According to a 2017 study in the Journal of the American Medical Association, only 30.95% of CBD products sold online were correctly labeled. Most contained less CBD than advertised, while 21.43% had significant amounts of THC.
CBD oil may benefit those with drug addiction, suggests a 2015 review of studies published in Substance Abuse.
CBD is the short name for cannabidiol, one of the two chemicals—among the dozens in cannabis—that have the most health benefits. The other, tetrahydrocannabinol (THC), produces the psychoactive effects described as being “high.” CBD oil generally does not contain THC, although some trace amounts may be present in products sold in certain states.
What to Look For
In June 2018, the U.S. Food and Drug Administration (FDA) approved Epidiolex, a CBD oral solution used for the treatment of certain rare forms of epilepsy in children under 2—Dravet syndrome and Lennox-Gastaut syndrome. Both are exceptionally rare genetic disorders causing lifelong catastrophic seizures that begin during the first year of life.
Medical marijuana is frequently prescribed to people with intractable (treatment-resistant) pain, including those with terminal cancer. There is some evidence that CBD contributes to this benefit.
Outside of these two disorders, CBD’s effectiveness in treating seizures is uncertain. Even with Epidiolex, it is uncertain whether the anti-seizure effects can be attributed to CBD or some other factor.
Part of this response could be explained by the way that CBD acts in the brain. In low doses, CBD may act as an agonist to several receptor sites, meaning it acts similarly to surrounding molecules that normally bind to the receptor, enhancing the signalling of those receptor sites. At higher doses, however, too much activity at the receptor site can lead to an opposite effect, negating the beneficial effects of CBD.
97021 Jadoon KA, Ratcliffe SH, Barrett DA, et al. Efficacy and safety of cannabidiol and tetrahydrocannabivarin on glycemic and lipid parameters in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, parallel group pilot study. Diabetes Care. 2016 Oct;39(10):1777-86. View abstract.
Children: It is possibly safe for children to take a specific prescription CBD product (Epidiolex) by mouth in doses up to 25 mg/kg daily. This product is approved for use in children with certain conditions who are at least 1 year old. It isn’t clear if other CBD products are safe in children.
Likely Effective for
Cunha, J. M., Carlini, E. A., Pereira, A. E., Ramos, O. L., Pimentel, C., Gagliardi, R., Sanvito, W. L., Lander, N., and Mechoulam, R. Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Pharmacology 1980;21(3):175-185. View abstract.
Leighty EG, Fentiman AF Jr, Foltz RL. Long-retained metabolites of delta9- and delta8-tetrahydrocannabinols identified as novel fatty acid conjugates. Res Commun Chem Pathol Pharmacol 1976;14(1):13-28. View abstract.
Anderson LL, Doohan PT, Oldfield L, et al. Citalopram and Cannabidiol: In Vitro and In Vivo Evidence of Pharmacokinetic Interactions Relevant to the Treatment of Anxiety Disorders in Young People. J Clin Psychopharmacol. 2021. View abstract.
There's no question that CBD is the buzzy wellness product of the moment. If you live in a state where it's currently legal, you might feel like CBD has gone from being sort of around to absolutely everywhere all at once. Coffee shops sell CBD lattes, spas offer CBD facials, beauty companies are rushing to release lotions with CBD or hemp oils in their formulas. And everyone from your anxious coworker to your arthritis-suffering dad wants to get their hands on some CBD gummies.
There are two main types of pain, Dr. Danesh says: musculoskeletal and nerve. "There could be benefit for both conditions," he says.
OK, first things first. What is CBD?
"It's kind of ironic," says Parrish. "With marijuana, we have got the federal government saying 'No' and a bunch of states saying 'Yeah, it's OK'—but with hemp, the feds say 'Yeah, it's OK,' but we still have some states saying it's not."
"My practice has patients walking in every day asking about CBD," says Houman Danesh, MD, director of integrative pain management for the Mount Sinai Hospital in New York City. But while there's lots of anecdotal evidence, he says, "it's still very difficult to say" what the real benefits are due to a serious lack of research.
It's also crucial to buy third-party-tested CBD for quality assurance (more on this later). Because the FDA doesn't regulate CBD, it is possible to buy a product that is more or less potent than advertised, or even contains small amounts of THC.