CBD Chewing Gum: Promising Concept, Thin Evidence
A 2025 expert commentary argues for cannabinoid-infused chewing gum as a novel drug delivery platform, but the single published clinical trial of the product found no significant efficacy over placebo, and the commentary’s optimistic framing rests largely on analogy to non-cannabinoid compounds and unpublished industry data.
Why This Matters
Patient interest in alternative CBD delivery methods continues to grow, and the commercial market for cannabinoid products has far outpaced the clinical evidence supporting them. Buccal drug delivery through chewing gum is an established pharmacokinetic strategy for other compounds, making the concept scientifically plausible on its face. When expert commentaries in peer-reviewed journals frame unproven products optimistically, they shape clinical expectations and regulatory conversations, making careful scrutiny of the underlying evidence essential.
Clinical Summary
Chewing gum has been validated as a drug delivery platform for several non-cannabinoid compounds, including caffeine, nicotine, and loratadine, where buccal absorption can bypass first-pass hepatic metabolism and achieve faster onset than conventional oral formulations. A 2025 expert commentary published in Medical Cannabis and Cannabinoids by Zubrzycki and colleagues argues that these pharmacokinetic advantages should extend to cannabinoids, particularly cannabidiol. The authors propose that lipid nanocarriers, mesoporous delivery systems, and mucoadhesive matrices could overcome cannabinoid hydrophobicity, a key formulation barrier, and that gum-based delivery might offer advantages over existing buccal products like Sativex (nabiximols) by maximizing mucosal rather than enteral absorption.
However, the evidence base for these claims is remarkably thin. The sole published placebo-controlled trial of CBD chewing gum, conducted by Van Orten-Luiten and colleagues in 2022 with 32 completers, found no significant difference between CBD gum and placebo for irritable bowel syndrome pain (p = 0.61), although the product was well tolerated. The commentary also references an unpublished Phase II trial sponsored by a company with which four of the seven authors are affiliated. The authors themselves acknowledge that research gaps remain in absorption mechanisms, dosing precision, and long-term safety, and that larger, well-powered clinical trials are needed before any clinical recommendations can be made.
Dr. Caplan’s Take
The pharmacokinetic logic here is real. Buccal delivery has clear theoretical advantages for cannabinoids, and the formulation science described in this commentary is genuinely interesting. But the gap between “plausible delivery mechanism” and “clinically effective product” is enormous, and the only time someone actually tested this in patients, it did not work. That single null trial matters more than all the bridging data from caffeine and nicotine combined. When patients ask me about CBD gum, I owe them that honesty rather than a story about what might eventually prove true.
In practice, I do not recommend CBD chewing gum for any specific condition. For patients already using CBD who are curious about delivery formats, I discuss the current evidence honestly: the concept has scientific merit, but no published clinical trial has demonstrated that CBD gum produces meaningful therapeutic effects. Until properly powered trials show otherwise, I guide patients toward delivery methods with better-characterized absorption profiles and focus on the conditions where cannabinoid evidence is most mature.
Clinical Perspective
This commentary sits at the very beginning of the research arc, in the territory of hypothesis generation rather than hypothesis confirmation. It confirms that buccal drug delivery is pharmacokinetically sound for certain small molecules and that formulation scientists are actively working on cannabinoid-specific challenges. It does not confirm, and in fact its own cited evidence contradicts, the notion that CBD chewing gum is therapeutically effective for any condition. Clinicians should not use this document to support patient-facing recommendations about CBD gum efficacy. The conflict-of-interest profile, with four of seven authors affiliated with a company commercially invested in cannabinoid delivery, warrants particular attention when interpreting the commentary’s optimistic conclusions.
From a safety standpoint, the Van Orten-Luiten trial did report good tolerability, which is modestly reassuring but insufficient to characterize long-term safety or interactions with other medications metabolized via cytochrome P450 pathways, a known concern with CBD. Cannabinoid hydrophobicity introduces additional uncertainty about actual mucosal absorption doses, meaning patients could receive highly variable exposure from gum-based products. The most actionable recommendation for clinicians now is straightforward: when patients raise CBD chewing gum, acknowledge the scientific rationale, clearly communicate that no published trial has shown clinical benefit, and redirect toward evidence-based management of their presenting condition.
Study at a Glance
- Study Type
- Expert commentary (narrative, non-systematic)
- Population
- Not directly studied; references one RCT in adults with IBS (n=32 completers)
- Intervention
- Cannabidiol-infused medicated chewing gum
- Comparator
- Placebo (sugar-free gum) in the referenced RCT
- Primary Outcomes
- IBS pain reduction in the cited trial (no significant difference, p=0.61)
- Sample Size
- Commentary only; cited RCT had 32 completers
- Journal
- Medical Cannabis and Cannabinoids
- Year
- 2025
- DOI or PMID
- Not provided in source data
- Funding Source
- Not explicitly stated; 4 of 7 authors affiliated with Aspeya Switzerland SA
What Kind of Evidence Is This
This is an expert commentary, a type of narrative opinion piece that occupies one of the lowest tiers of the evidence hierarchy. It presents no original data, conducts no systematic literature search, and performs no meta-analysis. The single most important inference constraint this imposes is that its conclusions reflect the authors’ selective reading and interpretation of the literature rather than a comprehensive or unbiased synthesis, meaning readers cannot treat its positive framing as representative of the full body of available evidence.
How This Fits With the Broader Literature
The broader literature on buccal drug delivery via chewing gum is well established for nicotine, caffeine, and certain antihistamines, where pharmacokinetic advantages have been demonstrated in multiple trials. The commentary attempts to extend this evidence base to cannabinoids, but the extension remains speculative. The Van Orten-Luiten et al. (2022) trial is the only published cannabinoid-specific gum study, and its null result stands in direct tension with the commentary’s optimistic framing. No independent replication or larger-scale trial has been published. The commentary does not meaningfully engage with the broader CBD bioavailability literature, which has documented substantial inter-individual variability in cannabinoid absorption across all delivery routes.
Common Misreadings
The most likely overinterpretation is concluding that CBD chewing gum has been shown to be an effective drug delivery method for cannabinoids. The commentary’s confident tone and detailed pharmacokinetic discussion can easily create this impression, but the evidence does not support it. Demonstrating that a gum matrix can release a compound and that buccal tissue can absorb it in principle is not the same as demonstrating that the resulting systemic or local exposure produces a therapeutic effect. The only clinical test of this specific product found no benefit over placebo, a finding the commentary acknowledges but does not foreground.
Bottom Line
Cannabinoid-infused chewing gum is a pharmacokinetically plausible delivery concept, but it remains clinically unproven. The sole published trial found no efficacy advantage over placebo, and the commentary’s positive case relies on analogy to other compounds, unpublished industry data, and authors with commercial affiliations. This document generates a hypothesis worth testing in properly powered, independent clinical trials but provides no basis for clinical recommendations today.
References
- Zubrzycki M, et al. Cannabinoid-infused chewing gum as a novel drug delivery platform. Medical Cannabis and Cannabinoids. 2025.
- Van Orten-Luiten ACB, et al.”; A placebo-controlled trial of cannabidiol chewing gum for irritable bowel syndrome pain. 2022. (Cited within the commentary as the only published RCT of CBD chewing gum; n=32 completers; p=0.61 for primary pain outcome.)
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