September 28, 2020 7 min read

Since CBD has gained its legal status, questions about how it works and whether it's safe have been buzzing around the wellness communities.

In a perfect world, we’d say that all CBD manufacturers hold consumer safety as their number one priority, but that isn’t always the case. In fact, there are great disparities between brands, so the safety of CBD products isn’t that cut and dry.

But let’s assume you find the best, highest-quality products out there. Is CBD safe when it’s made well?

How about if you take it every day? And how do you choose high-quality, safe CBD products when the industry is full of cheap, muddled products?

All great questions! Here’s what we know:

Table of Contents
Is CBD Addictive
CBD Side Effects and Safety Research
Does CBD Harm Your Liver?
CBD Drug Interactions
Low Quality CBD Products May Pose Risks
Resources

Key Takeaways

Generally, CBD is regarded as having a solid safety profile and low-risk for adverse effects.

Just as research regarding the use of CBD is still underway, research efforts regarding safety and potential side effects are still expected to grow.

Unlike THC, CBD will not get you high and does not pose a significant risk for addiction.

Still, CBD will affect every person differently, and some mild side effects are possible. Commonly reported side effects include diarrhea, weight and appetite changes, tiredness, and headaches.

Significant side effects from CBD may not be caused by CBD itself, but by drug interactions between CBD and your regular medications. CBD could cause some medications to be less effective and the two may not need to be taken at the same time.

The most significant risk associated with CBD may come from low-quality CBD formulations. Consumers can decrease this risk significantly by looking for clean products made from high-quality ingredients that are backed by third-party lab tests.

Ultimately, CBD’s good safety profile has been confirmed by various sources, but risks always apply to changes in your wellness routine. Talk to your doctor to see if CBD is a good choice for you.

Public Health Risks—Is CBD Addictive?

The World Health Organization published a report on CBD in 2017, which referred to CBD as “generally well tolerated with a good safety profile.” The leading health organization also suggested that adverse effects may be “a result of drug-drug interactions between CBD and patients’ existing medications.”

In other words, CBD is considered to have little to no public safety risks. Although it’s “good safety profile” definitely came into play when this judgement was made, other factors likely reduce CBD’s public safety risks compared to THC, the ever-popular, psychoactive cannabinoid found in cannabis.

Simply put, CBD doesn’t cause a “high.” That means it poses less risks for drug-induced accidents, like accidents that could be caused by driving while intoxicated.

Because of its lack of psychoactive effects, it’s thought that CBD has no risk for addiction. In fact, one 2017 study looked at the abuse potential of CBD and found that it may have no greater addiction-forming potential than the placebo.

Some experts even suggest that CBD has potential as a treatment for substance abuse, though research in this field is only preliminary.

In 2015, a systemic review of 14 clinical studies regarding CBD’s potential for managing substance abuse concluded that “CBD may have therapeutic properties on opioid, cocaine, and psychostimulant addiction, and some preliminary data suggest that it may be beneficial in cannabis and tobacco addiction in humans.”

Many researchers are even working to establish CBD as an alternative to highly addictive prescriptions, like opioids, which are responsible for the opioid epidemic that kills tens of thousands of people every year.

Some research suggests that CBD may help manage pain that is difficult to treat, and experts are hopeful that CBD can eventually be established as an alternative to risky opioids.

Although CBD has been repeatedly established as safe for the public and may even have benefits that will make it a useful tool against public health issues in the future, there are still some safety concerns to consider when looking for CBD to add to your daily routine.

CBD Side Effects And Safety Research

A doctor showing hemp flower to a patient.

CBD has been labeled “safe” in general, but any change to your wellness routine can pose risks, and all substances (including foods and water) may come with potential side effects, especially if you have allergies or overindulge.

Before you start taking CBD, you should make yourself familiar with any potential side effects linked to cannabinoid-based supplements.

To date, only a few studies have evaluated CBD’s safety profile and side effects in depth, but the results are similar. CBD is usually described as “well-tolerated” by humans and animals, and potential side effects are described as “rare” and “mild.”

One study looked at patients using CBD for epilepsy and psychiatric disorders. It concluded that the most common side effects may be “tiredness, diarrhea, and changes of appetite/weight.” The study also suggested that CBD may have a better side effect profile than the medications commonly used to treat these medical conditions.

A 2011 study found that CBD may have a better safety profile than THC and many other cannabinoids. In this study, high doses of up to 1,500mg of CBD per day were given to human subjects. Even at high doses, CBD was described as “well tolerated” and compared to THC, CBD did not alter blood pressure, body temperature, heart rate, or motor and psychological functions of participants. 

When observing anecdotal reports of CBD use, the commentary is overwhelmingly positive. The most common complaint is that CBD caused headaches, though some experts suggest that adverse effects are often dose dependent.

In other words, those that are experiencing adverse reactions to CBD may be taking too much.

It's important to note, however, that the endocannabinoid system is complex and differs greatly from person to person.

Just like with all dietary supplements and medications, the impact CBD has on each person will be unique. It’s important to talk to your doctor before making changes to your wellness routine, and always contact your doctor if you experience adverse reactions to any supplement, including CBD.

Does CBD Harm Your Liver?

A recent study about CBD toxicity in mice revealed that CBD may have a negative impact on the liver, which sparked some scrutiny within the wellness community.

However, this research isn’t as cut and dry as many like to believe. The study, which was performed on 8 week old mice, evaluated the effects of different doses of CBD, including incredibly high doses. The maximum threshold was modeled after the maximum recommended dose for Epidiolex, a CBD-based medication designed to treat a rare seizure disorder.

While the study did confirm signs of liver swelling at these high doses, it’s important to note that doses this high (the human equivalent of over 1,300mg per day for a person weighing 150lbs) surpass the amount usually needed for therapeutic use of CBD. Common daily doses usually fall between 10mg and 100mg, depending on the person and condition treated.

As you may already know, most medications (like ibuprofen, for instance) can have negative effects on the liver at high doses. In general, experts agree that when taken in small, therapeutic doses, CBD is generally safe, and much more research is needed to understand the impact of high-dose CBD on the liver.

CBD Drug Interactions

A bottle of prescription medicine that may interact with CBD.

As we noted earlier, the World Health Organization suggests that adverse effects from CBD may be caused by drug interactions. In the case of CBD-drug interactions, CBD may not be causing adverse effects by itself, rather it may make your regular medications less effective so that the symptoms the medication was prescribed for return.

If you’re taking medications that manage life-threatening symptoms, CBD-drug interactions could be serious.

The reason behind CBD’s drug interaction is complex, but to put it simply, CBD products should have a “grapefruit warning.”

The “grapefruit warning” is the warning label on many medications that says “Do not consume this medication with grapefruit juice.”

It may sound like a silly thing to put on a medication bottle, but it’s actually not. Grapefruit (and CBD) is metabolized by the same liver enzymes (called cytochrome P450 enzymes) needed to break down many common medications.

When you consume one of these medications with grapefruit juice, many of the necessary enzymes may be used to process the juice instead of the medication. Some of the medication may pass through the body without being used as a result of low enzyme availability.

CBD works the same way. If you take CBD alongside other medications, it may reduce the number of enzymes available, which can reduce the absorption and efficacy of the medications.

Don’t worry, though! The liver enzymes regenerate naturally, and you don’t run out!

In many cases, putting space between your CBD dose and daily medications may help correct this issue. Still, you should consult your doctor before taking CBD, especially if you take daily medications.

Low Quality CBD Products May Pose Risks

The most inherent risk associated with CBD comes from consuming low-quality CBD products. Because the industry is still mostly unregulated, CBD manufacturers can sometimes offer low-quality, contaminated, or misleading products that may cause adverse reactions.

In fact, the FDA sent warning letters to many CBD companies that were making false claims. Other reports claim to have found a dangerous street drug, commonly called “spice” or “K2”, in some less-than-trustworthy “CBD products.”

As a CBD consumer, it’s your responsibility to ensure that you choose high-quality CBD products from trustworthy sources.

Luckily, many CBD brands understand the need for transparency, and the practice of third-party lab testing has been adopted by the best CBD manufacturers.

These tests, which need to be performed by a third-party lab to ensure they aren’t biased or fraudulent, are used to help consumers identify the CBD content of different products. The most through tests provide a full analysis that looks for contaminants, too.

If you can’t find lab tests for a product, or the company refuses to send you the Certificate of Analysis from their lab tests, that’s a good sign that their CBD may not be what they claim.

Resources

  1. “CANNABIDIOL (CBD) Pre-Review Report” https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf
  2. “Oral cannabidiol does not produce a signal for abuse liability in frequent marijuana smokers” https://pubmed.ncbi.nlm.nih.gov/28088032/
  3. “Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444130/
  4. “Safety and side effects of cannabidiol, a Cannabis sativa constituent” https://pubmed.ncbi.nlm.nih.gov/22129319/
  5. “Hepatotoxicity of a Cannabidiol-Rich Cannabis Extract in the Mouse Model” https://www.mdpi.com/1420-3049/24/9/1694/htm
  6. “Dangerous street drugs found in some CBD products” https://www.mercurynews.com/2019/09/16/dangerous-street-drugs-found-in-some-cbd-products/

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