To make matters more confusing, nine states (including California, Washington, and Colorado) let residents buy cannabis-based products with or without THC. Nearly two dozen other “medical marijuana states” allow the sale of cannabis, including capsules, tinctures, and other items containing CBD or THC, at licensed dispensaries to people whose doctors have certified that they have an approved condition (the list varies by state but includes chronic pain, PTSD, cancer, autism, Crohn’s disease, and multiple sclerosis). Sixteen more states legalized CBD for certain diseases. But because all these products are illegal according to the federal government, cannabis advocates are cautious. “By and large, the federal government is looking the other way,” says Paul Armentano, deputy director of the Washington, DC–based National Organization for the Reform of Marijuana Laws (NORML), but until federal laws are changed, “this administration or a future one could crack down on people who produce, manufacture, or use CBD, and the law would be on its side.”
There’s no definite amount that’s appropriate for everyone, but the ratio of CBD to THC will indicate how psychoactive the product is and if it’s legal in your state. The more CBD compared with THC, the less of a high, and vice versa. “Managing psychoactivity is key to successful cannabis therapy,” says Lee. “Amounts should be made clear on the label and lab-certified so people know what’s helping them and what’s not.”
There are a number of possible side effects to using CBD oil, such as fatigue, dry mouth, lightheadedness, hypotension, and impaired motor functions. However, when used in moderate amounts, most people do not experience these side effects, and none of them are known for being fatal or particularly dangerous. More than 20,000 studies have been done in the past 15 years on cannabis, hemp, and cannabinoids, and the results have been overwhelmingly supportive of the therapeutic potential and viability of CBD oil. That being said, some people should be cautious before using this powerful oil.
Miller, whose clients include patients referred by physicians, uses CBD in a variety of delivery modalities that she has found effective. “Patches can be worn for pain or anxiety management. Capsules or concentrated drops can be taken orally for pain, inflammation, sleep, and anxiety. Balms and creams can be used on the hands and feet to manage arthritic pain. Vaping is another delivery method,” she says.
Cannabinol results from the degradation of THC. There is little of it in the fresh plant, but decarboxylation often raises the amount of CBN in the plant as an effect. CBN is only mildly psychoactive and has a higher affinity for the CB2 receptor than the CB1 receptor, linking CBN to the body’s immune system. In hemp oil, CBN is present in levels of 0.2% or lower.
While there is much debate on which form is better, this 2015 study leans in favor of full spectrum CBD oil products. There are many that believe that other cannabinoids, THC especially, are necessary to take full advantage of what cannabis has to offer. Ultimately, however, we are all different and it comes down to the individual user and their needs. If drug testing is a concern, you’re encouraged to seek out CBD isolate products (or terpsolates) or broad spectrum products instead of full spectrum.
“There’s no oversight,” says Marcel Bonn-Miller, PhD, adjunct assistant professor of Psychology in Psychiatry at the University of Pennsylvania and author of the JAMA article. Beyond the label, he adds, “There’s no consistency. You know that every Hershey’s bar you buy and every Coke you buy will be exactly the same. But that’s not the case with the majority of CBD products. It’s not unexpected to see variability within a given brand.” This means that you may notice improvements the first time you buy and try a particular product, but none the next.
‘CBD has proven anti-anxiety effects and may be helpful in depression, based on anecdotal reports,’ says Dr Gordon. ‘I use high CBD prescription cannabis medicine products as part of a mental health protocol with my patients suffering with anxiety and depression. The antidepressant effects of CBD have been shown in animal models, but we now need large, depression-specific studies in humans as the next step.’
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