What Is CBD Oil?
This cannabis extract may help treat nerve pain, anxiety, and epilepsy
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman’s World, and Natural Health.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles, California.
Cannabidiol (CBD) oil is an extract from hemp plants called Cannabis indica and Cannabis sativa . You might be more familiar with cannabis plants because they are grown for marijuana. However, CBD is not the same thing as marijuana.
CBD oil contains CBD that’s mixed with a base (carrier) oil, like coconut oil or hemp seed oil. These are called tinctures. You can get tinctures in different concentrations. The oil can also be put into capsules, gummies, and sprays.
People who support using CBD oil say that it can treat pain and anxiety; can help stimulate appetite and may help manage some types of seizures.
This article goes over what CBD is used for, the possible side effects, and what you should look for if you choose to buy CBD.
CBD vs. Marijuana
CBD is one component (called a cannabinoid ) that’s found in a hemp plant. Marijuana is a separate plant but it’s from the same species that hemp belongs to. Marijuana has CBD and hundreds of other compounds in it.
The main difference between hemp plants and marijuana plants is how much of a compound called tetrahydrocannabinol (THC) is in them. Hemp is grown to have less than 0.3% THC, while marijuana has more.
THC is what’s responsible for the psychoactive effects of cannabis—in other words, it’s what makes you feel “high.”
CBD oil generally does not have THC in it; however, a very small (trace) amount might be in products sold in certain states.
What Is CBD Oil Used For?
We’re not sure exactly how CBD works. Unlike THC, CBD doesn’t have a strong connection with the molecules in the brain that THC binds to create psychoactive effects. These are called cannabinoid receptors.
Instead, CBD works on other receptors, like the opioid receptors that help control pain. It also affects glycine receptors that control a brain chemical called serotonin which helps control your mood.
People that support the use of CBD claim that CBD oil can treat a variety of health problems, including:
- Chronic pain
- Drug use and withdrawal
- High blood pressure
- Muscle spasms
- Poor appetite
As CBD has gained popularity, researchers have been trying to study it more. Still, there has not been a lot of clinical research to look for evidence in support of these health claims.
CBD is not a safe option for everyone. Talk to your healthcare provider if you want to try it for managing a health condition.
A 2015 review of research that was published in the journal Neurotherapeutics suggested that CBD might help treat anxiety disorders.
The study authors reported that CBD had previously shown powerful anxiety-relieving effects in animal research—and the results were kind of surprising.
In most of the studies, lower doses of CBD (10 milligrams per kilogram, mg/kg, or less) improved some symptoms of anxiety, while higher doses (100 mg/kg or more) had almost no effect.
The way that CBD acts in the brain could explain why this happens. In low doses, CBD might act the same as the surrounding molecules that normally bind to the receptor that “turns up” their signaling.
However, at higher doses, too much activity at this receptor site could produce the opposite effect.
There have not been many trials to look at CBD’s anxiety-relieving effects in humans. However, one was a 2019 study published in the Brazilian Journal of Psychiatry.
For the study, 57 men took either CBD oil or a sugar pill with no CBD in it (placebo) before a public-speaking event.
The researchers assessed the participants’ anxiety levels using measures like blood pressure and heart rate. The researchers also used a reliable test for mood states called the Visual Analog Mood Scale (VAMS).
The men who took 300 mg of CBD oil reported less anxiety than the men who were given a placebo; however, the men who took 100 mg or 600 mg of CBD oil did not experience the same effects.
CBD oil might help people with substance use disorder, according to a 2015 review published in the journal Substance Abuse.
The review looked at the findings from 14 published studies. Nine of the studies looked at the effects of CBD on animals, and five studies looked at the effects on humans.
The researchers reported that CBD showed promise for treating people with opioid, cocaine, or psychostimulant use disorders.
However, the effects of CBD were quite different depending on the substance. For example, CBD without THC did not decrease withdrawal symptoms related to opioid use.
On the other hand, it did reduce drug-seeking behaviors in people using cocaine, methamphetamine, and other similar drugs.
Some experts suggest that CBD could help treat cannabis and nicotine dependence, but more research is needed to provide this theory.
High Blood Pressure
A 2017 study found that CBD oil may reduce the risk of heart disease because it can lower high blood pressure in some people.
For the study, nine healthy men took either 600 mg of CBD or the same dose of a placebo. The men who took CBD had lower blood pressure before and after experiencing stressors like exercise or extreme cold.
The study also looked at the amount of blood remaining in the heart after a heartbeat (stroke volume).
The stroke volume in the men who took CBD was lower than in was in the placebo group, meaning their hearts were pumping more efficiently.
The study suggested that CBD oil could be a complementary therapy for people with high blood pressure that is affected by stress and anxiety.
However, there is no evidence that CBD oil can treat high blood pressure on its own or prevent it in people at risk. While stress can complicate high blood pressure, it does not cause it.
In June 2018, the U.S. Food and Drug Administration (FDA) approved a CBD oral solution called Epidiolex.
Epidiolex is used to treat two rare forms of epilepsy in children under the age of 2: Dravet syndrome and Lennox-Gastaut syndrome. These are very rare genetic disorders that cause lifelong seizures starting in the first year of life.
Other than for these two disorders, CBD’s effectiveness for treating seizures is not known. Even with Epidiolex, it’s not clear if the anti-seizure effects are from CBD or another factor.
However, there is some evidence that CBD interacts with seizure medicines like Onfi (clobazam) and raises their concentration in the blood. That said, more research is needed to understand the link.
Possible Side Effects
Clinical research has shown that CBD oil can cause side effects. The specific side effects a person has and how bad they are varies from one person to the next and from one type of CBD to another.
Some common side effects people report from using CBD include:
- Changes in appetite
- Changes in mood
- Dry mouth
CBD oil may also increase liver enzymes, which is a marker of liver inflammation.
People with liver disease should talk to their healthcare provider before taking CBD oil. They may need to have their liver enzymes checked regularly if they are using CBD.
Can You Use CBD If You’re Pregnant?
You should not use CBD oil if you’re pregnant or breastfeeding. Even though the effects of CBD are not fully understood, it does pass through the placenta.
The American Academy of Pediatrics (AAP) further states that pregnant people should not use marijuana because of the potential risks to a developing fetus.
Do not drive or use heavy machinery when taking CBD oil—especially when you first start using it or switch to a new brand. Remember that some products do contain THC, even in small amounts.
CBD oil can interact with medications, including many that are used to treat epilepsy. One of the reasons for this has to do with how your body breaks down (metabolizes) drugs.
Cytochrome P450 (CYP450) is an enzyme your body uses to break down some drugs. CBD oil can block CYP450. That means that taking CBD oil with these drugs could make them have a stronger effect than you need or make them not work at all.
Drugs that could potentially interact with CBD include:
- Anti-arrhythmia drugs like quinidine
- Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
- Antifungal drugs like Nizoral (ketoconazole) and Vfend (voriconazole)
- Antipsychotic drugs like Orap (pimozide)
- Atypical antidepressants like Remeron (mirtazapine)
- Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
- Immune-suppressive drugs like Sandimmune (cyclosporine)
- Macrolide antibiotics like clarithromycin and telithromycin
- Migraine medicine like Ergomar (ergotamine)
- Opioid painkillers like Duragesic (fentanyl) and alfentanil
- Rifampin-based drugs used to treat tuberculosis
Always tell your healthcare provider and pharmacist about all the medicines you take, including prescription, over-the-counter (OTC), herbal, or recreational drugs.
The interactions between these medications and CBD are often mild and you might not have to change your treatment.
However, in some cases, you might have to change medications or space out your doses to avoid a reaction. That said, never change or stop medication without talking to your provider.
Dosage and Preparation
There are no guidelines for using CBD oil. Each product works a bit differently, depending on the form.
For example, putting the oil under your tongue can produce effects more quickly than swallowing a capsule that needs to be digested.
Here are a few ways that you can take CBD oil:
- Placing one or more drops under your tongue and holding it there for 30 to 60 seconds without swallowing. You can also use a spray that is spritz in your mouth/under your tongue.
- Taking a capsule or chewing a gummy
There’s no “correct” dose of CBD oil. How much you take and the form you choose will depend on your needs and what you hope to get for effects. The average dose range is from 5 mg to 25 mg.
Most oils come in 30-milliliter (mL) bottles and include a dropper cap to help you measure.
That said, it’s hard to figure out the exact amount of CBD per milliliter of oil. Some tinctures have concentrations of 1,500 mg per 30 mL, while others have 3,000 mg per mL or more.
How to Calculate CBD Dose
To determine an exact dose of CBD, remember that each drop of oil equals 0.05 mL of fluid. This means that a 30-mL bottle of CBD oil will have about 600 drops in it.
If the concentration of the tincture is 1,500 mg per mL, one drop would have 2.5 mg of CBD in it. The math to figure that out looks like this: 1,500 mg ÷ 600 drops = 2.5 mg
What to Look For
CBD oil comes in different forms: isolates, broad-spectrum, and full-spectrum.
- Isolates contain only CBD
- Broad-spectrum oils nearly all of the components of the plan (e.g., proteins, flavonoids, terpenes, and chlorophyll), but does not have THC oils have all the compounds including THC (up to 0.3%)
Alternative medicine practitioners believe that the compounds provide more health benefits, but the is a lack of evidence to support these claims.
Remember that CBD oils are unregulated. There’s no guarantee that a product is what it claims to be on its packaging. You also can’t know for sure that it’s safe and effective.
A 2017 study reported that only 31% of CBD products sold online were correctly labeled. Most had less CBD in them than was advertised, and 21% had significant amounts of THC.
If you are interested in buying CBD products, here are a few tips to keep in mind:
- Buy American: Domestically produced CBD oil might be a safer option than those that have been imported.
- Go organic: Brands certified organic by the U.S. Department of Agriculture (USDA) are less likely to expose you to pesticides and other harmful chemicals.
- Read the product label: Even if you choose a full-spectrum oil, don’t assume that every ingredient on the product label is natural. CBD products can also have preservatives, flavorings, or thinning agents in them. If you don’t recognize an ingredient, ask the dispenser what it is or check online.
Hemp plants can be grown for different purposes. Some species are made for marijuana but others are used to make CBD products.
Unlike marijuana, CBD oil does not “get you high.” Instead, it may help relieve stress, anxiety, drug withdrawals, and nerve pain.
While there are many claims about the health benefits of using CBD oil, the evidence is lacking. A lot of studies were done with animals, not humans.
If you want to try CBD oil, you should learn about the different dosages and preparations first.
You should also know that the products are not regulated, which means you can’t know for sure that a product will work and be safe.
Before you use CBD oil, talk to your provider. If you take certain medications or have a health condition, you may not be able to use these products.
Frequently Asked Questions
It would be hard to overdose on CBD oil. Research has shown that human tolerance for CBD is very high. One study reported the toxic dose would be about 20,000 mg taken at one time.
It depends on where you live, the type of product, how it was sourced (e.g., is it from hemp or marijuana), and its intended purpose (medical or recreational). In many states, you must be 18 or 21 to buy CBD oil. Check your state’s laws.
Not necessarily. While the names are sometimes used interchangeably, hemp oil can also refer to hemp seed oil, which is used for cooking, food production, and skincare products.
CBD oil is made from the leaves, stems, buds, and flowers of the Cannabis indica or Cannabis sativa plant. It should contain less than 0.3% THC.
Hemp oil is made from the seeds of Cannabis sativa and does not have TCH in it.
5 Mental Health Uses for CBD
Kendra Cherry, MS, is an author and educational consultant focused on helping students learn about psychology.
Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Iuliia Bondar / Getty Images
The cannabis plant has been utilized for medicinal purposes for thousands of years. The plant contains more than 80 different compounds, which are known as cannabinoids. While tetrahydrocannabinol (THC) is the most abundant and is well-known for its psychoactive properties, the second-most found compound, cannabidiol (CBD) does not have psychoactive effects.
There has been a growing interest in the potential mental health benefits of CBD in recent years. A 2019 research letter published by JAMA Network Open reported a significant increase in Internet searches for CBD in the United States. While search rates remained steady between 2004 and 2014, there was a 125.9% increase between 2016 and 2017. In April 2019 alone, there were 6.4 million Google searches for CBD information.
While there have been a number of studies suggesting that CBD might mental health benefits, a recent comprehensive review found that support for this use was scant and that further investigation is needed to substantiate the purported benefits.
There are a number of conditions that CBD is purported to help, although more research is needed to determine the potential effects and benefits of CBD. Some of the existing studies suggest that CBD holds promise in the treatment of a number of conditions including depression, anxiety, epilepsy, and sleep issues, among other things.
CBD appears to have a range of benefits for neurologic disorders, including decreasing the frequency and severity of seizures. Some of these conditions, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), may not respond well to anti-seizure medications. Viral clips of CBD treatments effectively alleviating seizures were shared widely in social media in recent years, and research has supported the effectiveness of these treatments.
A large-scale study on the use of CBD in the treatment of pediatric epilepsy found that CBD reduced the frequency of seizures by more than 50% in 43% of the patients with Dravet syndrome. The Food and Drug Administration (FDA) recently approved a cannabis-derived medication containing CBD, Epidiolex, to treat certain childhood seizure disorders.
Anxiety is a common problem for many people. Anxiety disorders affect an estimated 19.1% of U.S. adults each year. Some studies suggest that CBD may help alleviate symptoms of anxiety. One study look at the possible neural basis for CBD reducing symptoms of social anxiety disorder.
A 2015 study published in the journal Neurotherapeutics analyzed the existing preclinical studies on the use of CBD for anxiety and found that CBD was effective for a number of anxiety conditions including:
However, the authors of the study note that while the substance has considerable potential, further research is needed to better determine the therapeutic benefits and long-term effects.
According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S., affecting an estimated 17.3 million adults each year. Effective treatments are available, which include psychotherapy and medication, although interest in complementary and alternative treatments has also grown in recent years.
CBD has been investigated for having potential antidepressant effects. Some antidepressants work by acting on serotonin receptors in the brain. Low serotonin levels may play a role in the development of depression, and animal studies suggest that CBD might have an impact on these receptors which may produce antidepressant effects.
A 2018 study found that the antidepressant-like effects that CBD produces depend upon the serotonin levels in the brain. Cannabidiol does not appear to increase serotonin levels but instead affects how the brain responds to serotonin that is already present in your body.
Because CBD may have a calming effect, it may also hold promise in treating sleeping difficulties. Sleep is a critical component of mental health and well-being, yet the Centers for Disease Control and Prevention (CDC) reports that a third of U.S. adults do not get the recommended amount of sleep each night. This is problematic since not getting enough sleep is linked to health conditions such as depression, type 2 diabetes, obesity, and heart disease.
One study conducted with adults who had symptoms of anxiety and poor sleep found that 65% experienced improvements in sleep quality scores after a month of taking an average of 25mg of CBD daily, although those scores fluctuated over time. Further research is needed to determine the possible effects of CBD on sleep.
Post-Traumatic Stress Disorder (PTSD)
PTSD affects approximately 6.1% of U.S. adults. It is characterized by symptoms including re-experiencing traumatic events, intrusive thoughts, nightmares, and avoidance of things that may trigger memories of the trauma.
Some research suggests that CBD may be helpful in reducing the symptoms of this condition. In one study published in the Journal of Alternative and Complementary Medicine, researchers found that an oral dose of CBD in addition to routine psychiatric treatment for PTSD was associated with a reduction in symptoms.
Should You Try CBD?
While CBD holds promise, a recent comprehensive review of the research suggests that support for the mental health uses of CBD remains insufficient. This 2019 study was published in The Lancet Psychiatry and looked at 83 studies on the use of CBD to treat mental illness.
The researchers looked specifically at six different disorders: depressive disorders, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, and psychosis. The review examined previous studies dating from 1980 through 2018.
The review concluded that there is not enough evidence to support the use of CBD in the treatment of mental health conditions.
The study did find that pharmaceutical TCH (either with or without CBD) was linked to small improvements in symptoms of anxiety among people with other medical conditions such as chronic pain and MS, although this evidence was considered low-quality.
This does not mean that CBD isn’t necessarily effective; of the studies reviewed, most only included a small number of participants, followed participants for a short period of time, and less than half were randomized controlled trials.
Instead, this study suggests that there simply isn’t yet enough high-quality evidence to support the use of CBD to treat mental conditions. This may change in the future as more research is carried out.
Many experts remain optimistic that CBD may prove useful for a range of mental health conditions. “CBD has shown therapeutic efficacy in a range of animal models of anxiety and stress, reducing both behavioral and physiological (e.g., heart rate) measures of stress and anxiety,” suggested Nora D. Volkow, the Director of the National Institute of Drug Abuse in testimony presented to the Senate Caucus on International Narcotics Control.
CBD is available in a number of different forms and products. Cannabidiol can be extracted from both hemp and marijuana plants, which differ in terms of how much CBD and THC can be extracted.
CBD from hemp plants contains only small amounts of THC that are not sufficient to produce subjective psychoactive effects. CBD produced from marijuana plants, however, may contain varying amounts of THC which can produce unwanted effects.
There are also three main types of CBD available.
- Isolate contains only CBD
- Full-spectrum contains other compounds found in the cannabis plant, including THC
- Broad-spectrum contains other compounds from the cannabis plant but not THC
People may choose to take a full-spectrum product because research has shown that when cannabinoids including THC and CBD are taken together, it magnifies the therapeutic impact, a phenomenon known as the entourage effect. Research also suggests that CBD can actually counteract the negative effects caused by THC.
Like full-spectrum CBD, products labeled as broad-spectrum contain multiple cannabinoids, which are purported to provide the therapeutic benefits of the entourage effect without the psychoactive effects of THC.
Some of the ways that CBD can be used include:
- Oral: This includes oils (which are made by infusing cannabidiol with a carrier oil), oil tinctures (which are produced by combining CBD with alcohol or water), sprays, and capsules.
- Topical: This includes salves or lotions that are applied to the skin
- Edibles: This can include candies, gummies, and beverages.
- Inhaled: Some CBD oils are specially formulated to be used as vaping oil, although there has been an increase in concern about the health dangers posed by vaping.
Topical solutions may produce localized effects, but only those taken by mouth are likely to produce any mental health effects. It is important to note that while there is a wide variety of these products available on the market, the FDA has not approved any over-the-counter (OTC) CBD product. Many of these products may vary in terms of what they contain, their potency, and their effectiveness.
It is also important to note that while hemp-derived CBD that contains less than 0.3% THC is legal by federal law, it is still illegal in some states. You should always check your state laws before purchasing a CBD product.
Possible Side Effects
While CBD may have some benefits, it is also important to consider some of the possible risks. Research suggests that CBD appears to be well-tolerated at doses up to 600mg.
While CBD appears to be well-tolerated, that does not mean that it is without side effects. While these may vary depending on the individual, some reported side effects include:
- Mood changes
- Appetite changes
However, understanding the potential side effects is difficult because of the absence of regulation and manufacturing guidelines, which means that there is a lack of consistency in terms of purity and labeling. In other words, it is difficult to determine if the side effects are the same across different products, formulations, and dosages because it is often difficult to determine exactly what is in the products that are currently on the market.
It is important to talk to your doctor if you are thinking about taking CBD products. This is particularly true if you have an existing medical or psychiatric condition, or if you are currently taking any medications or supplements.
CBD may potentially have an effect on your condition or may interact with a medication that you are taking. For example, CBD can sometimes worsen symptoms of anxiety. CBD can also interfere with the metabolism of certain medications, which may change how your medications affect your body.
Some other concerns to consider before taking CBD:
- Drug testing: There have been reports of people failing drug tests after using CBD products that are labeled as containing no THC. While most CBD products contain only trace amounts of THC, there is still the possibility that these products may produce a positive result on a drug test. It is also important to remember that full-spectrum CBD products do contain varying amounts of THC.
- Mislabeling: Labeling accuracy also appears to be a common problem. One study found that almost 70% of CBD products sold online were mislabeled and contained significant amounts of THC. This can be problematic if you are taking CBD to address a mental health condition such as anxiety, since THC may have unwanted psychoactive effects. Mislabeling may also lead to positive drug test results, especially if the product contains more THC than it claims.
- Other possible risks: Finally, it is important to remember that researchers still do not know all the possible risks or benefits of taking CBD. More research is needed to learn about the mental and physical long-term effects of CBD, so you should always use caution and consult your doctor before using it.
A Word From Verywell
If you are experiencing the symptoms of a mental health condition, you should talk to a doctor or mental health professional. Self-medicating with CBD or other supplements can lead to delays in treatment, which may cause your symptoms to worsen. CBD also has the potential to aggravate some symptoms such as anxiety, sleep problems, and psychosis.
If you are still interested in trying CBD as an addition to your regular treatment, work with a healthcare provider who can help monitor your symptoms. Your doctor may recommend a product and dosage that is appropriate based on your symptoms and any medications you are taking. Always be sure to watch out for any potential negative side effects and be sure to talk to your doctor before you stop taking CBD.