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Dear Mr. Rosselli:                                                                                   
   
This letter is to advise you that the U.S. Food and Drug Administration (FDA) reviewed your websites at www.curapure.com and www.healthyhempstrategies.com in September and October 2019. We have determined that you take orders on your website www.curepure.com for the products “CBD Oil Drop Tincture (500 mg and 1000 mg),” “CBD Softgels, 25 mg (Anti-Inflammation, Multi-Symptom, and Sleep-Aid Formulas),” “CBD Pain Relief Cream, 500 mg,” “CBD Carnival Gummies, 600 mg,” “CBD-Infused Sheet Mask,” and ”CBD Softgels for Kids, 10 mg,” all of which you promote as products containing cannabidiol (CBD).   We have also determined that your healthyhempstrategies.com website links to the curapure.com website. The claims on your websites establish that your “CBD Oil Drop Tincture,” “CBD Softgels, 25 mg,” “CBD Pain Relief Cream, 500 mg,” “CBD Carnival Gummies, 600 mg,” “CBD-Infused Sheet Mask,” and “CBD Softgels for Kids, 10 mg” products are unapproved new drugs sold in violation of sections 505(a) and 301(d) of the Federal Food, Drug, and Cosmetic Act (the FD&C Act), 21 U.S.C. 355(a) and 331(d). Furthermore, these products are misbranded drugs under section 502(f)(1) of the FD&C Act, 21 U.S.C. 352(f)(1). 

As explained further below, introducing or delivering these products for introduction into interstate commerce for such uses violates the FD&C Act. You can find the FD&C Act and FDA regulations through links on FDA’s home page at www.fda.gov.  You can find specific information about how FDA regulates CBD at https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd.

The Agency is particularly concerned that you market one of your unapproved new drug products, “CBD Softgels for Kids, 10 mg,” for children. Your product has not been evaluated by the Agency for safety, effectiveness, and quality. The use of untested drugs can have unpredictable and unintended consequences, especially in vulnerable populations. For example, children may be at greater risk for adverse reactions associated with certain drug products due to differences in the ability of children to absorb, metabolize, distribute, or excrete such drug products or their metabolites.

Dietary Supplement Labeling

Information on your website at www.curapure.com indicates that you intend to market some of your CBD products as dietary supplements. For example, your “CBD Softgels, 25 mg,” “CBD Oil Drop Tincture,” and “CBD Carnival Gummies, 600 mg” products contain a Supplement Facts panel.  To the extent that you intend to market these products as dietary supplements, they cannot be dietary supplements because they do not meet the definition of a dietary supplement under section 201(ff) of the FD&C Act, 21 U.S.C. 321(ff). FDA has concluded that, based on available evidence, CBD products are excluded from the dietary supplement definition under sections 201(ff)(3)(B)(i) and (ii) of the FD&C Act, 21 U.S.C. 321(ff)(3)(B)(i) and (ii)1.  Under those provisions, if an article (such as CBD) is an active ingredient in a drug product that has been approved under section 505 of the FD&C Act, 21 U.S.C. 355, or has been authorized for investigation as a new drug for which substantial clinical investigations have been instituted and for which the existence of such investigations has been made public, then products containing that substance are outside the definition of a dietary supplement. There is an exception if the substance was “marketed as” a dietary supplement or as a conventional food before the new drug investigations were authorized; however, based on available evidence, FDA has concluded that this is not the case for CBD. FDA is not aware of any evidence that would call into question its current conclusion that CBD products are excluded from the dietary supplement definition under sections 201(ff)(3)(B)(i) and (ii) of the FD&C Act, 21 U.S.C. 321(ff)(3)(B)(i) and (ii), but you may present FDA with any evidence bearing on this issue.

Unapproved New Drugs

Based on our review of your websites, your “CBD Oil Drop Tincture,” “CBD Softgels, 25 mg,” “CBD Pain Relief Cream, 500 mg,” “CBD Carnival Gummies, 600 mg,” “CBD-Infused Sheet Mask,” and ”CBD Softgels for Kids, 10 mg” products are drugs under section 201(g)(1) of the FD&C Act, 21 U.S.C. 321(g)(1), because they are intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease and/or intended to affect the structure or any function of the body. 

Examples of claims observed on your websites www.curepure.com and www.healthyhempstrategies.com that establish the intended use of your products as drugs include, but may not be limited to, the following:

  On the webpage titled “Blog - News” on healthyhempstrategies.com:

     • “However, numerous clinical studies have revealed that CBD you [sic] can have a very impactful reaction against a wide variety of diseases such as multiple sclerosis, Alzheimer’s, anxiety, depression, and more.”

     • “In addition to being used for people who suffer from epilepsy, this product has been shown to be therapeutically beneficial for a variety of other ailments as well. These include the following:

       o Alzheimer’s
       o Parkinson’s
       o Multiple sclerosis
       o Huntington’s
       o Hypoxia-ischemia injury
       o Pain
       o Anxiety
       o Depression
       o Nausea
       o Rheumatoid arthritis
       o Cancer”

  On the webpage titled “Benefits of Infusing CBD into Melatonin or Curcumin” on healthyhempstrategies.com:

     • “Recent research indicates CBD (cannabidiol) is a non-toxic and non-psychoactive compound that has several beneficial effects including anti-anxiety, anti-inflammatory, antiemetic, anti-psychotic, and much more.”

  On the webpage titled “CBD for Post Traumatic Stress Disorder” on curapure.com:

     • “As you might imagine, this is one of the reasons why PTSD victims all over the U.S. (and the globe) have recently been drawn to CBD – for going on half a decade now, it has represented a potentially effective treatment with very promising results, and virtually no side effects.”

     • “In other words, it is becoming more and more clear that in terms of a safe and effective treatment for PTSD, CBD oil could be the answer.”

     • “To date, while PTSD-related studies involving cannabis and canna-related products have been few and far between (federal restrictions have made it all but impossible for researchers to gain access to the drug), there has been no shortage of data-backed suggestions that CBD for PTSD may be a reliable form of treatment.”

  On the webpage titled “CBD for Depression” on curapure.com:

     • “A growing number of people are using cannabidiol (CBD) products to assist in recovering from depression. If you’re considering adding CBD oil to your self-care routine, we’ve put together this article to help you understand the current scientific research about CBD and depression. Although clinical trials are lacking, there is good evidence that it could help your brain recover from depression.”

  On the webpage titled “CBD for Sleep Disorder” on curapure.com:

     • “PTSD is a chronic psychiatric condition, that occurs due to an emotional trauma or fear triggered in the brain and can happen to any gender or age. Studies have concluded that CBD treats all form of anxiety including post-traumatic stress disorder and anxiety-provoked sleep disorder. As CBD has anti-inflammation properties, it keeps a check on radical stress and thus helps in a better sleep.”

     • “Sleep apnea is a serious sleep disorder when your breath repeatedly starts and stops. People who suffer from sleep apnea get repeatedly awakened by their own breathing because of the narrowed airway. Therefore, you feel tired even after a snoring sleep. This can cause high blood pressure, fatigue, diabetes etc. Studies have revealed that CBD suppresses sleep apnea, as it is a muscle relaxant.”

     • “According to Studies, CBD oil, an extract from the cannabis plant relieves pain. It has been found useful to treat joint pain, arthritis, back pain etc.”

     • “A chemical imbalance in the brain is also a cause of depression. According to studies CBD restoration of chemical balances in the brain by releasing serotonin, that is a natural mood stabilizer.”

  On the webpage titled “CBD for Anxiety” on curapure.com:

     • “Not only does evidence suggest CBD counteracts many of THC’s adverse effects, but numerous animal studies and accumulating evidence from human experimental, clinical, and epidemiological studies suggest CBD has powerful anti-anxiety properties.”

     • “Administered acutely (‘as needed’), it appears safe, well-tolerated, and may be beneficial to treat a number of anxiety-related disorders, including:
       o Panic disorder
       o Obsessive Compulsive Disorder (OCD)
       o Social phobia
       o Post-Traumatic Stress Disorder (PTSD)
       o Generalized Anxiety Disorder (GAD)
       o Mild to moderate depression”

     • “CBD exerts several actions in the brain that explain why it could be effective in treating anxiety.”
 
  On the product page for “25 mg CBD Softgels (Anti-Inflammation Formula)”:

     • “Formulated with 10mg of Curcumin for added anti-inflammatory relief”

  On the product page for “500 mg CBD Pain Relief Cream”:

     • “The powerful cream is applied topically for temporary relief to treat pain and discomfort from arthritis, muscle strain, bruises, sprains, joint aches, and backache.”

  On the product page for “25 mg CBD Softgels (Multi-Symptom Formula)”:

     • “Formulated to relieve joint pain, muscle pain, anxiety, inflammation, PTSD, and more.”

  On the product page for “CBD-Infused Sheet Mask”:

     • “anti-inflammatory.”

Your “CBD Oil Drop Tincture,” “CBD Softgels, 25 mg,” “CBD Pain Relief Cream, 500 mg,” “CBD Carnival Gummies, 600 mg,” “CBD-Infused Sheet Mask,” and ”CBD Softgels for Kids, 10 mg” products are not generally recognized as safe and effective for the above referenced uses and, therefore, these products are “new drugs” under section 201(p) of the FD&C Act, 21 U.S.C. 321(p). New drugs may not be legally introduced or delivered for introduction into interstate commerce without prior approval from the FDA, as described in sections 301(d) and 505(a) of the FD&C Act, 21 U.S.C. 331(d) and 355(a). FDA approves a new drug on the basis of scientific data and information demonstrating that the drug is safe and effective.  There are no FDA-approved applications in effect for any of the above-mentioned products. 

Misbranded Drugs

Your ““CBD Oil Drop Tincture,” “CBD Softgels, 25 mg,” “CBD Pain Relief Cream, 500 mg,” “CBD Carnival Gummies, 600 mg,” “CBD-Infused Sheet Mask,” and ”CBD Softgels for Kids, 10 mg” products are also misbranded within the meaning of section 502(f)(1) of the FD&C Act, 21 U.S.C. 352(f)(1), in that their labeling fails to bear adequate directions for use. “Adequate directions for use” means directions under which a layperson can use a drug safely and for the purposes for which it is intended. (See 21 CFR 201.5.)  The aforementioned products are offered for conditions that are not amenable to self-diagnosis and treatment by individuals who are not medical practitioners; therefore, adequate directions for use cannot be written so that a layperson can use these drugs safely for their intended purposes. FDA-approved prescription drugs that bear their FDA-approved labeling are exempt from the requirements that they bear adequate directions for use by a layperson.  However, your products are not exempt from the requirement that their labeling bear adequate directions for use, 21 CFR 201.100(c)(2) and 201.115, because no FDA-approved applications are in effect for them. The introduction or delivery for introduction into interstate commerce of these misbranded drugs violates section 301(a) of the FD&C Act, 21 U.S.C. 331(a).

301(ll) and Adulterated Foods

We note that your “CBD Carnival Gummies, 600 mg” product appears to be promoted as a conventional food. Specifically, you promote this product as a “snack” and a “tasty treat.”  However, you should be aware that it is a prohibited act under section 301(ll) of the FD&C Act, 21 U.S.C. 331(ll), to introduce or deliver for introduction into interstate commerce any food to which has been added a drug approved under section 505 of the FD&C Act or for which substantial clinical investigations have been instituted and for which the existence of such investigations has been made public.  Based on available evidence, FDA has concluded that the prohibition in section 301(ll) applies to CBD. There is an exception if the substance was marketed in food before the drug was approved or before the substantial clinical investigations involving the drug had been instituted. However, based on the available evidence discussed above, FDA has concluded that this is not the case for CBD.  FDA is not aware of any evidence that would call into question its current conclusion that section 301(ll) of the FD&C Act prohibits the introduction into interstate commerce of any food to which CBD has been added, but you may present FDA with any evidence bearing on this issue.

You should also be aware that, as defined in section 201(s) of the FD&C Act, 21 U.S.C. 321(s), the term "food additive" refers to any substance the intended use of which results in its becoming a component of any food, unless the substance is generally recognized as safe (GRAS) among qualified experts under the conditions of its intended use, or unless the substance meets a listed exception2.   

Food additives require premarket approval based on data demonstrating safety. Any food additive that has not been approved for its intended use in food is deemed to be unsafe under section 409(a) of the FD&C Act, 21 U.S.C. 348(a), and causes the food to be adulterated under section 402(a)(2)(C)(i) of the FD&C Act, 21 U.S.C. 342(a)(2)(C)(i). Introduction of an adulterated food into interstate commerce is prohibited under section 301(a) of the FD&C Act, 21 U.S.C. 331(a).

There is no food additive regulation which authorizes the use of CBD. We are not aware of any information to indicate that CBD is the subject of a prior sanction (see 21 CFR Part 181). Furthermore, we are not aware of any basis to conclude that CBD is GRAS for use in conventional foods.   FDA's regulations in 21 CFR 170.30(a)-(c) describe the criteria for eligibility for classification of a food ingredient as GRAS. The use of a food substance may be GRAS based on either scientific procedures or, for a substance used in food before 1958, through experience based on common use in food (see 21 CFR 170.30).

We know of no basis for general recognition of safety for CBD based either on scientific procedures or common use in food prior to January 1, 1958. Based on our review of published, scientific literature, existing data and information do not provide an adequate basis to conclude that the use of CBD in food meets the criteria for GRAS status. Many unanswered questions and data gaps about CBD toxicity exist, and some of the available data raise serious concerns about potential harm from CBD. Our review of publicly available data associated with the one FDA-approved CBD drug, as well as our review of published scientific literature, identified potential for liver injury from CBD and potentially harmful interactions with certain drugs. In addition, studies in animals have shown that CBD can interfere with the development and function of testes and sperm, decrease testosterone levels, and impair sexual behavior in males. Therefore, based on our review, the use of CBD in conventional food products does not satisfy the criteria for GRAS status under 21 CFR 170.30.

FDA is not aware of any other exception to the food additive definition that would apply to CBD for use as an ingredient in a conventional food. Therefore, CBD added to a conventional food is a food additive under section 201(s) of the FD&C Act and is subject to the provisions of section 409 of the FD&C Act.  Under section 409, a food additive is deemed unsafe unless it is approved by FDA for its intended use prior to marketing. CBD is not approved for use in any conventional food. Food containing an unsafe food additive within the meaning of section 409 is adulterated within the meaning of section 402(a)(2)(C)(i) of the FD&C Act.  Introduction of an adulterated food into interstate commerce is prohibited under section 301(a) of the FD&C Act, 21 U.S.C. 331(a).

The violations cited in this letter are not intended to be an all-inclusive statement of violations that exist in connection with your marketed products. You are responsible for investigating and determining the causes of the violations identified above and for preventing their recurrence or the occurrence of other violations. It is your responsibility to ensure that your firm complies with all requirements of federal law, including FDA regulations.

You should take prompt action to correct the violations cited in this letter. Failure to promptly correct these violations may result in legal action without further notice, including, without limitation, seizure and injunction. 

Please notify FDA in writing, within fifteen working days of receipt of this letter, of the specific steps you have taken to correct violations. Include an explanation of each step being taken to prevent the recurrence of violations, as well as copies of related documentation. If you believe that your products are not in violation of the FD&C Act, include your reasoning and any supporting information for our consideration. If you cannot complete corrective action within fifteen working days, state the reason for the delay and the time within which you will complete the correction.

Your response should be sent to Shawn Goldman, United States Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Office of Compliance (HFS-608), Division of Enforcement, College Park, Maryland 20740-3835 or by email to [email protected].

Sincerely,

Donald D. Ashley
/S/
Director                                                      
Office of Compliance
Center for Drug Evaluation and Research
Food and Drug Administration

William A. Correll Jr.
/S/
Director                                      
Office of Compliance
Center for Food Safety and Applied Nutrition
Food and Drug Administration

• 1. CBD is the active ingredient in the approved drug product Epidiolex. Furthermore, the existence of substantial clinical investigations regarding CBD has been made public. For example, two such substantial clinical investigations include GW Pharmaceuticals’ investigations regarding Sativex and Epidiolex. (See Sativex Commences US Phase II/III Clinical Trial in Cancer Pain and GW Pharmaceuticals Receives Investigational New Drug (IND) from FDA for Phase 2/3 Clinical Trial of Epidiolex in the Treatment of Dravet Syndrome). FDA considers a substance to be “authorized for investigation as a new drug” if it is the subject of an Investigational New Drug application (IND) that has gone into effect. Under 21 CFR 312.2, unless a clinical investigation meets the limited criteria in that regulation, an IND is required for all clinical investigations of products that are subject to section 505 of the FD&C Act.
• 2. 2 Under section 201(s) of the FD&C Act, 21 U.S.C. 321(s), the following types of substances are excluded from the food additive definition: (1) pesticide chemical residues in or on a raw agricultural commodity or processed food, (2) pesticide chemicals, (3) color additives, (4) substances used in accordance with a “prior sanction” (i.e., a sanction or approval granted prior to the enactment of the Food Additives Amendment of 1958 under the Act, the Poultry Products Inspection Act, or the Meat Inspection Act), (5) new animal drugs, and (6) dietary ingredients in or intended for use in a dietary supplement.