Cannabidiol – better known as CBD – is the wonder substance of the moment, showing up everywhere from dog treats in Sandy Springs to an oil-selling booth at Perimeter Mall to craft cocktails in Buckhead.

Retailers say the hemp extract can help treat pain, anxiety and insomnia. But some medical experts say the booming business causes confusion with marijuana products and that CBD needs more safety research, regulation and enforcement of existing rules.

Joe Salome, the managing partner of The Georgia Hemp Company, explains the store’s products to a customer. (Evelyn Andrews)

The Georgia Hemp Company, a store specializing in CBD products, opened last year at 290 Hildebrand Drive in Sandy Springs. Its sells CBD oil, as well as infusing it in gummy candy, beauty products and seltzer water, among many others.

Joe Salome, the company’s managing partner, said he believes the increase in CBD use is due to people hearing anecdotal stories through the internet about how it can help with their conditions.

“There’s a lot more access to knowledge and positive stories about cannabis,” he said.

Ira Katz, owner of the Little Five Points Pharmacy in Atlanta, is concerned about CBD businesses proliferating without regulation.

“There are hundreds and hundreds of companies that have come out of the woodwork — in the last six months, even the last year — with all kinds of CBD products,” said Katz.

“I’m leery of that,” he said. “These companies are manufacturing products without any regulation or control. I recognized the value of CBD early on, but it should be from a qualified company that does the assays — the testing — and one that’s regulated.”

Companies have introduced a wide variety of CBD products, including candy, coffee and dog treats, but officials say that food uses are banned under little-enforced federal law. And in a time when some states are legalizing marijuana for recreation or medical uses, some experts say, the CBD craze is building off confusion about the various chemicals and plants involved.

The cannabis connection

Cannabis is a plant that contains CBD as well as THC, which is the substance that causes a “high.” Cannabis has different strains, including marijuana, known for its high THC content, and hemp, which has a low-thc content.

All CBD products are required by federal law to contain no more than 0.3% THC, and so CBD comes from the hemp plant, according to a Harvard Health Publishing article, one of its medical school’s publications.

Dr. Vinita Singh, the director of cancer pain at the Emory Pain Center, said she believes there was a spike in interest in CBD following the U.S. Food and Drug Administration’s approval of one drug containing the chemical. But that doesn’t mean all CBD products have been marked as safe, and much more research is needed into long-term effects of using the chemical, she said.

There is no sign that CBD is habit-forming, Singh said. That makes it a promising option for pain management, she said. But there is still a lot that is not known about CBD, including how safe it is, Singh said.

“It has the potential, but we’re still not sure about its effects,” she said. “There is a lot of research going on.”

Dr. Cynthia Rudert, a Sandy Springs gastroenterologist, says she thinks many sellers of CBD are “cashing in” on confusion with a different substance with known medical benefits: Low-THC oil.

“People are confused and think they’re interchangeable. People don’t know the difference,” said Rudert. “…You’re seeing signs pop up all over, saying, ‘Come in this gas station and buy CBD.’”

Rudert said she sees many patients who use CBD oil to manage stomach and digestive issues and is authorized to prescribe low-THC oil once it becomes available.

Low-THC oil comes from marijuana, not hemp, and was legalized by the state in 2015 for certain conditions, such as Crohn’s disease, cancer and seizures. Georgia residents with a registration card will be able to buy low-THC oil when it becomes available from local producers, though that could be a year or more away.

When people are able to obtain the low-THC oil in Georgia, it remains to be seen whether it will affect CBD sales.

Salome at the Georgia Hemp Company doesn’t see low-THC oil as a replacement or better version than CBD because many customers are using it to relieve other problems that can’t legally be treated with the oil, he said. But many customers remain confused about the differences and laws regulating them and marijuana, he said.

The Georgia Hemp Company sells CBD-infused gummy candy, on the left, and chocolate, right. (Evelyn Andrews)

Salome acknowledged that claims about how CBD can help have not been proven or evaluated by the FDA. People are only relying on anecdotal information at this point, and literature distributed by Salome’s company states that its CBD products are “not intended to diagnose, treat, cure or prevent any disease or condition.”

Adding CBD to food products is currently unlawful due to FDA regulations, according to the Georgia Department of Agriculture.

“The state of Georgia follows the rules established by the Federal Food and Drug Administration, and FDA has been very clear that CBD is not currently permissible for inclusion in food and dietary supplements,” Commissioner Gary W. Black said in an April statement.

Julie McPeake, a state Department of Agriculture spokesperson, confirmed the practice is still illegal, but added the state department only enforces the rule when it is in a product manufactured in the state. If it is a product shipped to Georgia to be sold, the state leaves it to the FDA to regulate.

“It is rampant issue at this point. There are a lot of products out there,” McPeake said. “There’s not enough enforcement capabilities.”

The FDA warns that it is important to talk with a doctor before using CBD to treat a disease, as it has not been proven to be effective or safe. The agency says it is working to study the effects CBD could cause in the body, because it’s unclear what the effects are when people are using it far more widely than the single medication with CBD that the FDA has approved.

The FDA also formed a working group in April to “explore potential pathways for dietary supplements and/or conventional foods containing CBD to be lawfully marketed” as interest in products containing CBD continues to grow, according to the agency’s guide.

Salome confirmed that he sells food products with CBD added, but said he’s “not concerned” about enforcement.

Local retailers

The Georgia Hemp Company, which has a wall decorated with a design of hemp leaves, carries CBD in a wide range of forms other than the traditional oil. There’s brownie mix, bath bombs, coffee, gummy candy, kombucha, seltzer water, lotion and pills. The store also sells vape pens that allow CBD oil to be inhaled, and such supplies for pets as dog biscuits.

Most of Salome’s customers use CBD to relieve anxiety, inflammation, pain or insomnia, he said. The company saw a boom in pet products around July 4, when many pet owners were looking for ways to keep their dogs calm during holiday fireworks, Salome said.

He also believes the millennial generation is increasingly looking for options other than traditional pharmaceuticals. Celebrities have begun endorsing it, and big box retailers like CVS and Walgreens are introducing it in stores.

Mari Geier, the co-owner of Nuts ‘n Berries Healthy Market, a health store in Brookhaven that has sold CBD since 2015, said she thinks it will become increasingly important as more businesses sell CBD to pay attention to the quality of the products and “not get duped in marketing.” Some businesses use words like “full-spectrum” and “broad-spectrum,” but they don’t mean much when it comes to what the product actually is, she said.

“You should not be buying CBD oil from a gas station shelf or on the internet from a business you don’t know,” she said.

Geier said the store started selling CBD products in 2015 after they begin seeing a small demand, starting with one trusted supplier. The store has since expanded to carry over 30 brands and beauty products and edibles.

“We thought we could help people by providing CBD,” she said.

A guide to hemp and CBD terminology

Cannabis: A plant with related strains, including those known as marijuana and hemp

Hemp: Hemp is a cousin to marijuana that contains lower levels of THC, the compound that produces a “high.” Hemp sold is required by federal law to contain an “extremely low” amount of THC – no more than 0.3%, according to the FDA. Industrial hemp and marijuana are both varieties of cannabis, but they have been bred for different uses and can be distinguished by their chemical and genetic compositions.

Marijuana: Marijuana contains much more THC than hemp and can produce a “high” when used. The plant is currently illegal in Georgia, most other states and federally.

CBD (cannabidiol): CBD is a chemical that occurs in cannabis; the kind sold in stores is typically an extract of the hemp plant. CBD is an essential component of medical marijuana, but only when it’s above 0.3% in potency.

Low-THC oil: Low-THC oil is derived from the marijuana plant and contains no more than 5% THC by weight. Low-THC oil was legalized in Georgia in 2015 in a law that allows only registered users to obtain the oil for use to treat select conditions, like cancer and seizures.