The benefits and side effects of using CBD oil
Cannabidiol (CBD) oil is a concentrated extract from hemp and cannabis plants, which is then mixed with other ingredients to create an array of CBD products including capsules, tinctures, edibles, creams, and vapes.
The purported health benefits of CBD are many, ranging from treating cancer to premenstrual syndrome. But like all popular remedies, the wide majority of marketing claims have yet to be proven.
Does CBD oil work?
There is some evidence in human clinical trials that large doses of CBD may be helpful for treating anxiety, epilepsy, addiction, inflammation, and psychosis, says Jeffrey Chen, MD, co-founder and CEO of Radicle Science, a health-tech company that offers research and validation services for CBD products.
In fact, in 2018, the FDA approved the use of Epidiolex, a CBD-derived drug, to treat rare forms of childhood epilepsy.
Additionally, there have been anecdotal reports of CBD helping with issues like pain, sleep disturbance, and stress. However, more significant human trials are needed to determine how well CBD treats these issues for a broad population, says Chen.
How to use CBD
There are many different ways you can use CBD. Deciding which method is best for you largely comes down to how quickly you want the effects to kick in.
The amount of time CBD takes to reach your bloodstream depends on the mode of consumption, says Chen:
- Inhaling it is the fastest, since it goes from your lungs to your bloodstream, causing the CBD level in your bloodstream to peak in 30 minutes or less.
- Putting it under your tongue allows it to get absorbed directly into your bloodstream. This is the second-fastest method, after inhalation.
- Swallowing it requires the CBD to first pass through your intestines and then your liver before reaching your bloodstream, which can take hours.
- Applying it to your skin often means it only works topically in that area and doesn’t reach your bloodstream. However, using transdermal CBD patches may cause the CBD to penetrate the layers of your skin and reach your bloodstream.
“How long effects last is difficult to predict because people take different doses and experience different effects from CBD — and some do not experience an immediate effect at all,” says Chen.
In terms of dosage, there isn’t an established, recommended CBD dosage, says Chen.
While most consumer products recommend serving sizes of 5 to 50 milligrams, research studies that have demonstrated benefits typically use several hundred milligrams of pure, pharmaceutical-grade CBD per day.
These quantities are “not available, sustainable, or affordable,” says Jordan Tishler, MD, president of the Association of Cannabinoid Specialists and founder of InhaleMD.
Side effects of CBD
CBD is generally considered to be safe and well-tolerated. However, it can sometimes cause side effects, since it interacts with your central nervous system as well as several other organs in your body.
Side effects of CBD can include:
- Dry mouth
- Reduced appetite
If you’re considering taking CBD oil or other CBD products, it’s recommended that you consult your healthcare provider first, particularly if you:
- Have underlying medical conditions such as kidney disease, liver disease, heart issues, a weakened immune system, or epilepsy.
- Are taking other medications, since CBD can interact with 139 other drugs. Older adults or people who take multiple medications are at a greater risk of experiencing side effects from combining CBD with medication.
Is CBD oil safe?
CBD is generally considered safe, particularly in low doses. “While low-dose CBD is not particularly effective, it’s not harmful either,” says Tishler.
However, when you get to higher doses, CBD can cause liver toxicity and has been shown to interact dangerously with many medications like blood thinners and heart medications, Tishler says.
A major concern with CBD is that most products are sold as supplements, not medication, so they are not regulated by the FDA and therefore, may not have accurate dosing information.
A 2017 study investigated 84 consumer CBD products and found that two-thirds did not correctly state how much CBD they contained:
- 26% of the products contained less CBD than they claimed
- 42% contained more CBD than they claimed
- 32% had correct dosing information
Important: The legalities of CBD oil are tricky and can depend on whether the CBD was extracted from hemp or cannabis. “Hemp is a type of cannabis that is low in THC and is legal at the federal level. High-THC cannabis is legal in dozens of states but illegal at the federal level,” says Chen.
While there are several CBD oils and products that claim to offer myriad health benefits, the science has not caught up with the marketing yet. So far, CBD has been approved by the FDA only for the treatment of epilepsy in children.
There isn’t much data in adult humans to show that CBD is a useful medication, says Tishler. He says most of the studies investigating the effects of CBD have been conducted in mice and cell cultures, and the results don’t necessarily apply to humans.
Since many of the effects of CBD are unknown, Chen recommends weighing the benefits you notice with any side effects you experience, before you decide to take it regularly.
Explainer: Low-Dose CBD Oil Can Now Be Bought Over-the-Counter. Here’s What That Means.
Last December, Australia’s Therapeutic Goods Administration (TGA) made a big announcement: it was “down-scheduling” or easing access to certain kinds of medicinal cannabis, moving it from a prescription-only medicine to pharmacist-only, or over-the-counter.
Low-dose cannabidiol – aka CBD – was previously only available through a special scheme, which involved doctors getting select permission for patients to access the product.
“The decision was made following an earlier TGA safety review of low-dose CBD, which indicated that the known adverse effects of CBD at low doses were not serious,” the TGA said at the time of the announcement.
It was made officially available over-the-counter on February 1, but there are no products approved for purchase just yet. Here’s a run-down of all the information you need to know, from when it’ll be available to what it treats, potential side effects, and how it’s different from other forms of cannabis.
What is CBD?
Cannabidiol is one of the chemical compounds found in the cannabis plant (yes, the marijuana plant). It’s extracted from the plant then generally mixed with a carrier oil.
CBD is a non-psychotropic medicine, meaning it won’t make you feel high or stoned, and won’t cause temporary impairment to your senses.
What’s it used for?
To treat issues such as anxiety, post-traumatic stress disorder, insomnia, childhood epilepsy syndromes and chronic pain, which includes arthritis, inflammatory pain, joint pain and migraines.
It can also help with period pain, endometriosis, chemotherapy-induced nausea, depression, epilepsy, multiple sclerosis and spasticity.
“We know it works, and it’s very clear that for some people, it’s life-changing in a positive way,” says Doctor Ben Jansen, founder and clinical director of Cannabis Doctors Australia, which specialises in medicinal cannabis and works with doctors and patients to gain access through the TGA. “If we can provide a medicine that’s beneficial to our patients with a low side-effect profile and get them off of medications that are potentially harmful, that’s a win-win.”
How is CBD different from other medicinal cannabis compounds?
The other major cannabinoid that doctors prescribe is tetrahydrocannabinol or THC.
“Commonly people will lump ‘medicinal cannabis’ into one broad topic without being really [specific] about the types,” says Jansen. “It’s really important for patients, doctors and the general public to know that there is a real difference between the two molecules.”
THC binds directly onto the nerves of the body and turns down their signals, bringing about the stoned feeling. Because of this, THC users are not legally allowed to drive, but patients who take CBD-only medicines lawfully can.
The two compounds are also used for different purposes: THC is better for calming pain signals or spasms and treating neurological conditions, whereas CBD works as more of a pain reliever and an anti-inflammatory.
How will CBD be available?
The TGA’s decision allows a maximum daily dose of 150 milligrams, available at pharmacies without a prescription. This includes formulas ingested through the mouth, through the oral mucosa (the membrane lining the mouth) and sublingually (under the tongue).
Topical creams and medicinal vapes with CBD are not included in the approved over-the-counter medicines, and will still require a prescription from a doctor.
“It’s interesting too because there are some concerns in the industry that even 150 milligrams per day might not be enough to be effective,” Cassandra Hunt, managing director of Freshleaf Analytics (which specialises in medicinal cannabis), tells Broadsheet. “Companies might find it hard to register their products with the TGA if that dose isn’t effective, because then the data won’t show it works.”
How do you take CBD?
CBD commonly comes in the form of an oil. Jansen suggests going low and slow with doses, especially for patients who haven’t previously used it with a prescription. Then you gradually increase the amount you take until you reach the minimal effective dose, or the smallest dose that gives the result you need.
It’s also recommended to eat food with a bit of fat when you take your dose, as that will help your body absorb the CBD faster and more effectively. One way of taking the CBD is to place your dose on a teaspoon, hold it under your tongue, and swallow after 90 seconds.
It’s also important to keep track of when and how much you’ve taken, so you have a record of all your doses.
Does CBD have side effects?
“Like everything, there’s a potential for side effects,” Jansen says. “With CBD the side-effect profile is pretty light and not that common. If you do get side effects, generally they’re fleeting and will eventually go away.”
The most common side effects are dry mouth, nausea and loose bowel movement. There’s also a possibility of drowsiness, but it’s a very rare occurrence.
Are products available to purchase?
While you’re now theoretically able to go to your local pharmacy and get CBD without a prescription, the TGA has not yet approved any products for over-the-counter use.
“To get registered with the TGA, you’ve got to have data that shows your product works, it’s efficacious, it’s safe and it’s manufactured in a quality environment,” Hunt says. “Once you’ve collected all that data, the process to get approval can still take 10 to 12 months.”
She adds, “It’s unlikely that we’ll see any products on the shelves later this year; more likely next year.”
How can I get CBD until then?
The best way to access low-dose CBD products right now is through a GP who can give you a prescription.