiness and fatigue, sleepiness, eye problems, liver inflammation and damage, and slow breathing, it's highly recommended that they be used only with a prescription or medical guidance," Pendse clarifies.
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Ramesh says that over the years he's had mixed reactions to CBD products.
“A couple of years later, I decided to try a CBD formulation for stress. That seemed to have no effect. Sometimes it has made me feel better but at other times it has given me mild anxiety. I didn't feel it was habit-forming per se, though there were perks that made me want to take it —I enjoyed eating food more as it improved my appetite. However, the anxiety it sometimes gave me, more than made up for the pros and over time I stopped using them," he shares.
“The effectiveness of CBD oil may vary, so does the risk. More concrete research needs to be done to understand the effectiveness of using CBD oil for multiple purposes. Those who are pregnant, actively breastfeeding, taking certain medications, or previous history of substance abuse should refrain from using CBD oil as it can worsen their health condition," says Dr Ankit Mule, consultant internal medicine, Wockhardt Hospitals, Mumbai. He also cautions against using CBD oil on children, especially without guidance from a doctor.
“Several research studies have shown that CBD usually carries a lower risk of making people addicted to it. Most individuals easily get influenced by seeing others and try to order this oil to seek instant relief from several problems like anxiety, sleep disorders, and pain without consulting their doctor. These impulsive habits can be harmful to their overall well-being," Mule cautions.
Karan Mehta, a 26-year-old Pune-based entrepreneur says he used CBD oil about three years ago, when fractured his clavicle bone post an accident. “My aunt, who lives in the US introduced me to CBD oil to manage the pain. And it really worked wonders. It also helped me calm down (I was diagnosed with ADHD as a child). It helped me focus better and grounded me. I would take it twice a day— early in the morning and before bed." Mehta doesn’t use CBD oil anymore, unless he feels very anxious, or disoriented—which is a rarity. Mehta hasn’t tried CBD products from any of the Indian brands as he feels they’re very highly priced.
WHAT THE BRANDS SAY
Samisht Sehgal, founder and CEO of Qurist, a Gurgaon-based company selling medical cannabis products, says that his motivation for starting the company was his grandmother being diagnosed with breast cancer. “In India, we give importance to length of life, rather than to quality of life. But, I really wanted my grandmom to enjoy quality life despite her cancer diagnosis. So, I got special permission and flew in CBD oil from the US. Her quality of life improved greatly— she could manage pain better, her appetite improved and she was less anxious." Sehgal shares that their most popular product is Pain Away, a pill containing CBD oil.
“Most of our consumers use our products for pain management, for arthritis, cancer care and palliative care," says Kotak. As for demographics, he shares that Bliss (pure CBD oil) for anxiety and stress management is popular amongst users between ages 30-45 while Combat (pure spectrum leaf extract), for pain management and palliative care is preferred by consumers aged 40-60. And while Kotak says that CBD products have several benefits, including improved focus, he says that products with THC (tetrahydrocannabinol), should be used with caution, as there’s a probability of it being abused.
Thanks to regular news reports, there's better awareness of CBD products in urban India but Sehgal says that it's not enough. “A lot of times, people are just surprised to know that medical cannabis is legal. Then the questions that we usually get are, ‘Does it have any side-effects?’ ‘Will it interact with the medicines I’m already taking? ‘Do I need to stop the medication I’m already taking to try medical cannabis?’ and so on," he shares. Another factor that stops people from readily trying out these products is the compulsory mandate of a medical prescription. “Yes, the need for a prescription from a doctor does dissuade customers as it can seem like too much trouble. But we highly recommend consulting a doctor before taking medical cannabis, because only a doctor can tell you how to adjust the dosage of your other medication accordingly," he says.
Another aspect is that the formulations for medical cannabis aren’t standardised, which can affect the impact of the product on every user. “It isn’t like paracetamol, where one could take 250mg. Every brand has a different formulation, every brand’s CBD and THC levels may vary and the method of extraction differs," Sehgal adds.
Formulations may differ but quality control is something that the brands don't compromise on. “We ensure the quality of our raw materials. We partner with trusted suppliers, conduct thorough third-party lab tests, and follow strict quality control measures at every stage of sourcing and production. While this does add to the expenses, it’s essential to guarantee the safety, efficacy, and consistency of products, ultimately ensuring a better experience for customers," reveals Kotak. While the premium price can be a deterrent for some, Kotak says that it’s often offset by effectiveness of the products, especially when recommended by doctors for specific conditions. “The key challenges in attracting more customers include overcoming the lingering stigma around cannabis-based medicines and the limited awareness about CBD’s benefits," he adds.
As a wellness category still in its nascence in India, there's a long way to go before CBD products are wholly accepted. Pendse reflects that view when he says that he would not prescribe CBD oil to any of his patients as it could interact with other medications of the patient and reduce their efficiency. Mule feels that more concrete research needs to be done on the effectiveness of CBD products for various conditions.
Sumitra Nair is an independent writer based in Kochi, Kerala.