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CBD, short for cannabidiol, is a natural compound that comes from the Cannabis sativa plant. Unlike its well-known cousin THC, CBD does not produce a “high” and is not psychoactive. CBD interacts with the endocannabinoid system, which regulates several physiological processes, such as appetite, pain, and mood. Studies show that CBD may have a range of health benefits. These include pain relief, anxiety and depression, epilepsy, and neuroprotective properties. It is typically extracted from hemp plants and can be found in many of products, such as oils, tinctures, creams, and gummies. However, there are concerns about the lack of regulation, with inaccurate labeling and unsafe additives. It is important for consumers to do their research and choose reputable CBD products from trusted sources. Despite some controversy, it has gained popularity as a potential natural remedy for various health conditions. Ongoing research aims to explore its full potential. (1,2,3)

CBD Through the Ages

CBD, or cannabidiol, has a rich history dating back thousands of years. The use of cannabis plants for medicinal purposes exists all the way back to ancient China.  They used it for pain relief and as an anesthetic during surgery. Throughout history, cannabis has proven useful for various medical purposes.  Nonetheles, it wasn’t until the mid-20th century that researchers were able to isolate CBD from the plant.

In 1940, Dr. Roger Adams successfully isolated it for the first time, paving the way for further research on its potential health benefits. However, it wasn’t until the 1990s that scientists discovered the endocannabinoid system.  This led to a better understanding of how CBD interacts with the body. In recent years, the popularity of CBD has grown significantly.  Many people use it as a natural remedy for various health conditions. While there is still much to learn about it and its full potential, its rich history and increasing use indicate that it may have promising health benefits.

 The Positives of CBD Use

Pain Relief

CBD has shown promise in providing pain relief for a variety of conditions. It interacts with the body’s endocannabinoid system, which helps regulate pain, among other things. A study published in the European Journal of Pain found that CBD applied topically to rats with arthritis significantly reduced their pain and inflammation (4). Another study found that oral treatment significantly reduced chronic inflammatory and neuropathic pain in rodents (5). In humans, a review of multiple studies found that CBD was effective in treating chronic pain associated with multiple sclerosis and cancer, with minimal adverse effects (6). It also enhances the pain-relieving effects of opioids, which could potentially reduce the need for high doses.  Lower doses significantly lowers the risk of addiction (7). More research will help us more fully understand it’s effects on pain. These preliminary studies suggest that it may be a promising natural alternative to traditional pain medications.

Anxiety and Depression Management

CBD has also gained attention in recent years for its potential benefits in managing anxiety and depression. CBD is a non-psychoactive compound that comes from the cannabis plant.  It interacts with the body’s endocannabinoid system to promote balance and homeostasis. Studies have shown that it may help reduce symptoms of anxiety and depression.  It does this by increasing serotonin levels in the brain and regulating the release of cortisol, a stress hormone (8). One study found that it was effective in reducing anxiety in individuals with social anxiety disorder.  Another found that it was effective in reducing symptoms of depression in animals (9).

While more research will presumably help us more fully understand the effects of CBD on anxiety and depression, these preliminary studies suggest that it may be a promising natural alternative to traditional medications. As with any supplement or medication, it’s important to speak with a healthcare provider before starting CBD.  This is especially important as it may interact with other medications and have potential side effects.


CBD is effective in reducing seizures in patients with epilepsy.  Some studies reporting a significant decrease in seizure frequency by as much as 50% (10, 11). In fact, the FDA has approved a CBD-based drug called Epidiolex for the treatment of seizures associated with two rare forms of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome (12). Many experts believe CBC works by interacting with the body’s endocannabinoid system.  It reduces inflammation and regulate neuronal excitability, both of which can contribute to seizures (13). More research will likely help us more fully understand it’s potential for epilepsy.  These preliminary findings suggest that it may be a promising treatment option for those with treatment-resistant forms of the condition (14).

Neuroprotective Properties

CBD has also been the subject of extensive research in recent years due to its potential neuroprotective properties. Studies have shown that it may have a positive impact on various neurological conditions. These include Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis (15). It reduces inflammation and oxidative stress in the brain, which are common factors in neurodegenerative diseases (16). Additionally, it enhances neurogenesis, the growth and development of new neurons in the brain (17). One study conducted on mice found that CBD improved their cognitive function and reduced the accumulation of beta-amyloid plaque, a hallmark of Alzheimer’s disease (18). Another study showed that it improved motor function in people with Parkinson’s disease (19). CBD has also been studied for its potential to reduce spasticity and pain in people with multiple sclerosis (20). 

While more research will help scientists to more fully understand the neuroprotective properties of CBD, these findings are promising. CBD’s potential to reduce inflammation, oxidative stress, and enhance neurogenesis could make it a valuable tool in the treatment of neurological conditions. As research in this area continues, it’s important to work with healthcare professionals to determine the best treatment options for individuals. 

The Downsides of CBD Use

Drowsiness and Fatigue

While it is generally considered safe, some CBD users have report drowsiness and fatigue after taking it. Studies have additionally shown that CBD can have sedative effects on the body.  This may lead to feelings of drowsiness and lethargy. According to a study from the Journal of Psychopharmacology, CBD increases levels of the sleep-inducing neurotransmitter adenosine in the brain.  This could explain its sedative effects (21). In addition to increasing adenosine levels, it may also affect the body’s production of cortisol, a hormone that helps regulate the sleep-wake cycle. A study published in the Brazilian Journal of Psychiatry found that it reduced cortisol levels in participants.  This could also contribute to its sedative effects (22). 

It is important to note that the sedative effects of CBD may vary depending on the dosage and individual factors such as body weight and tolerance. The method of consumption can also play a role.  Edibles and capsules often take longer to take effect and could potentially cause more prolonged sedation than inhalation or sublingual administration (23). While it may cause drowsiness and fatigue in some users, it is generally considered to have fewer side effects than traditional sleep aids or sedatives. However, individuals who experience excessive drowsiness or fatigue after taking it should consult with a healthcare professional.   A lower dosage or alternative treatment may be necessary. 

Dry Mouth

Another common side effect reported by CBD users is dry mouth, also known as xerostomia. This occurs when the salivary glands in the mouth do not produce enough saliva, leading to a dry, uncomfortable feeling. Research suggests that it may cause dry mouth by affecting the endocannabinoid system.  This system plays a role in regulating saliva production. In a study published in the Journal of Psychopharmacology, researchers found that CBD decreased salivary flow and increased feelings of thirst in healthy individuals (24). Another study published in the Journal of Cannabis Research shows that it’s use had a strong correlation with a higher risk of dry mouth among medical cannabis patients (25).

While dry mouth may seem like a minor inconvenience, it can have negative consequences for oral health. Saliva helps to keep the mouth moist, which is important for preventing tooth decay and other dental problems. When saliva production decreases, it can also lead to difficulty swallowing, a sore throat, and changes in taste sensation. To minimize the risk of dry mouth when using CBD, it is important to stay hydrated. Chewing sugar-free gum or using mouthwash can also help to stimulate saliva production. It may also be helpful to start with a low dose and gradually increase as needed.  Higher doses may increase the likelihood of experiencing side effects. 

Changes in Appetite and Weight

One common side effect associated with CBD use is changes in appetite and weight. Some studies have suggested that it may decrease appetite and lead to weight loss, while others have found the opposite effect. A study published in the International Journal of Obesity found that CBD administration in both animal and human subjects resulted in reduced food intake and weight loss (26). However, a separate study published in the Journal of Psychopharmacology found that it actually increased appetite and food intake in rats (27). The mechanism behind these conflicting effects is not fully understood. It is possible that it affects different appetite-regulating hormones and neurotransmitters depending on the dosage and duration of use. With more research, we will likely more fully understand the relationship between CBD and appetite. 

The Risks of Using CBD  

Drug Interactions

CBD is known to have interacts with some medications, which can have significant health implications for users. One study found that it can inhibit the activity of certain enzymes in the liver responsible for metabolizing many prescription drugs (28). This can lead to increased levels of these drugs in the bloodstream, which can cause unwanted side effects or overdose. It can also enhance the effects of some medications, leading to excessive sedation or other adverse effects. For example, CBD can increase the sedative effects of opioids, benzodiazepines, and alcohol.  This is dangerous and potentially life-threatening (29). It is essential for patients to discuss their CBD use with their healthcare providers, including their doctors and pharmacists.  Doing this will better ensure that they are not at risk for potential drug interactions.

Quality Control Issues

Quality control is an essential aspect of producing safe and effective CBD products, but can be a problem. The lack of regulatory oversight and standardization in the industry can lead to quality control issues.. For example, a study found that many CBD products on the market do not contain the labeled amount of CBD.  Some even contain harmful contaminants such as heavy metals or pesticides (30). Additionally, some products may contain THC!  This can be a real problem for individuals who are sensitive to the psychoactive effects of THC or who are subject to drug testing.

To address these quality control issues, it is important for manufacturers to implement rigorous testing procedures to ensure the potency and purity of their products. This can include third-party testing and certification, as well as implementing good manufacturing practices. Consumers can also take steps to ensure the quality of the products they purchase by researching the manufacturer.  One of the most effective ways to do so is by checking for third-party testing results.  Also, be cautious of products that make unrealistic health claims. 

Negative Research

Despite the growing interest in CBD and its potential health benefits, there is also negative research.  These studies and research suggest it may not be a panacea for all ailments. For example, one study found that it had no significant impact on opioid cravings or the symptoms of withdrawal (31). Another study shows that it did not improve symptoms of Parkinson’s disease, although it was well-tolerated by patients (32). Additionally, research has also suggested that it may have negative side effects for some individuals. One study shows that it could cause liver damage in mice.  Of course, only further research can determine if this applies to humans as well (33). Another study reported that it could cause a decrease in blood pressure.  For patients with low blood pressure or those taking medication for high blood pressure, this could be life-threatening (34). 

Furthermore, there is also a lack of regulation and standardization in the CBD industry, leading to concerns about product safety and efficacy. Some studies have found that CBD products may not contain the amounts of CBD advertised on the label.  Some also contain harmful contaminants such as heavy metals or pesticides (35). While there is still much research to be done on the potential benefits and risks of CBD, negative research highlights the importance of caution and thorough investigation before using it as a treatment for any health condition.  

The Ugly Side of CBD

The THC vs. CBD Misconception

CBD and THC are two compounds that are often associated with one another.  Many people mistakenly believe that they are the same thing. However, this is not the case, and it is one of the biggest misconceptions about CBD (35). While both CBD and THC are cannabinoids that are derived from the same plant, Cannabis sativa, they have different chemical structures and produce different effects on the body. THC is the psychoactive compound that is responsible for the “high” that people experience when using marijuana.  CBD does not produce the same intoxicating effects. Despite the clear differences between them, many people still confuse the two and believe that CBD can get them high or cause them to fail a drug test. This is not true, as it does not produce the same psychoactive effects as THC.  In addition, most drug tests do not screen for CBD. Additionally, there is no evidence to suggest that CBD is addictive or has any potential for abuse. 

Another common misconception about CBD is that it is only effective for certain conditions, such as epilepsy or chronic pain. However, research has shown that it may have a wide range of potential therapeutic benefits.  For instance, it can reduce anxiety and depression (36), improving sleep, and even potentially treating substance use disorders (36). While more research is needed to fully understand the effects of CBD on the body, early studies have shown promising results(37).   

Legal Status

The legal status of CBD has been a topic of much discussion and confusion in recent years. While it is a non-psychoactive compound derived from the cannabis plant, its legality has been influenced by the federal government’s classification of cannabis as a Schedule I controlled substance. The 2018 Farm Bill legalized hemp, defined as cannabis containing less than 0.3% THC, and removed it from the Controlled Substances Act (36). This means that hemp-derived CBD is legal at the federal level.  However, individual states may have their own laws regarding it.

Some states have legalized both hemp and marijuana-derived CBD, while others have more restrictive laws. Additionally, the FDA has issued warnings to companies making health claims about CBD products and has not approved it as a dietary supplement or food ingredient (37). Despite these legal uncertainties, the industry continues to grow rapidly, with a wide variety of products now available, including oils, tinctures, gummies, and topicals. While the legal landscape may continue to evolve, it is important for consumers to be aware of the laws and regulations surrounding CBD to ensure that they are using legal products that are safe and effective.

Lack of Regulation

Despite its growing use, there is a concerning lack of regulation of CBD products. The FDA has only approved one CBD-based medication, Epidiolex, for the treatment of seizures associated with certain forms of epilepsy. Other than that, CBD products are not regulated by the FDA, and there are no established standards for the purity, potency, or quality of products on the market (38). This lack of regulation can lead to variability in product content, which can be dangerous for consumers.

Without regulation, there is also the risk of misleading product claims and inaccurate labeling, which can lead to consumers purchasing products that do not meet their intended purpose. Some products contain less CBD than advertised or even harmful contaminants such as pesticides, heavy metals, and bacteria (39). Additionally, some products labeled as “CBD” actually contain higher levels of THC, which can have psychoactive effects and may cause a positive drug test (40). The lack of regulation also presents challenges for healthcare providers who want to recommend it to their patients. Without established guidelines or dosing recommendations, it can be difficult for healthcare providers to know what products to recommend and what doses to suggest. This lack of guidance can lead to inconsistent recommendations and potentially harmful outcomes. 

 Innaccurate Labeling

Inaccurate labeling of CBD products has been a growing concern in recent years. Some manufacturers mislabel their products, either by stating incorrect concentrations of CBD or by making false claims about the health benefits of their products. This can be problematic for consumers who rely on accurate information to make informed decisions about their health. Additionally, it can create confusion around the true effects of CBD and undermine the credibility of the industry as a whole. A study conducted in 2017 found that nearly 70% of CBD products sold online were mislabeled in some way.  Many containing less CBD than they claim and some containing none at all (41).

The lack of regulatory oversight in the industry has contributed to this problem. Without standardized testing and labeling requirements, it can be difficult for consumers to know what they are really getting when they purchase a CBD product. Some manufacturers may be intentionally misleading consumers in order to make a profit, while others may simply lack the resources or knowledge to accurately test their products. This makes it important for consumers to do their own research and purchase from reputable companies with a proven track record of accurate labeling. 

Unsafe Additives

Unsafe additives in CBD products have been a growing concern among consumers and health officials. Some products contain harmful additives, such as synthetic cannabinoids, heavy metals, and pesticides, which can have negative health effects on consumers. Synthetic cannabinoids are man-made chemicals that are not found in natural cannabis.  These may cause severe adverse effects, including seizures and death (42). Heavy metals, such as lead and arsenic, can be present in CBD products due to contaminated soil or improper manufacturing processes (43).

Pesticides used in the cultivation of hemp are also sometimes found in products, posing a risk to consumers’ health (44). These additives are often not disclosed on the product label, making it difficult for consumers to make informed decisions. The lack of regulation in the industry has contributed to the presence of unsafe additives in CBD products. As a result, consumers must be vigilant when purchasing CBD products and look for third-party testing and reputable brands to ensure the safety of the product.

Scams and Fraudulent Claims

The rise of CBD popularity has unfortunately been accompanied by a rise in scams and fraudulent claims surrounding CBD products. One common scam is the sale of “snake oil” products that claim to cure all ailments, but lack any scientific backing. These products often contain little to no CBD and can even be harmful. In addition, many products make false claims about their potency, purity, or ingredients. These misleading labels can lead consumers to believe they are getting a high-quality product, when in reality they are not. The lack of regulation in the industry only exacerbates the issue, as it allows for these fraudulent claims to go unchecked. Consumers should do their due diligence in researching companies and products before making a purchase to ensure they are not falling victim to these scams. (44)


The use of CBD has become increasingly popular for various reasons, including pain management, anxiety, and sleep disorders. However, the lack of regulation, inaccurate labeling, unsafe additives, and scams surrounding CBD pose significant risks to consumers. To ensure safe and effective use of products, it is essential to purchase from reputable companies that have third-party lab testing to ensure accurate labeling and purity of the product. It is also recommended to start with a low dosage and gradually increase it as needed. Patients should also consult with their healthcare provider before taking CBD, especially if they are taking other medications.

Despite the lack of research on the long-term effects of CBD, promising results have been reported in several clinical trials. However, more research is needed to fully understand the potential benefits and risks. In the future, researchers should focus on larger and more diverse populations to determine the optimal dosage and the long-term effects of CBD use. Further research may also explore it’s potential use in treating a variety of health conditions, including neurological disorders, cancer, and inflammation. Overall, the potential of CBD as a health aid is promising, but its safety and efficacy need to be further explored.