CBD User Guide
CBD, short for cannabidiol, is currently one of the most popular trends in health and wellness. There has been plenty of anecdotal evidence of CBD being used to successfully treat a variety of ailments (1). There have also been preliminary research studies showing evidence that CBD may be useful in treating anxiety (2), psychosis (3), epilepsy (4), and physical pain (5), to name a few. Whether one is curious about trying CBD or has tried it before and wants more information, this guide should provide a well-rounded overview of CBD. There are many ways to consume CBD, and it can understandably be overwhelming when choosing a preferred method of consumption.
Choosing A CBD Consumption Method
CBD oil is one of the most common forms of consumable CBD. So what is CBD oil exactly?
To make CBD oil, cannabidiol is extracted from the hemp plant and then infused with a carrier oil like hemp seed oil or MCT, which is extracted from coconut oil (6). Some may confuse CBD oil with hemp oil (also referred to as hemp seed oil), but they are not the same thing. The main difference between hemp oil and CBD oil is which part of the cannabis plant they come from. CBD is found in the leaves, flowers and stalks of hemp plants. Hemp oil is made from the seeds of the hemp plant, which contain no CBD, but are often used for hair and skin health. (7) Both CBD oil and hemp oil contain less than 0.3% THC, which is the cannabinoid with psychoactive effects (8).
CBD oil is consumed sublingually by using a dropper to place it under the tongue. The dropper allows for a fairly precise dosage, and also allows one to experiment with dose amounts. Taking CBD sublingually ensures one absorbs more CBD than one would with edibles, and the effects are fast acting (9). Unfortunately the dropper will not provide quite as accurate of a dose as something like a capsule will. One other drawback is that some users do not like the taste of natural CBD oils, but there are various flavor options available on the market.
The onset time and duration of the CBD effects will differ depending on various factors, but typically it takes up to 45 minutes minutes for sublingual CBD to kick in, and it lasts for 2-6 hours (15).
CBD tinctures are similar to CBD oil, but differ in the ingredients and the way they are made. CBD oil is made by extracting CBD from the hemp plant using CO2 and infusing it with a carrier oil, such as MCT. That means the only two ingredients in CBD oil are CBD and oil. Tinctures are typically made by soaking the cannabis in alcohol, or a combination of alcohol and water. Alcohol is used to break down and extract the CBD, and then additional ingredients are often added such as terpenes or other cannabinoids. Many commercially sold tinctures do not contain alcohol, but the extra ingredients still classify them as tinctures (12).
As with CBD oil, tinctures are consumed sublingually, which provides fast acting effects and even higher bioavailability than oil. Another benefit of tinctures is that they often have a better flavor than oil (12). The drawback is that they can contain alcohol, so anyone with an aversion to alcohol should not consume tinctures.
CBD can be consumed in the form of food just like THC edibles. CBD treats can either be cooked at home by adding CBD oil to whatever is being made, or be purchased pre-made. If cooking with CBD flower, it will need to be decarboxylated and infused with fat just like THC edibles. The easier method would be to simply add a few drops of CBD oil to a smoothie, salad dressing, or any other edible item.
If cooking is too nerve wracking or time consuming, one can also purchase edibles. One of the most popular CBD edible options are CBD gummies, but CBD chocolate bars, cookies, drinks, and many more products are also available.
CBD edibles are easy to consume anywhere, and can be a tasty option. One drawback to edibles is that they get partially broken down in the digestive system, and by the time they are absorbed, the user only receives 20-30% of the CBD they ingested (13).
It can take up to two hours for the effects of edibles to set in, since they must pass through the digestive system, and they last anywhere from four to eight hours (14, 15, 16). Both of these times vary per consumer and are affected by height, weight, activity, and other things consumed that day. With edibles, the CBD continues to release slowly over an extended period of time and can last for six to eight (16).
CBD creams are another option for consumption. They are made by extracting CBD oil and then infusing it with other healing ingredients like essential oils. Topicals are absorbed into the top layer of the skin, as opposed to being transdermal and infusing into the bloodstream.
Many people use CBD for rheumatoid arthritis, joint and muscle soreness (17), and chronic pain (18). As with other forms of CBD and THC, there still is not enough substantial evidence to prove these products work, however, it is easy to see why they might. CBD has the ability to increase natural endocannabinoids and desensitize pain receptors (18).
Exercise and strength training create micro-tears in muscles, and the body will feel sore until the immune cells repair the tissue. CBD is thought to limit some of the body’s inflammatory signals, helping with muscle pain but not restricting the body’s healing process.
An additional way that CBD is thought to help physical pain is through TrpV1 receptors (18). These are receptors in the body that when activated, produce heat to soothe pain (20). CBD activates these receptors, creating heat to address pain.
Topicals are best used for joint or muscular pain because they can be applied directly to the problem area. It can take 20-60 minutes for the effects to kick in (14,15), and they tend to last 2-5 hours (11,14), but vary considerably in both onset time and duration per consumer (16).
Smoking and Vaping
Just like cannabis containing THC, CBD flower can be smoked. Any of the regular cannabis smoking methods may be used such as a pipe, water pipe, or joint.
Vaping is similar to smoking in that the CBD is inhaled, but instead of flower, vape pens heat up CBD oil concentrate which is then vaporized and inhaled. Depending on how long and deep the inhalation is, the body will absorb 10-60% of the CBD. (13, 21).
Smoking and vaping are the fastest acting and most bioavailable methods of consumption. The CBD enters the lungs and then goes into the bloodstream, skipping the digestive system (11). It will only take a few minutes to feel the effects, up to 10 minutes at the most (14, 16). If one is trying to quit smoking nicotine, smoking or vaping CBD can be a great alternative with fewer health risks (22). Effects from these methods tend to last around 2-4 hours (11, 16).
Be aware of the health risks that come with smoking or vaping anything, such as lung injury (24).
CBD capsules or CBD softgels are pill capsules filled with CBD extract. When a capsule is consumed, CBD goes through the digestive system and ends up in the liver to be metabolized (25). Unfortunately, by the time CBD reaches the bloodstream, the concentration of compounds are reduced. This means that consuming CBD in the form of capsules has low bioavailability, roughly 13-19% (26).
A major benefit of capsules is the pre-measured dose. Capsules are also easy to bring and consume anywhere. The onset time and duration are the same as edibles; the CBD will take at least 60 minutes to take effect, depending on what else was consumed that day. It will also last 4 hours or more, slowly continuing to release throughout the day (14).What to look for in a CBD product Full Spectrum vs. Broad Spectrum
Some terms that will appear when exploring CBD products are full spectrum or broad spectrum, so users should be aware of the difference between full and broad spectrum CBD.
As we know, the cannabis plant contains many cannabinoids, two of which are CBD and THC. Full Spectrum CBD contains all of the cannabinoids, including THC. It has been reported that this type of CBD relieves pain better by interacting with the THC, but not everyone can legally consume THC or wants the psychoactive effects (10). Broad Spectrum CBD contains all cannabinoids except THC. Any THC is removed, making these products legal in the U.S. (28).
Quality CBD products will specify which CBD spectrum was used, or the THC to CBD ratio of the product.
When it comes to cannabis products, one of the most important things to look at is the ingredients. Depending on the type of product, one should make sure that it only has CBD (and THC if that is okay) and other natural additives.
Quality CBD products go through third-party lab tests to ensure their quality and confirm the exact amounts of ingredients. Since CBD isn’t currently regulated by the FDA, this is the best way to ensure that the products consumed are safe and contain what they claim to. Lab testing provides customers with an unbiased scientific analysis of cannabinoid profiles, meaning which cannabinoids and how much are in the product (29).
Where and when was it grown
Look for CBD products that are U.S. grown. This ensures that it falls under strict U.S. guidelines and agricultural regulations (30).
It is also important to check when the product was manufactured and when it expires.
Determining CBD dosage differs per person, and will take some trial and error. Obviously it is better to start small and increase from there, which could mean starting with 20 or 40 mg a day (23). Try and keep track of how much CBD is taken and what effects are felt, to determine if that dosage is right for the user. Do not ramp it up too quickly, because small doses of cannabis tend to provide stimulation while too much can cause sedation (11). Dosage will differ per consumption method.
CBD capsules or gummies are the easiest forms of CBD to track dosage. Generally each individual capsule or gummy is one dosage, but be sure to read the bottle for dose instructions.
Smoking or vaping is another easy method to monitor dosage. Because inhaling CBD is so fast acting, the effects (or lack of effects) should be felt within minutes. Try waiting 20 minutes just to be safe, and if no effects are felt, take another puff.
CBD edibles can be a little tricky to dose, but if the edible was purchased, the amount of CBD and/or THC will be on the label. If the edibles were made at home, be careful. The tricky aspect of dosing edibles is that they are slow acting, so the user will not know for up to a few hours. Many people have made the mistake of assuming it did not work and consuming more, but it is best to wait a few hours and determine whether the effects are felt.
For CBD cream, it is important to rub a very small amount on the skin to start. 24 hours should be enough time to check for a rash or other negative reaction. Once the user can confirm no adverse effects, they can apply more to the skin. More can always be added so starting with a small dose is best.
CBD oils and tinctures will list the amount of CBD in milligrams on the bottle, but will probably not list the amount per drop. One will need to look at the amount of total CBD in milligrams on the bottle and do the math. If a 20 milliliter bottle of CBD oil contains 400 drops, and the label says there are 2000 milligrams of CBD total, that means each drop contains 5 milligrams. Again, a nice low dosage to start with is 20 milligrams, so in this scenario the user would take 4 drops. A drop is literally that – just one drop – not the entire dropper.
The entourage effect is a common phrase used in relation to CBD products. As mentioned earlier, CBD and THC are two cannabinoids found within the cannabis plant. There are also many other cannabinoids, and they may support the effects of the main two. It is theorized that different combinations of these cannabinoids produce different effects. The entourage effect is based on a very small amount of research and mostly anecdotal evidence, but some preliminary research has shown that CBD may be more effective when taken in combination with THC (10). Terpenes are aromatic oils that are secreted from the same glands as CBD and THC. These are what give certain strains of cannabis particular looks, odors, and tastes (19). Terpenes may also be involved in producing entourage effects.
Are there any side effects of CBD?
While there are no reported long-term side effects of consuming CBD, one thing to be aware of is mixing medications. If on medication, talk to a doctor about the combination of substances and make sure it is safe. Other than that, reported side effects have included change in appetite, change in weight, diarrhea, drowsiness or fatigue, and mood change (27).
- Velasquez-Manoff, M. (2019, May 14). Can CBD really do all that? The New York Times Magazine. Retrieved from https://www.nytimes.com/interactive/2019/05/14/magazine/cbd-cannabis-cure.html
- Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1
- Zuardi A.W., Crippa J.A., Hallak J.E., Bhattacharyya S., Atakan Z., Martin-Santos R., McGuire P.K., & Guimarães F.S. (2012). A critical review of the antipsychotic effects of cannabidiol: 30 years of a translational investigation. Current pharmaceutical design, 18(32), 5131-40. DOI: 10.2174/138161212802884681
- U.S. Food and Drug Administration. (2018, June 25). FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy [Press Release]. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
- Reiman, A., Welty, M., & Solomon, P. (2017). Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report. Cannabis and Cannabinoid Research, 2(1), 160-166. http://doi.org/10.1089/can.2017.0012
- Team Bloom. (2020, March 29). What is the Best Carrier Oil for CBD? The 7 Best CBD Carrier Oils. Bloom. Retrieved from https://bloomhemp.com/blog/what-is-the-best-carrier-oil-for-cbd-the-7-best-cbd-carrier-oils/
- Callaway J., Schwab U., Harvima I., Halonen P., Mykkänen O., Hyvönen P., & Järvinen T. (2005). Efficacy of dietary hempseed oil in patients with atopic dermatitis. The Journal of Dermatological Treatment. 16(2), 87-94. DOI: 10.1080/09546630510035832
- Johnson, R. (2019). Defining Hemp: A Fact Sheet. Congressional Research Service. R44742, Version 7. Retrieved from https://fas.org/sgp/crs/misc/R44742.pdf
- Narang, N., Sharma, J. (2011). Sublingual mucosa as a route for systemic drug delivery. International Journal of Pharmacy and Pharmaceutical Sciences, 3, 18-22. Retrieved from https://innovareacademics.in/journal/ijpps/Vol3Suppl2/1092.pdf
- Russo, E. B. (2011). Taming THC: Potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364. https://doi.org/10.1111/j.1476-5381.2011.01238.x
- Project CBD. (2019). CBD User’s Guide. Project CBD. Retrieved from https://www.projectcbd.org/how-to/cbd-users-guide
- Price, S. (2020, January 20). CBD oil vs CBD tincture: what’s the difference? Health Europa, Medical Cannabis Network. Retrieved from https://www.healtheuropa.eu/cbd-oil-vs-cbd-tincture-whats-the-difference/96708/
- Bruni, N., Della Pepa, C., Oliaro-Bosso, S., Pessione, E., Gastaldi, D., & Dosio, F. (2018). Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules, 23(10), 2478. https://doi.org/10.3390/molecules23102478
- Barach, P. (2019). The different ways to consumer CBD – Which one is right for you? Green Flower. Retrieved from https://www.green-flower.com/articles/cbd/CBD-consumption-methods
- Santos-Longhurst, A. (2019). How much CBD should I take the first time? Healthline. Retrieved from https://www.healthline.com/health/how-much-cbd-should-i-take-the-first-time
- MacCallum, C. A., Russo, E. B. (2018, January 4). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12-19. DOI: https://doi.org/10.1016/j.ejim.2018.01.004
- Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European journal of pain, 20(6), 936–948. https://doi.org/10.1002/ejp.818
- Vukovi S, Srebro D, Vujovi KS, Vueti and Prostran M (2018) Cannabinoids and Pain: New Insights From Old Molecules. Frontiers in Pharmacology, 9, 1259. DOI: 10.3389/fphar.2018.01259
- Rahn, B. (2014). What are cannabis terpenes and what do they do? Leafly. Retrieved from https://www.leafly.com/news/cannabis-101/terpenes-the-flavors-of-cannabis-aromatherapy
- Walder, R. Y., Radhakrishnan, R., Loo, L., Rasmussen, L. A., Mohapatra, D. P., Wilson, S. P., & Sluka, K. A. (2012). TRPV1 is important for mechanical and heat sensitivity in uninjured animals and development of heat hypersensitivity after muscle inflammation. Pain, 153(8), 1664–1672. https://doi.org/10.1016/j.pain.2012.04.034
- Huestis M. A. (2007). Human cannabinoid pharmacokinetics. Chemistry & biodiversity, 4(8), 1770–1804. https://doi.org/10.1002/cbdv.200790152
- Abrams, D., Vizoso, H. P., Shade, S. B., Jay, C., Kelly, M. E., & Benowitz, N. L. (2007). Vaporization as a Smokeless Cannabis Delivery System: A Pilot Study. Clinical Pharmacology & Therapeutics, 82(5), 572-578. https://doi.org/10.1038/sj.clpt.6100200
- Ferguson, S. (2019). CBD dosage: Figuring out how much to take. Healthline. Retrieved from https://www.healthline.com/health/cbd-dosage
- CDC. (2020, February 25). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
- Arnone, V. (2020). Methods of ingesting CBD: Optimizing bioavailability & effectiveness. Big Sky Botanicals. Retrieved from https://bigskybotanicals.com/blog/cbd-methods-of-ingestion-bioavailability-effectiveness/
- Mechoulam, R., Parker, L. A., Gallily, R. (2002). Cannabidiol: an overview of some pharmacological aspects. The Journal of Clinical Pharmacology, 42(S1), 11-19. https://doi.org/10.1002/j.1552-4604.2002.tb05998.x
- U.S. Food and Drug Administration. (2020). What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. United States Government. Retrieved from https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
- Jordan, D. (2019). CBD edibles: What are they and what’s to know? Leafly. Retrieved from https://www.leafly.com/news/cannabis-101/cbd-edibles-what-are-they-and-whats-to-know
- Cooke, J. (2019 November). How CBD third-party testing works and why it’s important. Daily CBD. Retrieved from https://dailycbd.com/en/third-party-testing/
- Hudak, J. (2018). The farm bill, hemp legalization and the status of CBD: An explainer. Brookings. Retrieved from https://www.brookings.edu/blog/fixgov/2018/12/14/the-farm-bill-hemp-and-cbd-explainer/