CBD oil contains CBD mixed with an inert carrier oil, such as coconut oil or hemp seed oil. The bottled oil, called a tincture, is sold in various concentrations. There are also CBD capsules, CBD gummies, and under-the-tongue CBD sprays. Depending on where you live, some brands contain trace amounts of THC. CBD oil is believed by some to treat pain, reduce anxiety, and stimulate appetite in the same way that marijuana does. CBD has also shown promise in treating certain types of seizures.
CBD’s exact mechanism of action is unclear. Unlike THC, CBD has a relatively low affinity for cannabinoid receptors in the brain. These are the molecules to which THC binds to elicit its psychoactive effects. Instead, CBD is thought to influence other receptors, including opioid receptors that regulate pain and glycine receptors involved in the regulation of the “feel-good” hormone serotonin. Proponents claim that CBD oil can treat a wide variety of health problems, including:
Drug addiction and withdrawal
High blood pressure
Some of these claims are better supported by research than others. Despite its growing popularity, CBD oil remains sorely under-researched. Here is just some of what the current evidence says:
Part of this response could be explained by the way that CBD acts in the brain. CBD works as an agonist in many cases, meaning that it triggers a different reaction when binding to a receptor. It is possible that low doses can elicit a positive agonist response, while high doses “overwhelm” the brain and trigger a compensatory effect to “fight” CBD’s effects. According to the investigators, men provided 300 mg of CBD exhibited less anxiety than those given a placebo. Interestingly, those provided 100 mg or 600 mg of CBD oil did not.
CBD oil may offer benefit those with drug addiction, suggests a 2015 review of studies published in Substance Abuse. However, the effect of CBD on each addiction type was often very different. For example, with opioid addiction, CBD had little effect in minimizing withdrawal symptoms in the absence of THC. By contrast, CBD, on its own, appeared effective in reducing drug-seeking behaviors in users of cocaine, methamphetamine, and other psychostimulant drugs. There have also been suggestions that CBD may aid in the treatment of cannabis and nicotine addiction. Further research is needed.
Medical marijuana is frequently prescribed to people with intractable pain, including those with terminal cancer. There is some evidence that CBD contributes to this effect. Human studies evaluating the use of CBD in treating chronic pain are lacking. Those that do exist almost invariably include THC, making it challenging to isolate CBD’s distinct effects.
CBD oil may reduce the risk of heart disease by alleviating hypertension (high blood pressure) in certain people. For this study, nine healthy men took either 600 milligrams (mg) of CBD or 600 mg of a placebo. According to the researcher, those treated with CBD had lower blood pressure before and after exposure to stressful stimuli (including exercise or extreme cold).
Besides, the stroke volume (the amount of blood remaining in the heart after a heartbeat) was significantly reduced, meaning that the heart was pumping more efficiently. The findings suggest that CBD oil may be a suitable complementary therapy for people whose hypertension is complicated by stress and anxiety.
Outside of these two disorders, CBD’s effectiveness in treating seizures is uncertain. Even with Epidiolex, it is unsure whether the anti-seizure effects can be attributed to CBD or some other factor.2 There is some evidence that CBD interacts with seizure medications, such as Onfi (clobazam), and “boosts” their concentration in the blood. This would not only make the drugs more effective but extend their half-lives as well. Further research is needed.
Possible Side Effects
Clinical research has shown that CBD oil can trigger side effects – the severity and type of which can vary from one person to the next.3 Common symptoms include:
Changes in appetite
Changes in mood
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 check blood liver enzyme levels regularly. CBD oil should be avoided during pregnancy and breastfeeding. A 2018 study from the American Academy of Pediatrics warned women to avoid marijuana during pregnancy due to the potential risks to a baby’s development. Although it is unclear how CBD contributes, CBD is known to pass through the placental barrier. If you are thinking about using CBD oil to treat a health condition, please speak with your healthcare provider to ensure that it is the right option for you.
CBD oil can interact with certain medications, including some used to treat epilepsy. CBD inhibits an enzyme called cytochrome P450 (CYP450), which certain drugs use for metabolization. By interfering with CYP450, CBD may either increase the toxicity or decrease the effectiveness of these drugs. The potential drug-drug interactions include:
- Anti-arrhythmia drugs like quinidine
Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
Antifungal medications like Nizoral (ketoconazole) and Vfend (voriconazole)
Antipsychotic medications like Orap (pimozide)
Atypical antidepressants like Remeron (mirtazapine)
Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
Immune-suppressive drugs like Sandimmune (cyclosporine)
Macrolide antibiotics like clarithromycin and telithromycin
Migraine medications like Ergomar (ergotamine)
Opioid painkillers like Duragesic (fentanyl) and alfentanil
Rifampin-based drugs used to treat tuberculosis
Many of these interactions are mild and require no adjustment to treatment. Others may require a drug substitution or the separation of doses by several hours. To avoid interactions, advise your doctor about any drugs you are taking, whether they be prescription, over-the-counter, herbal, or recreational.
Dosage and Preparation
There are no guidelines for the appropriate use of CBD oil. CBD oil, also referred to as CBD tincture, is usually delivered sublingually (under the tongue). Most are sold in 30-milliliter (mL) bottles with a dropper cap. There is no “correct” dose of CBD oil. Depending on who you speak to, the daily dose can range from 5 mg to 25 mg per day. The tricky part, of course, is calculating the exact amount of CBD per milliliter of oil. After all, some tinctures have concentrations of 1,500 mg per 30 mL, while others will have 3,000 mg per mL (or more). To use CBD oil, place one or more drops under the tongue and let it sit there for 30 to 60 seconds without swallowing. Capsules and gummies are more accessible to dose, although they tend to be more costly. CBD sublingual sprays are used mainly for convenience.