CBD Q&A: Frequently Asked Cannabidiol Questions

Credit: Tinnakorn Jorruang

Reviewed by Dr. Richard Foxx, MD

Cannabidiol, or CBD, products are everywhere these days. Not only are they widely available, but they come in a variety of forms—while claims suggest they can treat nearly every malady known to humankind.

Further, there is the question of legality. All in all, CBD oil can be pretty confusing.

For the most part, there just isn’t much concrete information available. CBD oil is a relatively new area of exploration and there is still a lot to learn, but early studies have been promising.

Let’s take a look at what we know so far, and try to navigate through some of the most pressing CBD oil questions.

CBD Oil FAQs

1. What Is CBD?

CBD is the acronym for cannabidiol, one of the active compounds found in the Cannabis sativa plant. In recent years, there has been a lot of buzz surrounding the potential benefits of this lesser-known compound that’s unique to hemp plants.

CBD may offer a series of therapeutic uses and, unlike the other well-known compound in cannabis, tetrahydrocannabinol (THC), CBD does not possess any psychoactive effects. Basically, CBD does not get you “high.”

CBD is often processed into oil and sold in capsules, tinctures, sprays, food, and topical creams.

2. What Is CBD Used For?

People use CBD for a variety of reasons, some of which have a degree of scientific evidence. Others rely purely on anecdotal support. That said, preliminary studies showing efficacy in certain areas have been quite favorable.

Some areas where CBD may be effective include:

• Pain relief
• Anxiety/depression
• Cancer symptom relief
• Acne treatment
• Epilepsy and other neurological disorders
• Heart health/blood pressure
• Anti-inflammatory effects

Much of the supporting research on CBD has been conducted in small-scale human studies, animal studies, and lab tests, but more comprehensive work is underway.

Currently, the most convincing research for CBD shows its effects on childhood epilepsy. There is an FDA-approved drug for the neurological condition called “Epidiolex,” which features CBD. Much of the science, however, has not caught up to the claims.

3. Where Is CBD Legal?

You can get CBD virtually anywhere in the United States; however, its legal status across the country is in flux.

It is fully legal in a number of states in different degrees. Some states require a prescription to purchase, for example, while in others, it is on the open market.

Federally, CBD has a strange status. Current federal law classifies CBD the same as marijuana—an illicit substance. However, the law isn’t typically enforced with the same vigor.

Moreover, there is a bipartisan consensus to legalize CBD, provided it’s derived from hemp plants and not marijuana plants (both are in the cannabis family, but where marijuana contains a fair amount of THC, hemp contains only trace amounts).

4. Is CBD Oil Safe?

This is where things can get murky. CBD is generally safe, but as with all supplements, it is unregulated at this point. Purity, potency, manufacturing processes, and ingredient lists are inconsistent.

The FDA does not regulate products considered “supplements,” so until CBD becomes recognized as “medication,” it will not be subject to the same degree of testing.

There are also some side effects that can occur from CBD use, which have been noted to include drowsiness, nausea, diarrhea and changes in appetite. The oil can also interact with some medications, which we will examine in detail later.

Overall, CBD is well-tolerated by the majority of people who take it. Talking to your doctor about dosages for the specific issue you’d like to treat is recommended.

5. Is CBD Oil Addictive?

Because CBD does not produce the “high” caused by THC, it is unlikely that people will form an addiction. According to a report by the World Health Organization (WHO), “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…To date, there is no evidence of public-health related problems associated with the use of pure CBD.”

Now, there are two important considerations here. The WHO specified “pure CBD,” meaning no other compounds (i.e. THC, etc.) would be present. They also indicate “to date.” As CBD becomes more widely and regularly used, it’s possible that new findings will come to light.

6. What Is CBD Approved to Treat?

Right now, in the United States, the only condition CBD is approved to treat is epilepsy. Still, it is not pure CBD or the supplement that you would buy in a store. A pharmaceutical-grade CBD is an ingredient in Epidiolex, a prescription medication.

In Canada, where CBD is entirely legal, there are no CBD-specific products approved for any condition. It has, however, been evaluated and authorized for sale in Canada as part of a THC/CBD product called “Sativex,” which is used added to treatments aimed to relieve certain multiple sclerosis (MS) symptoms. 

7. What’s in CBD Products?

Because CBD products are unregulated, there is no standard for ingredients, potency, or purity. This means that there may be much variation and discrepancy between what’s in the bottle and what it says on the label.

For example, a 2017 research letter in JAMA found that nearly 70% of CBD extracts sold online were mislabeled. In addition, some CBD products are made with THC so that they will offer a psychoactive effect.

CBD may also be an ingredient, combined with others, in creams, food, tinctures, and more. There is a wide variety, so depending on what you’re using it for, you’ll have to read the label for instructions.

Pure CBD oil, of course, is available as well, but due diligence is essential.

A few things to look for when buying CBD include:

• European Union/Canadian/U.S./Australian organic certification
• Manufacturing standards certifications like pesticide/herbicide testing
• Third-party lab test certification to confirm levels of cannabinoids and absence of heavy metals.

8. Does CBD Interact with Other Medications?

As with any medication or supplement, blind self-treatment is risky. The medicines you are currently taking may interact in a negative way with CBD. The interactions may cause either of the substances to work ineffectively.

According to a report by the Canadian Broadcasting Corporation (CBC), the drug interactions doctors and pharmacists look for are substances that may already induce drowsiness or confusion, or impair motor skills. Such medications include morphine, oxycodone, sleeping pills, antidepressants, or antipsychotics.

Blood thinners may become more potent when mixed with CBD, and there is evidence to suggest that the same enzymes that metabolize CBD can also metabolize a host of other medications, which can have an effect on dosing and efficacy.

If you are taking any medications or supplements, talk to your doctor before including CBD in your regimen.

10. How Do You Take CBD?

There are numerous ways to take CBD, ranging from capsules to gummies to topical rubs. The method you select will ultimately come down to what you’re using it for and how fast you want it to work.

• Tinctures/sprays/oils/lozenges: These forms of CBD are generally absorbed under the tongue. Administering it in this area allows it to bypass the digestive tract for faster absorption than edibles. Effects would likely appear within 30 to 60 minutes.
• Edibles: Edibles might be fun, but they are probably not the best option for CBD in a therapeutic sense. They have to make it all the way through your digestive tract, which costs both time and CBD. Edibles can take up to two hours to kick in and you may only absorb 20% to 30% of what you took.
• Topical rubs: Rubs are generally used to treat localized pain, and are sometimes combined with other soothing products. Rubs do not have to pass through the digestive system, so they may work relatively quickly. However, you’ll probably have to use a very high-CBD product, and plenty of it, to get any effect. There is not a lot of research on the bioavailability (how easily a product is absorbed and utilized) of topical CBD rubs, so use them with caution.

11. How Much CBD Can You Take?

You’ll want to start slowly with CBD. At the present, there is little information to suggest effective doses, so, after consulting your physician, following the directions on the bottle is probably a good place to start. If you’re not noticing an improvement, ask your doctor or pharmacist about taking a little bit more.

Doses used in studies have ranged from 20 to 1,500 mg per day; however, there is no conclusive evidence to suggest either safety or danger at these levels. Furthermore, without regulated testing and dosing, it’s hard to tell exactly how much you’re getting per serving.

Some experts suggest dosing can be done on a personal weight basis, and taking 1 to 6 mg per pound of bodyweight might be the way to go. Some also suggest experimenting with doses to see what works for you, but this may only work if you’re consistently using the same product and starting with smaller doses.

To date, there simply isn’t enough information available to accurately suggest safe dosing, so be careful.

12. Is It Safe to Mix CBD and THC?

From a chemical standpoint, CBD and THC are perfectly safe to mix. They are both present in marijuana cannabis plants. That said, THC can make you high.

There are various THC/CBD products with varying ratios and each offers potentially therapeutic effects. However, because of the psychoactive capabilities of THC, you will want to use CBD/THC products with a little more care: no driving, operating heavy machinery, etc.

Also, consuming high doses of THC may lead to short-term illness or other health problems, especially if smoked. Take caution. 

13. Is There More Research Ahead on CBD?

Plenty of studies are now ongoing to look at the potential health effects of CBD. It is still a relatively new area of exploration, and because of its drug status, it was very difficult to research.

Legalization and growing interest should bolster a relatively limited pool of research and provide much more detailed information on how to safely and properly use CBD. It’s estimated that the picture will become clearer within the next five to 10 years.

Still, early/small-scale studies on the conditions mentioned earlier have all been promising.

CBD: So Far, So Good

So far, there seems to be some adequate uses for CBD and there is a wealth of anecdotal evidence suggesting it helps. Yet there is still so much to be discovered. Mostly, it seems safe, so it’s probably okay to use with discretion. Research the specific products you’re interested in, and remember to start small and be very careful.