2021 HME Business Handbook: Pain Management

Developing a Better Understanding of Cannabinoids

CBD has become a blanket descriptor for a range of chemical compounds that HME providers and DME pharmacies should more closely comprehend in order to help their clients.

As the public’s acceptance of cannabis products continue to grow, a growing number of consumers have been looking to CBD (cannabidiol) and hemp products in hopes of alleviating pain and inflammation, anxiety, and insomnia.

However, “CBD” has become a blanket term for therapeutic hemp products and that CBD is just one of the currently 160+ identified potentially therapeutic cannabinoids. Other cannabinoids that have been identified with therapeutic benefits are:

Like CBD, CBN is nonpsychoactive, meaning that it does not elicit a “high.” CBN can be used effectively as a sleep aid or sedative. This cannabinoid has also been shown to help regulate the immune system and works to relieve the pain and inflammation caused by several conditions.

CBG works to fight inflammation, pain, nausea and may work to slow the proliferation of cancer cells. Research has shown it also significantly reduces intraocular eye pressure caused by glaucoma.

Delta-8 THC is a federally legal form of THC that naturally occurs in both hemp and marijuana plants. Like other cannabinoids, Delta-8 THC can be synthesized. Users report that Delta-8 THC is one-half to three-quarters as psychoactive as Delta-9 THC.

As these cannabinoids gain popularity, both the legality and safety of these products should be of utmost importance to the HME provider selling them.

As for legality, it can be confusing. The 2018 U.S. Farm Bill states that hemp cannabis and cannabinoid products are federally legal provided that these products contain no more than 0.3 percent Delta-9 THC by weight and that these products are 100 percent industrial hemp-derived, not synthesized. Per the 2018 U.S. Farm Bill, all hemp-derived cannabinoid products and cannabinoids such as CBD, CBN, CBD, CBG, Delta-8 THC, etc., are federally legal as long as these products do not exceed 0.3 percent Delta-9 THC by weight.

It is much cheaper and much easier to produce synthetic molecules such as CBD, CBN, CBG, and Delta-8 THC. This, in turn, leads to greater profit, and many cannabis companies offer these man-made, less-expensive, and federally illegal products.

Remember, cannabinoids are molecules found in plants. In nature, these molecules vary from plant to plant and harvest to harvest. It is much more costly and much less efficient for a manufacturer to derive these nutrients or cannabinoids from natural plant sources than it is to synthetically manufacture them.

Unlike synthetic nutrients, synthetic cannabinoid products are currently federally illegal as these cannabinoids are not derived from industrial hemp per the 2018 U.S. Farm Bill. Reputable cannabis companies providing therapeutic products are well aware of this regulation and will always offer 100 percent hemp-derived cannabinoids.

This brings us to safety. Hemp cannabis products are commonly available in topical lotions and salves, oral tinctures and gummies, concentrates, or the hemp flower itself via inhalation. With so many delivery systems, it is imperative to ensure a “clean” and safe product.

Ensure the manufacturer fully discloses all ingredients and all manufacturing and extraction processes. Choose hemp products from companies that proactively provide independent third party certificates of analysis (COA) from reputable labs that provide the following laboratory analysis:

  • Total Cannabinoids
    This ensures the final product contains cannabinoid(s) labeled in the amounts they are labeled at. Also, this states that the product does not exceed 0.3 percent Delta-9 THC by weight.
  • Pesticides and Herbicides
    This states the product does not contain potentially toxic synthetic pesticides, herbicides, and residuals.
  • Heavy Metals
    States that the product does not exceed acceptable levels of lead, cadmium, arsenic and mercury.
  • Residual Solvents
    The product does not contain potentially toxic residual solvents such as butane or hexane.
  • Microbials
    The absence of molds, yeasts, and fungus in the product.

Also, providers should always choose reputable cannabis brands that proactively provide all certificates of analysis and regulatory certifications.


  • CBD has become a catch-all acronym for a variety of therapeutic cannabinoids, such as CBG, CBN and Delta-8 THC.
  • The legality and safety of these products should be of utmost importance to the HME provider selling them.
  • Reputable manufacturers should fully discloses all ingredients as well as all manufacturing and extraction processes.
  • They should also provide independent third-party certificates of analysis (COA) and a variety of elements providing the product is safe, clean and contains what it should.


To read more news and features about pain management, visit hme-business.com/pain. To learn about PūrWell’s formulations for the healthcare marketplace, visit purwell.com.

This article originally appeared in the May/Jun 2021 issue of HME Business.

About the Author

Nick DiFrancesco is founder and Chief Executive Officer of PūrWell (www.purwellc.om), which markets exclusively to healthcare providers, physicians, and independent pharmacies. PūrWell's proprietary formulations are crafted specifically to meet the needs of the healthcare marketplace, offering a range of strengths and applications for seamless customized treatment. For more information, email info@purwell.com.

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