Reviewed by Dr. Jeffrey Shapiro, MD
To say that CBD products are being sold everywhere, for everything, would be a vast understatement. At last count, they were just what you need to sleep better, reduce anxiety, relieve pain, improve focus, and treat multiple sclerosis (MS). In some cases, there is decent evidence to suggest their efficacy. In others, far more research needs to be done. But how do you keep track of all the ways to use CBD?
Much like the variety of ailments CBD may or may not treat, there are seemingly endless ways to take it. Vape pens, tinctures and oils, topical creams, CBD tea, CBD gummies, and more are available to consumers and can cause much confusion.
CBD products and supplements are no different from other medicines in that they are dose-dependent, and some forms of CBD may be more useful than others in different situations. For example, if you were looking for quick relief from anxiety, a spray or tincture would likely provide better and faster results than a CBD bath bomb—if a CBD bath bomb were to offer any benefits whatsoever.
What Is CBD?
CBD, or cannabidiol, is an extract found in cannabis plants. It is a cannabinoid that comes largely from hemp varieties, though it is also found in small amounts in marijuana plants.
Cannabinoids are naturally present in the human body as well, and CBD encourages their release. From there, they interact with receptors throughout the body and brain.
CBD does not provide the “high” associated with tetrahydrocannabinol (THC) and traditional marijuana, and although there is typically a small percentage of THC in CBD products, it is not enough to produce any mind-altering effects.
Today, hemp plants (by law) contain less than 0.3% THC, whereas marijuana plants generally contain anywhere from five percent to 30% THC.
4 Ways to Use CBD
Companies have harnessed the healing potential of CBD to develop a variety of products, some noteworthy and others seemingly frivolous.
1. CBD Vape Pens
While there are some who smoke CBD hemp flower in the traditional sense—rolling it up in a cigarette—more frequently, vape pens or e-cigarettes are used. These devices heat up concentrated doses of CBD oil until it boils. The vapor it produces is inhaled.
For fast action, this method is likely the best option. Inhaling CBD gets the compound into the bloodstream in about 30 seconds, which could make it valuable for people using CBD to deal with body pain or anxiety.
Although convenient, there could be some risks to vaping. Sometimes the cartridges carrying the oil contain a chemical called propylene glycol. When heated, it can turn into formaldehyde that can lead to irritation around the nose and eyes and potentially boost the risk of asthma or cancer. Getting around this, however, can be a simple as finding “solvent-free” oils or cartridges.
A common issue with most CBD products, including vape oils, is dosing. Without a standardized system in place to monitor and test products, there may be variation in what you’re getting. Labeling can also be confusing. Does a label saying 1,000 mg mean per dose or per cartridge?
Consult a medical professional to help you determine the appropriate dosage.
To assess your dose, the doctor will typically start with the minimum recommendation and go from there.
2. CBD Drops and Sprays
CBD tinctures are sold as drops or sprays and administered orally. A few drops of CBD oil under the tongue, held for about 30 seconds, should take effect in roughly 15 to 30 minutes.
A spray should be shot inside the cheek, and should take the same amount of time to kick in.
If the tincture or spray is delivered to the top of the tongue or back of the throat, it will take longer to work. Therefore, if you’re using the product to achieve focus, relieve anxiety, or treat a pain flare-up, under the tongue or inside the cheek is where to put the tincture.
Finding the best dose for your needs will take some experimenting, also under the guidance of a physician. Dosages start at the low end, with 10 mg or so, but it’s entirely possible you will need up to 30 mg.
3. CBD Topicals
CBD can also be used for joint pain as a topical rub. The extract is mixed into a CBD cream or balm with a base oil to enhance skin coverage and penetration. Base oils are likely to include beeswax, coconut oil, or another fat.
Because topical CBD products are localized and not absorbed by the entire body, they might be safer. This is not to say that other forms of CBD are unsafe, but rather there are no long-term studies confirming their safety. There is preliminary evidence to suggest that topical CBD may be an effective treatment for joint pain and inflammation associated with arthritis.
In order to be effective, these products likely need to be highly potent. Something in the range of 100 mg per ounce is probably okay, but testing the item before buying it can be a big help. The rub can take affect almost instantly, so if you try it and nothing happens, you probably shouldn’t bother.
4. CBD Edibles
Eating some CBD gummies, drinking a CBD tea, or taking a pill—any form of edible, really—may seem like fun, but it might be ineffective if you’re looking for quick relief. Because the CBD will enter through the digestive system, there is a slim chance you will notice any immediate benefits. Absorption will take at least 30 minutes, and probably longer.
Edibles are also considered the “least healthy” way to take CBD. Gummies and candies are just what the names say they are—candies. Sugar-laden, inflammatory candies. It’s also very possible that in order to get any effect from these products you will need to take a lot of them.
Pills will likely provide the most reliable dosage when it comes to edibles, but once again, the absorption process will delay its potential effects. Always seek your doctor’s advice on dosages and any potential risks.
Is CBD Legal?
As of December 2018, CBD oil is no longer a federally criminalized substance. That said, individual state laws can be a little murky. In places like Idaho, South Dakota, and Nebraska, CBD and all cannabis products are still completely illegal.
CBD is legal in all other states, yet there is variation on where it can be sold, who can buy it, and whether or not a prescription is required. Be sure to look at the laws in your area before purchasing any products.
CBD is also legal elsewhere in North America, including Canada and Mexico.
What Research Says
There is some very promising scientific research, as well as plenty of strong anecdotal evidence, suggesting that CBD can be useful in helping treat a variety of conditions. Three of the most notable uses thus far are for pain relief, anxiety, and epilepsy.
It’s also important to note that because CBD was illegal until very recently, research was very limited. Basically, CBD could not be given to humans. Now that it is widely legal, we will see if preliminary findings translate into more human studies.
There is evidence that CBD can aid in pain relief resulting from arthritis and other sources. A combination of THC and CBD has been noted for strong pain relief when taken as a spray, particularly in people suffering from multiple sclerosis and arthritis.
Two small human studies have shown a product called “Sativex” can help improve mobility, sleep, and overall pain in people with both MS and arthritis.
Studies have also shown that CBD extracts can reduce pain and inflammation in arthritic rats.
Topical rubs may help, too. Research found that the topical application of CBD was able to substantially reduce pain caused by arthritis.
The study, which was published in the European Journal of Pain using an animal model, showed that when applied for four days, CBD drastically lowered inflammatory markers and signs of pain. Furthermore, no negative side effects were observed.
Anxiety and Depression
Both human and animal studies have shown that CBD can offer relief from anxiety and depression. One small human study of 24 people with anxiety showed improvements in symptoms from taking 600 mg of CBD oil before public speaking.
There is also evidence that it may help with sleep—a contributing factor to depression and anxiety. CBD oil has also been shown to provoke anti-depressant responses in animal models.
In June 2018, the U.S. Food and Drug Administration (FDA) approved the use of a CBD product to treat seizures in epileptic patients.
Called “Epidiolex,” the oil-based formula specifically targets seizures associated with the epilepsy syndromes Lennox-Gastaut (LGS) syndrome and Dravet syndrome. Persons must also be two years of age and older.
Data collected over several years through multiple controlled clinical trials led to the FDA’s groundbreaking decision.
For example, a 2018 study found that LGS patients adding CBD oil to their conventional epilepsy treatment saw a decrease in the frequency of drop seizures when compared to placebo.
A 2017 study produced similar results in Dravet syndrome patients with convulsive, drug-resistant seizures.
CBD Side Effects and Precautions
Part of what gives CBD its broad appeal is that it’s generally regarded as safe. Most people tolerate it very well, and high doses can be safe to potentially treat a number of conditions. So far, no major or systemic side effects have been identified with CBD use.
Minor side effects may occur in some people. These individuals may experience:
- Changes in appetite
There is very little research on the effects of CBD oil in pregnant or nursing women and children. For this reason, most experts recommend these groups avoid its use entirely.
CBD: Knowing Your Options Can Make the Decision Easier
With so many potential uses and ways to take it, CBD oil can be both exciting and confusing. Knowing your needs and why you’re taking CBD is important when selecting the form of administration, as is getting the most bang for your buck.
Discuss your options with a medical professional, and you could be on your way to a more relaxed and pain-free existence.
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