Studies of CBD are ongoing, but some benefits have been found.
Marijuana contains more THC than CBD. Hemp has a very small amount of THC, less than 0.3 percent, and not enough to cause a high. As of 2018, CBD from hemp became legal in the U.S.
There are two types of cannabis sativa: hemp and marijuana. The hemp plant is the source of CBD used in most products.
There are also studies of oral, topical, and inhaled CBD for use in many other conditions including: dystonia (movement disorder), Fragile X syndrome (rare genetic disorder), graft-versus-host disease (bone marrow transplant rejection), multiple sclerosis (MS), opioid withdrawal, schizophrenia, and smoking cessation. CBD is also used to alleviate Parkinson’s symptoms, but there are some studies that advise against it.
CBD is the primary cannabinoid in hemp. It has various healing properties. For example, it seems to lessen inflammation, the body’s response to illness or injury. In this way, it may be helpful in treating many different diseases.
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.
Many drugs are broken down by enzymes in the liver, and CBD may compete for or interfere with these enzymes, leading to too much or not enough of the drug in the body, called altered concentration. The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.
Doubling up on side effects
While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC or prescription medications and substances that cause sleepiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol may lead to increased sleepiness, fatigue, and possibly accidental falls and accidents when driving. Increased sedation and tiredness may also happen when using certain herbal supplements, such as kava, melatonin, and St. John’s wort. Taking CBD with stimulants (such as Adderall) may lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn drugs (such as Prilosec) may increase the risk of diarrhea.
The researchers further warned that while the list may be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products may deliver highly variable cannabinoid concentrations (unlike the FDA-regulated prescription cannabinoid medications previously mentioned), and may contain many other compounds that can increase the risk of unintended drug interactions.
Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included
CBD oil should be avoided during pregnancy and breastfeeding. A 2018 study from the American Academy of Pediatrics warned women to avoid marijuana during pregnancy due to the potential risks to a baby’s development. Although it is unclear how CBD contributes, CBD is known to pass through the placental barrier.
CBD oil may reduce the risk of heart disease by alleviating hypertension (high blood pressure) in certain people, suggests a 2017 study in JCI Insight.
To use CBD oil, place one or more drops under the tongue and hold the dose there for 30 to 60 seconds without swallowing. Capsules and gummies are easier to dose, although they tend to be more costly. CBD sublingual sprays are available as well.
There is currently no known “correct” dose of CBD oil. Depending on individual needs and what is being treated, the daily dose may range between 5 and 25 mg.
The tricky part is calculating the exact amount of CBD per milliliter of oil. Some tinctures have concentrations of 1,500 mg per 30 mL, while others have 3,000 mg per mL (or more).
There have also been suggestions that CBD may aid in the treatment of cannabis and nicotine addiction. Further research is needed.
There are no guidelines for the appropriate use of CBD oil. CBD oil is usually delivered sublingually (under the tongue). Most oils are sold in 30-milliliter (mL) bottles with a dropper cap.