CBD is one of over 80 chemicals found in cannabis sativa plants like marijuana or hemp. THC, the major active chemical in marijuana, is the cannabidiol that causes a mind-altering “high.” CBD itself does not cause a high.

Although it will not result in a marijuana-like high, CBD does still affect the brain. According to the U.S. Department of Health, CBD appears to prevent the breakdown of a chemical in the brain that affects pain, mood and mental function. With the chemical breakdown prevented, the chemical levels in the blood increase and reduce psychotic symptoms associated with various mental health conditions. 

There are several methods for extracting CBD. One of the most common ways involves carbon dioxide. Under high pressure and high temperatures, carbon dioxide is used to extract, isolate and preserve CBD oil purity. Other liquid solvents, like ethanol, are similarly employed to create cannabis oils for vape pen cartridges and other products. How CBD is extracted affects its overall quality and purity. Carbon dioxide extraction is commonly considered the safest method of extraction.

CBD health claims run the gamut. According to Harvard Medical School, beyond proving to be an effective treatment for epileptic seizures, CBD is commonly used to address anxiety, insomnia and lack of sleep. Studies suggest cannabidiol can help users fall and stay asleep. For people battling chronic pain, animal studies have shown CBD applied directly to the skin could help lower pain and inflammation too.

Smoking is a costly health mistake you might be making before noon. According to the U.S. Department of Health, early research suggests that inhaling CBD with an inhaler for one week might reduce the number of cigarettes smoked by about 40% compared to the baseline. Other studies suggest CBD may be effective in treating substance use disorders like opioid relapse. 

CBD products come in all types. There are edible gummies, oils and tinctures made for consumption, capsules, concentrates, vape pen cartridges and CBD topical creams and salves.

Do not think for a moment you are alone in the CBD hype. As more familiar brands enter the cannabis industry, the collective market for CBD sales is expected to exceed $20 billion in the United States by 2024.

According to a 2019 Gallup poll, 14% of Americans say they use CBD products. Survey respondents ages 18 to 29 were most likely to report CBD use, as were people in the western region of the U.S. Among survey respondents who use CBD, 40% use it to treat pain, 20% for anxiety and 11% for sleep.

Despite a rapidly growing market, CBD continues to be shrouded in legal mystery. In 2018, the federal government passed the Farm Bill, which legalized industrial hemp production. However, legalized hemp did not mean legalization for all hemp-derived CBD products. Currently, state and local governments are in control of who can buy and/or use CBD products. Laws and regulations vary widely.

Due to ongoing studies, CBD cannot be legally included in foods or dietary supplements. Still, CBD-infused dishes continue to be a food trend and CBD products labeled “dietary supplement” are available on the market. In response, the FDA has sent warnings to several companies, and some local governments, like New York City, are cracking down too. Conversely, other states, like Maine, have passed or are in the process of passing laws allowing for the sale of edible CBD products.

Look out for CBD products marketed as healing or preventative. Under the 2018 Farm Bill, cannabidiol cannot be included in products marketed for therapeutic purposes.  According to the FDA, therapeutic products are any that intend to “prevent, diagnose, mitigate, treat, or cure serious diseases.”

Under the 2018 Farm Bill, CBD can only be included in "cosmetic" products and only if it contains less than 0.3% THC. The FDA defines a cosmetic as a “product (excluding pure soap) intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance.”

Before hitting the market, cosmetic products and ingredients are not subject to approval by the FDA. Only color additives are subject to such pre-market approval. 

While doctors can recommend cannabis to treat other conditions, CBD specifically can only be prescribed clinically to treat seizures. Epidiolex, the only FDA-approved CBD product, is used to reduce seizures in adults and children with two rare, severe forms of epilepsy. All other unapproved CBD products have not been subject to FDA evaluation meant to determine effectiveness in treating disease or validity of other claims. Unapproved products have not been FDA evaluated to find proper dosage, dangerous side effects or ways they interact with other drugs or foods.

According to a 2017 Penn Medicine study, nearly 70% of CBD extracts sold online are mislabeled. Of the 84 products tested, 42% were under-labeled, meaning that the product contained a higher concentration of CBD than indicated, and another 26% were over-labeled. The FDA has expressed concern that misleading or false claims may lead consumers to put off important medical care.

Given the evidence that CBD products may be mislabeled, consumers must be vigilant. According to Project CBD and Consumer Reports, people living in states where medical or recreational marijuana is legal should look to purchase their CBD products from a licensed dispensary. Others should shop products made in states that have legalized cannabis. Consumers should be wary of explicit health claims, toxic thinning agents in vape cartridges or brands that list total cannabinoid content instead of the amount of CBD and THC per serving.

Since consumers may have no way of knowing whether their CBD product contains more CBD or THC than labeled or includes other contaminants, poison control centers across the U.S. treated 1,529 cannabidiol related cases in 2019 alone. As of June 30, more than 920 cannabidiol cases have been reported in 2020.

The highly unregulated CBD market can be tough to navigate. To avoid contaminated or mislabeled cannabidiol, look for CBD products that have been tested by a third party and whose results are available online. Third-party tests commonly look into cannabinoid profiles to determine accurate levels of CBD and THC as well as check for any heavy metal contaminants. 

Although they all sound similar, full-spectrum CBD, broad-spectrum CBD and CBD isolate are different. Full-spectrum CBD contains all the phytochemicals naturally found in a plant, including CBD and trace amounts of other cannabinoids like THC. Full-spectrum CBD can result in a false positive drug test. To solve this, broad-spectrum CBD contains cannabidiol and all the other plant compounds, except THC. CBD isolate, lastly, is the purest CBD form. All other plant ingredients are removed.

While CBD oil is made from infusing cannabis in a carrier oil, CBD tincture involves soaking cannabis in alcohol and water. While tinctures are a more traditional means of consuming CBD, oils are more easily mixed in with smoothies and other foods you should eat every day.

CBD oil, even if derived from a hemp plant, is not the same as hemp seed oil. Hemp seeds do not naturally contain any THC or CBD. The only trace amounts of THC and CBD hemp seeds may contain are picked up during harvesting and processing. Hemp seed products can be added to foods as a source of protein, carbohydrates, oil and other healthy nutrients.

Based on studies of FDA-approved CBD drug Epidiolex, there is a risk cannabidiol may increase or decrease the effectiveness of other medications. This could result in adverse effects or a change in safe dosage. The U.S. Department of Health urges consumers not to take CBD in conjunction with Clobazam and Valproate. Other medications viewable here are also considered moderate threats when consumed along with CBD. 

Although CBD is often well-tolerated by users, side effects may include nausea, fatigue, dry mouth, diarrhea, reduced appetite and drowsiness. These symptoms can appear similar to signs you have not been drinking enough water.

While in the process of approving Epidiolex, the FDA identified CBD safety risks, including the potential for liver injury. Similar liver injuries have been seen in other studies as well. Although the FDA is confident liver injury risk can be managed in the Epidiolex case under medical supervision, there are concerns of potential liver injury associated with non-medically monitored CBD use.

According to the U.S. Department of Health, CBD has been used to treat Parkinson’s disease. Research has shown CBD can reduce public speaking anxiety and psychotic symptoms in people with Parkinson’s disease. However, more research suggests high doses of CBD could worsen people’s muscle movement and tremors.

CBD or CBD-infused products are not among the foods pregnant women should add to their diet. Given the lack of comprehensive research on how CBD affects developing fetuses, pregnant mothers or breastfed babies, the FDA strongly advises against its use during pregnancy or breastfeeding. Additionally, there is a chance purchased CBD products may also contain contaminants or substances like THC that pose a health risk to babies. CBD may also be transferred to babies via breast milk. 

Beyond being potentially damaging for pregnant women, CBD could negatively impact male reproductivity too. In tests on pregnant animals, high doses of CBD caused problems with the reproductive systems of developing male fetuses.

CBD has been shown to benefit children as well as adults. As part of a 2019 study, 155 autistic children 18 and younger each tried CBD oil for at least six months. More than 80% of the children’s parents reported a significant or moderate improvement in their child. A similar 2018 study of 60 children with autism found anxiety improved in over a third of the kids. However, while CBD can be safe for children it is not without side effects, including liver injury.  

Skin health is vital. A 2014 study found that CBD behaves as a highly effective sebostatic agent, meaning the cannabidiol can help reduce the production of acne-causing sebum. Another study found topical CBD treatments can improve the quality of life in patients with some skin disorders, especially of an inflammatory sort.

Some cannabis products are marketed as products for pets, not people. The FDA encourages pet owners against these items and urges them to speak with their veterinarians (who under federal law cannot prescribe CBD for animals) for more information on pet treatments. Still, pet cannabis lines are readily available. Even Martha Stewart has entered the animal-care cannabis game. Stewart is one of several celebrities currently profiting off the marijuana industry. 

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