Despite its popularity, information about cannabidiol—shortened to the acronym CBD—can be confusing. Especially when figuring out the right way to use it. How do you make sure the products you’re buying are legit? And what are the health benefits? And is CBD even legal? Here are the answers to your most pressing questions about CBD.
Our modern understanding of CBD comes in a variety of products and uses. Coffee shops sell CBD lattes, spas offer CBD facials, and beauty companies are spiking their products with CBD. And there are CBD gummies, as well.
While modern cannabidiol (CBD) might seem new, the cannabis product has been around for centuries. In a study published in 2020 in Dialogues in Clinical Neuroscience, researchers found that back nearly 12,000 years ago in Central Asia, where nomadic people and traders went, cannabis seeds followed. Over millennia, humans have learned the commercial value and medicinal applications of this plant.
CBD is a naturally-occurring chemical found in the Cannabis sativa plant. Cannabis is a plant genus that contains many different compounds that can have different effects on the body.
Two different cannabis plants are marijuana and hemp. THC (tetrahydrocannabinol) and CBD (cannabidiol) are two of the chemicals found in those plants. Marijuana has higher levels of THC and lower levels of CBD. In comparison, hemp has higher levels of CBD and lower levels of THC.
Unlike THC, which creates a “high” when used, CBD is not psychoactive. Therein lies the major difference.
The short answer: Nope. While cannabis plants contain hundreds of compounds (called phytocannabinoids), there are two main players: CBD and THC.
“CBD is the non-psychoactive portion of the plant, so what that means is you won’t have any effects like euphoria,” explained Junella Chin, DO, an osteopathic physician and a medical cannabis expert for cannabisMD.
According to Dr. Chin, about 5% of people say they feel altered after taking CBD. This is uncommon but for unknown reasons, some people simply react differently to CBD.
“Usually, they’re the same people who have side effects from Advil or Tylenol,” Dr. Chin noted. You never know how your body will react to any new supplement, so when taking CBD for the first time, do so safely with medical supervision.
It’s also crucial to buy third-party-tested CBD for quality assurance. Because the Food and Drug Administration (FDA) doesn’t regulate over-the-counter CBD, buying a product that is more or less potent than advertised or even contains small amounts of THC is possible.
And while it doesn’t regulate CBD products, the FDA will issue warning letters to companies who violate certain laws, such as those producing products containing THC or making false medical claims on their labels.
Read any CBD product testimonials, and you’ll see that people claim CBD has helped with a slew of health conditions—including back pain, psoriasis, osteoarthritis, and even cancer.
But the only CBD medication that is currently approved by the FDA is Epidiolex (cannabidiol) for the treatment of certain types of epilepsy.
“My practice has patients walking in every day asking about CBD,” explained Houman Danesh, MD, director of integrative pain management for the Mount Sinai Hospital in New York.
But while there’s lots of anecdotal evidence, Dr. Danesh added that it’s still difficult to say what the real benefits are due to a lack of research.
“Right now, you just have pharmacies trying to make some sort of sense out of it and say, ‘Yes, it works for this,'” Dr. Danesh said, “but that’s not the way medicine is practiced—it should be based on evidence, and there’s not a lot of evidence to really support these claims.”
And while unbiased research is scant, some studies are showing promise. For example, the researchers of a study published in 2021 in the Journal of Cannabis Research found that CBD-rich treatments helped relieve moderate to severe levels of pain, anxiety, and depression. The treatments also improved overall well-being in people with these symptoms. Still, the study did not show the benefit of CBD in those with mild symptoms.
According to Dr. Danesh, there are two main types of pain: Musculoskeletal and neurological.
“There could be benefits for both conditions,” Dr. Danesh said, who added that the tricky part is that there’s some evidence suggesting CBD works best for pain when combined with a little THC. “Depending on what type of pain you have, you might be able to do just CBD, but sometimes you need [both] CBD and THC.”
Figuring out how much you should take is challenging, as well. The dosage that alleviates one person’s pain might do very little for someone else.
“And until we can study it, it’s the wild west,” Dr. Danesh added. So, is it worth trying?
“I think CBD is a safe thing to try,” Dr. Danesh continued. Dr. Danesh also urged people to push for more research by putting pressure on representatives to get national bills passed that allow scientists to look closer at CBD and the conditions that respond to it.
CBD might be worth trying to help manage symptoms of anxiety.
“[CBD] tells your body to calm down and reminds you that you’re safe,” Dr. Chin explained. “It mellows out the nervous system, so you’re not in a heightened ‘fight-or-flight’ response.”
For that reason, people with anxiety may find it helps them feel more relaxed. Still, one of the biggest misconceptions about CBD is that it’s a wonder drug.
“A lot of times, people think CBD is a cure-all—and it’s not,” Dr. Chin added. “You should also have a healthy lifestyle with plenty of exercise and good nutrition. CBD is not going to fix everything.”
While CBD may treat symptoms of anxiety, it is important to seek care from a mental health professional to address and treat the root cause of your anxiety.
The best way for you to administer CBD depends on your preference. Some people don’t want to ingest anything and prefer a topical CBD cream or ointment.
“You can apply it to muscles, joints, and ligaments and still get a nice localized release,” Dr. Chin said.
The biggest differences between tinctures and edibles are the speed of delivery and how long the effects last.
“A tincture looks like a little liquid that you put under your tongue, and you feel relief within half an hour. If you prefer to taste something, you choose an edible, whether it’s a capsule, gummy, or baked good,” Dr. Chin said.
“There are literally hundreds of CBD brands at this point,” said Brandon Beatty, founder, and CEO of Bluebird Botanicals and an executive vice president of the U.S. Hemp Roundtable.
Here are a few things you should keep in mind when shopping.
If it’s a dietary supplement, it should have a back panel with an FDA disclaimer and warning section, according to Beatty.
“Ideally, it would be preferable to have access to their third-party lab testing results, too,” Beatty added.
Quality assurance is a real concern in the industry. Ensure your CBD products are tested by a third party to confirm the label’s accuracy. A third party is a reputable independent organization with no ties to the company selling the product.
Take the 2017 JAMA study, for example. The study tested 84 CBD products and found that 26% contained lower doses of CBD than stated on the bottle.
Look for a quality assurance stamp or certificate of analysis from a third party, or check the retailer’s website if you don’t see one on the product’s label.
NSF International is one of the leading third-party testing organizations for supplements. If you’re not sure your supplement is third-party tested, you can use the search tool on the NSF site for this purpose.
The topic of dosing is a confusing one for many people.
“A lot of brands don’t do a good job of clearly instructing their consumer on the dosing,” said Chris Roth, CEO, and co-founder of Highline Wellness.
When considering dosing, consider whether your CBD is full-spectrum, broad-spectrum, or isolate. Full-spectrum could include other cannabinoids like cannabidivarin or cannabigerol.
That’s important since “there’s something called the ‘entourage effect;’ when all together, they’re more effective than any one of them alone,” Roth explained.
The difference between full- and broad-spectrum CBD, is that broad-spectrum CBD contains no traces of THC.
Isolate, on the other hand, is 100% CBD. Some people might only need 10 milligrams of full-spectrum CBD, but with isolate, even taking 80 or 100 milligrams might not have the same effect, Roth added.
Claims of Curing Disease
If the product claims to cure disease, that’s a hard pass.
“You should avoid any company that makes disease claims,” Beatty said. “If [they are making these claims], it means they’re either willing to break the rules, or they’re not aware of the rules.”
You know how you check the batch number of raw chicken or bagged lettuce every time there’s a recall to make sure the one you bought isn’t making you sick? You should be able to do that with CBD products, too. Manufacturers should be placing a batch number on their products.
“This is a huge indicator as to whether they are following good manufacturing practices,” Beatty explained. “There should be a way to identify this product in case it was improperly made so the company can carry out a recall.”
As with any supplement, you want to know everything you’re ingesting besides CBD.
For example, “sometimes I notice that [CBD manufacturers] will add melatonin,” Dr. Chin said.
Where You Buy It
You can find CBD products in shopping malls, convenience stores, and coffee shops in many states. Then there are the plethora of online retailers selling CBD products. When in doubt, natural grocers are a safe brick-and-mortar place to buy CBD.
“Typically, they have a vetting process that does some of the legwork for you,” Beatty said.
In 2018, then-President Donald Trump signed the Farm Bill—aka the Agriculture Improvement Act—that made it federally legal to grow hemp.
That means that “consumers everywhere if they’re compliant with their state, can grow hemp and use hemp products,” Parrish explained, “and among those will be CBD.”
“Hemp can now be grown freely under federal law, which, of course, is huge,” Parrish continued. “But while it’s legal under federal law, it’s up to each state to set their own policy.”
Those policies vary widely. In several states, marijuana and CBD are fully legal for medicinal and recreational purposes. In other states, they are legal in some form for medicinal purposes. And still, other states permit just CBD oil.
For more information, the organization Americans for Safe Access has a helpful guide to the specific laws in each state.
“It’s kind of ironic,” Parrish said. “With marijuana, we have got the federal government saying ‘No’ and a bunch of states saying ‘Yeah, it’s OK.’ But with hemp, the feds say, ‘Yeah, it’s OK,’ but we still have some states saying it’s not.”
“Flying with CBD should pose no issues now,” Parrish said. However, Parrish added that if you’re traveling with a tincture, be mindful of TSA limits on how much liquid you can carry on an airplane.
Parrish also noted that you can mail CBD products, just like “companies that comply with the Bill can ship their hemp-derived CBD products anywhere in the [United States].”
Dr. Chin explained that CBD should not show up on a drug test as long as you’re buying third-party tested CBD with no added THC.
But Dr. Chin pointed out that athletes, who often are required to take more sensitive drug tests, “could potentially test positive” for trace amounts of THC if they’ve been using CBD products.
The short answer to CBD use during pregnancy: No. That’s because there is so little research on this topic.
An article published in 2020 in Frontiers in Pharmacology states that pregnant individuals are placing their fetuses in danger by using CBD products. Any CBD products can have other ingredients that may not be safe to use while pregnant.
It’s always wise to err on the side of caution when pregnant or breastfeeding, so forego the CBD until your little one is no longer dependent on you for nourishment.
Are you tempted to give your pup one of those CBD dog biscuits? “Generally, we expect CBD products to be safe, and they could show some benefit for anxiety in pets,” said John Faught, DVM, a veterinarian based in Austin, Texas.
But the challenge when considering CBD products for pets is the same as with people: lack of research.
“I believe there are good products out there today, but I also don’t know how to distinguish them at this time,” Faught said.
CBD is a naturally occurring chemical that may provide benefits for anxiety, depression, and pain. It may be more or less potent than advertised or contain small amounts of THC. So, if you use a CBD product, ensure a third party tested it for quality assurance since the FDA doesn’t regulate it.
While we have some research on the benefits of CBD, there still isn’t enough research on the subject, and there is still much to learn about CBD and its benefits.