CBD Chewing Gum: A Plausible Idea With Very Little Clinical Proof
A 2025 expert commentary argues for cannabinoid-infused chewing gum as a viable drug delivery system, drawing on bridging evidence from caffeine, nicotine, and other non-cannabinoid compounds, but the sole published placebo-controlled clinical trial of CBD gum found no significant benefit over placebo, leaving the concept firmly in the hypothesis stage.
Why This Matters
CBD products have proliferated commercially far faster than the clinical evidence supporting specific formulations and delivery methods. As consumers encounter CBD-infused gums alongside capsules, tinctures, and topicals, the question of whether any given delivery format actually improves bioavailability or therapeutic outcomes is not academic but directly relevant to patient safety and informed decision-making. This commentary arrives at a moment when the gap between product availability and rigorous evidence is widening, making clear-eyed evaluation of delivery science especially important.
Clinical Summary
Delivering cannabinoids through the oral mucosa via chewing gum is a pharmacologically reasonable concept. The buccal route can bypass first-pass hepatic metabolism, which substantially degrades orally swallowed CBD, and sustained chewing could theoretically maintain prolonged mucosal contact. A 2025 expert commentary published in Medical Cannabis and Cannabinoids (Karger) by a team including researchers from the University of Maine, the University of South Florida, and Aspeya Switzerland SA builds the case by drawing on bioavailability data from caffeine, loratadine, and nicotine gum formulations. In those non-cannabinoid systems, gum delivery has demonstrated faster onset and comparable or improved absorption relative to conventional tablets. The authors argue that formulation challenges posed by CBD’s high lipophilicity, which limits its release from hydrophobic gum bases, can be overcome through lipid nanocarriers, mesoporous silica systems, and mucoadhesive polymer coatings.
The critical problem is that the only published placebo-controlled trial of CBD chewing gum, conducted by Van Orten-Luiten and colleagues in 2022 with 32 patients experiencing irritable bowel syndrome, found no significant difference between CBD gum and placebo on the primary pain outcome. The mean pain visual analog scale difference was 0.1, with a 95% confidence interval spanning -0.3 to 0.5 and a p-value of 0.61. The commentary characterizes this result as demonstrating feasibility and tolerability rather than ruling out efficacy, but the evidence as it stands is null. Several industry-sponsored pharmacokinetic studies cited by the authors do not appear to have been published in peer-reviewed journals, further weakening the evidentiary foundation. The authors acknowledge that large-scale, well-powered randomized controlled trials remain necessary before any clinical recommendations can be made.
Dr. Caplan’s Take
I appreciate the intellectual honesty in this commentary’s structure, even as I find its framing more optimistic than the data warrant. The concept of buccal cannabinoid delivery is sound, and the pharmacokinetic logic is real: bypassing first-pass metabolism could genuinely improve CBD’s notoriously poor oral bioavailability. But the gap between a plausible delivery concept and a clinically demonstrated benefit is enormous. Patients ask me regularly about CBD gum products they have seen online or in stores, and an honest response requires saying that we currently have zero evidence that these products work better than swallowing the same compound in a capsule, let alone better than placebo.
In practice, I do not recommend CBD chewing gum to patients. When someone with chronic pain or IBS inquires about it, I explain that the one clinical trial conducted specifically on this product showed no benefit over placebo gum, and that the theoretical advantages have not been demonstrated in humans. If a patient is interested in cannabinoid therapy for a condition where evidence exists, I guide them toward formulations and routes with at least some clinical support, while being transparent that the field as a whole still has significant evidence gaps.
Clinical Perspective
This commentary sits very early in the research arc for cannabinoid chewing gum, functioning as a hypothesis-generating document rather than a confirmatory one. It confirms that buccal drug delivery is a well-established pharmaceutical concept for certain compounds and that formulation science has tools to address cannabinoid-specific challenges like lipophilicity. However, it does not confirm, and cannot confirm given its design, that these solutions translate into meaningful clinical outcomes for patients. The null result from the Van Orten-Luiten trial is the only clinical data point, and clinicians should not recommend CBD gum on the basis of bridging evidence from caffeine or nicotine, which differ substantially in molecular properties and absorption kinetics.
Clinicians should also note the conflict-of-interest landscape here: multiple authors are affiliated with Aspeya Switzerland SA, a company that appears to be active in cannabinoid product development. This does not invalidate the scientific reasoning, but it does mean the literature selection and framing may favor commercial prospects over dispassionate evidence assessment. From a safety standpoint, CBD chewing gum at the doses used in the published trial appeared well-tolerated, but long-term safety data and drug interaction profiles for buccal CBD delivery are entirely absent. The one actionable recommendation for clinicians today is straightforward: when patients ask about CBD gum, explain that the concept is scientifically interesting but clinically unproven, and redirect the conversation toward evidence-supported interventions for their specific condition.
Study at a Glance
- Study Type
- Expert commentary (non-systematic narrative synthesis)
- Population
- Not applicable (no original participants); referenced RCT studied IBS patients (n=32)
- Intervention
- Cannabinoid-infused chewing gum (conceptual; CBD gum in referenced trial)
- Comparator
- Placebo gum in referenced RCT; oral tablets for bridging bioactives
- Primary Outcomes
- No original outcomes; referenced RCT primary outcome was pain VAS (null result, p=0.61)
- Sample Size
- Not applicable (commentary); referenced RCT: n=32
- Journal
- Medical Cannabis and Cannabinoids (Karger)
- Year
- 2025
- DOI
- 10.1159/000547917
- Funding Source
- Not explicitly stated; multiple authors affiliated with Aspeya Switzerland SA
What Kind of Evidence Is This
This is an expert commentary that synthesizes published and unpublished literature to advocate for cannabinoid chewing gum as a delivery platform. It does not follow a systematic review methodology, meaning the literature selection may be incomplete or tilted toward supportive findings. As a commentary, it occupies the lowest tier of the evidence hierarchy for informing clinical decisions. The single most important inference constraint is that no systematic search strategy was described, so readers cannot assess whether contradictory or unsupportive evidence was excluded.
How This Fits With the Broader Literature
The broader buccal drug delivery literature does support the general principle that chewing gum can enhance absorption of certain compounds. Nicotine gum is the most commercially successful example, and caffeine gum has demonstrated faster onset than tablets in military performance research. However, cannabinoids present distinct formulation challenges due to their extreme lipophilicity and poor aqueous solubility, which limit direct extrapolation from these more hydrophilic compounds. The Van Orten-Luiten et al. (2022) trial remains the only peer-reviewed clinical data point specific to CBD gum, and its null finding aligns with the broader pattern in CBD research where mechanistic promise frequently outpaces clinical demonstration. Until additional well-powered trials are published, the cannabinoid gum concept remains pharmacologically interesting but clinically unsupported.
Common Misreadings
The most likely overinterpretation is concluding that because chewing gum works well for delivering nicotine and caffeine, it will necessarily work for CBD or other cannabinoids. This reasoning ignores the substantial physicochemical differences between these compounds. Nicotine and caffeine are relatively hydrophilic and release readily from gum bases, whereas CBD is highly lipophilic and tends to remain bound within the gum matrix. A second common misreading would be interpreting the commentary’s optimistic framing as evidence of efficacy. The document explicitly acknowledges that efficacy has not been demonstrated, but its tone and structure could easily lead a casual reader to believe the concept is further along than it actually is.
Bottom Line
This commentary establishes that cannabinoid chewing gum is a scientifically plausible delivery concept worth investigating, but it does not provide evidence that the concept works in practice. The sole published clinical trial found no benefit over placebo. Key supporting pharmacokinetic data remain unpublished in peer-reviewed journals. For clinicians and patients today, CBD chewing gum should be understood as an unproven product backed by an interesting hypothesis, not a validated therapeutic delivery system.
References
- Expert commentary on cannabinoid-infused chewing gum as a drug delivery system. Medical Cannabis and Cannabinoids (Karger), 2025. DOI: 10.1159/000547917.
- Van Orten-Luiten ACB, et al. Cannabidiol chewing gum for irritable bowel syndrome: a placebo-controlled, randomized, double-blind crossover trial. Cannabis and Cannabinoid Research, 2022. (n=32; primary pain outcome: mean VAS difference 0.1, 95% CI -0.3 to 0.5, p=0.61.)
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