Cannabidiol at the crossroads: panacea, placebo, or problem?

Cannabidiol (CBD) is widely perceived as a safe and effective treatment for a growing list of health indications and use for general wellness. Evidence for its safety and efficacy comes from a variety of sources, including preclinical studies, clinical trials, and observational studies of real-world evidence. The challenge in interpreting these data is that CBD products are diverse with respect to format, formulation, intended route of administration, dose, and regulatory oversight with regard to quality assurance and labeling. This Circumspectives article presents two perspectives: one emphasizing CBD's potential as a pharmacologically diverse therapeutic agent with tremendous potential to treat debilitating health conditions for which there are limited alternative therapies and another highlighting concerns with the quality of existing evidence, misapplications of use, and risks related to both direct effects of CBD as well as quality control issues with retail products that lack proper regulatory oversight. Finally, these perspectives are integrated to provide guidance for reducing variability and improving clinical translation in CBD research.