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“Our top therapies attempt to break the association between reminders of the trauma and the fear response,” said Mallory Loflin, an assistant adjunct professor at the University of California, San Diego and the study’s principal investigator. “We think that CBD, at least in animal models, can help that process happen a lot faster.” While large clinical trials are underway, psychologists say there isn’t compelling evidence yet as to whether this is a viable treatment.

“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.

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.”

Does CBD help anxiety and PTSD?

Some CBD products may contain unwanted surprises. Forensic toxicologists at Virginia Commonwealth University examined nine e-liquids advertised as being 100 percent natural CBD extracts. They found one with dextromethorphan, or DXM, used in over-the counter cough medications and considered addictive when abused; and four with a synthetic cannabinoid, sometimes called Spice, that can cause anxiety, psychosis, tachycardia and death, according to a study last year in Forensic Science International.

But without clinical trials in humans, psychologists say CBD’s effect on depression is still a hypothesis, and not an evidence-based treatment.

Facts about wellness.

However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”

You can find CBD products in shopping malls, convenience stores, even coffee shops in many states right now. But when in doubt, natural grocers are a safe brick-and-mortar place to buy CBD, Beatty says. "Typically they have a vetting process that does some of the legwork for you."

Figuring out how much you should take is challenging as well; the dosage that alleviates one patient's pain might do very little for someone else. "And until we can study it, it's the wild west," Dr. Danesh says.

There are two main types of pain, Dr. Danesh says: musculoskeletal and nerve. "There could be benefit for both conditions," he says.

Are there additional ingredients in there?

This 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," says Chris Roth, CEO and co-founder of Highline Wellness. When thinking about dosing, also consider whether your CBD is full-spectrum or isolate: Full-spectrum could include other cannabinoids like cannabidivarin or cannabigerol (this is important, since "there's something called the 'entourage effect' when all together, they're more effective than any one of them alone," Roth explains), while isolate 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," he says.

But even though it's infiltrating pretty much every corner of the wellness world (hi, vegan CBD brownies!) many people still find CBD a little confusing—especially when it comes to figuring out the right way to use it and how to make sure the stuff you're buying is, you know, actually legit. Below, we asked experts to answer the most pressing questions about CBD.

You've probably heard the terms cannabis, marijuana, and hemp all tossed around in relation to CBD. The plant Cannabis sativa has two primary species, hemp and marijuana. Both contain CBD, but there's a much higher percentage in hemp, which also has very low (less than 0.3%) levels of THC compared to marijuana.

"It's kind of ironic," says Parrish. "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."

Hosseini A, McLachlan AJ, Lickliter JD. A phase I trial of the safety, tolerability and pharmacokinetics of cannabidiol administered as single-dose oil solution and single and multiple doses of a sublingual wafer in healthy volunteers. Br J Clin Pharmacol. 2020. View abstract.

Naftali T, Mechulam R, Marii A, et al. Low-dose cannabidiol is safe but not effective in the treatment of Crohn’s Disease, a randomized controlled trial. Dig Dis Sci. 2017 Jun;62(6):1615-20. View abstract.

Hussain SA, Dlugos DJ, Cilio MR, Parikh N, Oh A, Sankar R. Synthetic pharmaceutical grade cannabidiol for treatment of refractory infantile spasms: A multicenter phase-2 study. Epilepsy Behav. 2020 Jan;102:106826. View abstract.

Side Effects

Formukong EA, Evans AT, Evans FJ. Analgesic and anti-inflammatory activity of constituents of Cannabis sativa L. Inflammation 1988;12(4):361-71. View abstract.

Hampson AJ, Grimaldi M, Axelrod J, Wink D. Cannabidiol and (-)Delta9-tetrahydrocannabinol are neuroprotective antioxidants. Proc Natl Acad Sci U S A. 1998;95(14):8268-73. View abstract.

Collin, C., Ehler, E., Waberzinek, G., Alsindi, Z., Davies, P., Powell, K., Notcutt, W., O’Leary, C., Ratcliffe, S., Novakova, I., Zapletalova, O., Pikova, J., and Ambler, Z. A double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosis. Neurol.Res. 2010;32(5):451-459. View abstract.

Malfait AM, Gallily R, Sumariwalla PF, et al. The non-psychoactive cannabis-constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis. Proc Natl Acad Sci USA 2000;97:9561-6. View abstract.