Updated on June 4, 2021.
Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
Cannabidiol (CBD) is an extract from the flowers and buds of the marijuana or hemp plant, which is typically diluted in a carrier oil like coconut or hemp seed oil. Depending on your state, you can find CBD in the form of an oil, extract, vaporized liquid, or oil-based capsule, as well as in food, drinks and beauty products sold at locales ranging from 24-hour gas stations to high-end cocktail bars.
This non-toxic, and non-intoxicating, extract is gaining attention in health and wellness communities as a natural remedy for common ailments such as chronic pain, anxiety,inflammation (particularly of the skin) and insomnia. CBD doesn’t produce a “high” like its sister cannabis compound, THC. In a 2017 report, the World Health Organization concluded that there is no evidence CBD has the potential for abuse or dependence, and “no evidence of public health related problems associated with the use of pure CBD.”But does that mean it’s safe?
To date, the only CBD product that’s been rigorously researched and approved by the Food and Drug Administration (FDA) is a medication for epileptic seizures, specifically certain kinds of childhood epilepsy. For all of CBD’s other potential uses—and risks—the medical community has a lot of work cut out for them.
Not only is there scant evidence to back up claims of CBD’s efficacy as a wonder-herb (yet), we actually don’t know much about this chemical compound at all. Or, for that matter, any of the other 103 known cannabinoids that interact with the human endocannabinoid system. Emerging medical trials (mostly in animals) show CBD as a promising antipsychotic, antidepressant and sleep aid, to name a few—but with so little information it’s difficult to guarantee its safety under every condition.
That said, cannabidiol and other cannabinoids are commonly thought to be non-toxic, are safe for human consumption, and until we learn more, appear to have many benefits, as well.
CBD is generally well-tolerated, and safe for most
With the small exception of those who may be allergic to the cannabis plant, CBD has no notable or dangerous side effects, and no reported cases of lethal overdose. Chronic use and doses of up to 1,500 mg/day of CBD are reportedly well-tolerated in humans.
While the medical community scrambles to catch up to its fanbase, anecdotally at least, CBD continues to gain popularity among those looking for relief from their symptoms without the mind-altering effects of THC or other pharmaceutical drugs. CBD products (even hose considered “full-spectrum” with less than .3% THC) are considered legally non intoxicating under the law for driving and operating heavy machinery. Though, like with any drug or supplement, you should always stick with the recommended dose.
Downsides: side-effects and potential drug interactions
Though not dangerous, CBD can cause undesirable side effects, and they should be noted before use: dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. And though it’s safe to drive on, common sense dictates you shouldn’t overdo it. CBD is being studied as a powerful sleep aid, and if you’re behind the wheel, feeling even a little sleepy isn’t wise.
More of an issue is that CBD raises concerns about possible drug interactions. Epilepsy studies showed increased blood levels when patients were on antiepileptic drugs and CBD at the same time—which means CBD has the potential to interact with a range of other substances and medications, such as blood thinners or sleeping pills. Always consult with your doctor before use, and alert them if you experience any changes in symptoms.
Another downside to CBD, though not commonly raised, is that the purer the extract, the more it contains an odor of marijuana weed. Not itself unpleasant, it does cause concern and risk in social situations where mis-identifying the source of the smell could be stigmatizing, or worse (at school, professional situations, etc). Perhaps this is why CBD skin products often feature the extract infused into carrier lotions with added perfumes or essential oils.
Lack of regulations is a potential concern
Because of the legally ambiguous nature of the marijuana industry, the FDA has not stepped in to help regulate products like CBD oil. States are scrambling to put standards in place as we speak, but resources to enforce anything at the local level are nearly non-existent.
A 2017 study of the quality and purity of CBD products found nearly 7 out of 10 didn’t contain the amount of extract promised on the label. One study showed that nearly 43% of the products contained too little CBD, while about 26% contained too much. Potentially worse, about 1 in 5 contained varying amounts of THC.
Until more consumer protections are in place to prevent poor quality or even unsafe products from hitting the marketplace, CBD use is largely buyer beware. On the stigma front at least, since hemp-derived CBD is now legal all 50 states under the 2018 US Farm Bill, we should start seeing a lot more channels for funding, research, and a lessening of stigma as both recreational and medical marijuana programs expand all over the country.
As always, if you plan to use products containing CBD, please consult with your doctor first.