“If you’re taking Prozac or some other medication, you really need to think carefully about what you’re doing, because it can harm you, and you should talk to your doctor about it,” says Blessing. Blessing does note that while the drug interactions are potentially very serious, the doses in consumer CBD products are so low that the risk is likely minimal. Regardless, the fact that CBD has drug interactions should indicate that it is, at least sometimes, in some doses, actually doing something.
Cannabinoids can be used along with opioid medications, and a number of studies have demonstrated that they can reduce the amount of opioids needed, lessen the buildup of tolerance, and reduce the severity of withdrawal. At least ten randomized, controlled trials on over one thousand patients have demonstrated efficacy of cannabinoids for neuropathic pain of various origins.
The only study that has tested the bioavailability of inhaled CBD is from 2014; it found a bioavailability of about 25 percent for 100 mg and 200 mg doses of CBD using a Volcano vaporizer. (The topical lotions are even less studied; there have been no clinical trials on them at all.) This is more efficient than ingesting CBD, in the same way that vaporizing THC is more efficient than eating it. To get an effect, you should ingest a different amount of CBD than you’d inhale ... but how much is that? How much is too much?
Industrial hemp contains, by weight, far less CBD than CBD-rich cultivars such as Harlequin or Sour Tsunami. This means that producing a single 10 mL dose of CBD would require the cultivation and extraction of far more hemp than it would from whole-plant marijuana; thus raising the risk of exposing users to more contaminants. Hemp is classified as a “bioaccumulator,” or a plant that naturally absorbs toxicants from the soil.
CBD oil contains CBD (and often other active compounds) in a carrier oil. There are a number of forms of CBD oil, including softgel capsules, tinctures, and under-the-tongue sprays. Some forms of CBD oil can also be applied directly to the skin, in the form of products like creams and salves. The concentration of CBD varies from product to product.
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THC is the primary psychoactive compound in marijuana and it is what people are searching for when they want a product that gives them a "high." Unlike THC, CBD isn't known to cause psychoactive effects, and is therefore attractive to those who want to avoid the high but who believe there are other benefits of CBD, said Sara Ward, a pharmacologist at Temple University in Philadelphia. [Healing Herb? Marijuana Could Treat These 5 Conditions]
A 2016 literature review indicated that cannabidiol was under basic research to identify its possible neurological effects, although as of 2016, there was limited high-quality evidence for such effects in people. A 2018 meta-analysis compared the potential therapeutic properties of "purified CBD" with full-plant, CBD-rich cannabis extracts with regard to treating refractory (treatment-resistant) epilepsy, noting several differences. The daily average dose of people using full-plant extracts was more than four times lower than of those using purified CBD, a possible entourage effect of CBD interacting with THC.
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There seems to be a good amount of misunderstanding about how the passage of the Agriculture Improvement Act of 2018 (or the “2018 Farm Bill”) affects the legality of selling industrial hemp-derived CBD products. But to reiterate, nothing in the 2018 Farm Bill alters the FDA’s position on CBD pursuant to the Federal Food, Drug, and Cosmetic Act (FDCA). Here are some additional highlights from that statement:
As mentioned above, cannabis and hemp differ in the levels of naturally occurring THC that they contain. THC is a cannabinoid like CBD. However, its properties are very different and often antagonistic to the effects of CBD. Hemp is naturally high in CBD and low in THC; the reverse is true of cannabis. In fact, hemp contains only about 0.3% – 1.5% THC, while cannabis contains about 5% – 10% or more THC.
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But Kase acknowledges that her CBD suggestions should not be confused with medical advice. Much like with her yoga instruction, she says that she is only sharing what has worked for her in the hopes that it will help others. “I don’t say, ‘I recommend and advise that you take ten drops, three times a day,’” she explained. “I say, ‘This is the particular brand that I use. You could try it and see if it helps.’ And people have told me that it does.”
Regular weed comes from the cannabis plant, while CBD is derived from hemp. What's the difference? "The legal definition of hemp is a cannabis plant that has less than .3 percent THC in it," says Trista Okel, founder and CEO of CBD product retailer Empower Body Care. "That is the only legal differentiation between hemp and marijuana." All pure CBD oil will have less than .3 percent THC but will be full of the (alleged) anxiety- and pain-reducing properties.
“Buddhism in Asia has a long history of tea drinking to help people stay awake,” he continued. “And I wouldn’t begrudge anyone taking something that eases bodily aches while sitting—although I think you shouldn’t do too much of that stuff because you can end up becoming dependent on it. If the pain is really bad, though, I’d take pain relievers. I have, in fact, done that myself.”
CBD oils may contain some THC. Cannabis may impair your ability to drive safely or operate equipment and may have short- and long-term effects on your memory, attention, mood, heart rate, and mental health. It is also easy to overconsume CBD oil, so it's important to start with a low dose, as it may take several hours or longer to begin to feel the effects after consumption.
While researchers are calling for more robust studies on the role of CBD on mood disorders, there is promising research that points to CBD’s role as an anxiolytic – which means it has anti-anxiety effects. Another study showed CBD to have antidepressant effects comparable to those of the prescription antidepressant Imipramine. We noted above that CBD increases levels of glutamate and serotonin – and it’s these same neurotransmitters that play a crucial role in mood regulation.
Weight plays a role in the effects of CBD oil, and bottle size should be selected based on how much you weigh. Let’s say you weigh less than 130 pounds and desire light CBD oil effects; this means that 11 mg or less will probably suffice per dose, giving roughly 40 doses from a 450-mg concentration. If you weigh more than 230 pounds and desire strong effects, then this same concentration will supply roughly 10 doses.