Cannabidiol, better known as CBD, is one of the main compounds in cannabis: a non-intoxicating cannabinoid that won't get you high but is widely used for pain, anxiety, sleep and epilepsy. It's concentrated in the resinous flower and can make up as much as 40% of the plant's extract. CBD is one of the 100-plus cannabinoids found only in the cannabis plant.

CBD vs. THC: are they the same thing?

No, CBD and THC are not the same. Cannabis contains more than 500 organic compounds, at least 113 of them cannabinoids, and two stand out for their therapeutic potential: CBD and THC. THC, or tetrahydrocannabinol, is the plant's main psychoactive compound, the one behind the high cannabis is famous for.

CBD doesn't get you high; THC does. But both have real therapeutic value, and they seem to work best as a team. Researchers call it a synergistic (or entourage) effect: CBD appears to boost some of THC's properties, like pain relief and the anti-tumor activity seen in lab studies, while taking the edge off its psychoactivity.

What is CBD used for?

CBD was first approved as a prescription drug in 2018 by the U.S. Food and Drug Administration (FDA), under the brand name "Epidiolex", to treat seizures in children with severe forms of epilepsy. Beyond that, people all over the world use CBD for a range of issues, including pain relief, sleep and general wellness.

Outside of epilepsy, research suggests CBD may help reduce anxiety in people living with schizophrenia or psychosis, or dealing with different kinds of addiction.

CBD has a long list of potential therapeutic uses. Studies point to effects on stress, depression and some mental health conditions. It's being researched as a neuroprotectant and muscle relaxant, which is why some health professionals recommend it (and it should be a professional's call) as palliative care for body pain and other uncomfortable symptoms.

CBD-rich cannabis oil is used day to day as a dietary supplement, a topical, or a medical treatment to help relieve:

• chronic pain,
• inflammation from inflammatory bowel or skin conditions,
• anxiety,
• depression,
• the severity and frequency of seizures in treatment-resistant epilepsy, and more.

Cannabis oil is also used to manage symptoms of neurological and neuropsychiatric conditions such as:

• multiple sclerosis,
• Alzheimer's,
• Parkinson's,
• schizophrenia.

CBD is just one of the more than 500 active substances, and one of the more than 100 cannabinoids, identified in cannabis so far.

How does CBD work in the brain?

Your brain, spinal cord and peripheral nervous system are home to CB1 and CB2 receptors, part of the endocannabinoid system, and these interact with cannabinoids. That interaction helps switch on and regulate the body's natural responses to stress, anxiety and pain. Homeostasis is the body's way of keeping its internal functions in balance, and research suggests CBD oil may support that natural process.

How to take CBD oil for pain

CBD can be taken by mouth or applied to the skin, depending on the product. There are tons of options, from oils and softgels marketed for anxiety to relaxing bath salts, creams and massage oils. You can smoke it too, of course, but if you're using CBD for therapeutic or medical reasons, it's best to skip combustion and go with healthier formats. 

Several studies have found that CBD has a strong anticonvulsant effect that works well across different types of epilepsy, and its use has taken off precisely because it doesn't get anyone high.

Thanks to modern breeding, you can grow strains that are almost entirely CBD, without having to take in much THC, the cannabinoid that does have psychoactive effects.

CBD drug interactions: what to watch for

CBD interacts with medications and can weaken or prolong their effect: it inhibits or ramps up cytochrome P450 enzymes (CYP for short), the liver enzymes that break down a huge number of compounds and drugs. That changes how those drugs get metabolized.

If you're on any medication, talk to your doctor first. You should also go easy if you have a history of mental illness or alcohol or drug abuse, or if you're pregnant or breastfeeding.

Many cannabis vape oils (e-liquids for e-cigarettes and vape pens) contain propylene glycol. When it overheats, this additive produces formaldehyde, a known carcinogen.

CBD side effects

Even though CBD isn't psychoactive and is generally considered safe, it can still cause side effects. The most common ones include nausea, fatigue and irritability.

CBD can raise blood levels of blood thinners and other drugs by competing for the liver enzymes that break them down. "People taking high doses of CBD may show abnormalities in liver-related blood tests," according to Harvard Health Publishing. Plenty of over-the-counter meds, like acetaminophen (Tylenol), have the same effect.

Other possible side effects: dry mouth, weakness, tiredness, headache and dizziness.

CBD is the cannabis compound most widely used for medical and therapeutic purposes, and research is promising for a long list of conditions. But like everything in the cannabis world, there's still a lot left to learn.

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