To avoid interactions, tell your doctor and pharmacist about all prescription, over-the-counter, herbal, or recreational drugs you are taking.
Among the few human trials evaluating CBD’s anxiolytic effects was one published in the Brazilian Journal of Psychiatry in 2019. For this study, 57 men were given either CBD oil or a placebo before a public-speaking event. Anxiety was evaluated using physiological measures (such as blood pressure, heart rate, etc.) and a relatively reliable test for mood states known as the Visual Analog Mood Scale (VAMS).
However, the effect of CBD on each addiction type was often very different. With opioid addiction, for example, CBD showed little effect in minimizing withdrawal symptoms in the absence of THC. By contrast, CBD on its own appeared effective in minimizing drug-seeking behaviors in users of cocaine, methamphetamine, and other psychostimulant drugs.
Dosage and Preparation
For this study, nine healthy men took either 600 mg of CBD or the same dose 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).
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 regularly check blood liver enzyme levels.
Since some CBD oils contain trace amounts of THC, you should avoid driving or using heavy machinery when taking CBD oil, particularly when first starting treatment or using a new brand.
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 and neurotransmitter serotonin.
A few drops of CBD oil in a mocha or smoothie are not likely to do anything, researchers contend. Doctors say another force may also be at play in people feeling good: the placebo effect. That’s when someone believes a drug is working and symptoms seem to improve.
Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”
Recently, the F.D.A. sent a warning letter to Curaleaf Inc. about its “unsubstantiated claims” that the plant extract treats a variety of conditions from pet anxiety and depression to cancer and opioid withdrawal. (In a statement, the company said that some of the products in question had been discontinued and that it was working with the F.D.A.)
Is CBD harmful?
Just as hemp seedlings are sprouting up across the United States, so is the marketing. From oils and nasal sprays to lollipops and suppositories, it seems no place is too sacred for CBD. “It’s the monster that has taken over the room,” Dr. Brad Ingram, an associate professor of pediatrics at the University of Mississippi Medical Center, said about all the wild uses for CBD now. He is leading a clinical trial into administering CBD to children and teenagers with drug-resistant epilepsy.
“If you take pure CBD, it’s pretty safe,” said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania’s Perelman School of Medicine. Side effects in the Epidiolex trial included diarrhea, sleepiness, fatigue, weakness, rash, decreased appetite and elevated liver enzymes. Also, the safe amount to consume in a day, or at all during pregnancy, is still not known.
Many soldiers return home haunted by war and PTSD and often avoid certain activities, places or people associated with their traumatic events. The Department of Veterans Affairs is funding its first study on CBD, pairing it with psychotherapy.
“It’s promising in a lot of different therapeutic avenues because it’s relatively safe,” said James MacKillop, co-director of McMaster University’s Michael G. DeGroote Center for Medicinal Cannabis Research in Hamilton, Ontario.