Since some CBD oils contain trace amounts of THC, you should avoid driving or using heavy machinery when taking CBD oil, particularly when first starting treatment or using a new brand.
In June 2018, the U.S. Food and Drug Administration (FDA) approved Epidiolex, a CBD oral solution used for the treatment of certain rare forms of epilepsy in children under 2—Dravet syndrome and Lennox-Gastaut syndrome. Both are exceptionally rare genetic disorders causing lifelong catastrophic seizures that begin during the first year of life.
According to a 2017 study in the Journal of the American Medical Association, only 30.95% of CBD products sold online were correctly labeled. Most contained less CBD than advertised, while 21.43% had significant amounts of THC.
To use CBD oil, place one or more drops under the tongue and hold the dose there for 30 to 60 seconds without swallowing. Capsules and gummies are easier to dose, although they tend to be more costly. CBD sublingual sprays are available as well.
Potential drug-drug interactions with CBD include:
CBD oil may also increase liver enzymes (a marker of liver inflammation). People with liver disease should use CBD oil with caution, ideally under the care of a doctor who can regularly check blood liver enzyme levels.
Here is just some of what the current evidence says.
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.
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.
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.
Does CBD help sleep and depression?
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.
More than 60 percent of CBD users were taking it for anxiety, according to a survey of 5,000 people. Does it help?
“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.
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.”
Conclusion: Topical CBD may be beneficial at relieving arthritis but no high-quality human studies prove this.
Conclusion: CBD may be beneficial at relieving pain but no high-quality human studies prove this.
Conclusion: CBD is beneficial for treating certain types of epilepsy.
Animal studies have shown that CBD has anti-inflammatory effects and works on the endocannabinoid and pain-sensing systems to relieve pain.
Conclusion: Topical CBD may help relieve inflammation and excessive sebum production associated with acne but more trials are needed.
Animal studies have shown some effect of CBD at relieving depression, possibly related to its strong anti-stress effect after either acute or repeated administration. 16
Unfortunately, few human trials investigating the use of CBD as a single agent to relieve pain exist, with most trials using a combination of CBD and THC to relieve pain. Notably, Health Canada has approved a combination medication that contains both THC and CBD in a 1:1 ratio for the relief of central nerve-related pain in multiple sclerosis, and cancer pain that is unresponsive to optimized opioid therapy.