Interested in CBD? You’re Not Alone. 30{d589daddaa72454dba3eae1d85571f5c49413c31a8b21559e51d970df050cb0e} of US Adults Are Too

What are the potential benefits that are driving people to incorporate CBD products into their lifestyles?

“In general, we are seeing CBD products be helpful for things like pain — especially related to arthritic-related pain — fibromyalgia, migraine . . . endometriosis, pelvic pain, period pain,” said Dr. Sherry Yafai, a board-certified emergency medicine physician, cannabis specialist, and medical director at The ReLeaf Institute in Los Angeles

“We are seeing a huge spike in CBD hemp-based products usage in both the pediatric and the elderly populations, and for good reason. Those are both populations that historically we don’t have great medications for treatment of significant diagnoses such as autism, cerebral palsy, pediatric seizures, dementia, Parkinson’s disease, ALS,” Yafai added.

Paul Armentano, Deputy Director of the National Organization for the Reform of Marijuana Laws (NORML) Foundation, also told Healthline that CBD may help ease symptoms of a number of conditions.

“[CBD] has been fairly well established as a therapeutic agent,” Armentano said, noting that one prescription CBD product, Epidolex, has been FDA-approved as an anti-seizure agent. “It’s also fairly well established as an anti-inflammatory agent, as an [anxiety reducing] agent.”

“There are a number of studies showing that the use of CBD can mitigate symptoms of autism and arguably holds some anti-psychotic properties, and it’s been used in clinical trials in patients with schizophrenia. We know it has antibacterial properties and has been associated with wound healing and addressing other skin conditions,” added Armentano.

If there are so many potential health benefits to using CBD products, why are some people still so hesitant to use them?

Most people are aware that CBD (cannabidiol) is somehow related to the cannabis plant, but this is a plant with something of a checkered history.

“CBD is one of a number of active constituents in the cannabis plant. Those constituents are known as ‘cannabinoids.’ The most well-known cannabinoid is THC, but arguably the second-most well-established and well-studied cannabinoid is CBD,” said Armentano

THC (tetrahydrocannabinol) is the chemical most responsible for the “high” associated with recreational cannabis use. However, CBD is something entirely different.

“CBD generally acts on a different receptor system [than THC] and isn’t associated with as significant changes in mood,” Armentano explained.

Although, he was quick to caution that it’s an oversimplification to say that THC is psychoactive and CBD is not, noting that the psychoactive effects CBD does possess are responsible for its benefits.

From a legal framework, there’s an important distinction made between hemp and marijuana, though both are cannabis plants.

Yafai told Healthline, “The differentiating factor . . . really has to do with how much THC is produced in the plant.”

Yafai also said that “hemp” is associated with the type of cannabis plant that only produces 0.3{d589daddaa72454dba3eae1d85571f5c49413c31a8b21559e51d970df050cb0e} THC or less as a chemical. It has nothing to do with any of the other 500-plus chemicals in the plant and “CBD is another one of these chemicals.”

CBD products are not currently required to disclose whether they’ve been derived from a specific cannabis plant, from hemp, or synthetically.

“Because the market is largely unregulated, there’s very little distinction made between those products, but they’re three entirely different products,” said Armentano.

“CBD derived from the cannabis plant is not a novel product. It’s well-studied and has an exceptional safety profile. All of those things cannot necessarily be said about the other products. They don’t have that long history and they haven’t been subject to the same level of study,” Armentano said.

“When it comes to synthetically derived products, again, there’s no regulatory oversight with respect to how those products are manufactured,” he added.

According to Armentano, CBD’s reputation has largely suffered from its association with the cannabis plant.

“If CBD wasn’t derived from or associated with cannabis, it would be a well-accepted, well-established, safe therapeutic product, and it would have held that status arguably for the better part of the last century,” Armentano said.

“There’s so much buzz around CBD because of the potential positive outcomes, but also because of the very low negative outcomes. In the world of cannabis — and CBD in particular — we’re seeing really positive outcomes with a really low side effect profile,” said Yafai.

“It is, generally speaking, a very mild medication, more like Motrin or Tylenol than something like Vicodin or Percocet,” she explained.

That doesn’t mean that CBD is completely safe for anyone to take.

“Anything you put in your body — even cake — has a side effect. It depends on the dose. So you can have a small slice of cake and that’s typically fine. But if you have a whole cake three times a day, you’re going to have a very different outcome,” said Yafai.

The same idea applies to CBD.

“With a small dose, side effects could be very minimal, like dry mouth or dry eyes. Increasing dosages will give you increased dry mouth and dry eyes, and other dry mucus membranes. With very large dosages you can see liver enzyme elevations,” Yafai said.

She also cautioned that CBD can interfere with certain types of medicines. These can include immunotherapies, transplant medications, blood thinners, and medications that modify your blood pressure or heart rate.

If you’re thinking of trying CBD and you take any kind of medication, you may want to ask your doctor about potential complications.

While the effects of CBD as a chemical have been studied, that’s not necessarily the same thing as the products available on the shelf.

Data from Healthline’s recent survey showed that people who are interested in CBD are keenly aware of this.

Among the respondents from the survey who said they currently use or are interested in using CBD products, far and away the most important factor was the quality and purity of the product. They said this weighed more heavily in decision-making than cost or ease of purchase.

Quality was also nearly twice as important to respondents as getting a recommendation from a health expert.

Armentano said, “We’re talking about an unregulated market, and because of the lack of regulation, these products often are of questionable purity and potency.”

“When third-party testing is done to determine if the labeling of the product is accurate and if the claimed amount of CBD is in the product, most of the time the labeling turns out to be far less than accurate. Most of these products contain far less CBD than advertised. Sometimes they contain no CBD at all,” said Armentano.

“They often contain levels of THC that’s above the legal limit in the United States. That’s why sometimes people take these CBD supplement products and then fail their drug test for THC and they have no idea why,” he cautioned.

One thing you can do to ensure you’re getting a quality product is to check the manufacturer’s website for a certificate of analysis (COA). The COA will apply to a specific batch number that should be listed on the product’s label.

“Every batch needs to be tested for pesticides, metal content, and things of that nature. If there’s a COA from four years ago, that may not be applicable to this year’s batch,” said Yafai.

If you’re at a point where you’re ready to try a CBD product, you’ll need to purchase it first. To that end, it’s relatively simple to come by.

“We’re seeing more people get curious about CBD, and because of that, more people are individually selling, it’s sold in pharmacies, it’s sold in dispensaries, it’s sold online, it’s available on Amazon,” said Yafai.

And as to what forms you can find it in, the sky’s the limit.

Healthline’s survey results showed that 79{d589daddaa72454dba3eae1d85571f5c49413c31a8b21559e51d970df050cb0e} of respondents were interested in gummies or other edibles, making this the most popular way to consume CBD, but certainly not the only way.

“We’re seeing it in gummy formats, flower formats . . . chocolates, oil tinctures, both rectal and vaginal suppositories, topical creams, and pomades. There’s also honey, teas, and sublingual strips,” Yafai shared.

In terms of price, it tends to increase as the dosage goes up.

Healthline’s survey results showed that 63{d589daddaa72454dba3eae1d85571f5c49413c31a8b21559e51d970df050cb0e} of people who are interested in CBD, but don’t regularly use it, simply don’t know what brand to buy.

So where should you start?

The same survey found that among people who already use CBD products, Charlotte’s Web is the most popular brand with 35{d589daddaa72454dba3eae1d85571f5c49413c31a8b21559e51d970df050cb0e} of respondents saying they have or would purchase it. Other favored brands included CBDistillery, CBDfx, and Green Roads, but there are certainly many more to choose from.

“Far and away the most popular brand is Charlotte’s Web. It is also one of the most expensive brands out there. It’ll cost roughly $70-$100 for a one-ounce bottle of medicine that should last about a month. The dose ranges are about 50mg-70mg per milliliter,” said Yafai.

As it stands today, these products aren’t covered by insurance except for some very specific circumstances. But it might still be worth checking with your provider. As research continues into CBD products, insurance policies could potentially change.

“Historically the way this medicine has come to fruition is that patients have tried it on their own and seen how it’s worked for them. The typical suggestion has been ‘start low and go slow’ if you’re going to do it on your own,” said Yafai.

“For adults — and we’re talking about individuals over the age of 21 who are not on any medications — we’re looking at anywhere from 5-20mg as a starting point,” she recommended.

For people with a history of sensitivity to any medication, a smaller dose might be more appropriate.

Of course, the dose is also going to be tied to the strength of the effects.

“One of the issues I have with many of the over-the-counter products that are available is that the feasible daily dose that one might consume would be far below the well-established therapeutic dose. You have people taking a substance that may theoretically be therapeutic, but they’re not taking it at a dose that would yield a therapeutic response,” said Armentano.

Yafai recommends checking online to find a local physician who has undergone some amount of training on these products to help guide you on dosing strategies and how to use CBD as a medication.

“I do recognize that most physicians don’t have a lot of information about what’s going on in this field, and I do urge patients to continue to pressure their physicians to get to know these medications better. You don’t want to rely on Facebook groups or Instagram messaging from the lay public for education on CBD,” Yafai said.