CBD User's Manual: How to Use CBD for Maximum Therapeutic Benefit
THC is the cannabinoid that almost certainly gets you high. CBD (cannabidiol) is the cannabinoid that apparently makes you feel better. This CBD User’s Manual contains everything one needs to know about marijuana’s most potentially medicinal molecules.
In 2009, a handful of CBD-rich cannabis strains were serendipitously discovered in Northern California. Often referred to as “America’s cannabis breadbasket”, California was the first state where certified patients could access medical marijuana legally. Thus began a great laboratory experiment in democracy involving CBD-rich cannabis therapeutics.
The advent of whole-plant, CBD-rich oil as a grassroots therapeutic option has changed the national conversation about cannabis. It’s no longer a question of whether medical marijuana works; today the key question is how to use cannabis for the maximum therapeutic benefit. However, most health professionals have little-to-no experience in this area.
Project CBD has created a CBD User’s Manual for all of us that addresses key questions about cannabidiol and cannabis therapeutics.
What is CBD?
Cannabidiol, or CBD, is a non-intoxicating component of the cannabis plant with enormous therapeutic potential. Although CBD doesn’t make people feel high like THC does, it’s causing quite a buzz among scientists, health professionals and medical marijuana patients who are using CBD-rich products to assist in the successful treatment of a wide range of conditions. Some common conditions CBD has been used to try and help with include chronic pain, cancer, Crohn’s, diabetes, rheumatoid arthritis, PTSD, cardiovascular disease, anxiety, antibiotic-resistant infections, multiple sclerosis, and schizophrenia.
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Academic research centers in the United States and elsewhere are currently studying the effects of CBD therapy on many health conditions, including the ones mentioned above. Scientists refer to CBD as a sort of all-encompassing compound because it confers therapeutic benefits in many different ways while tapping into how we function physiologically and biologically on a deep level. Extensive pre-clinical research and some clinical studies have shown that CBD has strong antioxidant, anti-inflammatory, anticonvulsant, antidepressant, antipsychotic, antitumoral, and neuroprotective qualities.
In addition, cannabidiol has been shown to have the ability to change gene expression and remove beta-amyloid plaque, the hallmark of Alzheimer’s disease, from damaged brain cells.
CBD or THC - Which One Is Better
THC (the psychoactive component of cannabis) and CBD are the power-couple of cannabis therapeutics. They can work separately though they also work well together. CBD and THC interact synergistically to potentiate each others' curative qualities.
CBD enhances THC’s pain-killing and anticancer properties while lessening its psychoactivity. CBD can also mitigate adverse effects caused by too much THC, such as anxiety, paranoia, and increased heart rate.
When both compounds are present in sufficient amounts in the same cannabis strain or product, CBD will lower the ceiling on the THC high while prolonging its duration.
“Relaxing, but not intoxicating” is how one person described CBD-rich cannabis anecdotally.
CBD broadens the range of conditions potentially treatable with cannabis such as liver, cardiovascular and metabolic disorders which may be less responsive to THC-dominant strains. Plus, CBD and THC both apparently stimulate neurogenesis which is the creation of new brain cells.
From a legal standpoint, CBD has a broader range of applications because it is purportedly and currently legal in all 50 states and more than 45 countries worldwide. Because THC produces psychological effects, it is classified as illegal at the federal level of the U.S. State laws vary, so, if you choose to use a product with both THC and CBD be sure to make sure it is legal in your area. Generally speaking, in most states that have legalized marijuana (medicinally and/or recreationally) CBD products containing THC will generally be legal as well.
CBD also has the advantage in that it is not psychoactive yet still offers numerous healing properties. This means it is not hindering in one’s daily tasks and day-to-day activities.
What’s the Best Way to Take CBD?
There is no one-size-fits-all when it comes to the administration of CBD. This is because everyone is different and everyone metabolizes the nutrients differently. So what works for one person may not be the best for another. CBD-rich cannabis strains for smoking and/or vaping are available in many medical marijuana dispensaries. However, many CBD patients prefer non-inhalable products made with cannabis oil concentrates.
There are a wide variety of CBD products on the market. Products range from tinctures to vaporizer oils, to topical balms. In addition, these products are often available in different concentrations. The time of onset and duration of effect vary depending on the method of administration and body type.
CBD products can be taken sublingually, orally or applied topically. The inhalation of CBD vaporizer oils is apparently good for treating acute symptoms that require immediate attention as the effects can typically be felt within a minute or two and typically last for a couple of hours or more. The effects of orally administered CBD-rich cannabis oil can last for up to four hours or more but the onset of effects is much slower (30-90 minutes) than with inhalation.
Can CBD Assist with Epilepsy?
Marijuana has a rich history as a medicine for quelling seizures and convulsions going back over thousands of years. In the mid-19th century, the U.S. Pharmacopoeia listed cannabis tincture as a treatment for pediatric epilepsy. Also, subsequent scientific studies have documented the anticonvulsant effects of CBD, THC, and whole-plant cannabis. CBD-dominant/low-THC cannabis strains and oil extracts have appeared to have facilitated dramatic improvement in some children with intractable seizure disorders.
According to some studies, between 10 to 15 percent of children with severe epilepsy who are given CBD oil products experience a near-complete cessation of seizures. At the very least, most children improve with a significant decrease if not total elimination of seizures. Many parents of epileptic children have learned through trial and error that augmenting CBD-rich oil by adding some THC—or better yet, THCA (the unheated, non-psychoactive form of THC that’s present in raw cannabis flowers and leave) helps with seizure control.
What is the Right CBD: THC Ratio for Me?
CBD therapy is a highly personalized medicinal practice. This means there is no single ratio, strain or product that’s right for everyone. Optimize your therapeutic use of cannabis by finding the optimal combination of CBD and THC that works best for you.
A person’s sensitivity to THC is a key factor in determining the appropriate ratio and dosage of CBD therapies. Many people enjoy the cannabis “high” and can consume reasonable amounts of any cannabis product without feeling too impaired or dysphoric. Others find THC unpleasant. Though CBD can lessen or potentially neutralize the intoxicating effects of THC, some people opt for CBD products with little-to-no THC at all.
In general, a greater ratio of CBD to THC means less of a “high.” In some states with legalized medical and/or recreational marijuana available, cannabis oil concentrates and other products with varying ratios of CBD/THC are available so that users can adjust or minimize psychoactive effects to suit their own needs and sensitivities. And again: those who don’t like THC have the option of healing without that “high” by using a CBD infused substance with little-to-no THC measurable.
While not intoxicating, in some cases CBD substances with low amounts of THC are not always the most effective treatment options available. In essence, the goal is to administer consistent, measurable doses of a CBD therapy that includes as much or as little THC as a person is comfortable with.
Are Specific CBD: THC Ratios Better for Different Conditions?
Through extensive research and numerous clinical studies, some patterns are beginning to emerge. For example: with anxiety, depression, spasms, psychosis, and seizure disorders, many people report they do well with small doses of CBD therapy with little to no THC in the mix. With cancerous conditions, autism, and many other diseases some say that they benefit more from a balanced ratio of CBD and THC. Additionally, many clinical trials have shown that a 1:1 CBD:THC ratio can be effective for neuropathic pain.
RELATED: How CBD Can Assist with Depression
In addition, some people report using CBD products with different CBD: THC ratios at different times of the day. For example, some people prefer a higher THC content during the day and higher CBD content at night. Plus, virtually any cannabis strain or CBD product could potentially benefit a wide range of autoimmune and inflammatory disorders because of the way CBD and THC interact within the body.
CBD and THC work within a widespread regulatory system called the endocannabinoid system (ECS). The ECS is comprised of a multitude of receptors, located throughout all of the human body. CBD and THC primarily interact with two receptors: CB1 and CB2. CB1 receptors are primarily located in the brain and nervous system, and CB2 receptors primarily in the immune system.
Because CBD and THC interact with the CB2 receptors within the immune system, CBD therapy is a promising new therapy for numerous autoimmune and inflammatory disorders.
Note: The CBD:THC ratio is not an indication of how much CBD or THC is present in a given cannabis product or strain.
What is the Optimal Dosage of CBD?
Similar to administration, there is no one-size-fits-all for dosage either. An effective dosage can range from as little as a few milligrams of CBD per day to several hundred milligrams or more. It’s always recommended to start with a small dose, especially if you have little to no experience with cannabis or CBD extracts. Additionally, with many CBD products it’s recommended to take two smaller doses each day, rather than one large dose at any given time.
Experiment by using the same dose and ratio for several days. Observe the effects and, if necessary, adjust the ratio or amount. Be aware that cannabis compounds such as CBD have biphasic properties, which means that low and high doses of the same substance can produce different (and sometimes even opposite) effects.
For example, small doses of cannabis tend to stimulate systems while large doses produce a sedative effect. While not lethal, too much THC can amplify anxiety and mood disorders. CBD has no known adverse side effects, but an excessive amount of CBD could be less effective therapeutically than a moderate dose. Less-is-more is often the case with respect to initial CBD therapy processes.
How do I Choose a Quality CBD Product?
Look for products with clear labels showing the quantity and ratio of CBD and THC (if any) per suggested dose, a manufacturing date, and a batch number (for production quality control). Select products with quality ingredients (no corn syrup, trans-fats, GMOs, artificial additives, thinning agents or preservatives). For best results, CBD products should be lab-tested for consistency and verified as being free of mold, bacteria, pesticides, solvent residues, and other contaminants. PLUS, always choose organic.
It is also best to avoid products extracted with toxic solvents like BHO, propane, hexane or other hydrocarbons. Look for products that utilize safer production methods such as CO2 extraction.
As mentioned above, you should always purchase organic CBD products. This is because cannabis is an incredibly efficient bioaccumulator. This means it absorbs everything in the soil around it, nutrients and chemicals alike. Therefore, if chemicals such as herbicides and pesticides are used in the growing process, they are likely to end up in the final product as well.
Keep in mind that the CBD market is largely unregulated so it’s important to do your homework before purchasing and/or consuming any CBD products. For example, the FDA has tested dozens of so-called “CBD hemp oil” products and found that in many cases these products contained little-to-no CBD at all.
RELATED: How To Choose A High-Quality CBD Oil
Full-Spectrum CBD vs. CBD Isolates
Single-molecule CBD will (almost inevitably) become a federally-approved Big Pharma medicine. Products infused with a crystalline CBD isolate, derived and extensively refined from industrial hemp, are already being marketed by unregulated internet storefronts. But single-molecule CBD is less effective therapeutically than whole-plant CBD extract.
Scientific studies have established that synthetic, single-molecule CBD has a very narrow therapeutic window and requires a precise high dosage for efficacy. On the other hand, lower dosage whole-plant CBD treatment regimens are now reportedly showing efficacy for alleviating the symptoms of many conditions among patients with various health conditions.
Whether synthesized in a Big Pharma lab or derived from industrial hemp, single-molecule CBD lacks critical secondary cannabinoids and other medicinal compounds found in high-resin, organically produced cannabis strains. These compounds interact with CBD and THC to enhance their therapeutic benefits. Scientists call this the entourage effect. Overall, the whole phytochemical structure seems to be a better choice than merely a few bits of it produced in a lab.
Numerous cannabis compounds have medicinal attributes, but the therapeutic impact of the whole-plant extract is apparently greater than the sum of its parts.
Hemp-Derived CBD vs. Marijuana-Derived CBD
At a molecular level, the difference between hemp-derived CBD and marijuana-derived CBD is virtually nonexistent. However, currently, the final products made with well-extracted CBD differ in THC and CBD concentrations, as well as in legality to make a difference.
As mentioned previously, hemp-derived CBD is legal in all 50 states because it typically contains very little or no THC. This is because well-cultivated hemp plants are often very low in THC, yet high in CBD.
On the other hand, marijuana plants typically contain much higher levels of THC. This means that CBD products made with marijuana-derived CBD will often have a larger concentration of THC as well. These products are not legal in all 50 of the United States of America and typically are only legal in states with legalized medical and/or recreational cannabis laws on the books.
Are CBD Vaporizer Oils Safe?
Many marijuana and hemp-derived CBD vaporizer oil products include thinning agents which dilute the oil that is heated and inhaled by vape-pen users. Beware of vaporizer oils that contain harmful ingredients such as propylene glycol. When overheated, this chemical additive produces formaldehyde (which is a carcinogen) as a byproduct according to a 2015 report published in the New England Journal of Medicine.
Why do so many vape oil products contain this thinning agent? The answer is simply because it is the cheapest option. And for many CBD companies: money is the only objective. When this happens (and it does... more than we can know) quality is compromised.
Instead, look for a vaporizer oil that is free from any additives and uses a healthier base such as vegetable glycerin.
Does CBD Have any Side Effects or Negatively Interact with any Drugs?
CBD is considered a very safe substance by many health professionals. However, patients taking other medications should still check with their doctor about potential pharmaceutical drug interactions. Although relatively non-serious, mild interactions have occurred but are only typically observed when an individual is concurrently consuming incredibly high doses of CBD on a consistent basis in addition to prescribed pharmaceutical therapies.
The most common interaction so far is with cytochrome P450 enzymes. At high dosages, CBD can temporarily deactivate cytochrome P450 enzymes, thereby altering how the human body metabolizes a wide range of compounds including THC. Interestingly, Cytochrome P450 enzymes apparently metabolize more than 60 percent of Big Pharma medications.
The way CBD interacts with these enzymes is similar to that of how grapefruit interacts with some medications. However, CBD is a more potent inhibitor of cytochrome P450 than the grapefruit compound Bergapten. If you’re unsure about your medications, you can simply ask your doctor if grapefruit interacts with your medication. If grapefruit does, then CBD probably does as well. Patients on a CBD-rich treatment regimen should monitor changes in blood levels of prescription medications and, if need be, adjust dosage.
Will Big Pharmaceutical Companies Control the CBD Market when Cannabis is Legalized?
Only if we let them. Cannabis/hemp is a medicinal plant and it should be regulated as such, and not as a pharmaceutical or a street drug.