A Florida Massage Therapist’s Guide to CBD Oil

Everyone, and I mean everyone, is talking about CBD oil.

Massage boards are full of questions about suggested use and legality. You are likely seeing emails from massage suppliers with new CBD products. And at every massage conference, there are CBD oil booths with a company selling “the best” CBD oil.

As the popularity of CBD oil has grown, its use has gained much interest from both clients and fellow health practitioners. More and more massage therapists in Florida and around the country are using CBD oil for massage and have had numerous positive reviews.

However, many questions still remain. Is using CBD oil legal in Florida? Can I use it with my massage clients within the scope of practice? Will it help clients with x? Can I sell it in my massage establishment?

I will try my best to provide you with current information and point you towards some places to look for answers. First, before we get to specifics such as Federal laws, Florida laws, and board rules, let’s learn more about CBD oil. Here are ten frequently asked questions.

1. What is CBD oil?

Both marijuana and hemp plants are considered as “cousins” as they come from the same cannabis sativa species.

CBD, or cannabidiol, is one of the 100+ diverse cannabinoids found both hemp and marijuana. Cannabidiol has been shown in clinical research studies to benefit anxiety, cognition, movement disorders, and pain.

In particular, CBD oil is a concentrated cannabidiol extract which can be taken from either marijuana or hemp plants.

There are many ways to extract the oil from the plant and make CBD oil. One of the most common ways is Carbon dioxide (CO2) extraction to produce a clear, light amber colored oil.

A basic understanding of these different sources (hemp and marijuana) may save you from legal actions and impending sanctions depending on each state.

2. Is there a difference between CBD oil from marijuana and CBD oil derived from hemp?

Yes. As discussed previously, we know that CBD oil can be extracted either from the marijuana plant or hemp plant. CBD oil from marijuana may have a higher concentration of the psychoactive THC (Tetrahydrocannabinol) as compared to hemp, which only has minute traces of THC.

THC vs CBD

Chemically speaking, THC and CBD are the most famous and well-identified phytocannabinoids of the cannabis plant – both marijuana and hemp plants included in this species.

Tetrahydrocannabinol, or THC, is the main psychoactive component, or the one responsible for the “high” users can feel.

On the other hand, cannabidiol or CBD, is not psychoactive. It is also known to balance the side effects THC gives.

However, take note that both THC and CBD have therapeutic benefits. The difference is marijuana can get a person high, or “stoned”. while the CBD from hemp does not. As a result, the use of CBD from hemp in the form of oils, creams, and patches is growing.

Remember, that both THC and CBD are present in both marijuana and hemp plants. The difference lies in how much of these cannabinoids are present in each of them. In marijuana, THC content is high, giving itself the notorious profile. THC levels in marijuana can range from 15%-40%. While in hemp plants, THC is likely around 0.3% or lower and it has higher CBD content.

THC is basically what all the legal fuss is about using CBD oil. Hemp was made illegal to grow without a permit in the U.S. under the Controlled Substances Act passed in 1970 because of its relation to marijuana. At that time, the entire Cannabis species (which includes hemp) was categorized as a Schedule 1 drug.

3. What is the THC limit of CBD Oil?

Finally, in 2014, a U.S Farm Bill, set the THC limit for hemp and allowed for institutions of higher education to grow hemp as part of a pilot program. As stated by U.S. Federal law, hemp should not contain more than 0.3% of THC.

In 2018, another U.S. Farm Bill was passed. One of the changes in the 807-page document was the management of hemp. Hemp is now managed by the Department of Agriculture as a crop rather than by the Justice Department as an illegal substance.

The bill outlined actions that would be considered violations of the law, such as producing a plant with higher than 0.3% THC.

Hemp can be used in various commercial/textile items, such as paper, clothing, and food. Why has it not been used previously? It was illegal to grow. Hemp’s relation to marijuana was hard to legally shake. As perspective and laws have changed, hemp is now able to show its many uses.

4. What are the benefits of using CBD oil?

Through various research studies, we know that cannabidiol (CBD) is a promising compound. It is known for its anti-anxiety, anti-inflammatory, antipsychotic, antioxidant and neuroprotective effects that could greatly help a lot of conditions influenced by such pathophysiology. Let’s move onto uses for specific conditions and research.

5. Are the benefits of hem just hype or are there published research studies regarding CBD oil?

Fortunately, CBD oil is backed up by science and research. It is a very promising and natural compound that continues to spark more research and clinical trials. Read on to find out more about why CBD oil is more than just a fad.

Chronic pain which includes Osteoarthritis (OA) and neuropathic pain

The endocannabinoid system influences the pathophysiology of osteoarthritis. With the production and release of endocannabinoids, this pain mechanism may be interrupted. In addition to that, one study has shown to decrease knee joint swelling in OA.

Analgesia effects, anti-anxiety, and anti-depression

A study has found that CBD does have pain-relieving effects as well as anti-anxiety and anti-depression properties.

Anti-acne

One study has shown that CBD can actually influence the proliferation of some types of skin cells and has good antibacterial activity. In addition to CBD’s anti-inflammatory effect, it can be used as a good anti-acne agent.

Cancer-related symptoms

This is probably one of the most popular benefits and what makes medical marijuana, in general, is so controversial. We cannot deny the fact that CBD does have good qualities to treat, or at least influence certain conditions. Cancer is one of those conditions. Another study showed that cannabis does have antiemetic and antitumor properties. Though studies are predominantly still primarily used on animals, this poses a good lead for future established clinical trials.

Movement disorders such as Parkinson’s Disease (PD), Multiple Sclerosis (MS) and Huntington’s Disease (HD)

One study has shown that with CBD administration, patients reported an improved quality of life, although the improvements noted were non-motor parameters yet. However, CBD’s ability as an anxiolytic, antidepressant, antipsychotic and neuroprotective properties are indeed promising.

In another study, administration of CBD resulted in the improvement of motor patterns in patients with dystonic movement disorders.

Although more studies are needed for these, CBD oil is a promising tool for the following:

Treatment for substance abuse

In an animal study, CBD has shown to reduce morphine-dependence and heroin-seeking behavior through the administration of CBD. This results from CBD influencing the circuits of the brain that are associated with addiction.

Florida opioid epidemic – which massage profession is a part of solving

Prevention of Diabetes

In an animal study, CBD has shown to reduce diabetes and inflammation in non-obese rat models by 56%.

Antipsychotic effects

Through its antipsychotic properties, a study shows that CBD may help with the management of some mental disorders like schizophrenia.

Despite all these wonderful things and positive customer/patient feedback CBD brings, it is important to remember that CBD is relatively a new compound that needs to be studied and tested further in human models. It is a promising compound indeed, but one should not rely solely for the betterment of one’s health. Rather, having it as an adjunct to therapy would sound more rational.

6. How does CBD Oil work in the body?

How cannabinoids, in general, work is closely associated with our body’s endocannabinoid system. This system has specific receptors such as C1and C2 where the psychoactive THC sensitively binds to. However, with different studies over the years, it has been found that CBD does not actually have much influence of the said receptors. Rather, CBD works through other different mechanisms and receptors inside the body that can ultimately affect the endocannabinoid system:

Activation of TRPV1 receptors

Various cannabinoids, CBD included, can activate the TRPV1 receptors that are responsible for pain and body temperature regulation.

At high doses, activation of 5-ht1A receptors

A study has shown that high doses of CBD binds fairly well to the 5-ht1A receptors which are responsible for regulating pain, anxiety and addiction. Also, this receptor has an influence on sleep patterns, nausea and vomiting.

Activation of PPAR-gamma receptors

The PPAR-gamma receptors are involved in insulin sensitivity and dopamine release.

Antagonizes GPR55 receptors

The affinity of CBD to GPR55 receptors, which are highly concentrated in the brain, can help control blood pressure and bone density.

7. What are the side effects of CBD Oil?

Although CBD has been established as a relatively safe compound, several research studies show some adverse effects. One study has shown positive changes in appetite, diarrhea, and fatigue from CBD intake.

Another study has shown that local irritation may result and low skin penetration is possible in water-loving or hydrophilic structures. In addition to that, CBD may have potential interactions to certain drugs, especially antiepileptic drugs. If you are taking any medications, please consult with your physicians first before using CBD Oil.

8. Can CBD oil get me, or my clients, high and addicted with topical use?

No. Even though THC-containing CBD oil only has 0.3% of THC in it, this percentage is not significant at all to cause any THC-like psychoactive effects. It will take you tons and tons of impossible amounts of CBD oil to get you high and addicted.

9. Is CBD legal use and sell?

To tell you the truth, it’s complicated. There is actually no straightforward answer to this question. Although industrial hemp use is now widely considered legal in all 50 states because of Federal law, state laws still come into play.

It can all boil down to where the CBD oil came from, marijuana or from hemp.

From a legal perspective, hemp-derived CBD is often considered legal as the plant does not give psychoactive effects. Other hemp-derived products are textiles and clothing are also not illegal. Marijuana, on the other hand, has a very different story. Since it has psychoactive effects from the THC content. Thus, marijuana-derived CBD is not legal in the majority of the states.

Now, the problem is that since hemp and marijuana are cousins and come from the same plant species family, there is also a close association between CBD Oils of both plants. This results in a stigma towards hemp-derived CBD Oil that also causes confusion and differing state laws.

As of early 2019, there are less than ten states that consider the use of hemp and marijuana to be legal – both recreationally and medicinally.

But this number is changing all the time. So much that I do not want to list them here. Check here to see to the status of state laws.

If you are from these states, you are likely free to use CBD oil from any plant source without a doctor’s prescription. If you’re not in these states, it would be best to consult with your state laws to determine the legality of CBD Oil use.

What about in Florida?

Marijuana

On a federal level, medical marijuana is still illegal. However, Florida voters approved the Florida Medical Marijuana Legalization Initiative on November 8, 2016. Known as Amendment 2, this law authorizes the use of medical marijuana by Floridians with certain debilitating illnesses.

Department of Health Medical Marijuana FAQ

CBD oil

We talked about the Farm Bill and paving a way for legal CBD and hemp use, but there is still so much confusion and old regulations that still exist. Just this year Sarastota police planned a crackdown on CBD oil retailers, including massage establishments. Then they announced plans to delay that effort.

One of the issues is that most CBD retailers are not licensed medical marijuana dispensaries. A Sarasota police investigator stated CBD oils derived from hemp still fall under the definition of cannabis. Therefore, they say selling CBD oil is not legal under Florida law unless it is distributed by a medical marijuana treatment center.

*UPDATE*
Just this summer, Governor DeSantis signed Florida Senate Bill 1020, regulating hemp in Florida, which includes state regulation cannabidiol (CBD). It appears the Department of Health now has to make some rules regarding Hemp and CBD oil. Here is a helpful page from the Florida Department of Agriculture.

10. Is it within the scope of practice for massage therapists to use CBD oil?

I am not a lawyer and I cannot interpret Florida law. However, I am a Florida Laws and Rules course instructor and I can copy and paste the definition of “massage” below according to Florida’s Massage Practice Act.

Take note of the last line, “the application to the human body of a chemical or herbal preparation”. Does that apply to CBD oil?

480.033 Definitions.—As used in this act:

(3) “Massage” means the manipulation of the soft tissues of the human body with the hand, foot, arm, or elbow, whether or not such manipulation is aided by hydrotherapy, including colonic irrigation, or thermal therapy; any electrical or mechanical device; or the application to the human body of a chemical or herbal preparation.

Tell me your thoughts now about CBD oil and massage. Do you plan to use it in your practice or sell it in your establishment? If you are already using it, what results are you seeing?