Every Question You Have About CBD—Answered
Does CBD get you high? What are the actual benefits? Will it show up on a drug test? Here’s everything you need to know about the product that’s suddenly everywhere.
There’s no question that CBD is the buzzy wellness product of the moment. If you live in a state where it’s currently legal, you might feel like CBD has gone from being sort of around to absolutely everywhere all at once. Coffee shops sell CBD lattes, spas offer CBD facials, beauty companies are rushing to release lotions with CBD or hemp oils in their formulas. And everyone from your anxious coworker to your arthritis-suffering dad wants to get their hands on some CBD gummies.
But even though it’s infiltrating pretty much every corner of the wellness world (hi, vegan CBD brownies!) many people still find CBD a little confusing—especially when it comes to figuring out the right way to use it and how to make sure the stuff you’re buying is, you know, actually legit. Below, we asked experts to answer the most pressing questions about CBD.
OK, first things first. What is CBD?
CBD, short for cannabidiol, is a chemical compound from the Cannabid sativa plant, whish is also known as marijuana or help, according to the US National Library of Medicine.
It’s a naturally occurring substance that’s used in products like oils and edibles to impart a feeling of relaxation and calm. Unlike its cousin, delta-9-tetrahydrocannabinol (THC), which is the major active ingredient in marijuana, CBD is not psychoactive.
So you’re saying CBD won’t get me high?
Nope. The cannabis plant is made up of two main players: CBD and THC. “CBD is the non-psychoactive portion of the plant, so what that means is you won’t have any effects like euphoria,” says Junella Chin, DO, an osteopathic physician and a medical cannabis expert for cannabisMD. “You won’t feel sedated or altered in any way.”
There are two possible exceptions to this. The first is that some people, for unknown reasons, just react differently to CBD. According to Dr. Chin, about 5% of people say they feel altered after taking CBD. “Usually they’re the same people who have side effects from Advil or Tylenol,” she says. You never know how your body will react to any new supplement, so when taking CBD for the first time, do so safely under supervision.
It’s also crucial to buy third-party-tested CBD for quality assurance (more on this later). Because the FDA doesn’t regulate CBD, it is possible to buy a product that is more or less potent than advertised, or even contains small amounts of THC.
Where does hemp come in to all this?
You’ve probably heard the terms cannabis, marijuana, and hemp all tossed around in relation to CBD. The plant Cannabis sativa has two primary species, hemp and marijuana. Both contain CBD, but there’s a much higher percentage in hemp, which also has very low (less than 0.3%) levels of THC compared to marijuana.
When people talk about hemp oil, they’re referring to oil extracted from the seeds of the hemp plant. There are no cannabinoids—CBD or THC—in hemp oil. This ingredient is packed with healthy fats and often appears in beauty products for its moisturizing benefits.
What are the health benefits of CBD?
The only CBD medication that is currently FDA-approved is Epidiolex, which the agency approved last year for the treatment of certain types of epilepsy. But many people swear CBD has helped with a slew of other health conditions, including back pain, osteoarthritis, even cancer.
“My practice has patients walking in every day asking about CBD,” says Houman Danesh, MD, director of integrative pain management for the Mount Sinai Hospital in New York City. But while there’s lots of anecdotal evidence, he says, “it’s still very difficult to say” what the real benefits are due to a serious lack of research.
“Right now, you just have pharmacies trying to make some sort of sense out of it and say, ‘Yes, it works for this,'” he says, “but that’s not the way medicine is practiced—it should be based on evidence, and there’s not a lot of evidence to really support these claims.”
Still, is CBD worth trying for pain management?
There are two main types of pain, Dr. Danesh says: musculoskeletal and nerve. “There could be benefit for both conditions,” he says.
The tricky part is that there’s some evidence suggesting CBD works best for pain when combined with a little THC, says Dr. Danesh. “Depending on what type of pain you have, you might be able to do just CBD, but sometimes you need CBD and THC.” This makes accessing a product that will actually help you more difficult due to different regulations in each state. In New York, where Dr. Danesh practices, for example, CBD is available over the counter. But as soon as you add THC, you need a prescription.
Figuring out how much you should take is challenging as well; the dosage that alleviates one patient’s pain might do very little for someone else. “And until we can study it, it’s the wild west,” Dr. Danesh says.
The takeaway? “I think CBD is a safe thing to try,” says Dr. Danesh. But he urges patients to push for more research by putting pressure on representatives to get national bills passed that allow scientists to look closer at CBD and the conditions that respond to it.
What about my anxiety—can CBD help with that?
CBD might be worth trying to manage symptoms of anxiety. “[CBD] tells your body to calm down and reminds you that you’re safe,” Dr. Chin says. “It mellows out the nervous system so you’re not in a heightened ‘fight or flight’ response,” she says, so people with anxiety may find it helps them feel more relaxed.
Still, one of the biggest misconceptions about CBD is that it’s a wonder drug. “A lot of times people think CBD is a cure-all, and it’s not,” Dr. Chin says. “You should also have a healthy lifestyle with plenty of exercise and good nutrition—CBD is not going to fix everything.”
I’ve heard of edibles, tinctures, vape pens. What’s the best way to take CBD?
It really depends on what your goal is and why you’re taking CBD in the first place.
Some people don’t want to ingest anything and therefore prefer a topical CBD cream or ointment. “You can apply it to muscles, joints, and ligaments and still get a nice, localized release,” Dr. Chin says.
The biggest differences between tinctures, edibles, and vape pens are speed of delivery and how long the effects last. Vape relief is faster but wears off faster too—usually in about two hours, says Dr. Chin. “Say you wake up in the morning and pulled your back out, you might want to take CBD through a vape pen, which delivers in 10 minutes.”
Tinctures and edibles take longer to work but last four or five hours. “A tincture looks like a little liquid that you put under your tongue, and you feel relief within half an hour,” Dr. Chin says. “If you prefer to taste something, you choose an edible, whether it’s a capsule, gummy, or baked good.”
What should I look for when shopping for CBD products?
“There are literally hundreds of CBD brands at this point,” says Brandon Beatty, founder and CEO of Bluebird Botanicals and an executive vice president of the U.S. Hemp Roundtable. Here are a few things you should keep in mind when shopping.
What does the label look like?
We don’t mean the color or millennial font. If it’s a dietary supplement, it should have a back panel with an FDA disclaimer and warning section, according to Beatty. “Ideally, it would be preferable to have access to their third-party lab testing results too.”
Speaking of which: Has it been third-party tested?
Nearly every expert Health spoke to agreed that your CBD products should be tested by a third party to confirm the label’s accuracy. This is a real concern in the industry—take the 2017 Journal of the American Medical Association study, for example, which tested 84 CBD products and found that 26% contained lower doses than stated on the bottle. Look for a quality assurance stamp or certificate of analysis from a third party (aka not the actual brand) or check the retailer’s website if you don’t see it on the product’s label.
What’s the dosing?
This is a confusing one for many people. “A lot of brands don’t do a good job of clearly instructing their consumer on the dosing,” says Chris Roth, CEO and co-founder of Highline Wellness. When thinking about dosing, also consider whether your CBD is full-spectrum or isolate: Full-spectrum could include other cannabinoids like cannabidivarin or cannabigerol (this is important, since “there’s something called the ‘entourage effect’ when all together, they’re more effective than any one of them alone,” Roth explains), while isolate is 100% CBD. “Some people might only need 10 milligrams of full-spectrum CBD, but with isolate, even taking 80 or 100 milligrams might not have the same effect,” he says.
Does it claim to cure any diseases?
If so, hard pass. “You should avoid any company that makes disease claims,” says Beatty. “If so, it means they’re either willing to break the rules or they’re not aware of the rules.”
Is there a batch number?
You know how you check your raw chicken or bagged lettuce every time there’s a recall to make sure the one you bought isn’t going to make you sick? You should be able to do that with CBD products too. “This is a huge indicator as to whether they are following good manufacturing practices,” says Beatty. “There should be a way to identify this product in case it was improperly made so the company can carry out a recall.”
Are there additional ingredients in there?
As with any supplement, you want to know everything you’re ingesting in addition to the main event. For example, “sometimes I notice that [CBD manufacturers] will add melatonin,” says Dr. Chin.
Are you buying it IRL?
You can find CBD products in shopping malls, convenience stores, even coffee shops in many states right now. But when in doubt, natural grocers are a safe brick-and-mortar place to buy CBD, Beatty says. “Typically they have a vetting process that does some of the legwork for you.”
That all sounds good, but is it legal?
First, a little background. Industrial hemp was legal in the United States until Congress passed the Marihuana Tax Act in 1937. (“Some of our early presidents grew hemp,” notes Sarah Lee Gossett Parrish, a cannabis industry attorney based in Oklahoma.) Nearly 80 years later, the 2014 Farm Bill took the position that states can regulate the production of hemp and, as a result, CBD. Then last year, President Trump signed a new Farm Bill that made it federally legal to grow hemp.
This means that “consumers everywhere, if they’re compliant with their state, can grow hemp and use hemp products,” Parrish explains, “and among those will be CBD.”
In other words, the latest bill removed hemp from the Drug Enforcement Administration, or DEA’s, purview. “Hemp can now be grown freely under federal law, which, of course, is huge,” Parrish says. “But while it’s legal under federal law, it’s up to each state to set their own policy.”
These policies vary widely. Marijuana and CBD are currently fully legal for both medicinal and recreational purposes in Alaska, California, Colorado, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, Washington, and Washington D.C. In 23 states, it’s legal in some form, such as for medicinal purposes. Another 14 states permit just CBD oil. But both are illegal in Idaho, Nebraska, and South Dakota. For more information, the organization Americans for Safe Access has a helpful guide to the specific laws in each state.
“It’s kind of ironic,” says Parrish. “With marijuana, we have got the federal government saying ‘No’ and a bunch of states saying ‘Yeah, it’s OK’—but with hemp, the feds say ‘Yeah, it’s OK,’ but we still have some states saying it’s not.”
Can you travel with CBD?
That same 2018 Farm Bill means you can now travel between states with legit CBD products. “Flying with CBD should pose no issues now,” Parrish says. However, if you’re traveling with a tincture, be mindful of TSA limits on how much liquid you can carry on an airplane, she adds. (You can also mail CBD products, just like “companies that comply with the Bill can ship their hemp-derived CBD products anywhere in the U.S.,” Parrish notes.)
Will CBD show up on a drug test?
It should not, as long as you’re buying third-party tested CBD with no added THC, says Dr. Chin. But she does point out that athletes, who often are required to take drug tests that are more sensitive, “could potentially test positive” for trace amounts of THC if they’ve been using CBD products.
Last question: Can I give it to my dog?
Tempted to give your pup one of those CBD dog biscuits? “Generally we expect CBD products to be safe, and they could show some benefit for anxiety in pets,” says John Faught, DVM, a veterinarian based in Austin, Texas.
But the challenge when considering CBD products for pets is the same as with people: lack of research. “I believe there are good products out there today, but I also don’t know how to distinguish them at this time,” Faught says.
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Does CBD get you high? What are the benefits and effects? Can you use it for pain and anxiety? Will it show up on a drug test? Is CBD legal? Experts answer all your top questions about CBD.
What Are the Benefits of CBD?
More than 60 percent of CBD users were taking it for anxiety, according to a survey of 5,000 people. Does it help?
By Dawn MacKeen
The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays. More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm. Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby. The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too.
What is CBD?
Cannabidiol, or CBD, is the lesser-known child of the cannabis sativa plant; its more famous sibling, tetrahydrocannabinol, or THC, is the active ingredient in pot that catapults users’ “high.” With roots in Central Asia, the plant is believed to have been first used medicinally — or for rituals — around 750 B.C., though there are other estimates too.
Cannabidiol and THC are just two of the plant’s more than 100 cannabinoids. THC is psychoactive, and CBD may or may not be, which is a matter of debate. THC can increase anxiety; it is not clear what effect CBD is having, if any, in reducing it. THC can lead to addiction and cravings; CBD is being studied to help those in recovery.
Cannabis containing 0.3 percent or less of THC is hemp. Although last year’s Farm Bill legalized hemp under federal law, it also preserved the Food and Drug Administration’s oversight of products derived from cannabis.
What are the claims?
CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep. Part of CBD’s popularity is that it purports to be “nonpsychoactive,” and that consumers can reap health benefits from the plant without the high (or the midnight pizza munchies).
Just as hemp seedlings are sprouting up across the United States, so is the marketing. From oils and nasal sprays to lollipops and suppositories, it seems no place is too sacred for CBD. “It’s the monster that has taken over the room,” Dr. Brad Ingram, an associate professor of pediatrics at the University of Mississippi Medical Center, said about all the wild uses for CBD now. He is leading a clinical trial into administering CBD to children and teenagers with drug-resistant epilepsy.
Is This A Scam?
Facts about wellness.
Will these trends change your life — or
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Does CBD work?
“It’s promising in a lot of different therapeutic avenues because it’s relatively safe,” said James MacKillop, co-director of McMaster University’s Michael G. DeGroote Center for Medicinal Cannabis Research in Hamilton, Ontario.
Last year, the F.D.A. approved Epidiolex, a purified CBD extract, to treat rare seizure disorders in patients 2 years or older after three randomized, double-blind and placebo-controlled clinical trials with 516 patients that showed the drug, taken along with other medications, helped to reduce seizures. These types of studies are the gold standard in medicine, in which participants are divided by chance, and neither the subject nor the investigator knows which group is taking the placebo or the medication.
While there is hope for treating other conditions with the plant extract, Epidiolex remains the only CBD-derived drug approved by the F.D.A. Most of the research on cannabidiol has been in animals, and its current popularity has outpaced science. “We don’t have the 101 course on CBD quite figured out yet,” said Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.
Does CBD help anxiety and PTSD?
For students with generalized social anxiety, a four-minute talk, with minimal time to prepare, can be debilitating. Yet a small experiment in the journal Neuropsychopharmacology found that CBD seemed to reduce nervousness and cognitive impairment in patients with social anxiety in a simulated public speaking task.
However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”
Many soldiers return home haunted by war and PTSD and often avoid certain activities, places or people associated with their traumatic events. The Department of Veterans Affairs is funding its first study on CBD, pairing it with psychotherapy.
“Our top therapies attempt to break the association between reminders of the trauma and the fear response,” said Mallory Loflin, an assistant adjunct professor at the University of California, San Diego and the study’s principal investigator. “We think that CBD, at least in animal models, can help that process happen a lot faster.” While large clinical trials are underway, psychologists say there isn’t compelling evidence yet as to whether this is a viable treatment.
Does CBD help sleep and depression?
Up in the wee hours of the night, stuck watching videos of puppies? CBD may be promising as a sleep aid; one of the side effects of the Epidiolex trials for epilepsy was drowsiness, according to Mr. MacKillop, a co-author of a review on cannabinoids and sleep. “If you are looking for new treatments for sleep, that may be a clue,” he said.
But he cautions that the side effects could have been because of an interaction with other medications the children were taking to control the seizures. So far, there hasn’t been a randomized, placebo-controlled, double-blind trial (the gold standard) on sleep disorders and CBD.
A recent chart review of 72 psychiatric patients treated with CBD found that anxiety improved, but not sleep. “Over all, we did not find that it panned out as a useful treatment for sleep,” said Dr. Scott Shannon, assistant clinical professor of psychiatry at the University of Colorado, Denver and the lead author of the review in The Permanente Journal.
Sleep can be disrupted for many reasons, including depression. Rodents seemed to adapt better to stressful conditions and exhibited less depressive-like behavior after taking CBD, according to a review in Journal of Chemical Neuroanatomy. “Surprisingly, CBD seems to act faster than conventional antidepressants,” wrote one of the authors of a new review, Sâmia Joca, a fellow at the Aarhus Institute of Advanced Studies in Denmark and an associate professor at the University of São Paulo in Brazil, in an email interview. Of course, it’s difficult to detect depression in animals, but the studies that Ms. Joca and her colleagues reviewed suggested that in models of chronic stress exposure, the mice and rats treated with CBD were more resilient.
But without clinical trials in humans, psychologists say CBD’s effect on depression is still a hypothesis , and not an evidence-based treatment.
Is CBD harmful?
“If you take pure CBD, it’s pretty safe,” said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania’s Perelman School of Medicine. Side effects in the Epidiolex trial included diarrhea, sleepiness, fatigue, weakness, rash, decreased appetite and elevated liver enzymes. Also, the safe amount to consume in a day, or at all during pregnancy, is still not known.
Recently, the F.D.A. sent a warning letter to Curaleaf Inc. about its “unsubstantiated claims” that the plant extract treats a variety of conditions from pet anxiety and depression to cancer and opioid withdrawal. (In a statement, the company said that some of the products in question had been discontinued and that it was working with the F.D.A.)
Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”
Some CBD products may contain unwanted surprises. Forensic toxicologists at Virginia Commonwealth University examined nine e-liquids advertised as being 100 percent natural CBD extracts. They found one with dextromethorphan, or DXM, used in over-the counter cough medications and considered addictive when abused; and four with a synthetic cannabinoid, sometimes called Spice, that can cause anxiety, psychosis, tachycardia and death, according to a study last year in Forensic Science International.
Earlier research found fewer than a third of 84 products studied contained the amount of CBD on their labels. Some users of CBD have also failed drug tests when the product contained more THC than indicated.
This year, 1,090 people have contacted poison control centers about CBD, according to the American Association of Poison Control Centers. Over a third are estimated to have received medical attention, and 46 were admitted into a critical care unit, possibly because of exposure to other products, or drug interactions. In addition, concern over 318 animals poured into the American Society for the Prevention of Cruelty to Animals’ Animal Poison Control Center.
Is CBD a scam or not?
A few drops of CBD oil in a mocha or smoothie are not likely to do anything, researchers contend. Doctors say another force may also be at play in people feeling good: the placebo effect. That’s when someone believes a drug is working and symptoms seem to improve.
“CBD is not a scam,” said Yasmin Hurd, director of the Addiction Institute of Mount Sinai in New York City who led a double-blind study of 42 recovering heroin addicts and found that CBD reduced both cravings and cue-based anxiety, both of which can cycle people back into using. “It has a potential medicinal value, but when we are putting it into mascara and putting it into tampons, for God’s sake, to me, that’s a scam.”
More than 60 percent of CBD users were taking it for anxiety, according to a survey of 5,000 people. Does it help?