Cannabidiol (CBD) is a molecule best known for its presence in marijuana, but recently it has been isolated and infused in everything from popcorn to bedsheets. The hypothesis behind this recent boom is that CBD can provide users with many of the same benefits as marijuana without the high that results from tetrahydrocannabinol (THC). Does the evidence support this?
Let’s start by looking at safety. While the government continues to classify marijuana as a highly controlled schedule 1 substance (despite being far safer than lower-scheduled drugs), the DEA has a slightly more favorable view of CBD alone. If associated with less than 0.1% THC, CBD products are now placed in the less restrictive schedule 5 group. There seems to be ample evidence to suggest that orally administered CBD is safe in moderate doses. Daily oral doses up to 600 mg have shown no severe effects in healthy individuals.
Primarily gastrointestinal side effects, such as diarrhea and reduced appetite, tend to be cited in the literature. There is some concern about liver damage when CBD is combined with other drugs, but this phenomenon is not very well established. Nevertheless, you should certainly consult with a physician before using CBD. This is particularly essential if you are taking other medications.
My personal perspective is that the safety profile of CBD is encouraging, but the lack of regulation in the industry is concerning. While it seems clear that oral CBD in moderate doses is safe, it can be tough to verify the dose in the products on the market. Varying routes of administration compound this problem even further. We have no idea how much CBD infused into a bed sheet makes it into your system or what risk this type of exposure carries.
If CBD can be delivered safely, there seem to be tangible benefits for some people. The only FDA-approved formulation, Epidiolex, is currently being used to treat seizures from certain causes. The majority of people using CBD aren’t using it for this indication, however. People generally use it with the intention of easing anxiety, relieving pain, or falling asleep faster.
Data on these purported benefits exists, but there aren’t as many large, high quality studies as one would like to see. Animal studies and small clinical trials suggest that CBD may reduce anxiety and PTSD symptoms, but the authors of this review noted several limitations. Though cannabis has been used for pain relief for thousands of years, it remains unclear what role CBD plays in this. Many of the studies exploring pain relief, such as this one looking at patients with cancer, utilize a combination of THC and CBD.
Lastly, CBD products have become increasingly popular as sleep aids, and it seems that the molecule may decrease sleep latency (how long it takes to fall asleep) in people with insomnia. Nevertheless, little is known about how CBD impacts sleep quality, which is something essential to consider before using any sleep aid. We’ve discussed in the past how just because substances like alcohol and benzodiazepines knock people out quickly, this doesn’t guarantee that they’re beneficial to overall sleep. In the case of these sedatives, we now know that sleep quality is impaired. The jury’s still out on CBD.
While we await quality studies on safety and efficacy, millions worldwide will continue to use CBD products. If you’re one of these users or are thinking about becoming one, be extremely careful about product selection. A 2017 study found that over half of CBD extracts sold online had CBD levels significantly higher or lower than reported. Additionally, it’s probably a good idea to stick with what’s been studied: oral delivery of CBD in moderate doses. While I’m hopeful that CBD will be a useful tool in the near future, the cost and uncertainty may prevent it from being worthwhile in the present.
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