Side Effects Of CBD Oil In The Elderly

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Cannabidiol Use in Older Adults ABSTRACT: Cannabidiol (CBD) is a nonpsychoactive component of the Cannabis sativa plant. CBD products, which have become popular in the United States, are Cannabidiol or CBD oil has become increasingly popular in the United States as a remedy for a variety of ailments. Many older adults have also embraced CBD to treat everything from depression to chronic pain. CBD oil is made from hemp plants. It may help treat pain, anxiety, and seizures. Here is what you should know before trying it.

Cannabidiol Use in Older Adults

ABSTRACT: Cannabidiol (CBD) is a nonpsychoactive component of the Cannabis sativa plant. CBD products, which have become popular in the United States, are frequently used to treat pain, anxiety, and sleep disorders—conditions that affect older adults. Evidence is insufficient to recommend the use of CBD for these disease states. OTC CBD products are widely available, and there are significant concerns regarding their safety, including mislabeling, standardization issues, and drug interactions. The informed pharmacist will be a valuable resource for discussing the use and safety of CBD with older adults.

Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) are among the many cannabinoids, or components, of the Cannabis sativa plant. CBD is nonpsychoactive, whereas THC has psychoactive properties such as euphoria and psychosis. Two common strains of Cannabis sativa are marijuana and hemp. 1 CBD may be derived from either marijuana (which often contains more than 15% THC) or hemp (having a THC concentration of no more than 0.3%). 2 In addition, CBD may be extracted from Cannabis indica and hybrid plants, which may have higher concentrations of CBD than THC. A recent survey revealed that one in seven Americans uses CBD products, with the most common reasons for its use being pain, anxiety, poor sleep, and arthritis. 3

Endogenous cannabinoids and phytocannabinoids such as CBD and THC modulate the endocannabinoid system (ECS). THC is a partial agonist on the cannabinoid (CB) 1 receptor that results in central nervous system (CNS) effects, such as the “high” associated with marijuana; it also has limited CB2 agonist activity in the immune system. CBD has minimal activity on CB receptors, but it affects the ECS and the non-ECS. 4 Some of the proposed mechanisms of CBD include agonist activity at serotonin 1A, transient receptor potential vanilloid 1, G protein–coupled receptor 55, and adenosine A2A receptors, which may explain some of the possible analgesic, anti-inflammatory, anxiolytic, and antiepileptic effects of CBD. 1,5

In the United States, about two-thirds of states have legislation approving cannabis for recreational use (11 states) and/or medicinal purposes (21 additional states). Seven states mandate pharmacist involvement, such as dispensing activities or consulting to dispensaries. 6 The only FDA-approved (in 2018) CBD product is Epidiolex, which is indicated for treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome. 7 The law prohibits the sale of foods or dietary supplements to which CBD has been added; however, a wide variety of products containing CBD are available at retail stores. 8

Formulations

CBD formulations used in clinical trials include oral capsules, sublingual spray, oil-based solution, and topical gel. OTC CBD products are available in numerous other formulations, including topical balms and creams, e-liquid for inhalation, and infused foods and drinks. 1,9 Given the many formulations and manufacturers, nearly all CBD products lack standardization. The exception is Epidiolex, which is available as an oil-based oral solution formulated with sesame oil and standardized to contain 100 mg/mL of pure CBD extract. 7

CBD levels in commercially available products vary widely. The FDA has issued warning letters every year since 2015 to companies marketing unapproved new drugs that allegedly contain CBD. 8,10-13 As part of these warnings, the FDA tests the chemical content of CBD compounds, and it has found that many products do not contain the claimed level of CBD. Commercially available products have been assessed in laboratories, whose findings support the FDA’s concerns about product inconsistency and mislabeling. A laboratory assessment of OTC CBD products sold in the U.S. demonstrated that only 26 of 84 (31%) products tested were accurately labeled. 14 Not only was the amount of CBD in products overlabeled or underlabeled, but 21% of products contained THC even though it was not listed in the product information. In addition, the FDA has cited concerns regarding reports of contaminants such as pesticides and heavy metals. 8

The mislabeling of CBD products results in dosing uncertainty in the use of any commercially available OTC product. This is an important caveat in the extrapolation of dosages used in clinical research. In such research, a range of dosages have been used for different indications and routes of administration. For example, Epidiolex oral solution is approved for weight-based dosing from 5 mg/kg/day to a maximum of 20 mg/kg/day. 7 CBD has been given orally at dosages of 100 mg to 800 mg. 15,16 CBD topical gel has been used for fragile X syndrome at a dosage of 50 mg to 250 mg daily. 17 For smoking cessation, a CBD metered-dose inhaler has been administered at a dosage of 400 mcg as needed. 18

Administration and Absorption

CBD absorption depends on the product formulation. In animal and human studies, CBD administered orally has been shown to be poorly absorbed, with bioavailability of 13% to 19%. 19,20 CBD’s bioavailability is believed to be reduced by first-pass metabolism. Poor bioavailability can be avoided with the use of alternative formulations. There is an emerging market for novel delivery methods to increase CBD’s oral bioavailability. 21

Absorption of CBD may also be altered by food intake. In clinical trials, coadministration of Epidiolex with a high-fat, high-calorie meal increased plasma levels of CBD fourfold to fivefold compared with administration on an empty stomach. 7 In one study using a purified (99%) CBD capsule, coadministration with food resulted in a maximum concentration and AUC of 14-fold and fourfold higher, respectively, compared with administration on an empty stomach. 22 CBD inhalation in humans has an average bioavailability of approximately 31%, with the use of one type of metered-dose inhaler demonstrating bioavailability of more than 65%. 18,23 Transdermal absorption of CBD is variable in animal studies and has yet to be fully elucidated in humans. 4

CBD Uses

CBD is FDA-approved for certain types of seizure disorders; for more information, see the manufacturer’s website for Epidiolex (www.epidiolex.com). The following section will focus on the common reasons for off-label CBD use, including pain, sleep disorders, and anxiety, all of which affect older adults.

Pain: An estimated 50 million American adults (20.4%) experience chronic pain, with persons aged 65 years and older constituting 61.2% of those affected. 24 Much of the data on chronic pain (e.g., neuropathic pain, cancer pain, diabetic peripheral neuropathy, fibromyalgia, HIV-associated sensory neuropathy, spasticity associated with multiple sclerosis [MS], and rheumatoid arthritis) involve the use of marijuana and cannabinoids (often THC, combination THC-CBD, or nabiximols [a specific mixture of THC, CBD, other minor cannabinoids, flavonoids, and terpenes]). Formulations used in pain studies range from smoked, oral, or oromucosal spray of THC; synthetic cannabis (nabilone); synthetic THC (dronabinol); and vaporized cannabis, with results suggesting modest reductions in pain and spasticity. 25

Sativex (nabiximols), an oromucosal THC-CBD spray, is approved in several European countries for treating symptoms of moderate-to-severe spasticity associated with MS, and a phase II/III clinical trial is currently under way in the U.S. to evaluate nabiximols for advanced cancer pain with inadequate analgesia from chronic opioids. 26 There is a paucity of data on CBD used for pain; most studies are in preclinical stages. 5,25,27

Sleep Disorders: Sleep disorders are disproportionately more prevalent in older adults. 28 Patients have commonly reported that cannabis is helpful for sleep. 29 CBD is used for alleviation of insomnia, but little is known about its effectiveness. One study that compared CBD with placebo for insomnia in 15 patients suggested that 160 mg of CBD may improve sleep duration without next-day sedation. 30 Somnolence was reported in nearly one-third of patients taking Epidiolex in clinical trials, which provides additional support for CBD’s benefits for sleep in some patients. 7 However, more research is needed to determine whether CBD is useful for individual components of insomnia, such as sleep latency, wakefulness after sleep onset, sleep duration, and overall sleep quality.

Anxiety: Evidence is not strong for the use of CBD for anxiety disorders. CBD has demonstrated some benefit for social anxiety disorder and social phobia when patients undergo a simulated public-speaking test. 31,32 However, these trials had small sample sizes and study biases. It is theorized that CBD could be beneficial for anxiety based on its mechanism of action at the serotonin receptor. 31

Other Disease States: Data on the use of CBD for various other conditions are mixed, and evidence is insufficient to recommend this practice. The efficacy of CBD has been studied in bipolar disorder, Crohn’s disease, diabetes, dystonia, fragile X syndrome, graft-versus-host disease, Huntington’s disease, opioid withdrawal, Parkinson’s disease, schizophrenia, and smoking cessation. 33 In addition, CBD has been reported to be useful for addiction, possibly by modulating dopamine and serotonin. 1

Adverse Effects and Safety

The use of CBD is considered “possibly safe” when used appropriately, based on some clinical evidence. 33 However, insufficient high-quality data exist to recommend CBD for most older adults. The most common adverse effects associated with CBD, reported in clinical trials of Epidiolex, are somnolence (~32%), decreased appetite (16%-22%), diarrhea (9%-20%), and increased liver-function tests (13%). 7 Other side effects are orthostatic hypotension, lightheadedness, and dry mouth. Adverse effects appear to be dose-related. The safety of CBD in the geriatric population has not been fully clarified, and Epidiolex clinical trials did not include patients older than 55 years. 7

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There are practical concerns regarding CBD use in older adults. The geriatric population may be more susceptible to adverse effects of CBD commonly seen in younger adults, including sedation. CBD is hepatically metabolized, predominantly via CYP2C19 and CYP3A4. 4 Older adults with reduced hepatic function may be more susceptible to adverse effects of CBD.

Commercially available CBD products may not contain the CBD concentrations claimed on the label, and the FDA warns consumers to be aware of this inconsistency when using such products. 13 Of particular concern is the THC component in mislabeled CBD products. Older adults may be predisposed to adverse effects caused by the psychoactive properties of THC. The use of marijuana in older adults has been associated with increased risk of injury and adverse events. 34

Drug-Drug Interactions

CBD has been shown to inhibit hepatic enzymes. 4 In human studies, coadministration of CBD with antiepileptic drugs resulted in increased concentrations of drugs that are substrates of CYP2C9, CYP2C19, and CYP3A4. 35 Given CBD’s known sedative effect, there is also a theoretical concern for additive hypnotic reactions in combination with CNS depressants. TABLE 1 lists potential interactions with CBD.

The Pharmacist’s Role

A recent survey by the Arthritis Foundation revealed significant use of and interest in CBD for arthritis. The Foundation acknowledges the possible efficacy of CBD for treating pain, insomnia, and anxiety while also recognizing the lack of rigorous clinical studies. 36 Despite a scarcity of evidence for CBD use in the geriatric population, education on known and potential benefits and risks is vital to a patient’s decision-making process. The pervasive direct-to-consumer advertising and ubiquity of CBD products may foster misinformation or misinterpretation of actual evidence. The pharmacist should be prepared to give an unbiased assessment of CBD, including concerns about product mislabeling, underlabeling and overlabeling of CBD, and lack of THC labeling in a product containing it.

The pharmacist should consider patient-specific factors when discussing CBD use. A review of potential drug-drug interactions is warranted prior to using CBD. Counseling on pharmacokinetic variables, such as oral administration with or without food, may be relevant. Comorbidities may also be pertinent to the discussion, and safety concerns should be reinforced. For example, a patient with preexisting respiratory disease should avoid inhalation as the route of CBD administration. An honest and impartial discussion will facilitate a stronger patient–healthcare provider relationship.

If a patient has decided to use CBD, the pharmacist can direct the patient toward a top-quality CBD product. TABLE 2 provides questions to consider when recommending a CBD product. Given the increasing number of states and U.S. territories legalizing marijuana for medicinal or recreational use, the informed pharmacist will be a valuable resource for discussing the use and safety of CBD with older adults. 6

10 Potential Health Benefits of CBD for Older Adults

Cannabidiol or CBD oil has become increasingly popular in the United States as a remedy for a variety of ailments. Many older adults have also embraced CBD to treat everything from depression to chronic pain.

Cannabidiol, otherwise known as CBD, is derived from the Cannabis sativa plant, also known as marijuana or hemp. More than 80 chemicals called cannabinoids have been identified in the Cannabis sativa plant. THC, the chemical that causes a “high,” is the active ingredient in marijuana. However, cannabidiol is most often obtained from hemp, and contains just trace amounts
of THC.

There have been few side effects noted in CBD use studies, but they do occur and can include dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. CBD can also interact with other medications, such as blood thinners.

The benefits of CBD are increasingly being researched and documented. Here are 10 areas in which CBD use has potential benefits for seniors.

1. Anxiety

CBD may have the potential to help manage anxiety. Researchers think that it might change the way that the brain’s receptors respond to serotonin, which is closely associated with mental health outcomes. In one study, social anxiety sufferers were able to give a speech more easily with the help of CBD. Additionally, research done with animals has shown decreased expression of anxiety with CBD. CBD can help promote stress reduction and lead to fewer physiological effects from anxiety, like increased heart rate.

2. Neurodegenerative Disorders

CBD might be a promising product in the fight against neurodegenerative diseases. A loss of neurons in different parts of the nervous system leads to a corresponding decline in cognitive and motor functions; these conditions, such as Parkinson’s, dementia and stroke, cause the brain and nerves to deteriorate over time. Researchers are actively studying brain receptors to uncover the ways that CBD could help.

We discussed how CBD can lower inflammation. Because inflammation can actually make neurodegenerative symptoms worse, CBD can promote good brain health through this mechanism, too. Keep an eye out for more studies to come on this subject. CBD could evolve to become a useful tool to turn to in the fight against neurodegenerative diseases.

3. Mental Health & Mood-related Disorders

As people age, they experience major changes as a result of getting older. Health usually declines and people are more likely to deal with loss and grief. Additionally, social isolation, depression and loneliness may all play a factor in decreased mental health. CBD has been shown to help with these and other related conditions. CBD may interact with brain receptors that are involved in mood regulation. CBD can promote stress reduction, mindfulness and improvement in cognitive function. This powerful combination can strongly contribute to how the mind perceives its situation while enhancing mood.

4. Sleep Quality

Sleep issues and insomnia challenge many individuals, and older adults are no exception. This may be caused by changes in sleep patterns as individuals age. Additionally, medical conditions and prescribed medications further complicate things.

Prescription sleep medications can be effective. However, their use comes with long-term concerns. They may lead to dependence, addiction and even worse sleep quality over time.

CBD can help promote calmness and relaxation. Higher quality sleep can be the end result. This can be a natural way to lead to more regular and helpful sleep for older adults. Plus, it can reduce the need to take prescription sleep medications.

5. Pain Management

Around half of the older adult population lives with arthritis. Compared to traditional pain medications, CBD can be a compelling alternative as a natural and potentially safer remedy. Studies have indicated that CBD can reduce inflammation while alleviating pain. Conditions improved include joint pain, arthritis and multiple sclerosis.

6. Bone Health

Keeping bones healthy can be a challenge, especially for seniors living with osteoporosis. Bones become more fragile and vulnerable over time, making them more prone to breaking. For these reasons, seniors often experience significant pain and a propensity for fractures when falls occur. In addition to reducing inflammation and promoting cell repair, research shows that CBD may aid in strengthening bones. It can also promote the body’s ability to heal. While more research is needed, results in this area so far are promising.

7. Addiction & Dependence

When older adults are confronted with an illness, prescribed medication will usually follow. Tolerance may build for many medications that are taken over time. In some cases, addiction or dependence can be the end result. This can cause permanent damage to the body.

CBD has been shown to alleviate some conditions that involve opioids, generally without significant side effects. On top of that, CBD can aid in combating developed dependencies that grew out of the use of prescribed medications. It appears that CBD has the potential to help fight relapses and assist in overcoming withdrawals that develop during this time.

8. Heart Health

Heart disease is the leading cause of death for older adults. A top contributor to heart disease is high blood pressure. CBD has shown to be very promising as an alternative and natural treatment for high blood pressure. One recent study determined that it lowered the resting blood pressure of the study’s participants.Additionally, researchers administered stress tests and found a positive stress response in individuals evaluated in the study. Another study suggests that antioxidant properties of CBD can aid in lowering cardiac inflammation and deter the death of related cells that results from oxidative stress.

9. Cancer Treatment

CBD may help alleviate the symptoms of cancer along with the side effects stemming from treatment. In fact, CBD has shown a reduction in tumor growth in animals. It may even help the body absorb medications better or increase their potency.

Here, CBD may positively manage inflammation and change how cells can reproduce. CBD could also have the capacity to inhibit the growth of some types of tumor cells and stem their ability to reproduce efficiently.

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10. Appetite Stimulation

A major health concern for seniors is malnutrition due to loss of appetite, whether due to medicaiton or age. This can lead to unnecessary and unwanted weight loss, muscle and tissue weakness, and other health issues. Marijuana has been studied extensively in this area, and is proven to enhance appetite in its users. CBD can stimulate appetite as well, according to some studies. In this way, it can be beneficial for seniors combating malnutrition and appetite loss.

Conclusion

Scientific research takes time and effort. With a broad range of CBD brands exploding on the market and the potential health benefits of the product coming to light, researchers have only just begun to scratch the surface on the ways that cannabinoids can promote wellness in seniors. In early studies, CBD has been shown to be very promising in improving a variety of ailments and conditions.

CBD is readily available over the counter in many forms. Older adults should talk to their doctor, pharmacist or home health provider before starting a CBD regimen. It’s important to determine if CBD treatment is the right option and make sure that no drug interactions or concerns exist. Also the stigma of marijuana and CBD use can be powerful; family members or the physician may harbor some negative associations to CBD and related products. Home health providers can step in to advocate for their patients who wish to use CBD to manage pain or anxiety. Providing educational materials and promising research on CBD to family members and skeptics should be a goal if you are offering CBD as an option in a home health regimen.

Brett Shay is the CEO of CareBridge Academy, a certified nurse aide and home health aide training school located in Philadelphia. He also leads Chosen Family Home Care, which is one of the nation’s only agencies dedicated to addressing the needs and challenges of the LGBTQ community and provides culturally competent care to the diverse local population.

CBD Oil Benefits vs. Side Effects

While it may be helpful, it may not be safe for all

Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman’s World, and Natural Health.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles. She helped co-author the first integrative geriatrics textbook, “Integrative Geriatric Medicine.”

CBD oil is said to have a variety of possible health benefits. It is used as an appetite stimulant, a sleep aid, a treatment for skin conditions like eczema and psoriasis, for relief of pain, to prevent seizures, and much more.

Though derived from cannabis, the same plants grown for marijuana, CBD oil is not he same as pot. But that doesn’t mean that CBD oil is 100% safe. Some possible side effects, like dry mouth, may be fairly minor. Others, like anxiety, are potentially more significant. And certain potential side effects may even make using CBD oil inadvisable for some people.

This article goes over what CBD is used for, the possible side effects, and what you should look for if you choose to buy CBD.

What Exactly Is CBD Oil?

CBD oil is a hemp plant extract known as cannabidiol mixed with a base (carrier) oil like coconut oil or hemp seed oil. CBD oil comes from Cannabis indica and Cannabis sativa plants.

CBD Oil Benefits

People who support the use of CBD claim that CBD oil benefits people with a variety of health problems. CBD oil is said to be good for:

  • Acne
  • Anxiety
  • Cancer
  • Depression
  • Drug use and withdrawal
  • High blood pressure
  • Muscle spasms
  • Poor appetite
  • Skin conditions like eczema and psoriasis

As CBD has gained popularity, researchers have been trying to study it more. Still, there has not yet been a lot of clinical research focused on finding evidence to back up these health claims.

Here’s a deeper dive into what is known about a few of the purported health benefits of CBD oil.

Anxiety

A 2015 review of research that was published in the journal Neurotherapeutics suggested that CBD might help treat anxiety disorders.

The study authors reported that CBD had previously shown powerful anxiety-relieving effects in animal research—and the results were kind of surprising.

In most of the studies, lower doses of CBD (10 milligrams per kilogram, mg/kg, or less) improved some symptoms of anxiety, while higher doses (100 mg/kg or more) had almost no effect.

The way that CBD acts in the brain could explain why this happens. In low doses, CBD might act the same as the surrounding molecules that normally bind to the receptor that “turns up” their signaling. However, at higher doses, too much activity at this receptor site could produce the opposite effect.

There have not been many trials to look at CBD’s anxiety-relieving effects in humans. However, one was a 2019 study published in the Brazilian Journal of Psychiatry.

For the study, 57 men took either CBD oil or a sugar pill with no CBD in it (placebo) before a public-speaking event.

The researchers assessed the participants’ anxiety levels using measures like blood pressure and heart rate. The researchers also used a reliable test for mood states called the Visual Analog Mood Scale (VAMS).

The men who took 300 milligrams (mg) of CBD oil reported less anxiety than the men who were given a placebo; however, the men who took 100 mg or 600 mg of CBD oil did not experience the same effects.

Addiction

CBD oil might help people with substance use disorder, according to a 2015 review published in the journal Substance Abuse.

The review looked at the findings from 14 published studies. Nine of the studies looked at the effects of CBD on animals and five looked at the effects on humans.

The researchers reported that CBD showed promise for treating people with opioid, cocaine, or psychostimulant use disorders.

However, the effects of CBD were quite different depending on the substance. For example, CBD without THC did not decrease withdrawal symptoms related to opioid use.

On the other hand, it did reduce drug-seeking behaviors in people using cocaine, methamphetamine, and other similar drugs.

Some experts suggest that CBD could help treat cannabis and nicotine dependence, but more research is needed to provide this theory.

Skin Conditions

Some studies have suggested that CBD oil may benefit the skin.

A 2020 paper, for example, found that CBD oil may help reduce inflammation, which could be useful for treating a variety of skin conditions including allergic dermatitis, acne, and psoriasis.

Cancer

Proponents say CBD oil has benefits for people with cancer. Although some studies have shown promise, there have been no large studies proving the benefits of CBD oil as a cancer treatment.

Other studies suggest that CBD might interact with cancer drugs.

If you have cancer and are considering CBD, talk to your oncologist first about whether or not it is safe for you to use.

High Blood Pressure

A 2017 study found that CBD oil may reduce the risk of heart disease because it can lower high blood pressure in some people.

For the study, nine healthy men took either 600 mg of CBD or the same dose of a placebo. The men who took CBD had lower blood pressure before and after experiencing stressors like exercise or extreme cold.

The study also looked at the amount of blood remaining in the heart after a heartbeat (stroke volume). The stroke volume in the men who took CBD was lower than in was in the placebo group, meaning their hearts were pumping more efficiently.

The study suggested that CBD oil could be a complementary therapy for people with high blood pressure that is affected by stress and anxiety.

However, there is no evidence that CBD oil can treat high blood pressure on its own or prevent it in people at risk. While stress can complicate high blood pressure, it does not cause it.

Sleep

Proponents say CBD oil has benefits as a sleep aid, but research so far is inconclusive.

A 2017 review pointed out that many studies have been small and limited. However, the authors also noted that because cannabinoids seem to have an effect on the sleep-wake cycle, their potential as a sleep aid is worthy of additional research.

Seizures

In June 2018, the Food and Drug Administration (FDA) approved a CBD oral solution called Epidiolex.

Epidiolex is used to treat two rare forms of epilepsy in children under the age of 2: Dravet syndrome and Lennox-Gastaut syndrome. These are very rare genetic disorders that cause lifelong seizures starting in the first year of life.

Other than for these two disorders, CBD’s effectiveness for treating seizures is not known. Even with Epidiolex, it’s not clear if the anti-seizure effects are from CBD or another factor.

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However, there is some evidence that CBD interacts with seizure medicines like Onfi (clobazam) and raises their concentration in the blood. More research is needed to understand the link.

Possible CBD Oil Side Effects

Clinical research has shown that CBD oil can cause side effects. The specific side effects and their severity varies from one person to the next and from one type of CBD to another.

Some common CBD side effects people report include:

  • Anxiety
  • Changes in appetite
  • Changes in mood
  • Diarrhea
  • Dizziness or fatigue
  • Dry mouth
  • Nausea
  • Vomiting

Do not drive or use heavy machinery when taking CBD oil—especially when you first start using it or switch to a new brand. Remember that some products do contain THC, even in small amounts.

Special Concerns

Your healthcare practitioner may advise against using CBD oil if you:

  • Have liver disease: CBD oil may increase liver enzymes, which is a marker of liver inflammation. Talk with your healthcare provider before taking CBD oil. You may need to have your liver enzymes checked regularly if you decide to use it.
  • Have eye issues: CBD oil may also cause eye-related side effects. A 2018 study found that it may increase pressure inside the eyes. For people with glaucoma, this can make the condition worse. Some people also report dry eyes as a side effect of CBD oil.
  • Are pregnant or nursing: You should not use CBD oil if you’re pregnant or breastfeeding. Even though the effects of CBD are not fully understood, it does pass through the placenta.

The American Academy of Pediatrics (AAP) further states that pregnant people should not use marijuana because of the potential risks to a developing fetus.

Can CBD Oil Get You High?

CBD oil does not get you high. Although it is from a plant that is in the same family as the marijuana plant, it does not contain tetrahydrocannabinol (THC), the compound responsible for this feeling.

CBD Oil Marijuana
A component of the hemp plant Separate plant in the hemp family that contains CBD and hundreds of other compounds.
No or trace amounts of THC Significant amounts of THC
Works receptors in the brain, but not those that induce psychoactive effects (e.g., opioid receptors that help control pain, glycine receptors that impact mood control) THC binds to cannabinoid receptors in the brain to create “high” feeling

What CBD Oil Can Interact With

CBD oil can interact with medications, including many that are used to treat epilepsy. One of the reasons for this has to do with how your body breaks down (metabolizes) drugs.

Cytochrome P450 (CYP450) is an enzyme your body uses to break down some drugs. CBD oil can block CYP450. That means that taking CBD oil with these drugs could make them have a stronger effect than you need or make them not work at all.

Drugs that could potentially interact with CBD include:

  • Anti-arrhythmia drugs like quinidine
  • Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
  • Antifungal drugs like Nizoral (ketoconazole) and Vfend (voriconazole)
  • Antipsychotic drugs like Orap (pimozide)
  • Atypical antidepressants like Remeron (mirtazapine)
  • Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
  • Immune-suppressive drugs like Sandimmune (cyclosporine)
  • Macrolide antibiotics like clarithromycin and telithromycin
  • Migraine medicine like Ergomar (ergotamine)
  • Opioid painkillers like Duragesic (fentanyl) and alfentanil
  • Rifampin-based drugs used to treat tuberculosis

Always tell your healthcare provider and pharmacist about all the medicines you take, including prescription, over-the-counter (OTC), herbal, or recreational drugs.

The interactions between these medications and CBD are often mild and you might not have to change your treatment. However, in some cases, you might have to change medications or space out your doses to avoid a reaction. Never change or stop medication without talking to your provider.

What’s a Safe Dosage of CBD Oil?

There are no guidelines for use, nor is there a “correct” dose of CBD oil. That said, the average dose range is from 5 mg to 25 mg.

Available forms include:

  • Tinctures (CBD oil mixed with a base oil)
  • Capsules
  • Gummies
  • Sprays

Which you choose largely comes down to your preference and what you hope to get in terms of effects. For example, putting the oil under your tongue can produce effects more quickly than swallowing a capsule that needs to be digested.

Each product works a bit differently, depending on the form, so it’s important to follow the provided directions.

How to Calculate a CBD Dose

Sprays, gummies, and capsules are easy to use because their doses are pre-measured.

Tinctures are a bit more challenging. Most oils come in 30-milliliter (mL) bottles and include a dropper cap to help you measure.

But some tinctures have concentrations of 1,500 mg per 30 mL, while others have 3,000 mg per mL or more. That means figuring out the exact amount of CBD per milliliter of oil requires a little math.

To determine an exact dose of CBD, remember that each drop of oil equals 0.05 mL of fluid. This means that a 30-mL bottle of CBD oil will have about 600 drops in it.

If the concentration of the tincture is 1,500 mg per mL, one drop would have 2.5 mg of CBD in it (1,500 mg ÷ 600 drops = 2.5 mg).

Safer Buying Practices

Remember that CBD oils are unregulated. There’s no guarantee that a product is what it claims to be on its packaging. You also can’t know for sure that it’s safe and effective.

A 2017 study reported that only 31% of CBD products sold online were correctly labeled. Most had less CBD in them than was advertised, and 21% had significant amounts of THC.

If you are interested in buying CBD products, here are a few tips that can help you make the best choice:

  • Buy American: Domestically produced CBD oil might be a safer option than those that have been imported.
  • Go organic: Brands certified organic by the U.S. Department of Agriculture (USDA) are less likely to expose you to pesticides and other harmful chemicals.
  • Read the product label: Don’t assume that every ingredient on the product label is natural. CBD products can also have preservatives, flavorings, or thinning agents in them. If you don’t recognize an ingredient, ask the dispenser what it is or check online.

Frequently Asked Questions

CBD oil comes in different forms:

  • Isolates contain only CBD.
  • Broad-spectrum oils have nearly all of the components of the plant (e.g., proteins, flavonoids, terpenes, and chlorophyll), but do not have THC. oils have all the compounds including THC (up to 0.3%)

Alternative medicine practitioners believe that the compounds provide more health benefits, but the is a lack of evidence to support these claims.

Not necessarily. While the names are sometimes used interchangeably, hemp oil can also refer to hemp seed oil, which is used for cooking, food production, and skincare products. CBD oil is made from the leaves, stems, buds, and flowers of the Cannabis indica or Cannabis sativa plant. It should contain less than 0.3% THC. Hemp oil is made from the seeds of Cannabis sativa and does not have TCH in it.

It would be hard to overdose on CBD oil. Research has shown that human tolerance for CBD is very high. One study reported the toxic dose would be about 20,000 mg taken at one time.

It depends on where you live, the type of product, how it was sourced, and its intended purpose (medical or recreational). In many states, you must be 18 or 21 to buy CBD oil. Check your state’s laws.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825-36. doi:10.1007/s13311-015-0387-1

Scheau C, Badarau IA, Mihai LG, et al. Cannabinoids in the pathophysiology of skin inflammation. Molecules. 2020;25(3):652. doi:10.3390/molecules25030652

American Society of Clinical Oncology. Is CBD safe for people With cancer?

Babson KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Curr Psychiatry Rep. 2017;19(4):1-2. doi:10.1007/s11920-017-0775-9

Miller S, Daily L, Leishman E, Bradshaw H, Straiker A. Δ9-tetrahydrocannabinol and cannabidiol differentially regulate intraocular pressure. Invest Ophthalmol Vis Sci. 2018;59:5904-5911. doi:10.1167/iovs.18-24838

Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling accuracy of cannabidiol extracts sold online. JAMA. 2017;318(17):1708–1709. doi:10.1001/jama.2017.11909

Cather JC, Cather JC. Cannabidiol primer for healthcare professionals. Proc (Bayl Univ Med Cent). 2020;33(3):376-379. Published 2020 Jul 6. doi:10.1080/08998280.2020.1775437

Bergamaschi MM, Queiroz RHC, Zuardi AW, Crippa JAS. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011;6(4):237-249. doi:10.2174/157488611798280924

By Cathy Wong
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman’s World, and Natural Health.

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