CBD doesn’t pose significant risks for users, and most topical CBD products don’t enter the bloodstream.
However, certain side effects are possible, such as:
• changes in appetite
• changes in weight
CBD may interact with:
• certain over-the-counter (OTC) drugs
• prescription medications
• dietary supplements
Proceed with caution if any of your medications or supplements contain a “grapefruit warning.” Grapefruit and CBD both interfere with enzymes that are crucial to drug metabolism.
Like other drugs and supplements, CBD may also increase your risk of liver toxicity.
The Entourage Effect is the term used to describe the enhanced effects of cannabinoids, such as CBD, when multiple compounds synergistically work together rather than alone.
Terpenes are the organic compounds responsible for creating the unique aroma of each individual cannabis plant. Terpenes do more than determine the scent finger print, they also provide therapeutic benefits like their cannabinoid partners, THC and CBD.Terpenes can also modify how much of each cannabinoid is absorbed.
While there are many different slang terms for the green, narrow-leafed plant you may recognize, the plant is scientifically called Cannabis sativa5. The word “cannabis” can be used to describe any products made from the plant. Cannabis plants contain multiple chemical compounds, including a group referred to as “cannabinoids.” Out of more than 100 cannabinoids, researchers have primarily studied two that appear to have the greatest impact on humans: tetrahydrocannabinol (THC) and CBD.
Most commonly known effects of cannabis, such as “getting high,” are caused by the cannabinoid, THC. The term “marijuana” specifically refers to parts of the Cannabis sativa plant that contain THC.
Cannabis plants and derivatives that contain less than 0.3% THC are classified as “hemp.” As of 2018, hemp is no longer defined as a controlled substance by the U.S. federal government. As a result, there has been an influx of hemp-related products in the American market. These products are generally marketed as CBD products.
CBD, the other commonly known cannabinoid, can be legally sold in the U.S. when extracted from hemp and marketed according to relevant regulations. CBD does not have psychoactive properties and does not bring about the same effects as THC. Also, CBD does not have effects that would lead to potential dependency or risk of abuse.
CBD is an increasingly popular substance in the U.S. While many health benefits have been attributed to CBD, in most cases, scientific validity of its effectiveness is still unclear.
There are several common forms of CBD:
Oral solutions, such as the FDA-approved drug Epidiolex
Oral sprays that are applied under the tongue
Oils and tinctures, sometimes described as drops or droplets16
Vapes and vape juices to use in a vaping pen
Edible items, such as gummies, chocolates, or cookies, and beverages, such as coffees and teas
Pills and capsules
Topical solutions, including lotions, creams, patches, gels, and ointments
Research shows that CBD has a calming effect on the nervous system. CBD can also alter mood because it affects the serotonin system. Outcomes vary among people and depend on the product type and dose.
Unlike THC, CBD does not induce a feeling of being “high.” Even large doses of CBD do not produce THC-like effects. Additionally, a few studies have demonstrated that CBD reduces the psychoactive effects of THC.
Studies of short-term CBD use show that patients do not experience withdrawal.
So far, CBD’s effectiveness in the treatment of epilepsy is well-supported by research. Other early research suggests that CBD may also help treat schizophrenia and substance use disorders.
Currently, there is insufficient research to determine the effectiveness of CBD in treating other health conditions. However, preliminary research suggests CBD can help with a number of sleep disorders, including insomnia22 REM sleep behavior disorder23, and excessive daytime sleepiness disorder24. Additional preliminary research suggests CBD can also help patients improve sleep and reduce anxiety.
Most negative effects of CBD medications and products are mild. For example, patients who use Epidiolex may experience diarrhea or other gastrointestinal issues. Some people may experience drowsiness when they take CBD. Other negative effects experienced with CBD may be due to an interaction between the CBD and other medications the patient is taking.
CBD can interact with other prescriptions a person takes. In particular, CBD can slow the liver’s ability to break down certain medications. Additionally, using CBD as well as herbs or supplements can make the patient too sleepy.
Before using any CBD product, consult your doctor. Let your doctor know of any medications, herbs, or supplements you are taking, so they can assess if CBD might cause a negative interaction. Your doctor will be able to inform you if CBD is a viable option to meet your health goals.
Research on the effects CBD has on sleep disorders is still preliminary. Some people who use CBD for chronic pain report sleeping better. Currently, it is unclear whether these patients sleep better because of the pain relief or because CBD directly affects their sleep.
Other initial studies of CBD and sleep disorders suggest positive outcomes. However, not everyone experiences the same sleep benefits with CBD use, and different doses might lead to different effects. Research suggests that low doses of CBD are stimulating, while high doses of CBD are sedating. Discrepancies in experience can also be attributed to the method of CBD administration and dose. Additional research is needed to deepen our understanding of CBD as an intervention for sleep disorders.
Insomnia and CBD
People who suffer from insomnia experience difficulty falling asleep or staying asleep25 at night. This disorder affects daytime wakefulness, ability to concentrate, and mood. Because of their history of poor sleep, people with insomnia may suffer from anxiety about getting inadequate sleep, which can then increase sleeplessness at night26.
Given the potential positive outcomes of CBD treating anxiety, it is speculated that CBD may also help reduce the anxiety associated with insomnia. Additionally, a new pilot study27 of CBD and THC use in humans with physician-diagnosed insomnia is underway. The results of the study will offer more insight into the effects CBD has on insomnia.
REM Sleep Behavior Disorder and CBD
In REM sleep behavior disorder, patients verbalize and make aggressive movements28 during their rapid eye movement (REM) stage of sleep. The disorder is most common in older patients with neurodegenerative diseases, such as Alzheimer’s disease and Parkinson’s disease.
In a limited study of four patients with Parkinson’s disease, CBD helped manage the REM sleep behavior disorder symptoms. Before taking CBD, the patients experienced disorder symptoms 2–7 times per week. After taking CBD, the symptoms occurred 0–1 times in a week. Further studies are necessary, but these initial results suggest CBD as a possible treatment for REM sleep behavior disorder.
Excessive Daytime Sleepiness Disorder and CBD
Those who have excessive daytime sleepiness disorder struggle to stay awake during typical daytime hours. One solution for waking up on time and staying wake may be CBD. Initial research on animals shows that CBD functions as a wake-inducing drug. However, other studies suggest CBD functions as a sedating drug. Further research is needed to determine what doses and methods of CBD use affect wakefulness and sleepiness.