Today, there are at least 29 states with some form of legal access to medical marijuana and a further 17 states with specific access to cannabidiol (CBD) products. Despite this new wave of acceptance, cannabis-based products are still a novel therapy for most people. 
When you start digging into it, the world of cannabinoids begins to seem complicated. Cannabinoids, marijuana, cannabidiol...are they all the same? What are the side effects of CBD or of tetrahydrocannabinol (THC)? Is one compound equally as safe as another? Everyone says CBD is safe but is it really?
We are here to help clarify the finer details of CBD oil’s safety profile for prospective users.
Is CBD Oil Dangerous?
The short answer, at least according to the research so far, and thousands of anecdotes from users, is that CBD has an excellent safety profile. In a recent, thorough review of the literature, An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies, the authors confirmed that “the often described, favorable safety profile of CBD in humans was confirmed and extended by the reviewed research.” So, this clarifies that CBD is safe, but it isn’t the full story on CBD tincture side effects.
According to this same review, the side effects of CBD are considered better than other drugs. The researchers state, “In comparison with other drugs, used for the treatment of these medical conditions [epilepsy and psychotic disorders], CBD has a better side effect profile.” They declare that even in the high doses administered in clinical trials, CBD seems well tolerated.
But that can’t be everything, right? Of course not. All substances, medicinal or not, can trigger mild, yet unwanted side effects. Don’t believe us? Consider that you can drink too much water too fast, and become ill with water intoxication. Everything we consume as humans have some risk of side effect.
The Real Side Effects of CBD Oil
The known side effects of CBD oil, when derived from hemp or low THC marijuana, are generally rare and the experience quite mild. Marijuana with higher THC is another story.
In the review mentioned, the authors discovered that when people did report negative side effects of CBD, the following was notable:
- Changes in appetite and weight
These side effects were experienced by a small percentage of participants, across a number of clinical trials for the newly-approved CBD epilepsy drug. The side effects of CBD are much different than those experienced from marijuana with a high THC content.
The psychoactive compound, THC, can trigger much more adverse side effects like anxiety, paranoia, heart and blood pressure issues, impaired mental functioning, hallucinations, and flashbacks in some users. This is usually when THC products are taken in high doses, or regularly and a lot. To date, there are no reports of CBD oil products triggering these types of problematic side effects.
What About Interactions With Other Drugs?
This is, strictly speaking, not a side effect, but rather a pharmacological characteristic of CBD that comes into play for people who take certain chronic medications.
From the Update on Safety and Side Effects of Cannabidiol, researchers note there are no studies on specifically CBD-drug interactions so far, and, considering CBD is often used as a co-therapy with pharmaceuticals, this is worthy of consideration. So far, understanding CBD pharmacology and the way it is metabolized have given rise to hypotheses and theories about its drug-drug interactions.
Let’s take a look at how CBD is metabolized in the liver, and how this affects the metabolism of some pharmaceuticals.
CBD seems to monopolize one of the enzymes in our liver responsible for metabolizing or processing drugs. This means that if taken concurrently with CBD, a number of drugs will have trouble breaking down as usual. In turn, this means you could suddenly have higher or lower levels in your body of any medication you take than you would without CBD.
Depending on how much CBD you take, this has implications for dosing, obviously. It could result in higher or lower levels of the pharmaceutical in your blood, which could increase its potency. Depending on the drug, this could be dangerous, but not necessarily.
If blood levels are monitored, doctors may be able to reduce the pharmaceutical’s dose appropriately. In many cases, it could mean a lower dose of the synthetic medicine, not a bad thing at all. More studies are needed to understand the full scope of CBD-drug interactions, though, and never attempt to take especially high-CBD products together with chronic medications without consulting with your doctor first.
A Brief Explanation of All Things Cannabis
Because cannabis terminology is still entering into mainstream consciousness, let's review the very basics.
The following terms are still applied quite loosely in popular culture, so don’t be surprised if you see marijuana oil labeled as cannabis oil or vice versa. The definitions below are more to form a general foundation for you.
Cannabis is a broad term used to describe the cannabis sativa species of plant. This broad definition takes all forms of the plant into account, including the types that make you high and the types that don’t.
Technically, both hemp and marijuana products come from the same species. All cannabis plants contain different combinations of compounds called cannabinoids and, in part, it's these combinations which help to differentiate between the subsets. 
For the purposes of this article, ‘marijuana’ refers to THC-heavy products. Medical or recreational marijuana is usually cultivated for high THC content and generally focused on big flower formation. It's this cannabinoid which is responsible for the ‘high’ or psychoactive effects marijuana is well known and demonized for.
Hemp products are easy to define because they are legal to grow in the U.S and are differentiated from marijuana because of its low THC content. To be legal, hemp must contain less than 0.3 percent THC. While hemp is conventionally grown for its stalks, seeds, and fibers, it is increasingly used for its non-psychoactive cannabinoids, especially CBD.
A Final Note On CBD Side Effects
So far, CBD has an excellent safety profile, with only mild side effects like tiredness and diarrhea, and then only in pretty high doses. That being said, there is more to learn about its possible interactions with other drugs and pharmaceuticals, and whether or not it is of benefit if taken concurrently. Until then, it would be advisable to work with your healthcare provider if you plan on using CBD as a co-therapy.