Increasingly, during office visits, my patients initiate conversations about CBD (cannabidiol). They have questions, express concerns, and have either tried CBD or desire to try products that contain CBD. In this article, I list the top five questions I receive from patients regarding CBD and then provide a response to each. The questions are listed most asked to least asked.
1. WILL CBD MAKE ME HIGH AND CAN I OVERDOSE WITH CBD?
No. CBD is not psychogenic. Overdose is not likely; there are no clinical studies/ scientifically-based studies suggesting a person can overdoes on only CBD.
2. WILL CBD SHOW UP ON A DRUG SCREENING?
No. The typical drug screens test for tetrahydrocannabinal (THC) and only test for CBD when specifically requested. THC has a psychogenic effect and could influence job performance. CBD does not have a psychogenic effect. Most patients I see have injuries related to their employment, and the initial visit includes a drug screen. Our clinic also provides pre-employment drug screens for candidates soon to be hired. We perform at least 30 drug screens daily.
3. DOES CBD COME FROM MARIJUANA?
Yes, marijuana is one CBD source. Hemp, with essentially no reported psychoactive properties, is another source; and CBD is presently being researched for synthesis. I share with patients that the source of CBD is the key. “The CBD must be from hemp,” I tell them that hemp contains minimal THC, typically less than 0.03%; this is not enough to cause any psychogenic effects.
4. IS CBD A CURE ALL?
No. CBD is not a magic elixir that cures anything and everything—despite what some patients will tell you. For those of us following CBD uses, new non-scientifically based benefits are being reported regularly; we must realize that no medical claims can legally be made about any benefits CBD may provide. Per the FDA, CBD remains recognized as only a dietary supplement.
I am reminded of the patient I saw a few months ago after a forklift crushed his foot. To assist with pain management, I gave the patient a sublingual 25mg CBD tablet B.I.D. and 800 mg motrin B.I.D. The patient returned a week later complaining of minimal pain and shared that he experienced no seizures since he started the sublingual CBD and he usually had 3-4 mild seizures daily! I did not expect that information exchange!
4. IS CBD LEGAL?
Yes and No. Hemp-derived CBD is federally legal. But some state laws remain restrictive for hemp-based CBD. As the doctor, it is critical to understand what is and what is not legal in your state regarding CBD.
5. WILL CBD MAKE ME SLEEPY?
No. Among other things, lack of sleep makes you sleepy. CBD, even in higher doses ( >500mg) has not been definitively shown to cause a sedative effect.
One patient shared with me that taking sublingual CBD made her feel how she, “is supposed to feel”. I liked that, and studies have shown that CBD may influence homeostasis.