The interest in CBD oil as a natural remedy is huge, with up to 6 million people in the UK alone having tried it, and it’s only growing. But what exactly is CBD oil? What are the potential benefits – and side-effects – and what research is there to back them up? Is it safe? And what does the law have to say about this cannabis-derived product?
What is CBD oil?
CBD – or cannabidiol – oil is an extract of the cannabis or hemp plant used as a natural remedy for a wide variety of ailments. CBD is one of numerous different compounds known as cannabinoids that are present in cannabis and is the second most common active ingredient after THC, the substance that gets marijuana smokers stoned. However, CBD does not have the psychoactive effects associated with THC – it doesn’t get you high.
CBD oil is an increasingly popular product on the health and wellness market and is sold in a number of forms. Bottled oil, often mixed with hemp seed oil, is taken orally – either directly as droplets or mixed into drinks such as coffee and smoothies – while CBD also comes in capsules, chewable ‘gummies’, topical creams and in e-liquids that are inhaled using a vaping device.
Users report benefits of CBD oil across a wide range of conditions but in particular in relation to the alleviation of pain, anxiety, depression and sleep disorders. There is early pre-clinical evidence that appears to support some of these claims (see section on the benefits of CBD oil, below) with further research pending. There are two CBD-based medicines currently in use by the NHS, for the treatment of epilepsy and symptoms of multiple sclerosis.
One aspect of CBD oil that makes it appealing to both users and medical researchers as an alternative to traditional treatments is its relatively low level of side-effects (although CBD can produce side-effects – see the section below for further details).
According to recent studies, between 4 and 6 million people in the UK – from a wide range of age groups and backgrounds – have tried CBD in some form, while a 2019 poll in the US found that 14% of Americans had used CBD.
What are the benefits of CBD oil? What is it used for?
CBD oil is used as a natural remedy aiming to treat a wide range of ailments, from mental health conditions such as anxiety, depression and sleep problems to physical issues including pain and inflammation as well as neurological illnesses like epilepsy and multiple sclerosis. Some pet owners even use CBD oil to treat dogs and cats.
A questionnaire-based study of over 2,400 CBD users (conducted by a group of US researchers from The Center for Medical Cannabis Education, the National University of Natural Medicine and San Diego State University), found that the most common medical conditions for which CBD was taken were pain, anxiety, depression and sleep disorders. They also included a wide range of other complaints, including migraines and headaches, PTSD, nausea, cancer, allergies, epilepsy, multiple sclerosis, Parkinson’s disease and Alzheimer’s. Over 65% of those surveyed believed that CBD oil treated their conditions ‘very well’ or ‘moderately well’ without the use of other remedies or medications.
Pre-clinical studies using human subjects have provided evidence of possible beneficial effects of CBD on anxiety, stress, sleeping disorders, pain, epilepsy and multiple sclerosis, while early laboratory and animal tests point to the value of further study in areas related to the use of CBD in treating each of the other listed illnesses.
There are currently two CBD-based medications available by prescription on the NHS, for those suffering from specific conditions where other treatments have been ineffective.
Nabiximols, which has the registered brand name Sativex, contains a combination of CBD and THC and can be given to people with multiple sclerosis who are suffering from spasticity – a tightening or stiffening of the muscles that affects movement and speech – where other treatments have been ineffective. Studies are also ongoing into the drug’s effectiveness in treating certain cancer-related symptoms.
According to UK law, companies selling CBD products such as CBD oil, capsules, gummies and e-juices used for vaping cannot currently make medical claims about them (so it is best to steer clear of any brands that do this). Instead, they are advertised as food supplements. However, CBD is generally considered to be safe for people in non-vulnerable groups (see sections on the safety of CBD and CBD side-effects below).
What are the side-effects of CBD oil?
Interest in CBD oil, both from the point of view of those who use it and from researchers attempting to understand its effects on various medical conditions, is often related to the fact that it is considered to have few serious side-effects. CBD is generally considered ‘well tolerated’ by clinicians, which refers in general to its relative lack of serious side-effects and, more specifically, to the small number of people who choose to opt out of studies involving CBD as a result of those side-effects.
However, there are a number of generally low-level side-effects regularly associated with CBD oil. The results of a study of over 2,400 CBD users published in 2018 found that dry mouth was the most commonly experienced, noticed by 11% of those surveyed. A sense of euphoria (although not the kind associated with the ‘high’ of recreational cannabis use) and increased hunger were both symptoms in around 6% of cases, while red eyes were reported by under 3% and sleepiness in less than 2%. Other sources suggest CBD oil can sometimes cause nausea and diarrhoea.
The UK’s Food Standards Agency refers to early studies on mice given extremely high doses of CBD that suggest it could cause liver injury, and recommends “as a precaution” that healthy adults do not take more than 70mg of CBD a day, unless in consultation with a doctor.
How does CBD oil work?
The benefits of CBD oil are likely to be based to a large degree on the influence it has on something called the Endocannabinoid System.
The Endocannabinoid System
The Endocannabinoid System (ECS) is a cell-signalling system in the human body whose main purpose is believed to be homeostasis – maintaining stable internal bodily functions. The ECS was only discovered in the 1990s so research into it is ongoing but it is thought to help regulate a number of functions including immune system responses such as inflammation, pain, metabolism, stress and anxiety, memory and elements of female reproduction.
The ECS is also involved in the effects that the active ingredients of cannabis – including CBD and THC – have on the body.
The Endocannabinoid System consists of three main elements: endocannabinoids, which are molecules produced by the body that tell certain cells what to do, endocannabinoid receptors – where the endocannabinoids ‘bind’ in order to send those signals – and enzymes, which break down the endocannabinoids so that they are able to bind to the receptors.
Researchers are currently aware of two types of endocannabinoid receptors. CB1 receptors are found in greater abundance in the brain and central nervous system. CB2 receptors are more common in the peripheral nervous system – ie the nerves that communicate messages from the brain and spinal cord to other parts of the body – and especially in cells relating to immune responses.
Two key endocannabinoid molecules have also been identified – anandamide (AEA) and 2-arachidonoylglyerol (2-AG). These are produced by the body as required to regulate a variety of functions.
The Endocannabinoid System and CBD
Not to be confused with endocannabinoids, which are formed inside the body, cannabinoids are substances like CBD and THC which are found in cannabis and hemp plants. However, when consumed or inhaled they still interact with the endocannabinoid system.
THC binds to both kinds of receptors and can have multiple effects, both positive and negative, including those that anyone who has smoked marijuana will be familiar with.
The precise function of CBD in the ECS is currently unconfirmed but it interacts with receptors in a different way to THC and it’s thought that it may prevent endocannabinoids from being broken down, thereby prolonging their effects. This could explain any ability CBD has to aid pain relief or help with stress-related complaints such as anxiety. It’s also possible that CBD could bind to an as yet undiscovered endocannabinoid receptor.
CBD can also interact with non-cannabinoid receptors including 5-HT, the receptor for serotonin, which contributes to wellbeing and happiness.
Is CBD oil safe?
One of the reasons many people choose to take CBD oil – and why medical researchers are continuing studies into its potential to treat a wide range of illnesses – is its relatively mild side-effects in comparison with some traditional medicines.
A report by the World Health Organization on CBD found no evidence that CBD is addictive or can lead to health problems within communities: “In humans, CBD exhibits no effects indicative of any abuse or dependence potential… To date, there is no evidence of recreational use of CBD or any public health related problems associated with the use of pure CBD.”
However, it is important to be aware that there are side-effects sometimes associated with taking CBD oil. The most commonly reported side-effect is dry mouth. Others include drowsiness, diarrhoea and changes to appetite (see the section on side-effects of CBD oil, above). It is currently unclear how safe vaping is, so vaping with CBD products should be treated with equal caution.
Due to the ongoing nature of research into CBD, the UK’s Food Standards Agency advises as a precaution that people in vulnerable groups, such as pregnant and breastfeeding women and those taking medication, do not use CBD and that healthy adults do not take more than 70mg a day (approximately 28 drops of 5% strength CBD oil), unless advised by a doctor.
In general, it is a good idea to talk to your doctor if you are considering taking CBD oil.
Does CBD oil get you high?
The short answer is no, CBD itself doesn’t get you high. CBD is the second most common cannabinoid in hemp plants but does not possess the psychoactive effects of the most common, THC, which is the compound responsible for the ‘stoned’ feeling people experience when they smoke or eat marijuana.
Given that they are extracted from the same plant, however, trace amounts of THC can be found in CBD oil products. Brands that process their hemp correctly and abide by government guidelines can legally have an ‘untraceable’ amount of THC in them (considered to be up to 0.01%). Although a recent study of CBD oil products available in the UK found that almost half contained measurable levels, making them technically illegal, these averaged just 0.04% THC, meaning they would not cause any psychoactive effects.
Is CBD oil a drug? Is it legal?
Although it is extracted from cannabis plants, in its pure form CBD is not a controlled substance in the UK, meaning it is legal to buy products containing it. And pure CBD does not contain THC, the active ingredient in recreational – and illegal – marijuana, so will not get you high.
However, it is very difficult to remove absolutely every trace of THC from CBD during the extraction process and UK Home Office advice to those selling CBD products says that any single pack (bottle or packet) of a product should contain no more than 1mg of THC, an amount so small that it would have no noticeable effect on those using it.
The law and CBD producers
There are no special requirements for CBD products being imported into the UK providing they do not contain a ‘detectable’ amount of THC. In this case, a detectable amount is considered to be 0.01%. However, given the difficulty of accurately testing at such low levels, imported products that have not been rigorously analysed by a suitably accredited laboratory may fall foul of the law if the results are not completely accurate. In fact, a recent study of 30 CBD oil products available in the UK found that 45% contained measurable levels, averaging 0.04%, and are thus technically illegal there. Even that level won’t cause psychoactive effects but it is a reminder to choose a reputable brand of CBD oil which can demonstrate good provenance and reliable processing of its products.
Further laws relating to THC levels apply to those growing cannabis plants for the production of CBD in the UK. The levels of THC in different strains of cannabis can vary hugely. Strains genetically manipulated to produce recreational marijuana can have considerably more THC in them than the hemp plants used to produce CBD oil and the Home Office will only issue licences to hemp farming business for the cultivation of plants “from approved seed types with a THC content not exceeding 0.2%”.
CBD oil and Novel Foods regulations
Another recent development that those marketing hemp products in the UK will soon have to take into account is the Food Standards Agency’s classification (in January 2019) of CBD products as so-called Novel Foods.
Novel foods are foods which have not been widely consumed by people in the UK or the EU before May 1997. This means that the foods don’t have what the FSA calls “a history of consumption”. Before a Novel Food can be legally marketed in the UK it must go through a safety assessment and authorisation process. Applications to be included in the process are open from 1st January 2021 and will require producers to provide a dossier of information demonstrating that their products are fit to be sold under the classification.
What does CBD stand for? What does it mean?
If you’ve read the earlier sections of this article, you may well have gathered by now that the three letters CBD don’t actually stand for words. Instead they are a shortened version of the single word cannabidiol. Confusingly, cannabidiol is itself a cannabinoid, one of the many compounds along with THC found in cannabis and hemp plants. It’s also not to be confused with cannabis oil, which is a resinous form of marijuana – although cannabis oil does contain cannabidiol/CBD.
How do you take CBD oil? Methods and products
CBD oil can be consumed in a variety of formats but perhaps the most popular product is bottled oil. Good CBD oil brands come with an integrated dropper in the cap so that measured doses of oil can be easily administered directly into the mouth or added to food and drink.
CBD oil can be dropped into the mouth and swallowed immediately but there is evidence that some of its potency is lost through the process of digestion.
The method of consumption generally considered to be the most efficient and effective is ‘sublingual’ application – which simply means placing droplets of the oil beneath the tongue and holding them there for a few moments before swallowing. This allows the CBD to enter the bloodstream quickly due to the large number of blood vessels under the tongue and leads to maximum absorption.
Many people enjoy consuming CBD in drinks, with CBD coffee currently an on-trend option. However, there is evidence that CBD in a solution can degrade when exposed to heats above 71°F so if you like your coffee hotter than lukewarm it’s possible you may be consuming less CBD than you think. Smoothies are another favourite of health-conscious CBD users but research suggests that ingested CBD is better absorbed when accompanied by food or drink containing high levels of fat, which may not always fit with other aspects of certain health and fitness regimes.
The same is worth bearing mind if you decide to use any of the CBD soft gels, capsules or chewable gummies on the market. While these contain a measured dose, which can be useful depending on the reliability of the brand, varying amounts are likely to be lost during the digestion process.
CBD oil can also be administered through creams and cosmetics applied to the skin. Most creams are known as topical, meaning they do not penetrate beyond the upper layers of the skin. However there are cannabinoid receptors (see the section on how CBD oil works, above) in the skin and there is initial evidence that topical CBD creams may help with localised complaints such as arthritis. Another form of delivery through the skin is transdermal, which allows active ingredients to penetrate into the bloodstream and thereby affect the entire system. Early research is looking into transdermal creams or patches as a possible delivery mechanism for CBD.
Finally, electronic vaping devices are a popular way to consume CBD oil via pre-made CBD e-juices. Because the vapours are inhaled directly into the lungs, vaping CBD can provide rapid assimilation into the body. However, the safety of vaping itself is still in question, so there may be dangers inherent in inhaling any substance in this way.
How much CBD oil should I take? How to decide on dosage
Once you’ve decided which method or methods of CBD oil consumption might best suit you, you need to consider how much to take. The ideal dosage can vary from person to person based on a number of factors including age, weight, the particular condition they wish to treat, their own specific reactions to the CBD and the way they plan to take it.
A recommended approach is to start with small doses, as low as 5-10mg per day, and to work your way up in similar increments. The aim is to find the smallest amount of CBD that has the desired effect and does not elicit any unwanted side-effects. It’s worth taking each dosage for a few days before you increase it, to give your body time to respond, and it’s useful to keep a diary of how you feel afterwards (remember, the effects may be subtle). If you experience any unwanted side-effects, reduce the dosage.
For a general idea of the dosage size you might arrive at, use Jersey Hemp’s CBD dosage calculator, which takes into account your weight.
The method you use to take CBD can affect how much of it actually makes it into your bloodstream. Sublingual (under the tongue) application provides the most efficient delivery. If you ingest the CBD, digestive processes, as well as what you eat or drink with it, may influence how much is absorbed (see the section above on how to take CBD oil for more information).
Other factors to bear in mind are exactly when you take the CBD oil and how often you take it. If your CBD product makes you drowsy, it may make more sense to use it in the evening; if you find it gives you a boost then taking it with breakfast could work best. And if the reason you take it relates to the timing of a particular event – such as a public speaking appointment that could cause anxiety – then you may want to take it just prior to that. In all cases, it’s worth bearing in mind that any effects are generally reported as lasting between two and six hours.
Some CBD users also choose to take smaller doses several times per day. What works best for you is likely to be the result of careful, incremental trial and error.