With the hype surrounding cannabis legalization in many states, you’ve probably also heard about cannabidiol (CBD)—though CBD is legal even in states where marijuana isn’t. It’s relatively new on the scene, but a quick Google search will confirm that it’s got a skyrocketing fan base of users claiming it helps with issues like insomnia, anxiety, pain, and more. So what exactly is CBD? How is it different from marijuana? And what kind of proven effects (if any) does it have? Here’s a rundown on everything we know about CBD so far.
- CBD comes from the cannabis plant (or hemp plant) but is not psychoactive and won’t get you high.
- CBD is commonly used to ease many ailments but only proven to treat one type of epilepsy (Lennox-Gastaut syndrome).
- There are preliminary studies on other benefits (e.g., for anxiety and pain), but more research is needed to confirm these and to establish dosage.
- There are no major risks to CBD itself. However, CBD supplements aren’t regulated by the Food and Drug Administration (FDA) and can be mislabeled.
- Be mindful of finding trustworthy manufacturers and providers if you choose to use CBD. Research reputable sellers with good recommendations.
CBD is one of the many compounds that naturally occur in cannabis plants (it can also be derived from hemp). While the tetrahydrocannabinol (THC) compound found in cannabis produces that infamous high, CBD is different in that it’s not psychoactive (it can’t get you high). It’s sold in almost every form imaginable—pills, oils, gummies, topical creams, vape juice—with pretty packaging that often states health benefits. But it’s important to know that there still isn’t a ton of medical research on what CBD can (or can’t) effectively treat, and CBD products aren’t regulated by the FDA.
This question likely depends on how you feel when you aren’t using CBD. Most people who use it regularly report feeling less stress, pain, and anxiety (so if you don’t feel these things normally, you may not notice a drastic effect). It’s also believed to reduce inflammation and is available in topical forms (creams and gels) that some claim help with sore muscles or menstrual cramps. Note: None of these claims have been fully scientifically vetted just yet.
In short, yes, as long as it contains less than 0.3 percent THC. CBD products that contain a higher amount are generally legal only in states where recreational marijuana has also been legalized. That said, some states have different laws depending on whether CBD is derived from hemp or marijuana plants. Because of these varying regulations, not to mention age limitations, it’s important to get familiar with the current CBD laws in your state.
Here’s an online map of individual state CBD laws for reference, but always double-check with your state’s official government website.
A 2018 study in the New England Journal of Medicine found that 10- or 20-milligram doses of CBD reduced the frequency of epileptic seizures in patients with Lennox–Gastaut syndrome (a type of severe childhood-onset epilepsy). The FDA has approved a CBD drug called Epidiolex™ for this reason. This is the only confirmed benefit of CBD so far.
As for its other therapeutic effects, more research is needed to confirm whether CBD is effective in dealing with issues like anxiety, pain, and insomnia. However, the research so far appears promising:
- In a 2011 study in Neuropsychopharmacology, CBD appeared to reduce anxiety tied to public speaking in a group of people with generalized social anxiety disorder (SAD).
- In a 2016 animal study, a topically applied CBD gel reduced joint inflammation and behaviors associated with pain.
- Patients with chronic pain reported that CBD products had reduced their discomfort for ailments such as back pain, neck pain, and migraines, and had reduced their use of other pain medications, including opioids (Journal of Pain, 2019).
- In a 2019 study of 72 adults reporting anxiety and sleep problems, CBD appeared to decrease anxiety in nearly 80 percent of participants and improve sleep in more than 66 percent (though their sleep fluctuated through the course of the three-month study).
- In a small 2019 study in the Journal of Alternative and Complementary Medicine, 10 out of 11 patients with post-traumatic stress disorder (PTSD) had lower measures of PTSD symptoms after taking CBD for eight weeks (alongside their usual treatments).
“In our study, we found that CBD looked to be a useful addition to ongoing psychiatric treatment for anxiety,” says Dr. Scott Shannon, a CBD researcher and assistant clinical professor in the Department of Psychiatry at the University of Colorado. “We found marginal results for sleep support, but many of our patients were convinced it helped them. We do need more studies, as the current public use of CBD far exceeds our science.”
CBD does have some minor side effects, namely dry mouth, fatigue, and drowsiness. But research has shown that these are not an issue for most users.
“CBD was well tolerated [in our studies] with very few people stopping it due to side effects,” says Dr. Shannon. “[It had] many fewer [side effects] than with psychiatric medications.”
Although CBD itself has not been tied to any major risks (according to the National Institutes of Health), the main safety concern lies in the fact that supplements aren’t regulated by the FDA like medications are. That means there’s no way of guaranteeing the purity or ingredients listed on the label. In a 2017 analysis of 84 CBD products sold online, only 30 percent were correctly labeled, while the rest contained higher or lower amounts of CBD than they claimed (vaping liquids were most frequently mislabeled, while oils were most frequently labeled correctly), and 21 percent also contained THC. Even more concerning, some users in Utah ended up at the nearest poison control center after ingesting synthetic substances falsely marketed as CBD oil, according to a CDC report.
Also, since it’s still relatively new on the market, it’s hard to know what the right dose is for individual needs. As a general rule, it’s recommended to start with around 20 milligrams per day and adjust from there. Also, it’s worth mentioning that it can take a while (over an hour) for the effect of gummies or other edibles to kick in—don’t be too hasty to take a second dose.
“I’ve been using a CBD spray for a few months now. I have moderate anxiety and it seems to help me feel a little more laid-back. I use one spritz [dose] during the day and I’m still really functional. Sometimes I’ll take two at night to help me relax after a stressful day.”
—Valerie S., recent graduate, Los Angeles, California
“I find CBD to be very effective for helping with sleep and pain, without the nasty side effects I could be experiencing with pain and sleeping pills.”
—Jonathan M., fourth-year student, University of California, Berkeley
“I refuse to use them. I am not comfortable with CBD products—more research needs to be conducted.”
—Jamie W., fifth-year student, University of New Brunswick, Fredericton, Canada
“I’m concerned about unstudied long-term effects. Similar to how vaping chemicals deal additional damage to the human body (who would have guessed a different form of smoking would be bad for the human body?), I don’t feel comfortable putting CBD into/onto my body yet.”
—Alec S., second-year graduate student, Colorado School of Mines, Golden, Colorado
Scott Shannon, MD, CBD researcher and assistant clinical professor in the Department of Psychiatry, University of Colorado.
Bergamaschi, M., Queiroz, R., Chagas, M., de Oliveira, D. C., et al. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology, 36(6), 1219–1226. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21307846
Bonn-Miller, M. O., Loflin, M. J. E., Thomas, B. F., Marcu, J. P., et al. (2017). Labeling accuracy of cannabidiol extracts sold online. JAMA, 318(17), 1708. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29114823
Devinsky, O., Patel, A. D., Cross, J. H., Villanueva, V., et al. (2018). Effect of cannabidiol on drop seizures in the Lennox–Gastaut syndrome. New England Journal of Medicine, 378(20), 1888–1897. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMoa1714631
Elms, L., Shannon, S., Hughes, S., & Lewis, N. (2019). Cannabidiol in the treatment of post-traumatic stress disorder: A case series. Journal of Alternative and Complementary Medicine, 25(4), 392–397. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482919/
Grinspoon, P. (2019, August). Cannabidiol (CBD)—what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
Hammell, D., Zhang, L., Ma, F., Abshire, S., et al. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European Journal of Pain, 20(6), 936–948. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/
Horth, R. Z., Crouch, B., Horowitz, B. Z., Prebish, A., et al. (2018). Notes from the field: Acute poisonings from a synthetic cannabinoid sold as cannabidiol—Utah, 2017–2018. Morbidity and Mortality Weekly Report, 67(20), 587–588. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6720a5-H.pdf
MedlinePlus. (2019). Cannabidiol (CBD). Retrieved from https://medlineplus.gov/druginfo/natural/1439.html
Moeller-Bertram, T., Schilling, J., Hughes, C., Wallace, M., et al. (2019). Can CBD reduce the use of pain medication? Lessons from a survey in a pain clinic environment. Journal of Pain, 20(4). Retrieved from https://www.jpain.org/article/S1526-5900(19)30652-2/pdf
Shannon, S., Lewis, N., Lee, H., & Hughes S. (2019). Cannabidiol in anxiety and sleep: A large case series. Permanente Journal, 23:18–041. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30624194