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Everything you need to know about CBD oil
Last updated Fri 15 December 2017

By Jon Johnson Reviewed by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

What is CBD oil? Benefits Legality Side effects Risks How to use
Cannabidiol oil is used for health purposes, but it is controversial. There is some confusion about what it is and the effect it has on the human body.

Cannabidiol (CBD) may have some health benefits, but there may also be some risks. It is also not legal in every state.

This MNT Knowledge Center article will explain what CBD is, what it can be used for, the potential risks, the legality of CBD, and how to use it.

What is CBD oil?
CBD is one of many compounds, known as cannabinoids, that are found in the cannabis plant. Researchers have been looking at the potential therapeutic uses of CBD.

Oils that contain concentrations of CBD are known as CBD oils. The concentration and uses of different oils vary.

Is CBD marijuana?
Cannabis plant
CBD oil is a cannabinoid derived from the cannabis plant.
Until recently, the most well-known compound in cannabis was delta-9 tetrahydrocannabinol (THC). This is the most active ingredient in marijuana.

Marijuana contains both THC and CBD, but the compounds have different effects.

THC is well-known for the mind-altering "high" it produces when broken down by heat and introduced into the body, such as when smoking the plant or cooking it into foods.

Unlike THC, CBD is not psychoactive. This means that it does not change the state of mind of the person who uses it. However, it does appear to produce significant changes in the body and has been found to have medical benefits.

Most of the CBD used medicinally is found in the least processed form of the cannabis plant, known as hemp.

Hemp and marijuana come from the same plant, cannabis sativa, but they are very different.

Over the years, marijuana farmers have selectively bred their plants to be very high in THC and other compounds that interested them, either for a smell or an effect they had on the plant's flowers.

On the other hand, hemp farmers have not tended to modify the plant. It is these hemp plants that are used to create CBD oil.

How CBD works
All cannabinoids, including CBD, attach themselves to certain receptors in the body to produce their effects.

The human body produces certain cannabinoids on its own. It has two receptors for cannabinoids, called CB1 receptors and CB2 receptors.

CB1 receptors are found all around the body, but many of them are in the brain.

The CB1 receptors in the brain deal with coordination and movement, pain, emotions and mood, thinking, appetite, and memories, among others. THC attaches to these receptors.

CB2 receptors are more common in the immune system. They affect inflammation and pain.

It used to be thought that CBD acts on these CB2 receptors, but it appears now that CBD does not act on either receptor directly. Instead, it seems to influence the body to use more of its own cannabinoids.


Benefits
Because of the way that CBD acts in the body, it has many potential benefits.

Natural pain relief or anti-inflammatory properties
People commonly use prescription or over-the-counter drugs to relieve pain and stiffness, including chronic pain.

Some people feel that CBD offers a more natural way to lower pain. A study published in the Journal of Experimental Medicine found that CBD significantly reduced chronic inflammation and pain in some mice and rats.

The researchers suggest that the non-psychoactive compounds in marijuana, such as CBD, could be a new treatment for chronic pain.

Quitting smoking and drug withdrawals
There is some promising evidence that CBD use may help people to quit smoking. A pilot study posted to Addictive Behaviors found that smokers who used an inhaler containing the compound CBD smoked fewer cigarettes but did not have any additional craving for nicotine.

Another similar study posted to Neurotherapeutics found that CBD may be a promising substance for people who abuse opioids.

Researchers noted that some symptoms experienced by patients with substance use disorders might be reduced by CBD. These include anxiety, mood symptoms, pain, and insomnia.

These are early findings, but they suggest that CBD may be used to avoid or reduce withdrawal symptoms.

Epilepsy and other mental health disorders
CBD is also being studied for its possible role in treating epilepsy and neuropsychiatric disorders.

A review posted to Epilepsia noted that CBD has anti-seizure properties and a low risk of side effects for people with epilepsy.

Studies into CBD's effect on neurological disorders suggest that it may help to treat many of the disorders that are linked to epilepsy, such as neurodegeneration, neuronal injury, and psychiatric diseases.

Another study published in Current Pharmaceutical Design found that CBD may have similar effects to certain antipsychotic drugs and that it may be safe and effective in treating patients with schizophrenia.

More research is needed to understand how this works, however.

Helps fight cancer
CBD has been studied for its use as an anti-cancer agent.

A review posted to the British Journal of Clinical Pharmacology notes that CBD appears to block cancer cells from spreading around the body and invading an area entirely.

The review indicates that this compound tends to suppress the growth of cancer cells and promote the death of these cells.

Researchers note that CBD may help in cancer treatment because of its low toxicity levels. They call for it to be studied along with standard treatments, to check for synergistic effects.

Anxiety disorders
Patients with chronic anxiety are often advised to avoid cannabis, as THC can trigger or amplify anxiety and paranoia in some people.

However, a review from Neurotherapeutics suggests that CBD may help to reduce the anxiety felt by people with certain anxiety disorders.

The researchers point to studies showing that CBD may reduce anxiety behaviors in disorders such as:

post-traumatic stress disorder
general anxiety disorder
panic disorder
social anxiety disorder
obsessive-compulsive disorder
The review notes that current medications for these disorders can lead to additional symptoms and side effects and that people may stop taking the drugs because of these unwanted effects.

CBD has not shown any adverse effects in these cases to date, and the researchers call for CBD to be studied as a potential treatment method.

Type 1 diabetes
Type 1 diabetes is caused by inflammation when the immune system attacks cells in the pancreas.

Recent research posted to Clinical Hemorheology and Microcirculation found that CBD may ease the inflammation in the pancreas in type 1 diabetes. This may be the first step in finding a CBD-based treatment for type 1 diabetes.

Acne
Acne treatment is another promising use for CBD. The condition is caused, in part, by inflammation and overworked sebaceous glands in the body.

A recent study posted to the Journal of Clinical Investigation found that CBD helps to lower the production of sebum that leads to acne, partly because of its anti-inflammatory effect on the body.

CBD could be a future treatment for acne vulgaris, the most common form of acne.

Alzheimer's disease
Initial research published in the Journal of Alzheimer's Disease found that CBD was able to prevent the development of social recognition deficit in subjects.

This means that CBD could potentially prevent people in the early stages of Alzheimer's from losing their ability to recognize the faces of people that they know. This is the first evidence that CBD has potential to prevent Alzheimer's disease symptoms.

Legality
Cannabis is legal for either medicinal or recreational use in some but not all states. Other states approve CBD oil as a hemp product without approving the general use of medical marijuana.

Laws may differ between federal and state level, and current marijuana and CBD legislation in the United States can be confusing, even in states where marijuana is legal.

There is an ever-changing number of states that do not necessarily consider marijuana to be legal but have laws directly related to CBD oil. This information is up to date as of July 24, 2017, but the laws frequently change.

The laws vary, but they generally approve CBD oil as legal for treating a range of epileptic conditions at various concentrations. A full list of states that have CBD-specific laws is available here.

Different states also require different levels of prescription to possess and use CBD oil. In Missouri, for example, a person must show that three other treatment options have been unsuccessful in treating epilepsy.

If you are considering CBD oil as a treatment for a suitable condition, talk to your local healthcare provider. They will have an understanding of safe CBD sources and local laws surrounding usage. Research the laws for your own state. In most cases, a prescription will be required.


Side effects
Many small-scale studies have looked into the safety of CBD in adults and found that it is well tolerated across a wide range of doses.

There have been no significant side effects in the central nervous system or effects on vital signs and mood among people who use it either slightly or heavily.

The most common side effect noted is tiredness. Some people have noticed diarrhea and changes in appetite or weight.

Risks
There are still very little long-term safety data available, and, to date, tests have not been carried out on children.

As with any new or alternative treatment option, a patient should discuss CBD with a qualified healthcare practitioner before use.

The United States Food and Drug Administration (FDA) has not approved CBD for the treatment of any condition. It can be difficult to know whether a product contains a safe or effective level of CBD or whether the product has the properties and contents stated on its packaging and marketing.


How to use
CBD oil is used in different ways to relieve the symptoms of different conditions.

Some CBD oil products can be mixed into different foods or drinks, taken from a pipette or dropper, or are available as a thick paste to be massaged into the skin. CBD can also be purchased in capsule form.

Other products are provided as sprays that are meant to be administered under the tongue.

Here are a few recommended dosages, although these may vary between individuals based on other factors, such as body weight, the concentration of the product, and the condition being treated.

Due to the lack of FDA regulation for CBD products, seek advice from a medical professional before settling on any particular dosage.

All dosages relate to taking CBD oil by mouth. These can include:

Chronic pain: Take between 2.5 and 20 milligrams (mg) by mouth for no more than 25 days.
Epilepsy: Consume between 200 and 300 mg of CBD by mouth daily for up to 4.5 months.
Movement problems associated with Huntington's disease: Taking 10 mg every day for six weeks can help ease movements.
Sleep disorders: Take between 40 and 160 mg.
Schizophrenia: Consume between 40 and 1,280 mg CBD by mouth daily for up to 4 weeks.
Glaucoma: One dose of between 20 and 40 mg applied under the tongue can help to relieve pressure in the eye. However, caution is advised - doses greater than 40 mg might actually increase pressure.
As regulation in the U.S. increases, more exact doses and prescriptions will start to emerge.