Does CBD Really Work?
Physical Health
It seems like CBD — the common name for cannabidiol — is everywhere now. You can find products with CBD in gas stations, grocery stores, vitamin shops, and pharmacies. In 2022, CBD products had more than 4 billion dollars in sales in the United States (US). CBD is marketed as a treatment for many different health concerns. When a product claims to treat everything, it’s usually too good to be true.
Research on the potential uses of CBD is still in the early stages. Until 2018, the US Drug Enforcement Agency (DEA) considered CBD a Schedule I controlled substance — a drug with no currently accepted medical use and a potential for abuse. After changes to the law loosened regulations on CBD, more research has been possible. Because the research on CBD is still in the early stages, it’s not possible to say for sure whether it works for many medical conditions. Continue reading to learn more about CBD and its safety and efficacy.
What Is CBD?
Cannabidiol is a type of cannabinoid — a substance that comes from the plant Cannabis sativa. CBD can be isolated from hemp plants (cannabis plants with less than 0.3 percent THC) and non-hemp plants (plants with more than 0.3 percent THC).
The cannabis plant has more than 500 different chemicals, including cannabinoids. The two most common types of cannabinoids are CBD and delta-9-tetrahydrocannabinol (more commonly known as THC). THC is the cannabinoid responsible for the mind-altering effect that makes you feel high. However, CBD doesn’t cause a high.
CBD is available in several different dosage forms, including:
- Oils that can be smoked or consumed
- Edibles such as gummies or baked goods
- Pills that can be taken by mouth
- Tinctures that are placed under the tongue
- Cosmetics such as lotions, creams, or ointments
How Does CBD Work?
Your body naturally makes compounds that are similar to cannabinoids, such as CBD and THC. These compounds are called endocannabinoids, and they’re part of the endocannabinoid system. This system is made up of a network of chemicals and chemical receptors throughout your body to help regulate several processes in your body, such as:
- Memory
- Learning
- Emotions
- Sleep
- Temperature regulation
- Pain perception
- Inflammation
- Immune response
- Appetite
When you take CBD, it can work like your body’s natural endocannabinoids. CBD can bind to the endocannabinoid receptors naturally present throughout your body to regulate different processes.
What Is CBD Used For?
Researchers are currently investigating the potential uses of CBD. The endocannabinoid system regulates many different systems in your body. Because CBD interacts with your natural endocannabinoid system, there is a potential for CBD to be used in several different medical conditions.
At this time, CBD’s effectiveness has only been proven for epilepsy disorders. The current research on CBD in several medical conditions is discussed below.
Epilepsy
Epilepsy is a brain disorder that causes seizures. Seizures can happen when there’s a sudden burst of electrical activity between your brain cells that changes how you look or act.
The strongest evidence for CBD is in treating epilepsy disorders in children. In fact, the evidence was so strong that the US Food and Drug Administration (FDA) approved the first purified CBD product, sold by the brand name Epidiolex.
Epidiolex can be used in people 1 year of age and older for difficult-to-treat seizures associated with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex. This is the only FDA-approved CBD product currently available.
Anxiety
Anxiety is a feeling of unease, fear, or dread. While occasional anxiety is a normal reaction to stress, for some people with an anxiety disorder, the anxiety may not get better and can interfere with their daily life. Anxiety is the most common mental illness worldwide.
CBD may interact with your endocannabinoid system and receptors in your body that regulate fear and anxiety. Small studies in animals and humans have found that CBD may be a useful treatment for people with anxiety disorders.
A 2019 study on more than 103 people with anxiety and sleep problems found that about 80% of people with anxiety experienced lower anxiety after taking CBD for 1 month.
Insomnia
Insomnia is a sleep disorder where you have difficulty falling asleep. About 1 in 3 people around the world have symptoms of insomnia. When you don’t get enough sleep, it can disrupt your daily life.
Your endocannabinoid system is involved in regulating your sleep. CBD may be able to modulate the endocannabinoid system to improve insomnia symptoms. A review of 34 studies on the effect of CBD on sleep found that CBD alone or along with THC may be an effective treatment for insomnia.
Anxiety can be a factor in insomnia for many people. In the 2019 study on sleep and anxiety mentioned above, about 65% of people with problems experienced improvements in sleep and anxiety after using CBD for 1 month.
More research is needed to understand how CBD can affect sleep in people diagnosed with insomnia. Several clinical trials are currently ongoing to study the effect of CBD and THC on sleep.
Chronic Pain
Chronic pain is pain that lasts for months or years and interferes with your daily activities and quality of life. It can be caused by many different medical conditions, such as:
- Arthritis
- Cancer
- Injuries
- Headaches
Chronic pain can be challenging to treat. Additionally, many treatments for chronic pain cause undesirable side effects. This includes opioid medications, which can also cause dependency or addiction. Researchers have been searching for effective pain treatments with the fewest side effects. Because pain is regulated by the endocannabinoid system, CBD has been investigated as a treatment for different types of pain.
A 2022 review of 12 studies on CBD in chronic pain found that CBD may be an effective treatment option for people with chronic pain.
A 2016 study in rats with arthritis found that applying CBD oil to the skin improved arthritis symptoms. However, studies in humans with arthritis have had mixed results. A 2022 study in people with 2 types of arthritis found that taking CBD for 12 weeks didn’t improve their pain.
A 2018 study on people with multiple sclerosis (MS) found that CBD supplementation may improve symptoms like pain to help them get around more easily.
CBD has been studied in combination with THC to treat other types of pain. A 2013 study found that an oral (mouth) spray with a combination of CBD and THC improved cancer-related pain.
More research is needed to learn how CBD may affect people with different types of chronic pain.
Substance Use Disorder
Substance use disorder (SUD) — commonly known as addiction — is a mental health condition where you use a substance (such as drugs or alcohol) even though there are harmful consequences.
Early research suggests that CBD may be an effective treatment for people with SUD. Although some cannabinoids (namely THC) do have the potential to cause addiction, CBD has not shown an addictive potential. However, large studies are needed to understand the efficacy and safety of using CBD to treat SUD.
Heart Health
CBD has shown promising results in improving heart health. Heart disease is the leading cause of death in the US. Researchers are investigating whether CBD may have a role in preventing or treating heart disease.
Small studies in animals and humans have found that CBD may improve heart-related conditions such as high blood pressure, arrhythmia (irregular heartbeat), heart attack, stroke, and heart failure.
More research is needed to learn how CBD can affect your heart and blood vessels.
Cancer
Cancer is a disease where cells in your body begin to grow out of control. CBD’s role in managing cancer is currently being investigated. So far, there isn’t any evidence that CBD can cure cancer, but CBD may be useful in several different areas of cancer management, including:
- Prevention
- Treatment
- Side effect management (including nausea and vomiting or pain)
A potential complication of using CBD during cancer treatment is that it may interact with some chemotherapy drugs. The drug interaction may make chemotherapy drugs less effective or have worse side effects. If you’re undergoing treatment for cancer, make sure to talk to your healthcare team about all medications you’re taking, including CBD.
Other Potential Uses for CBD
CBD may offer an effective treatment for medical conditions other than those mentioned above, including:
As more researchers continue to investigate the potential applications of CBD in different medical conditions, we will get more information. Many clinical trials are currently underway. If you’re interested in joining a clinical trial for CBD, ask your healthcare provider if there is a study in your area.
Is CBD Safe?
CBD is generally well-tolerated by most people who take it. There haven’t been any reports of a lethal overdose due to CBD or any other cannabinoid. Additionally, the current research shows low risks for using CBD for a short period of time. More research is needed to discover if there are any long-term risks associated with CBD use.
CBD Side Effects
Like all medications and supplements, there are potential risks and side effects. Side effects of CBD may include:
- Drowsiness
- Appetite changes
- Diarrhea
- Mood changes
- Liver problems
In addition to side effects, CBD may interact with other medications you’re taking. CBD can change the way your liver metabolizes (breaks down) certain medications. Depending on the medication, CBD may make it effective or result in more severe side effects.
CBD Product Mislabeling and Contamination
CBD products don’t have to follow the same manufacturing standards as FDA-approved drugs. Without strict manufacturing oversight, CBD products may not be accurately labeled, or they may contain contaminants.
Researchers in a 2017 study published in the Journal of the American Medical Association (JAMA) found that only about 30 percent of CBD products analyzed contained the amount of CBD advertised on the label. This means that 70% of the products had significantly more or less CBD than advertised on the label. Additionally, about 20% of the CBD products analyzed contained THC. CBD products contaminated with THC may cause additional side effects and make you feel impaired or high.
Another potential safety issue for CBD products is the potential for contamination with toxic metals such as lead, mercury, arsenic, or cadmium. A 2022 study found that CBD products were frequently contaminated with toxic metals.
To avoid CBD products with inaccurate labels or contaminants, you should look for companies that provide a certificate of analysis from an outside laboratory (also called third-party testing). The certificate of analysis should give you more information about the purity and quality of the CBD product you’re looking to purchase.
Is CBD Legal?
You can buy CBD in most parts of the US and Canada. In the US, the 2018 Farm Bill made products made from hemp legal to sell. However, laws about the sale and use of CBD may differ from state to state.
It's important to know that you may test positive in a cannabis drug test while taking a CBD product. Talk to your healthcare provider to learn more about the CBD laws in your state.
Is CBD Right for You?
Before you take any CBD product, you should talk to your healthcare provider. Your provider can help you use CBD safely by checking for drug interactions and discovering the best product and dose for you.
Talk to your provider immediately if you notice any new or worsening side effects while you’re taking CBD.