*In the world of herbal remedies CBD, short for cannabidiol, is like the second coming among enthusiasts. Praised for its healing prowess—for everything from pain and insomnia to gastrointestinal issues and inflammation—the cannabis-born compound is fast developing cult-like status. Not only are physical health benefits reported, but more and more people are turning to CBD to help with mental health conditions—particularly anxiety and depression. And the research is promising. A review in [Frontiers in Immunology](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161644/) found that CBD creates a calm in the brain that’s visible on scans—doctors can actually see the angst dissipate. There’s still a lot to learn about CBD’s impact on mood, but we’ve got all the intel to help you weed through the field.*

## What Is CBD Again?

Maybe you’re already an expert on CBD, so feel free to skip to the section below; if you need a crash course, follow right along. CBD is one of two primary chemical entities (cannabinoids) found in the cannabis plant (the other one is tetrahydrocannabinol, THC). Unlike THC, which is what causes you to get high, CBD has no psychoactive effects (one reason why so many people are trying it). CBD derived from hemp differs from marijuana by its THC content. Hemp has less than the legal limit of 0.3% THC, while marijuana contains more than 0.3% THC. 

To complicate matters, CBD is only FDA-approved for use in one medication, Epidiolex, which is used to treats the seizures associated with two rare forms of epilepsy. Because it’s largely unregulated, navigating the world of CBD can feel like a long, strange trip. And since you can’t be sure exactly what you’re getting, word to the wise: Consume with caution and always consult with your doctor.


Basics

We’ve got the 411 on whether CBD is really as magical as people make it out to be.

Get All the Info on CBD

## How Does CBD Impact the Brain?

Understanding how CBD affects the brain starts with a lesson about the endocannabinoid system (ECS), basically the biggest system in the body that you’ve never heard of. It controls just about every internal function we have. Movement, pain sensation, immune responses, temperature, mental functioning like perception, mood, and memory—you name it. 

The ECS is like Big Brother, constantly keeping an eye on things so when something’s not working right, it can take action. For example, let’s say your body generates a whole lot of heat after a workout. In this case, endocannabinoids bind to receptors, which then alert the ECS that it’s time to get your body to cool down by producing sweat.     

Now, here’s how CBD comes into play. When you take CBD, you’re basically supporting the work the ECS is already doing to help your body function on the regular. Researchers believe CBD works to alleviate symptoms of anxiety and depression by binding to one of the main receptors within the ECS, the CB1 receptor. 

Found mostly in the brain, the CB1 receptor is thought to tame central nervous system inflammation and help modulate the effects of serotonin, a neurotransmitter that oversees mood. In fact, the way many antidepressants work is by increasing serotonin in the brain. 

Additionally, anxiety and stress inhibit GABA, a naturally occurring brain chemical that directs neurons to slow down or stop firing. This neurotransmitter essentially tells the body to chill out by helping to induce sleep, relax muscles, and create a sense of calm. Some scientists believe CBD can help modulate GABA so the body returns to its regularly scheduled programming.


How CBD Impacts the Brain

## How Effective Is CBD for Anxiety & Depression?

While there’s a solid amount of scientific research that shows CBD can be effective for anxiety in animals, as well as anecdotal evidence and case reports that show it may be beneficial for alleviating anxiety in humans, there is less data on the effectiveness of CBD for depression, though there have been some promising animal studies. For example, a 2018 study on rats published in *NeuroscienceNews* showed that just a single dose of CBD helped to reduce symptoms of depression for up to one week. Researchers believe CBD helps repair neural circuitry in the prefrontal cortex and hippocampus, which get damaged as a result of depression.

Also keep in mind, anxiety and depression have a complicated relationship. Both are conditions related to poor sleep, pain, and mood regulation. When we experience more anxiety, we experience more pain, and when we are feeling more depressed, we feel more anxious. It’s a chicken/ egg-like scenario. Here’s where CBD may fit in:

CBD is thought to positively influence the processes that regulate our mood, sleep, and pain perception, among others. These processes need to function properly, so we feel better, sleep more soundly, and experience less pain. Anxiety and [depression](https://www.healthcentral.com/condition/depression) are conditions related to poor sleep, pain, and poor mood regulation because the endocannabinoid system isn’t working to the best of its ability.

Experts believe careful CBD dosing may help temper anxiety-induced racing thoughts that can cause disrupted sleep as well as panicked awakenings during the night. (In some people, though, too much can make anxiety worse, so be sure to dose slowly and carefully). 

Sleep disruption and depression are also closely linked. More than 90% of depressed patients complain about difficulties falling asleep, sleep disruption, or early morning awakenings. CBD may improve their mood or their ability to manage the condition overall. CBD can also be used to treat parasomnias, sleep disorders like jaw grinding, sleepwalking, or nightmares, and it also cuts the time it takes to fall asleep. 

CBD may also have a positive interaction with serotonin receptors in the brain. In a study on mice published in *CNS & Neurological Disorders*, researchers found that when depressed rodents were given CBD, it impacted the way their brains’ chemical receptors responded to serotonin, producing an antidepressant effect.

Additionally, CBD can have benefits in social settings. Researchers found CBD decreased anxiety in patients with social phobia by lowering activity in the amygdala and increasing prefrontal cortex activation, the two areas of the brain involved with regulating anxiety. And, it may also help reduce major angst before a stressful event, such as public speaking. Studies, including one published in *Neuropsychopharmacology*, have shown that CBD administered before a public speech significantly reduced overall anxiety, cognitive impairment, and performance anxiety. 

While the research and anecdotal evidence is promising, because CBD is unregulated, it’s difficult to study, and any given sample can differ from the next, which means it’s also tricky to determine just how effective it is. Factors like the severity of depression and anxiety, as well as genetics play a role. And the benefits aren’t universal either. 

CBD can be very effective for some people and not make a dent in others. Though it shouldn’t be a stand-alone treatment, it may be a beneficial co-pilot to other anti-anxiety meds or antidepressants, particularly in the time before the effects of antidepressants start to kick in.

CBD for Anxiety & Depression

Anxiety and depression often go hand-in-hand. Learn more about the link between the two mental health conditions here.

Get the Details on the Link Between Anxiety and Depression

## Who Should Consider CBD for Anxiety & Depression (and Who Shouldn’t)?

If you’re considering CBD, before you make a move, talk with your primary care physician or mental health provider. Remember, CBD is not a substitute for talk therapy or medication. It’s also not a magic cure-all and may work better for some people than for others.


## What Forms of CBD Are Most Effective?

__Oils or Tinctures:__ Keep in mind, not all CBD plant extracts and formulations are created equal (blame it on the wild west unregulated substances create). However, experts believe the most effective form of CBD is an oil or tincture (alcohol-based solution) that’s placed under the tongue. These sublingual preparations ensure the cannabinoids get distributed throughout the body. This method bypasses the gut, which is why experts often prefer it to edibles, most of which get destroyed by the gastrointestinal system. Every person will react a little differently due to their individual biology, metabolism, and DNA, natch.

__Dry-herb Vaporizing:__ For patients who are feeling all kinds of jittery and need more immediate relief, some experts recommend vaping CBD through a dry-herb vaporizer, which heats up dried CBD flowers (unlike traditional vape pens which require oil-based cartridges). These are relatively safe because they avoid the by-products produced from burning plant material and can be set to a desired temperature that allows you to get the most benefit from the CBD you are consuming. 


Which Forms Work Best?

## How Much CBD Should I Take? 

That’s one of the great mysteries; the optimal CBD dose is not an exact science. And doctors agree there isn’t one universal dosage of CBD because different people (and different animals, for that matter) respond to different dosages of CBD. 

What experts also agree on is that CBD works best when taken on a regular basis—daily, often two-to-three times a day—because the effects can take time to build—sometimes even months (though, some people report feeling less angsty right away). 

And, the best way to know what works for you is to start on a low dose and titrate up if needed (follow the recommended dosage instructions on the bottle and talk to your doctor). It may not take as long as for someone with mild symptoms to feel the effects as someone who is dealing with more severe anxiety or depression. Ultimately, the goal is to find the lowest, most effective dose. Work with your doctor and give yourself time to figure it all out. 


Dosage

## What Are the Potential Risks and Side Effects of Using CBD?

CBD is thought to be relatively safe—a position that’s backed by the [World Health Organization](https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf)—but there can be some mild side effects including:

- fatigue
- diarrhea
- changes in appetite

There is one major caveat: CBD may cause interactions with certain other drugs, including those for heartburn, [migraine](https://www.healthcentral.com/condition/migraines), and [hypertension](https://www.healthcentral.com/condition/hypertension)—both by enhancing their effects or negating them. This is because medications and natural plant supplements are metabolized by the same liver pathways, and they affect the same serotonin receptors in the brain, so it’s a complex interplay. The bottom line: Talk to your doctor to be sure you're not overconsuming one or the other.

## How Do I Find a Doctor Who’s Trained/Familiar With Using CBD?

CBD and cannabis-related curriculum is not (yet) taught in medical schools, so it can be a challenge to find a doctor who’s knowledgeable about the landscape. Most physicians don’t know much about the science behind medical cannabis and how to integrate it within a patient’s treatment plan. 

So, you’ll need to do a bit research. Look for integrative and holistic physicians who understand how to support and educate you in the use of phytomedicines.

The [Society of Cannabis Clinicians](https://www.cannabisclinicians.org/find-a-cannabis-doctor/) has a provider finder on their website where you can look for health-care professionals in your area who are well-versed in CBD. The [Association of Cannabis Specialists](http://www.cannabis-specialists.com/) is another great resource for researching cannabis clinicians near you. Another option: Hit up your local CBD dispensary. Oftentimes, they may be able to tell you which physicians are sending their patients in to buy CBD.

Side Effects

Experts believe careful CBD dosing may help temper the anxiety-induced racing thoughts that can cause disrupted sleep as well as panicked awakenings during the night. While CBD may not help someone with depression directly, it may benefit in other ways that can improve their mood or their ability to manage the condition overall. For example, sleep disruption and depression are closely linked. More than 90% of depressed patients complain about difficulties falling asleep, sleep disruption, or early morning awakenings. CBD can also be used to treat parasomnias, sleep disorders like jaw grinding, sleepwalking, or nightmares, and it cuts the time it takes to fall asleep.

What does CBD do for anxiety & depression?

This is one of the great mysteries; the optimal CBD dose is not an exact science. Doctors say there isn’t one universal dosage of CBD because different people (and different animals, for that matter) respond to different dosages of CBD. What experts also agree on, however, is that CBD works best when taken on a regular basis (daily). And the best way to know what works for you is to start on a low dose and titrate up if needed. It may not take as long as for someone with mild symptoms to feel the effects as someone who is dealing with more severe anxiety or depression. The goal is to find the lowest, most effective dose, so work with your doctor and give yourself time to figure it out.

How much CBD should you take for anxiety or depression?

Generally, it takes about 20 minutes for CBD to make its way to the bloodstream (though every person will react a little differently due to their individual biology, metabolism, and DNA, natch).

How long does it take for CBD to work for anxiety or depression?

Experts believe the most effective form of CBD is an oil or tincture (alcohol-based solution) used sublingually (placed under the tongue). A sublingual preparation ensures the cannabinoids get distributed throughout the body. For patients who are feeling all kinds of jittery and need more immediate relief, some experts recommend vaping CBD through a dry-herb vaporizer, which heats up dried CBD flowers. These are relatively safe because they avoid the by-products produced from burning plant material and can be set to a desired temperature that allows you to get the most benefit from CBD you are consuming.

What form of CBD is most effective for anxiety or depression?

CBD for Anxiety & Depression FAQ

CBD is thought to positively influence the endocannabinoid system, which regulates our mood, sleep, and pain perception. This means that it can be used to help with symptoms of depression and anxiety.

More Info on CBD

Cannabidiol (CBD) is a chemical found in the Cannabis sativa plant. It is a naturally occurring substance that can be used to impart feelings of relaxation and calm.

Daniele Piomelli, Ph.D.

Director and Professor, Anatomy & Neurobiology

Ryan Vandrey, Ph.D.

Associate Professor Behavioral Pharmacology Research Unit

Hollis Karoly, Ph.D.

Research Associate

We went to some of the nation’s top experts in CBD to bring you the most up-to-date information possible.

Cannabidiol (CBD)

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We've got the 411 on whether CBD is really as magical as people make it out to be—and if it's actually even legal.

Let's Talk About CBD

Cannabidiol (CBD): Uses, Dosages, Side Effects, Interactions

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Junella Chin, M.D.

Chief Medical Officer at Yesterday Wellness and Integrative Medical Cannabis Physician; co-author of Cannabis and CBD for Health and Wellness; Board Member of American Academy of Cannabinoid Medicine

Matthew Mintz, M.D.

Author of Medical Cannabis and CBD: A Physician's Guide for Patients; Internal Medicine and Primary Care Doctor

April Hatch, R.N.

Member of the American Cannabis Nurses Association; co-founder of Cannabis Care Team

We went to some of the nation's top experts in CBD to bring you the most up-to-date information possible.

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oil dropper CBD-iStock-1250578741

There's a lot of buzz about the calming powers of CBD. We went to the experts and dug into the research. Here are the facts. 

The Facts About Using CBD for Anxiety & Depression

- __CBD & Social Anxiety:__ *Journal of Psychopharmacology*. (2010). “Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report.” [journals.sagepub.com/doi/abs/10.1177/0269881110379283](https://journals.sagepub.com/doi/abs/10.1177/0269881110379283)
- __The Benefits of CBD:__ *Frontiers in Immunology*. (2018). “Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age.” [ncbi.nlm.nih.gov/pmc/articles/PMC6161644/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161644/)
- __Therapeutic Effects of CBD for Anxiety:__ *Neurotherapeutics*. (2015). “Cannabidiol as a Potential Treatment for Anxiety Disorders.” [ncbi.nlm.nih.gov/pmc/articles/PMC4604171/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/)
- __The Benefits of CBD for Public Speaking:__ *Neuropsychopharmacology*. (2011). “Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients.” [ncbi.nlm.nih.gov/pmc/articles/PMC3079847/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079847/)
- __CBD Effects on Sleep & Anxiety:__ *The Permanente Journal*. (2019). “Cannabidiol in Anxiety and Sleep: A Large Case Series.” [thepermanentejournal.org/issues/2019/winter/6960-cannabis.html](http://www.thepermanentejournal.org/issues/2019/winter/6960-cannabis.html)


Ashley Maltz, M.D.

Medical Reviewer

Can CBD Treat Anxiety and Depression?

Whether you're CBD-curious or already a long-time advocate, we've got all the info you need on how this plant chemical works and how you might benefit.

Your Everyday Guide to CBD

Let's Talk About CBD for Anxiety & Depression

Jamie Robinson



*<p style="text-align: center;">Jamie Robinson works to inform veterans and the public about the health benefits of cannabidiol.</p>*

Jamie Robinson is educating people on the health benefits of [non-psychoactive CBD oil](http://www.healthcentral.com/slideshow/13-sizzling-questions-about-marijuana-and-chronic-pain#slide=8), the difference between hemp and marijuana, and how to make cannabidiol (CBD) available to people who might benefit from it. An entrepreneur living in Denver, she has a bachelor of arts degree in psychology and is a CBD Educator. In addition to being a veteran of the armed services herself, she works to inform veterans and the public regarding the health benefits of CBD oil.   

She’s focused on our veterans and combat K9’s (yes, you read that right — the dogs that serve our country) suffering from post-traumatic stress disorder (PTSD), traumatic brain injury, and chronic pain. This is a controversial topic. But should it be so contentious?

__Health Central (HC): What motivated you to get involved with CBD oil to help our veterans and K-9’s?__

__Jamie:__ My sister, a military veteran, was found to have multiple brain cysts of unknown origin causing Parkinson’s-like tremors in her hand. After 14 years of follow-up tests and countless visits with specialists, she has yet to receive a diagnosis or cure.

__HD: Why CBD?__

__Jamie:__ Since CBD has been shown to reduce tremors in some people with neurodegenerative disorders as well as reduce seizures in some cases of epilepsy, I decided to learn more about this all-natural compound. In my review of the research, I found a link between CBD and positive outcomes in veterans with PTSD. And since there is [evidence cannabis can help neuropsychiatric and neurological disorders](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604187/), I wondered if it might help people like my sister.

__HC: The [United States Veterans Affairs (VA) reports](https://www.research.va.gov/currents/0817-benefits-and-risks-of-medical-marijuana.cfm) that a review of 13,000 publications on cannabis found 75 studies relating to pain or potential harms. [One study](http://annals.org/aim/article/2648596/benefits-harms-plant-based-cannabis-posttraumatic-stress-disorder-systematic-review) funded by the VA concluded there is insufficient evidence to assess the effects of marijuana on PTSD and [another study](http://annals.org/aim/article/2648595/effects-cannabis-among-adults-chronic-pain-overview-general-harms-systematic), also funded by the VA, concluded there is limited evidence to suggest cannabis may alleviate neuropathic pain in some patients, and there is insufficient evidence regarding other types of chronic pain. Does this affect your efforts to make CBD available for veterans?__

__Jamie:__ I think it is important to note here — there is a [difference between marijuana and hemp](http://www.healthcentral.com/slideshow/13-sizzling-questions-about-marijuana-and-chronic-pain#slide=4). Hemp contains very little THC and high amounts of CBD. The research I have reviewed strongly supports the health benefits of CBD. There is a plethora of information regarding the use of CBD at [EchoConnection.org](https://www.echoconnection.org/). They provide a comprehensive approach regarding the therapeutic effects of CBD and cannabinoids, and they provide support in a safe environment. 

__HC: According to MedicalMarijuana.com, Veterans Affairs Secretary David Shulkinays says there is evidence medical marijuana (MMJ) could help certain veterans, but federal law needs to change to make it accessible. Are there caregivers at Veterans Affairs who are willing to help?__

__Jamie:__ Yes, some believe in the health benefits of CBD as I do. In his detailed presentation, [Dr. Philip Blair discusses the endocannabinoid system](https://youtu.be/4cJ_Rhei1eg) insufficiencies noted in PTSD. He tells us that recent trials with Elixinol hemp CBD Liposomes have shown dramatic symptom relief in veterans with chronic PTSD.

__HC: Are you hopeful that the VA will embrace CBD as a viable treatment option for veterans and military K9s?__

__Jamie:__ Yes, I am hopeful because we have scientific evidence that the endocannabinoid system can be deficient and feeding it CBD can help heal the body from within. Animals also have an endocannabinoid system and military K9’s can suffer from PTSD just as soldiers do, so there is hope in treating the four-legged vets with CBD as well.

__HC: Are there channels you go through and do you have any recommendations or tips for other advocates?__

__Jamie:__ Yes, my friend, [Kathleen May](http://www.kenoshanews.com/opinion/voice_of_the_people/time-to-eliminate-stigma-attached-to-medical-cannabis/article_f50f7005-f353-5fc0-969d-552f413e93cc.html), just visited with government representatives in Wisconsin regarding the legalization and access to cannabis. And, U.S. Army veteran [Matt Kahl](https://www.leafly.com/news/politics/medical-marijuana-colorado-cannabis-ptsd-veteran-matthew-kahl), Executive Director for Veterans Natural Rights, the [Weed for Warriors Project](http://www.wfwproject.org/), and [Grow for Vets USA](https://growforvets.org)are among those fighting to raise awareness, de-stigmatize cannabis, and enact regulatory changes that can positively affect the lives of our veterans.



Jamie Robinson advocates for the power of non-psychoactive CBD, which comes from both hemp and marijuana, especially to help veterans with PTSD and pain management. In this Q&A, she talks about the health benefits of CBD, the difference between hemp and marijuana, and more.

Jamie Robinson promo

Jamie Robinson is educating people on the health benefits of non-psychoactive CBD oil and how it can help veterans with PTSD and pain management.

Q&A With Jamie Robinson: CBD for Pain Management

Pain Management: A Look At CBD for Veterans

New research looks at ways the compound from cannabis may be effective in treating pain from multiple sclerosis.

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Can CBD Help Your Multiple Sclerosis?

- __Cannabis for MS Evidence:__ National MS Society. (2017). “Cannabis for Multiple Sclerosis Symptoms.” [nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Professionals/Cannabis-and-Multiple-Sclerosis.pdf](https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Professionals/Cannabis-and-Multiple-Sclerosis.pdf)

- __Medical Marijuana and MS:__ The National MS Society. (2020). “Medical Marijuana (Cannabis) and MS FAQS.” [nationalmssociety.org/Treating-MS/Complementary-Alternative-Medicines/Marijuana/Marijuana-FAQs](https://www.nationalmssociety.org/Treating-MS/Complementary-Alternative-Medicines/Marijuana/Marijuana-FAQs)

- __CBD for Health Conditions Info:__ Harvard Health. (2018). “Cannabidiol (CBD) — what we know and what we don’t.” [health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476](https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476)


Can CBD Help Treat MS Pain?

What Is CBD?

Know Your CBD Sources

Can CBD Relieve MS Symptoms?

Not All CBD Is the Same

How Is It Supposed to Work?

How CBD May Relieve Pain

CBD May Decrease Spasticity

What Type of CBD Is Best?

Risks of Using CBD for MS

Talk to Your Doctor

The Bottom Line

“I actually don't remember what it was like not to be in pain,” says Bridget Seritt, who has dealt with chronic illness since she was a small girl. “I have both types of arthritis—rheumatoid and osteoarthritis. I have Sjogren's syndrome. I have lupus, and I have Ehlers-Danlos syndrome, which is a genetic collagen disorder that affects all of my joints, ligaments, and tendons.” 

When she lived in Georgia, her treatment centered on methotrexate, a drug used to slow down the progression of rheumatoid arthritis.  

Unfortunately, Seritt experienced all three of the drug’s most common side effects—nausea, stomach upset, and fatigue—and, for a time, she used black-market cannabis to alleviate those symptoms. (Georgia didn’t have a medical-marijuana program at the time.) Seritt moved to Colorado in 2013, still taking “a handful of opiates and a whole bunch of prescription medications,” and quickly realized that, as a chronic-pain patient requiring high doses, the growing war on opioids might affect her options for relief sooner rather than later.   

It didn’t take long: Her new pharmacy wasn’t always able to fill her full oxymorphone prescription on time. “I was consistently running out,” she says, which led to muscle spasms. Since cannabis was legal in Colorado, “I decided to see if it would help with pain and withdrawal. I smoked a couple of joints, but it didn’t do anything except help my insomnia.” That was good enough, and eventually she replaced smoking pot with making her own cannabis butter and topicals.    

It wasn’t until about three months later that Seritt noticed another change: “I could walk better. I could be active for longer periods of time, and I didn't need as long to recover.” Between 2014 and 2015, she went from being able to walk just 200 feet to hiking several miles. She credits medical cannabis.  


Small business marijuana dispensary in Oregon.

GettyImages-581032315

### Which States Allow Medical Marijuana for Arthritis?

If Seritt still lived in Georgia, she wouldn’t have achieved this level of relief without breaking the law. Currently, the state allows only cannabis oil with less than 5% THC—the chemical that causes most of pot’s psychoactive effects. In Colorado, however, some form of medical marijuana has been [legal since 2000](http://sensiblecolorado.org/history-of-co-medical-marijuana-laws/), and patients aren’t limited to low-THC oils. Instead, patients like Seritt have access to a seemingly endless variety of cannabis products with a wide range of potency, along with professional staff equipped to answer medical questions. Colorado also allows home cultivation of up to six plants per patient, so they can grow the specific strains they need to get results.    

Though medical marijuana programs exist in 33 states and Washington, D.C., cannabis is still illegal in the eyes of the federal government. As a Schedule I drug according to the Controlled Substances Act (CSA), it’s considered a dangerous substance with "no currently accepted medical use." That means that doctors and patients complying with state laws still operate as federal outlaws, risking fines, arrest, even prison time.  

Several bills in congress aim to erase cannabis from the CSA. Among them, Oregon Sen. Ron Wyden’s cleverly-titled [S.420 Marijuana Revenue and Regulation Act](https://www.congress.gov/bill/116th-congress/senate-bill/420); Hawaii Rep. Tulsi Gabbard’s March reintroduction of the [Ending Federal Marijuana Prohibition Act](https://www.congress.gov/bill/115th-congress/house-bill/1227/text); New Jersey Sen. Cory Booker’s [Marijuana Justice Act](https://www.congress.gov/bill/115th-congress/senate-bill/1689); and New York Sen. Charles Schumer’s [Marijuana Freedom and Opportunity Act](https://www.congress.gov/bill/115th-congress/senate-bill/3174/). Passing any of these bills would allow millions of Americans with arthritis to legally benefit from the plant’s therapeutic properties. 

### How Does Medical Marijuana Relieve Arthritis Pain? 

Traditional arthritis treatments are rife with potentially dangerous side effects. Cases in point: Tylenol and non-steroidal anti-inflammatory drugs, or NSAIDs, can exacerbate liver and bleeding issues. Excessive doses of Tylenol can cause liver toxicity and high dose anti-inflammatory drugs, such as NSAIDs, can cause gastrointestinal bleeding and kidney problems. [Disease-modifying anti-rheumatic drugs](https://www.healthcentral.com/article/a-beginners-guide-to-ra-dmards) (DMARDs) and [biologics](https://www.healthcentral.com/slideshow/faq-you-need-read-starting-biologics) can interfere with the immune system's ability to fight infection. And, if those categories don’t work, patients are left with opioids, which can become habit-forming.  

“If you put the opioids head-to-head with cannabis for mild to moderate pain, what we find is that they're about equal,” says Jordan Tishler, M.D., a Boston cannabis physician at Inhale MD, Harvard instructor of medicine, and president of the [Association of Cannabis Specialists](https://www.cannabis-specialists.org/). “In that situation, cannabis may be equally effective, but it's a lot safer.”  

Scientific evidence confirming Dr. Tishler’s experience continues to grow, showing cannabis to be “remarkably helpful as a pain medication, interacting with receptors in multiple locations throughout the body,” he says. It also impacts pain processing in the spinal cord and brain. Preclinical data suggest that cannabinoids [have particular therapeutic potential for rheumatic diseases](https://www.nature.com/articles/s41584-018-0025-5) like rheumatoid arthritis and osteoarthritis (plus systemic sclerosis and fibromyalgia, too).  

“I could walk better. I could be active for longer periods of time, and I didn't need as long to recover.”

<a id="how-cannabinoids-work">Here’s how it works:</a> Cannabis contains dozens of cannabinoids, chemicals that interact with our body’s own endocannabinoid system, which [regulates inflammation and pain](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685274/). THC is the most well-known (it’s what gets you high) and CBD is another. “The THC in cannabis is the primary pain reliever, so what I do as a doctor is find the smallest dose of the THC or cannabis that will do the job with the minimum side effects,” Dr. Tishler says. The most common side effect, unsurprisingly, is getting stoned. “All pain medications have side effects and cannabis is no different,” he says.  

Like any other clinician, Dr. Tishler helps arthritis patients manage side effects through dosing, timing, and route of delivery. For example, for [chronic pain](https://www.practicalpainmanagement.com/patient/treatments/marijuana-cannabis/navigating-cannabis-options-chronic-pain), he might recommend an edible with 5 mg THC twice a day for long-lasting coverage, and a vaporizer for acute relief on an as-needed basis. 

“One cannabinoid called THC-A—which is different from THC—is a better anti-inflammatory than THC or CBD,” he says. “When I treat somebody with an autoimmune disease like rheumatoid arthritis, I often try to add THC-A to the THC so that we're covering the underlying inflammation as well as deriving pain control.” Dr. Tishler supplements THC-A through an extract; Seritt gets her dose of THC-A and THC from a paste made from fresh plants that she grows herself. 

#### Watch Our Interview with Dr. Tishler.  

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### Why Do Medical Marijuana Programs Matter?

When it comes to CBD for arthritis, Dr. Tishler is unconvinced that the extract is particularly useful for pain at the available doses. (The most [compelling research so far has been in rodents](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/), not humans.) 

“There's also the issue of how harmful hemp-derived CBD oils may be. Not because of the CBD, but because of whatever else might be in that bottle,” says Dr. Tishler, who cites traces of everything from pesticides and heavy metals to fentanyl, an anesthetic pharmaceutical.

The [2018 Farm Bill loosened regulations](https://www.natlawreview.com/article/will-hemp-derived-cbd-be-fully-legal-passage-2018-farm-bill-not-quite) on hemp-derived CBD by removing hemp products from the list of Schedule 1 drugs. There’s only one CBD drug that’s been approved by the U.S. Food and Drug Administration (FDA) — [Epidiolex for severe epilepsy ](https://www.healthcentral.com/article/fda-approves-marijuana-based-epilepsy-drug)— and the FDA doesn’t regulate supplements, so scams are rampant. Recent research from Penn Medicine revealed that 70% of CBD products available online mislabeled their CBD content. These are precisely the types of shenanigans medical marijuana laws are meant to prevent, and why medical programs are important, even for states with legal recreational cannabis.  

“Medical patients are not the same as recreational cannabis users,” says Dr. Tishler. An arthritis patient wants medicine that’s easy to take, precisely dosed, and provides reliable results with the least intoxication. (Not exactly a recreational user’s idea of a party.) 

Having a medical system in place allows physicians to follow up on what patients are purchasing through the registry system. Medical dispensaries and dual-licensed shops are best equipped to answer patient questions about how to dose cannabis or what contraindications there might be. 

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“It’s completely inappropriate to have this type of advice coming out of the mouth of a budtender,” says Dr. Tishler.  

There are other advantages to medical-marijuana programs. In states like Colorado, patients pay standard sales tax on cannabis, but not high excise taxes or additional state taxes applied to recreational cannabis sales. [Minors with qualifying conditions can also register](https://www.colorado.gov/pacific/marijuana/laws-and-youth) as medical marijuana patients, which isn’t addressed by the recreational model.

### Advocating for Access

There are many reasons to keep an eye on upcoming cannabis bills, both federal and in your specific state. Even putting the overarching problem of federal prohibition aside, the state laws are a messy patchwork of contradicting rules. For example, cannabis is straight-up illegal—for any reason—in Idaho, Kansas, Nebraska, and South Dakota. There are [33 states offering medical marijuana](https://www.leafly.com/news/health/qualifying-conditions-for-medical-marijuana-by-state), but only seven list arthritis as a qualifying condition (Arkansas, California, Connecticut, Hawaii, Illinois, New Mexico, and New York).  

Some states allow physicians more leeway by letting them determine “other medical conditions” at their discretion. In some states, even CBD oil is a no-go. In Kentucky, only people participating in a clinical trial or an expanded access program are legally allowed to possess it; in Mississippi, only people with a debilitating epileptic-seizure disorder qualify.

The laws are constantly evolving. If access is important to you, contact your state legislators and congress members and let them know. There are dozens of pending marijuana bills and resolutions on the state and federal level right now. (Check out [this list](https://norml.org/laws) from NORML to see which ones affect you and the arthritis patients in your life. Then refresh your browser and do it again, as cannabis laws can rapidly change.)  

Having a medical-marijuana program in place doesn’t necessarily guarantee unfettered access. Seritt, who makes her own cannabis medicine from homegrown plants, laments the passing of [House Bill 1220](https://leg.colorado.gov/bills/hb17-1220), which lowered the number of plants one residence could grow from 99 to a dozen, max. Her belief? “If your state program doesn’t allow access to fresh plants or cultivation, you don’t have real medical access.”




Commercial cannabis plant growing in warehouse

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For people with arthritis pain, cannabis can bring relief without the side effects caused by frequent NSAID or opiate use. But it’s still not legal everywhere--new legislation could change that.

For people with arthritis pain, medical marijuana can bring relief without the side effects caused by traditional treatments. But it’s still not legal everywhere—yet. 

What Every Arthritis Patient Needs to Know About Cannabis

Medical Marijuana for Arthritis Pain Relief: Laws, Research, and a Patient Story

What Every Person With Arthritis Needs to Know About Cannabis

Medical cannabis, which is currently available for prescriptive purposes in 33 states, can be used to treat the symptoms of a variety of physical and mental health conditions, from cancer to HIV to anxiety. And now, new research has revealed it may help with obsessive-compulsive disorder. 

An October 2020 study in the *Journal of Affective Disorders* looks at cannabis use and its effect on symptoms of OCD. Within four hours of smoking cannabis, users reported roughly a 50% reduction in symptoms like compulsions and unwanted thoughts. Cannabis with higher concentrations of cannabidiol (CBD) was associated with an even greater reduction in OCD symptoms. 

Carrie Cuttler, Ph.D., lead author and an assistant professor in the department of psychology at Washington State University in Pullman, gets into the specifics. “We found an average reduction in self-reported intrusions from before to after cannabis use of 49%,” she says. “Self-reported severity of compulsions were reduced by 60% from before to after cannabis use, and anxiety ratings were reduced by 52%.” 

Does this mean cannabis could eventually become a prominent treatment approach for OCD? More research is needed, but here’s what we know so far.  

## Living With OCD 

OCD is a chronic mental disorder characterized by two key symptoms: obsessions (a.k.a. unwanted thoughts or intrusions) and compulsions. It affects around one in 100 people, or a total of two to three million adults in the U.S. People [living with OCD](https://www.healthcentral.com/slideshow/ocd-myths-and-facts) often report uncontrollable behavior patterns, like an obsessive need to clean, organize, or check on things. They may also have serious and lasting fears that cause great anxiety in their day-to-day life. 

Common OCD obsessions include:

- Contaminants and germs
- Fear of violence toward oneself or others
- Frequent/“forbidden” sexual impulses
- Excessive concern with morality (often tied to religion)
- Worry about freak accidents
- Superstitions

Common OCD compulsions include: 

- Excessive cleaning, of oneself or one’s environment
- Constant checking to make sure nothing has gone wrong 
- Repeating routine activities over and over again
- Mentally reviewing situations constantly in an effort to prevent harm

The factors contributing to OCD are multifaceted—they include genetics, brain chemistry, environment, and past traumatic experiences. The condition is typically treated with antidepressants and psychotherapy. Specifically, providers will often use a method called exposure and response prevention, where patients gradually expose themselves to their fears, then learn a new way to respond. 

## The Future of Cannabis & OCD

Needless to say, [cannabis](https://www.healthcentral.com/article/cannabis-and-pain-management) isn’t a traditional treatment approach, but Cuttler explains that it has real potential. “We’ve found previously that acute cannabis intoxication can reduce symptoms of anxiety,” she says. “We’ve seen reductions in the intrusive thoughts characteristic of PTSD associated with cannabis use.” And now, her research is linking it directly to symptoms of OCD. 

Specifically, Cuttler notes, the CBD finding may pave the way for future therapies. “It’s particularly promising because CBD does not have the intoxicating properties of THC,” she explains. “There might be fewer side effects, and there wouldn’t be the intoxication associated with it.” You’ve probably heard of CBD, but we’ll fill in the gaps: It’s a natural compound in marijuana that has no intoxicating or addictive effects, and it has been studied for its potential therapeutic impacts on chronic pain and anxiety. CBD won’t get you high, which makes it an appealing choice for medical use.   

Cuttler notes that her research only looks at the effects of cannabis in the short-term, for just a few hours after consuming it. “There doesn’t seem to be any sort of long-term beneficial effect of cannabis in reducing these symptoms over time,” she says. For long-term support, “people with OCD would definitely be encouraged to seek out therapy, specifically cognitive behavioral therapy and exposure and response prevention therapy.”

This treatment approach also needs more research before being applied on a broader scale. Cuttler explains that her data, which was gathered with support from a medical cannabis data company called Strainprint, included self-reported information from participants. This can sometimes be vulnerable to personal bias. “At least some of these reductions are likely driven by people’s expectations about the effects of cannabis on these symptoms,” she says. Further clinical trials will help account for this discrepancy.  

For now, hold off on trying this at home. Those new to medical marijuana should consult a medically trained specialist before using it to treat their condition. But if you know someone with OCD, it’s worth keeping an eye on this alternative therapy, which may represent a breakthrough in the coming years.

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OCD-iStock-921346044

In the hours after smoking marijuana, users reported a dramatic reduction in compulsions, unwanted thoughts, and anxiety – all hallmark symptoms of OCD. Here’s what that could mean for the future of cannabis research (especially related to CBD) and this chronic mental health condition. 

Cannabis to Treat OCD

Scientists thinks so. A new study found that medical marijuana drastically reduces compulsions and obsessions.

Could Cannabis Help Treat OCD?

- __Cannabis Legality, State-by-State:__ Marijuana Policy Project. (2020.) “State Policy.” [mpp.org/states/](https://www.mpp.org/states/)

- __Medical Marijuana Safety:__ National Institute on Drug Abuse. (2020.) “Is marijuana safe and effective as medicine?” [drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine](https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine)

- __Medical Marijuana Uses:__ *Annals of Internal Medicine*. (2018.) “Risks and Benefits of Marijuana Use.” [ncbi.nlm.nih.gov/pmc/articles/PMC6157909/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157909/)

- __Cannabis & OCD Study:__ *Journal of Affective Disorders*. (2020.) “Acute Effects of Cannabis on Symptoms of Obsessive-Compulsive Disorder.”  [doi.org/10.1016/j.jad.2020.09.124](https://doi.org/10.1016/j.jad.2020.09.124)

- __OCD Symptoms:__ National Institute of Mental Health. (n.d.) “Obsessive-Compulsive Disorder.” [nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml](https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml)

- __OCD Prevalence:__ International OCD Foundation. (n.d.) “Who Gets OCD?” [iocdf.org/about-ocd/who-gets/](https://iocdf.org/about-ocd/who-gets/)

- __OCD Common Obsessions:__ International OCD Foundation. (n.d.) “What is OCD?” [iocdf.org/about-ocd/](https://iocdf.org/about-ocd/)

- __Treatments for OCD:__ International OCD Foundation. (n.d.) “How is OCD Treated?” [iocdf.org/about-ocd/ocd-treatment/](https://iocdf.org/about-ocd/ocd-treatment/)

- __CBD:__ Policy Lab. (2020.) “A Guide To Cannabidiol (CBD) Clinical Trials.” [policylab.us/clinical-trials/cbd/](https://policylab.us/clinical-trials/cbd/)


Could Cannabis Be Used to Treat Obsessive-Compulsive Disorder?

Sara Asher, a 28-year-old with severe ulcerative colitis (UC) from Eugene, Oregon, starts her day by taking a capsule containing cannabis oil to help reduce inflammation and stimulate her appetite. Throughout the day, if she experiences breakthrough symptoms like severe pain or abdominal spasming — or if nausea prevents her from keeping her capsule down — she smokes cannabis for quick relief. She takes another capsule of cannabis oil before bedtime, which helps her keep her to better control her symptoms. 

“I take it in a capsule because it lasts in your system much longer than smoking ever would,” Asher tells HealthCentral in a phone interview. “[But] when you ingest cannabis, it takes 90 minutes to kick in. The smoking — that will give you the instant relief on the exhale.”

Asher started using cannabis for symptom relief shortly after being diagnosed with UC four years ago.

“My friends at the time were like, ‘You know what really helps with stomach pain and nausea? Cannabis,’” she says. “I laughed at them. [But when I tried it], the next day, [I went from 50 bowel movements a day to 15](https://www.healthcentral.com/article/ulcerative-colitis-symptoms-is-this-normal). A huge difference.”

[Little research](https://www.nature.com/articles/ajg2014245) has been published on cannabis or marijuana usage for inflammatory bowel disease (IBD), including UC. But anecdotally, many patients find that it helps relieve their symptoms.

### How cannabis compounds affects the body

Cannabis oil contains different levels of chemical compounds called cannabinoids, which may affect the body differently. The chemical compound cannabidiol (CBD) has been found to [reduce inflammation](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/). The chemical compound delta-9-tetrahydrocannabinol (THC) has been shown to reduce nausea and improve appetite. [THC has also been associated with the “high” feelings that marijuana is known for](https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-marijuana-effects); CBD, however, does not have this association.

“There are [Food and Drug Administration (FDA)]-approved THC-based products for nausea and vomiting — for patients with cancer chemotherapy, and for anorexia, [and] for patients with AIDS,” said Ed Hoffenberg, M.D., director of the Center for Pediatric Inflammatory Bowel Diseases at Children’s Hospital Colorado, in an e-mail interview. “THC can decrease nausea and increase appetite, [and] so it’s not surprising that IBD patients use THC for these indications.”

### Using cannabis for IBD is mostly uncharted territory

Some doctors may prescribe [medication containing CBD or THC](https://www.fda.gov/NewsEvents/Testimony/ucm511057.htm) off-label to patients with UC. If patients seek guidance from their doctors about smoking [medical marijuana](https://www.healthcentral.com/slideshow/13-sizzling-questions-about-marijuana-and-chronic-pain) or ingesting cannabis oil capsules, though, the physicians may not have enough information to feel confident making recommendations.

“There is little data on IBD, and currently, the benefit is theoretical,” Hoffenberg says. “A number of patients have reported perceived benefit from CBD, but there is no consistency in the product used, dose, frequency, [or] route of administration. Potential mechanisms include reducing inflammation, but there are possibly other mechanisms as well. As an example, for the CBD product [Epidiolex](https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm611046.htm) — just approved for children with severe seizure disorders — the mechanism of action is not known.”

Most UC patients who use cannabis rely upon trial and error to determine the right dosage, method of administration, and frequency of administration that’s right for them.
 
“[There’s] no data and little consistent anecdotal reports,” Hoffenberg said.

Asher purchases empty capsules and fills them with cannabis oil.

“I fill it halfway, but a lot of people do [an amount equivalent to] a grain of rice,” Asher said. “Put a little in the capsule at first; then people can see what works best for them.”

### Doctors may be wary of discussing cannabis for IBD

Some doctors, including [UC specialists](https://www.healthcentral.com/slideshow/questions-to-ask-doctor-about-ulcerative-colitis), may feel uncomfortable discussing cannabis because it isn’t prescribed the same way as FDA-approved drugs.

“Medical or recreational marijuana through dispensaries is much less regulated, or minimally regulated, compared to FDA products,” Hoffenberg said. 

“A concern that providers have is that patients will stop taking traditional medicines and just use cannabis [or] CBD — in other words, put all their eggs in one basket with unproven short- or long-term effects.”

Some doctors may not want to discuss cannabis products with UC patients because of the “high” that’s associated with THC. While CBD isn’t associated with negative effects (it doesn’t get you “high”), research in adolescents and adults under age 25 have shown that THC has been associated with impaired judgment, impaired driving, magnified impairment if combined with alcohol, psychosis when taken in high doses, withdrawal symptoms, and the potential for addiction or use of other drugs, according to Hoffenberg.

### Positive effects of cannabis for UC patients

Although the research is limited, some studies have shown that cannabis can be helpful for people with UC.

“There is a disease-modifying effect of CBD or cannabis,” Hoffenberg says. “There are many factors that show short-term improvements in IBD — both Crohn’s and ulcerative colitis — like diet, antibiotics, but few interventions that show long-term response.”

Hoffenberg’s own research on cannabis usage in adolescents and young adults with IBD has shown some positive results.

“Although scores for pain, appetite, and disease activity were similar to non-users,” Hoffenberg says, “cannabis oil users perceived a positive impact in sleep quality, nausea, and appetite.”

Anecdotally, many people living with IBD and UC find relief with cannabis.

“I have more severe ulcerative colitis,” Asher says. “Cannabis [helps me eat](https://www.healthcentral.com/slideshow/foods-avoid-ulcerative-colitis). I’ve been able to get off of 16 other medications.”

### UC is not a qualifying condition for medical marijuana

To qualify for medical marijuana, your doctor must certify that you have a [qualifying condition](https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855), but ulcerative colitis is not on the list. Designations vary by state, but if you have UC, you may qualify for medical marijuana if you have chronic or severe pain.

Asher has a medical marijuana card to legally use cannabis in Oregon, but she’s petitioning the Oregon Health Authority to include IBD as a qualifying condition.

“I fall under the category of severe pain and severe nausea,” Asher says, “but I want IBD to have its own category, among cancer, PTSD, [and others]. We have the same immunosuppression as [people who have] AIDS. We take the same drugs as cancer patients. It’s very odd to me that IBD does not have its own category, when cannabis can improve quality of life.”




iStock-1066991804

Cannabis oil

Learn about the research and potential benefits of marijuana, cannabis oil, or CBD on ulcerative colitis symptoms.

CBD for UC

Treatment for Ulcerative Colities can include many things. Some people with UC find relief in making dietary changes, doing UC-friendly exercises, and more.

More info on UC!

UC Treatment

We went to some of the nation's top UC experts to bring you the most scientific and up-to-date information possible.

You have some seriously effective options for managing symptoms of ulcerative colitis—and a darn good chance at reaching remission, too.

Let's Talk About Treatment for UC

Ulcerative Colitis Treatment, Medications, Surgery and Other Therapies

You have some seriously effective options for managing symptoms—and a darn good chance at reaching remission, too.

Let's Talk About Treatment for Ulcerative Colitis

Can medical marijuana, CBD, or other forms of cannabis help your IBD symptoms? Here’s what the research and experts say.

Should You Use Cannabis or CBD for Ulcerative Colitis?

Ulcerative Colitis: Can Cannabis or CBD Help?

Some People With UC Are Using Cannabis. Should You?

*It’s found everywhere from the fancy natural food market and the chain drugstore to the neighborhood pet shop—and heck, even the gas station around the corner. Hailed as a cure-all for just about every condition known to man, cannabidiol, more commonly known as CBD, is pervasive—like Millennial-pink pervasive.* 

*In fact, according to a 2019 Gallup poll, one in seven Americans say they use CBD-based products. While legit everyone and their mother, grandmother, and best friend seem to be using it, many people still don’t know exactly what CBD is—and for good reason: There’s all kinds of confusion surrounding it. We’re here to clear the whole messy situation up.* 


## What Is CBD Cannabidiol, Anyway?

To understand CBD, first you need to understand the cannabis plant. It’s a species that contains over 100 different chemical constituents called cannabinoids. The two primary cannabinoids are: 

- __Tetrahydrocannabinol (THC)__, the substance responsible for the psychoactive effects that make you feel high
- __Cannabidiol (CBD)__, which has no psychoactive effects, but does likely interact with the body’s natural endocannabinoid system (more on this below)

Cannabis and marijuana are terms often used interchangeably but *read*: They are not the same thing. Think of cannabis as the mothership, where CBD, marijuana, and hemp come from. Marijuana *only* refers to parts and/or strain of the cannabis plant containing high levels of THC (more on this later). 

People have widely reported that CBD is helpful for a slew of conditions ranging from anxiety and insomnia to gastrointestinal problems and chronic pain. Keep in mind, CBD is FDA-approved for only one medication called Epidiolex, which treats the seizures resulting from two severe types of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients two years of age and older. Using it for anything else is at your own risk, so *always* talk with your doctor before you try it.


## Is CBD Legal?

Because it’s so mainstream, you might automatically assume CBD is legal. And it is (sort of) depending on the strain of cannabis plant it’s derived from. Here’s the deal: 

- Cannabis that has 0.3% THC or less is known as hemp and is considered legal.

- Cannabis with 0.3% THC or greater, known as marijuana, is illegal depending on the state in which you live. At the federal level, marijuana is classified as a Schedule 1 drug, so any marijuana-derived product is considered illegal. 

- States have the power to legalize both medical and recreational marijuana. And currently, 33 states have legalized medical marijuana, and 11 states and Washington, D.C. have legalized marijuana for recreational use for adults over 21.

### Marijuana-derived CBD vs. Hemp-derived CBD

Here’s where things get really tricky: Though it can come from both hemp and marijuana, only CBD derived from hemp is legal everywhere. Marijuana-derived CBD is illegal (if you’re in a state where marijuana is illegal) because it’s classified as a controlled substance—regardless of the percentage of THC it contains. 

And, to make things even more complicated, even if you live in a state where marijuana is legal, technically, you can’t cross over to the state next door with it because it’s still illegal at the federal level. Is your head spinning yet? We feel you. To clear up some confusion, [here's a guide to the latest marijuana laws by state](https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx).

Is CBD Legal?

## How Does CBD Work in the Body? 

Believe it or not, we have a built-in biological system called the endocannabinoid system (ECS), (and no, it wasn’t designed specifically to process cannabis). It’s actually the body’s main regulatory system, meaning it keeps many functions in balance and sailing smoothly; it’s kind of like the body’s natural caretaker. 

It’s made up of __endocannabinoids__, which our bodies naturally produce. These are molecules that closely resemble the cannabinoids found in the cannabis plant, cannabinoid receptors to which endocannabinoids bind, and enzymes, which are responsible for breaking down endocannabinoids once they’ve completed their job. 

These three components manage a diverse range of physiological processes such as protecting neurons, regulating the immune system, influencing gastrointestinal functions, and impacting how we perceive pain. When something’s out of whack internally, endocannabinoids bind to receptors, which alert the ECS that certain functions aren’t working properly. For example, if the body is overheated, the ECS will tell the body to cool down by producing sweat. 

When you consume THC, the main cannabinoid found in the cannabis plant, it interacts with two main receptors within the ECS, the CB1 receptor, found mostly in our brain and central nervous system, and the CB2 receptor, found mostly in the immune system. When THC binds to them, it causes psychoactive effects by disrupting mental and physical functioning like memory, concentration, and coordination. 

For example, THC affects the functioning of the brain’s hippocampus and orbitofrontal cortex, which are areas responsible for creating new memories and shifting our attention from one thing to the next. As a result, marijuana can interfere with performing complicated tasks and cause impaired thinking. So while you might really be focusing on the insanely amazing glory of the clouds right now (and not much else), you’re probably also feeling pretty darn relaxed thanks to a boost to the brain’s pleasure centers. (Though in some people, higher doses of THC can spike anxiety instead of dulling it.)

Experts aren’t sure exactly how CBD, the other main cannabinoid found in the cannabis plant, works in the body, but it is thought to impact CB1 and CB2 functioning in a somewhat more indirect way than THC. However, they do have a theory as to why and how cannabinoids appear to target so many conditions: Because our own ECS is responsible for regulating systems throughout the whole body, it’s plausible that people would report a wide range of beneficial effects.

How It Works

Chronic conditions that may benefit from CBD oil.

CBD Info Chronic Conditions

Chronic Conditions That May Benefit From CBD

## Which Conditions Is CBD Used for?

Many people swear up and down and sideways that CBD helps relieve whatever is ailing them. According to a study published in *Cannabis and Cannabinoid Research*, 62% of CBD users say they use the remedy to treat a specific medical condition vs. using it for general wellness. Though more research is needed—and when we say more, we mean a lot more—here’s a rundown on what we know so far about the conditions CBD might help.

Conditions

### Anxiety 

According to studies done on rats by the National Institute on Drug Abuse, preclinical data showed CBD reduced the heart rate of angsty rodents and helped them chill out overall. Researchers say the CBD may have an effect on serotonin levels in the brain, which helps deliver a calming response. 

Scientists also believe CBD can reverse the anxiety-producing effects of THC when it’s administered simultaneously in humans. And in some small-scale human studies, neuroimaging showed CBD reduced amygdala activation in the brain, the area that’s involved in processing emotions. 

CBD for Anxiety

### Pain

A 2018 study published in *Cannabis and Cannabinoid Research* reports that chronic pain is the most common condition CBD is used to treat. Though the exact way CBD relieves pain isn’t fully understood, scientists speculate it may block inflammatory agents in the body, dulling symptoms like prickling, tingling, and burning caused by damage to or inflammation of the nerves. 

They also think CBD might interact with CB2 receptors found in the immune system, which are responsible for the body’s response to pain and inflammation. People report relief for the pain associated with conditions like arthritis, fibromyalgia, migraine, back, muscle, and multiple sclerosis. The other big benefit? It’s nonaddictive unlike other common treatments. 

CBD for Pain

### Insomnia

Experts aren’t entirely sure how CBD helps with sleeplessness, but they do think it may interact with receptors that affect the sleep/wake cycle. Also, because CBD may reduce the pain associated with many conditions, it can help those suffering experience a sounder snooze, so they stop tossing and turning in discomfort. 

In a recent study published in *The Permanente Journal*, participants who suffered from both anxiety and insomnia were given 25mg of CBD in capsule form each day. After the first month, sleep improved in 66% of the subjects and anxiety improved in 79%, suggesting that by decreasing anxiety, sleep may also get better. 

CBD for Insomnia

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### Gastrointestinal Symptoms

Researchers believe there are high levels of endocannabinoid receptors in the GI tract. Some small-scale animal studies have shown that CBD may have a beneficial effect on inflammatory bowel disease. In these studies, the use of cannabinoids given prophylactically helped reduced the patients’ abdominal pain and diarrhea, and it improved their quality of life overall by inhibiting the inflammatory reaction.

### Chemo Side Effects

Because CBD is thought to have anti-inflammatory and anti-anxiety properties, it’s been reported to help minimize pain associated with [cancer](https://www.healthcentral.com/condition/cancer) and the chemotherapy treatments used to treat cancer. There are several THC-based drugs approved to treat symptoms like nausea and vomiting produced by chemotherapy. These include Dronabinol (Marinol), which comes in capsule form and Nabilone (Cesamet), an oral synthetic cannabinoid that acts like THC.

CBD for Chemo Patients

## What Forms Does CBD Come in?

CBD can be found in the cannabis flower (i.e., the cannabis products someone might smoke) as well as edible cannabis, oils, tinctures, lotions, and concentrated forms of cannabis (i.e., the cannabis someone might ingest through vaping). __CBD oil__, which is usually placed under the tongue, has been found to be most effective because it’s super concentrated and often works quickly, sometimes in under an hour. 

CBD that’s absorbed by the digestive tract in __capsule, food, or liquid forms__ is also recommended, but it may take longer to have an effect—up to two hours, however, it can also have an extended release. 

__Topical products__, like lotions, gels, and balms, have been found to be effective for spot treatment for inflammation and painful joints.


Forms

## Proceed With Caution

Keep in mind, the science supporting the beneficial claims about CBD is limited—since researching it is highly regulated. And because of this, there is still a lot we don’t know about CBD pharmacology, dosing, or its effects. Scientists face several barriers in conducting research on CBD. 

First, the one CBD-based medication that has been approved by the FDA, Epidiolex, contains a strain of CBD that’s very different from the CBD most people use. Since it’s controlled, it’s a pure sample of CBD and doesn’t have all the other plant-based compounds typically found in medical, recreational, and hemp-based forms. 

These products are super tough to study, because every sample can widely differ from the next. Like most unregulated substances, it’s like the wild west out there, and you don’t know exactly what you’re getting, so talk with your doctor and dose slowly.  


Precautions

## What Are the Potential Risks of Using CBD?

While it’s relatively safe, side effects from CBD may include:

- Nausea
- Fatigue
- Irritability
- Stomach upset  

However, there's accumulating evidence that it can have significant drug interactions with certain other medications. This is because CBD is metabolized in the liver by a group of enzymes called CYPs. When cannabidiol is present in the body it can prevent CYPs from metabolizing other drugs, including those for:

- Heartburn
- [Migraine](https://www.healthcentral.com/condition/migraines)
- Hypertension

To play it safe, if you’re using any other medication for any condition—even one not listed here—talk to your doctor before using CBD.   


Risks

## How Can I Use CBD Safely? 

If you're looking to try CBD, talk with your primary care doctor about whether it might interact with any of the other drugs you’re currently taking. If they are reluctant to recommend it, seek out a doctor who specializes in integrative medicine or check with a national organization like the [American Medical Marijuana Physicians Association](https://ammpa.net/) for a provider in your area.

Buying a reputable batch can be tricky because the CBD products you can buy at stores (including those at cannabis dispensaries) are not regulated by the FDA, so any time you buy a CBD product, what you’re actually getting could contain different amounts of CBD than what is stated on the label. In fact, [research](https://www.sciencedaily.com/releases/2017/11/171107112244.htm) has shown that the CBD content in almost 70% of CBD-labeled products available online may be mislabeled. 

Experts recommend buying CBD that’s been third-party tested. Look for a stamp of quality assurance on the bottle and if it’s not there, scan the QR code with your smartphone or check the company’s website for a certificate of authenticity. Here, you can compare it to the label to make sure the concentration of CBD or THC matches. You’ll also want to check out what else the product contains: 

- If the CBD is labeled __full-spectrum__, then it likely contains all of the other natural compounds found in the cannabis plant, including some THC. 
- If it’s __broad-spectrum__, then it may contain all the other plant compounds except THC.
- If it‘s labeled __CBD isolate__, then it should be a pure form of CBD without any another plant compounds or THC (though again there’s no way to be absolutely sure).  

As for where to buy it, your doctor may be able to give you some recommendations. Or if you live in a state where dispensaries are legal, usually their staff is knowledgeable. Always start by taking a small amount and wait to see how it affects you before upping your dose.

Safety

CBD stands for cannabidiol, and it’s the second most prevalent chemical ingredient, or cannabinoid, found in cannabis. But unlike THC, the other main cannabinoid in cannabis, it does not have psychoactive effects.

What does CBD stand for?

While CBD is available in a few forms, oil is the most common because it’s easily ingestible and generally contains a higher percentage of CBD than most other forms. It’s created from a concentrated extract made from cannabis flowers or leaves that are dissolved in an edible oil such as olive oil or sunflower oil. Because CBD is unregulated and largely unstudied, its effects are speculative. Many people report it relieves a host of different conditions like anxiety, pain, and insomnia, reduces inflammation throughout the body, alleviates symptoms associated with gastrointestinal disorders, and minimizes the side effects from chemotherapy.

What does CBD oil do?

Figuring out how much CBD you should take is one of the great unknowns. Because of the lack of research, docs can’t properly study it, so how much to take is anyone’s guess and could vary from person to person and from product to product. Before taking it, first talk with your doctor because it could have drug interactions, which can interfere with medications you’re currently taking. Then start slow and see how your body reacts. 

How much CBD should you take?

Some experts recommend CBD as an oil that you put under your tongue for a faster onset or in pill or capsule form, which delivers a slow, extended release. Before you take anything, talk with your doctor and go slow. If you live in a state where medical marijuana is legal, your doctor may recommend taking CBD along with a low dose of THC because researchers believe the two work better together to treat pain. If you are taking a bit of THC, experts advise doing so at night, so you sleep off any psychoactive effects.

How do you use CBD oil for pain?

CBD FAQ

- __Cannabis Habits Among Users:__ *Cannabis and Cannabinoid Research*. (2018). “A Cross-Sectional Study of Cannabidiol Users” [ncbi.nlm.nih.gov/pmc/articles/PMC6043845/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043845/)

- __All About the Endocannabinoid System:__ *Biological Psychiatry*. (2016). “An introduction to the endogenous cannabinoid system.” [ncbi.nlm.nih.gov/pmc/articles/PMC4789136/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789136/)

- __CBD Evidence & Issues:__ *Epilepsy Currents*. (2014). “Cannabidiol: Promise and Pitfalls.” [ncbi.nlm.nih.gov/pmc/articles/PMC4189631/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189631/)

- __The Legality of CBD & Cannabis:__ *Medical Cannabis and Cannabinoids*. (2018). “The Trouble with CBD Oil.” [karger.com/Article/FullText/489287](https://www.karger.com/Article/FullText/489287)

- __How CBD Works in the Body:__ *International Journal of Molecular Sciences*. (2018). “Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System.” [ncbi.nlm.nih.gov/pmc/articles/PMC5877694/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877694/)

- __CBD & Anxiety:__ *Neurotherapeutics*. (2015). “Cannabidiol as a Potential Treatment for Anxiety.” [ncbi.nlm.nih.gov/pmc/articles/PMC4604171/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/) 

- __CBD Effects on Anxiety & Sleep:__ *The Permanente Journal*. (2019). “Cannabidiol in Anxiety and Sleep: A Large Case Series.” [ncbi.nlm.nih.gov/pmc/articles/PMC6326553/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/)

- __CBD & Inflammation:__ *Future Medicinal Chemistry*. (2009). “Cannabinoids as novel anti-inflammatory drugs.” [ncbi.nlm.nih.gov/pmc/articles/PMC2828614/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/)

- __CBD & GI Issues:__ *Current Neuropharmacology*. (2016). “Role of Cannabinoids in Gastrointestinal Mucosal Defense and Inflammation.” [ncbi.nlm.nih.gov/pmc/articles/PMC5333598/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333598/)


*CBD, short for cannabidiol, is having a major moment right now. While many people are turning to the herbal alternative to help treat a host of different conditions, the majority are using it to ease chronic pain (in no small part because it’s nonaddictive, unlike many traditional treatments). In fact, among the 62% of survey participants who reported using CBD to treat a medical issue, the top condition they used it to treat was, you guessed it, chronic pain, according to a study published in* Cannabis and Cannabinoid Research. *And those pain-related conditions include everything from arthritis and fibromyalgia to migraine, muscle pain, and even cancer. If you've been wondering if CBD is the pain-reliever you've been looking for all your life, we'll help figure out if it's time to make the first move.* 

## What Is CBD Again? 

You’ve seen bottles of CBD lining the shelves of natural food stores, in jars of beauty creams and gummies, and even baked into dog treats. CBD is legit everywhere these days. But what exactly is this so-called wunderkind cure-all? Here’s the science: It’s one of two main cannabinoids, chemical entities found in the cannabis plant (the other one is tetrahydrocannabinol, THC). 

Unlike THC, which causes you to get high, CBD has no psychoactive effects, and many people find it to be therapeutic for things like anxiety, insomnia, nausea, and pain. And while everyone from grandmas to dogs are using it, CBD is only FDA-approved for one medication called Epidiolex, which treats the seizures associated with two rare and severe forms of epilepsy. So, essentially, usage for anything else is completely unregulated.

And, not only is it unregulated, but it’s also very difficult for scientists to study. That’s because what you buy at retail is mixed with other plant chemicals—which are often unknown. So, any given sample experts study can seriously vary from the next. (Epidiolex, on the other hand, is made from a chemically pure strain of CBD.) In fact, [research](https://www.sciencedaily.com/releases/2017/11/171107112244.htm) has shown that the CBD content in almost 70% of CBD-labeled products available online may be mislabeled. 

The moral of this cautionary tale is: You don’t know what you’re getting—so consume at your own risk and *always* consult with your doctor before you try it.

It’s not just for treating pain. Learn about all the benefits of CBD here.

All the Info on CBD

## How Can CBD Relieve Pain? 

Researchers don’t exactly know how CBD works in the body to alleviate pain, but they do have several theories. In pre-clinical studies using rat subjects, CBD was found to inhibit the release of glutamate and other inflammatory agents, dulling sensations like prickling, tingling, and burning, which are characteristic of neuropathic pain (the pain caused by damage to or inflammation of the nerves). 

It’s also thought to have some serious antioxidant power that’s greater than ascorbic acid (vitamin C) or tocopherol (vitamin E)—antioxidants can neutralize tissue-damaging chemicals that cause inflammation.  Plus, CBD is said to promote sounder sleep, which helps minimize the snooze disruptions people with chronic pain often experience. 

Some researchers also believe that CBD interacts with certain receptors in the brain (called CB2 receptors), which are primarily found in the immune system and responsible for the body’s response to pain and inflammation. THC, on the other hand, mostly attaches to CB1 receptors, which are found in the brain and associated with cognitive actions like coordination, mood, thinking, memory, and appetite (this is why smoking marijuana, which is high in THC, affects users on a cognitive level). [Depending on the condition, doctors may recommend a combination of CBD and THC for even greater pain relief](https://www.healthcentral.com/article/laws-for-cannabis-and-arthritis#how-cannabinoids-work).


How CBD Helps Pain

## What Forms Are Most Effective for Pain Relief?

Generally, CBD is most effective in oil that’s placed under the tongue because it’s concentrated and kicks in quickly, usually in under an hour. CBD swallowed in capsules, food, or liquid is absorbed through the digestive tract and absorption is slower, often taking one-to-two hours but with an extended release so the effects last longer. Topical products, like lotions, gels, and balms, applied to the skin over a painful joint, have been found to reduce inflammation. 

## Which Types of Pain Can CBD Help Relieve?  

While every expert will tell you more research is needed, many patients are proving CBD helps with the pain related to a variety of conditions. Here’s the lowdown on what we know so far.

### Arthritis Pain

Arthritis, a condition characterized by joint pain, swelling, stiffness, and a decreased range of motion is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. According to a study of arthritis sufferers by the Arthritis Foundation, 29% of those surveyed use CBD to treat arthritis symptoms. 

CBD is thought to help by decreasing joint inflammation and protecting the nerves. A study published in *Pain* found that CBD even prevented osteoarthritis pain in rats. Another study published in the *European Journal of Pain* found that topical CBD gel significantly reduced joint swelling, pain, and inflammation in rats with arthritis. Yes, these studies are in small furry rodents and not actual humans. But animal research is the starting point for many trials, so consider them for what they are: a beginning. 

Arthritis

### Fibromyalgia Pain

Characterized by chronic pain all over the body, as well as related symptoms like fatigue and insomnia, fibromyalgia affects about 4 million people in the United States. While the cause is unknown, some researchers believe fibromyalgia may be the result of an endocannabinoid deficiency syndrome. 

Similar to the cannabinoids found in cannabis, endocannabinoids naturally occur in the body, and they manage a diverse range of physiological processes such as regulating the immune system, influencing gastrointestinal functions, and impacting how we perceive pain.  But when levels are low or the endocannabinoid system is too weak to carry out its usual commands, body-wide symptoms like those that come with fibromyalgia may result. 

So the theory here is that taking plant-based cannabinoids like CBD and THC (basically supplementing what the body needs like a multivitamin) can treat the deficiency and relieve symptoms. Other evidence shows taking CBD oil may even change the way people with fibromyalgia process pain by making cells surrounding nerves less sensitive.


CBD for Fibromyalgia

### Migraine Pain

According to the Migraine Research Foundation, 39 million people in the United States suffer from [migraines](https://www.healthcentral.com/condition/migraines), a neurological disorder that causes debilitating headaches as well as other symptoms such as visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch, and smell, and tingling or numbness in the extremities or face. Most (small-scale) studies have looked at the combined effects of CBD and THC as a treatment, including a study published in *Headache*, which found that the THC-CBD combo reduced migraine attacks and the pain that comes with them by more than 40%.  


CBD for Migraine

### Back Pain

While CBD in most forms is basically a top-to-toe treatment, meaning it generally can’t target specific parts of the body, there’s compelling evidence that topical-based CBD creams, gels, and salves work better for back pain. They not only reduce inflammation and neuropathy (nerve dysfunction), but you can place them on the areas that are most affected like an on-the-spot treatment. And, they’ve also been found to reduce the anxiety associated with pain and help improve relaxation, which can be difficult for the chronic back pain sufferer. 

### Muscle Pain/Soreness

Any active person knows, muscle pain and soreness go hand in hand with exercise. Because CBD has been shown to fight inflammation, which is behind muscle soreness, applying a CBD salve right to the area concentrates the treatment and can help ease the aches.  


CBD for Back Pain

### Multiple Sclerosis Pain

In 25 countries including the UK and Canada, a medication called Sativex, a cannabis-derived oral spray containing equal parts THC and CBD is approved for treating spasticity, the painful continuous muscle stiffness, and involuntary contractions that affect about 80% of MS patients. Sativex is thought to inhibit nerve impulses via the cannabinoid receptors in the central nervous system and in immune cells. Studies have shown that within 12 weeks, patients have seen improvement in symptoms as well as an improved quality of life. While Sativex is not yet FDA approved in the U.S., it is undergoing testing here. 


### Cancer Pain

CBD is thought to have anti-inflammatory and anti-anxiety properties, which can help minimize cancer pain. And, aside from alleviating the spasticity and pain associated with MS, Sativex has been shown to help relieve pain associated with [cancer](https://www.healthcentral.com/condition/cancer) as well, and particularly in patients who are unresponsive to opioid therapy. There are several THC-based drugs including Marinol (dronabinol), which comes in capsule form and Cesamet (nabilone), an oral synthetic cannabinoid that acts like THC. Both help treat the nausea and vomiting that often come as a side effect of chemotherapy, the treatment most frequently offered to cancer patients.


CBD for Cancer

## Who Shouldn’t Use CBD for Pain Relief?  

Side effects from CBD are generally mild and may include:

- Nausea
- Fatigue
- Irritability
- Stomach upset 

The biggest concern, however, are drug interactions with some other medications, including those for heartburn, migraine, hypertension, and other conditions. This has to do with the way CBD is metabolized in the liver by a group of enzymes called CYPs. Cannabidiol can prevent CYPs from metabolizing other drugs. 

There is also evidence that CBD may have interactions with other common drugs like ibuprofen, acetaminophen, some anti-seizure drugs, statins, anti-diabetic drugs, and more. To play it safe, if you’re using any other medications, talk to your doctor before using CBD.   

## How Can I Find a Doctor Who’s Familiar With Using CBD for Pain?

This can be a little tricky. Because CBD is not FDA approved for general use, your primary care physician may be reluctant to recommend it. If your primary doc isn’t pro-CBD or is unfamiliar with the effects, look for a doctor who specializes in integrative medicine or check with a national organization like the [American Medical Marijuana Physicians Association](https://ammpa.net/) for a provider in your area. 


Products can be purchased online, over the counter, and at cannabis-specific dispensaries throughout most of the country. The best way to help ensure a quality sample is to look for products that have been tested by a third-party company. This should be marked on the label, and if not, check the company’s website. Keep in mind, because CBD is unregulated, you won’t know the quantity of CBD or the other constituents that may be present. (Research shows as many at 70% of CBD products may be mislabeled.) Additionally, there are no established clinical guidelines regarding forms and dosing, so be sure to talk with your doctor before using CBD. 

Where can I purchase CBD?

CBD is a single chemical entity molecule and the second main cannabinoid found in cannabis. Unlike THC, CBD is not psychoactive, i.e. it can’t get you high. Many people find it to be therapeutic for things like anxiety, insomnia, nausea, and pain. THC works by binding to receptors in the brain and central nervous system to produce psychoactive effects.

How is CBD different from THC?

Yes and no. CBD can come from both hemp and marijuana, however, only CBD derived from hemp is legal everywhere because it contains under 0.3% THC. CBD that comes from marijuana is illegal, depending on the state in which you live, regardless of its percentage of THC. Currently, 33 states have legalized medical marijuana, and 11 states and Washington, D.C. have legalized marijuana for recreational use for adults over 21.

Is CBD legal?

CBD & Pain FAQ

CBD & Pain

CBD oil has many uses, including pain treatment. Learn how CBD can help treat symptoms of arthritis, fibromyalgia, back pain, multiple sclerosis, and cancer. 

More and more people are using this buzzy herbal remedy to treat all kinds of pain. But how effective is it?

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