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The pandemic, climate change, rapid inflation and a surge in violence are contributing to a mental health crisis.
Against that backdrop, demand for antidepressants, anti-anxiety and anti-insomnia drugs is booming. In 2021, there were 337,054,544 antidepressant prescriptions, according to data from IQVIA. In the first four months of 2022, more than one in five Americans over the age of 18 had a prescription for a mental health condition, according to CDC data. In addition, roughly 40% of adults had experienced symptoms of either depression or anxiety in the past four weeks.
Illicit drug use has also surged during the pandemic. In 2020, almost 300 people used drugs ranging from amphetamines to heroin, according to a UN report summarized by Reuters. In addition, some 209 million used cannabis.
As a consequence of this surge in prescription and illicit drug use, there is growing concern about their side effects, said Inesa Ponomariovaite, the founder of Nesa’s Hemp, which sells cannabidiolic acid (CBDa) extract. At the same time, a growing number of consumers are looking for complementary/alternative medicine products, which can prompt skepticism from conservative physicians.
In any event, a growing number of consumers are interested in obtaining natural therapies for conditions such as anxiety and depression. The overall brain-health supplement market could be worth $19.7 billion by 2030.
“The problem is what the cannabis plant has to offer in the purest form is not what the whole [CBD] industry is selling,” Ponomariovaite said. “CBD is a synthetic second form of the CBDa molecular structure from the plant.”
CBDa converts into CBD when heated via decarboxylation.
An article in Frontiers in Psychiatry notes that many depressed individuals have explored using CBD. In addition, animal studies have uncovered an antidepressant effect of the compound, although data in humans remains largely anecdotal.
The CBD has become a multibillion-dollar business in recent years, reaching $5.18 billion internationally in 2021, according to Grand View Research.
The FDA has sent warning letters to several CBD vendors for falsely describing the contents of their products and for misbranding violations.
The mental health crisis is also fueling interest in classic psychedelics such as psilocybin, given their potential to reduce depression and anxiety when used in a therapeutic context. Growing interest in classic psychedelics could lead to a sea change in psychiatry, assuming they win regulatory approval.
Ponomariovaite has enlisted laboratories to test the contents of various CBD products and has identified the presence of old and heavy metals in some products.
She has also received anecdotal evidence from a number of consumers reporting that their anxiety or depression has lifted after taking CBDa extract. “This started with my housekeeper, who was on antidepressants for over eight years,” Ponomariovaite said. “She saw improvements almost immediately after starting to take the CBDa product.”
“I can’t make any claims here, but I can tell you that we never had a person that had depression who did not improve after taking CBDa,” Ponomariovaite said.
Preclinical evidence for CBDa in depression has been positive.
Nesa’s Hemp is working with physicians to gather case studies from customers taking CBDa.
The pharmaceutical industry generally has had a limited interest in cannabis derivatives. To date, FDA has approved a handful of cannabis-related products, including Epidiolex (cannabidiol), Marinol (dronabinol) and Syndros (dronabinol), for indications including epilepsy and nausea from chemotherapy.
Ponomariovaite anticipates that demand for CBDa will ramp up as more patients with depression, anxiety and other conditions report success with the supplement. “I keep seeing more people looking for help,” she said. “That’s why I work crazy hours. I want to make the world a better place.”