In 2018, the passage of the Farm Bill flooded the U.S. market with CBD in the form of tinctures, balms, and even sodas. Along with tetrahydrocannabinol (THC), cannabidiol (CBD) is one of the chemicals in cannabis known to have the most health benefits. By learning how CBD works as part of cannabis medicine, you can better determine whether it might be part of your future cannabis considerations. 

What Is Cannabidiol (CBD)? 

Scientists first isolated cannabidiol at the end of the 19th century and was the first of 113 different cannabinoids identified in cannabis plants. Both THC and CBD are present in cannabis mainly as acids that are decarboxylated when cannabis is heated. 

In the 1940s, we learned that CBD lacks psychotropic activity. THC is the cannabinoid responsible for the psychoactive effects of cannabis, or what makes you feel “high.” Scientific discoveries led to possibilities that CBD oil may treat pain, anxiety, and stimulate appetite the same way that the THC in cannabis does, but without affecting a patient’s mental state. 

The Entourage Effect

Other cannabinoids like CBN, CBC, CBA, and CBG along with terpenes such as myrcene, pinene, limonene, and caryophyllene, are also naturally present in cannabis and play a supportive role. Research has shown that taking a precise, balanced formulation of these cannabinoids and terpenes is more effective than taking CBD or THC alone. An interaction between the cannabinoids and terpenes is known as “the entourage effect”. CBD works better in combination with other cannabinoids and terpenes found in the hemp plant (including some THC), than when isolated.

CBD-isolate (which can be sold over the counter) will not provide the same effects as a marijuana-based product (which can only be purchased at the dispensary). To experience the health benefits of isolated CBD from hemp, full-spectrum CBD provides the most benefits. Only purchase hemp-derived CBD isolate products from a trusted supplier in your area who balances their products with a scientifically-based amount of cannabinoids, flavonoids and terpenes. Beware of products also sold at these stores such as Delta-8 THC and THC-O, which have not been studied for safety or effectiveness and should be avoided for medical patients. 

To be sure that your CBD is medical grade, get it from a state-licensed dispensary. 

Can CBD Bring Down a THC High?

CBD acts as an antagonist and modulator of THC at the CB1 and CB2 receptors, potentially reducing the effects of THC intoxication. A 2006 study showed that taking CBD can help reduce some of the more unpleasant side effects of taking marijuana, such as intoxication, sedation, and a racing heartbeat. 

However, a more recent study conducted in 2019 reported the opposite finding, discovering a somewhat counterintuitive effect of CBD. When participants inhaled the low-CBD and THC variant, their subjective assessment of their intoxication was higher than when they vaporized THC alone, indicating that in low doses CBD might actually enhance the psychoactive effects of THC. More research is needed to know if CBD actually can bring down a THC high. 

Scientific Discoveries Involving CBD: Seizures

Some patients living with uncontrolled seizures have reported beneficial effects and reduced seizure activity when using medical cannabis, especially strains that are rich in CBD. Research further suggests CBD can help prevent some types of seizures. Clinical trials have demonstrated a significant reduction in seizures for people taking CBD to treat Lennox-Gastaut, Dravet syndrome, or tuberous sclerosis complex.

CBD has been studied in recent years as a potential treatment for some of epilepsy’s most troubling symptoms. A CBD-based pharmaceutical called Epidiolex earned FDA approval in 2016. Studies have shown it significantly reduces seizures in people with three different, rare types of epilepsy. 

CBD may enhance the effect of some other antiepileptic drugs. It’s very important to work with your doctor when using CBD oil to help treat seizures. Your doctor can help determine if CBD will interact with any of your current medications.

In addition to its use in seizure disorders, CBD has been marketed as a treatment for a number of medical conditions, including Alzheimer’s disease, Parkinson’s disease, Anxiety, Depression, and Chronic pain.

A 2019 study showed that patients who used medical marijuana were able to sleep better and reported less anxiety. Some research has shown that CBD may work by affecting serotonin levels in the brain. Serotonin plays a role in your mood, sleep, digestion, and behavior. Research suggests that serotonin levels can help treat anxiety and depression. Certain medications, such as antidepressants, also work by regulating serotonin levels.

A 2021 retrospective observational study suggests CBD-rich treatment may have a beneficial impact on pain, anxiety, and depression symptoms as well as overall well-being for patients with moderate to severe symptoms.

Hemp-derived CBD products with less than 0.3% THC are legal federally but still illegal under some state laws. Marijuana-derived CBD products, on the other hand, are illegal federally but legal under some state laws. Outside of a state dispensary where marijuana derived CBD can be sold, CBD oil generally doesn’t have THC, although trace amounts might be in products sold in certain states.

CBD oil contains CBD mixed with an oil, typically coconut or hemp seed. The bottled CBD oil is called a tincture and is sold in different concentrations. Beyond tinctures, CBD capsules, gummies, under-the-tongue sprays, and beverages are common products sold in many retail stores. CBD is readily obtainable in most parts of the United States. 

In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. The Farm Bill (2018) made hemp legal in the United States, making it virtually impossible to keep CBD illegal.

Drug Interactions

Information from studies of the FDA-approved CBD drug Epidiolex show a risk of CBD impacting or interacting with other medications. Taking CBD with other medications may increase or decrease the side effects or effectivity of the other medications. Any change in your care plan or medication and their dosage amount could impact the dose of CBD that can safely be used. It’s always important to disclose CBD or medical marijuana use with your physician. These changes may lead to an increased chance of adverse effects or decreased effectiveness of other medications. 

Drug interactions were also seen in other studies of CBD in published literature. When not being monitored by a healthcare provider, taking other medicines with CBD can be a potential safety risk. Research on the interactions between CBD products and herbs or other plant-based products in dietary supplements remains very scant. Patients should use caution when combining CBD products with herbs or dietary supplements

A very recent study called into question earlier findings that CBD causes elevations in liver tests in healthy adults.

Always consult a physician when changing doses or adding CBD to your regimen, especially if you take other pharmaceutical medicines. To learn more about CBD and whether medical marijuana could help with your therapy, reach out to today.


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  • Gabrielle Dion

    Medicate OH's Founder and Publisher is a native of Cincinnati, Ohio and holds an undergraduate degree in journalism and a master's degree in public administration, both from Northern Kentucky University. She has more than 20 years of experience writing and editing professionally for the medical and wellness industries, including positions with The Journal of Pediatrics, Livestrong, The Cincinnati Enquirer, and Patient Pop.