Research

A handful of studies suggest a possible role for CBD in addressing social anxiety, including one in which individuals treated 90 minutes before a public speaking exercise felt less stressed than placebo-receiving peers. There are some indications that CBD may also help with anxiety generally, but studies on that have various limitations. For example, one longer-term observational study yielded a somewhat complicated outcome: Individuals with moderate to severe anxiety experienced improvement, but those with milder anxiety became slightly more anxious. Among the most promising studies is a 2022 Nature publication reporting that people with moderate to severe anxiety experienced a 60% to 70% reduction in symptoms after four weeks of treatment with a high-CBD-content product. Those individuals knew they were receiving CBD, though, so a blinded randomized controlled trial (RCT) is underway to confirm the earlier findings.

Published case reports and uncontrolled clinical trials suggest the potential of using CBD products for better sleep. In one unblinded study of 23 patients with epilepsy, 85% of those treated daily for three months with CBD showed an improvement in sleep. However, the handful of RCTs to date studying sleep for people without epilepsy are inconclusive. One study of healthy volunteers found no effect of a single dose of CBD while another, of people with insomnia, found better self-reported sleep after one dose.

Studies of CBD administered orally for pain have yielded mixed findings — though they did not explore the efficacy of high doses. Topical CBD looks more promising. In one 2020 study of patients with peripheral neuropathy, those given a topical CBD oil experienced a significant reduction in sharp pain and cold, itchy sensations compared to those who received a placebo.

CBD shows promise for reducing drug cravings for patients with opioid use disorder. In one study, former heroin users who received CBD had a two- to three-fold decrease in cravings compared to those receiving a placebo. That study was fairly small, but researchers are working to replicate results with a larger cohort. In addition, early research suggests CBD may hold some hope for treating alcohol use disorder. Tobacco-related results are mixed.

CBD comes in many forms, including oils, tinctures, capsules, patches, vapes, and topical preparations for use on skin. If you’re hoping to reduce inflammation and relieve muscle and joint pain, a topical CBD-infused oil, lotion or cream — or even a bath bomb — may be the best option. Alternatively, a CBC patch or a tincture or spray designed to be placed under the tongue allows CBD to directly enter the bloodstream. Dcotors don’t recommend smoking anything, including CBD.

Outside of the US, the prescription drug Sativex, which uses CBD as an active ingredient, is approved for muscle spasticity associated with multiple sclerosis and for cancer pain. Within the US, Epidiolex is approved for certain types of epilepsy and tuberous sclerosis.

People taking high doses of CBD may show abnormalities in liver-related blood tests. Many nonprescription drugs, such as acetaminophen (Tylenol), have this same effect. You should let your doctor know if you are regularly using CBD so that he or she can check your liver enzymes periodically.

A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements, and no one, really, is regulating the CBD market. So you cannot be sure that the product you buy has active ingredients at the dose listed on the label.

In addition, the product may contain other unknown elements. If you buy CBD, it is safest to make sure that there is independent laboratory testing as attested to by a COA (certificate of analysis) that should accompany every CBD product.

Side effects of CBD could include nausea, fatigue, and irritability. CBD can increase the level of blood thinning and other medicines in your blood by competing for the liver enzymes that break down these drugs. Grapefruit has a similar effect with certain medicines. This interaction is particularly important if you are taking a blood thinner, an anti-epileptic, or an immunosuppressant medication, all of which need to have stable levels in your blood.

People taking high doses of CBD may show abnormalities in liver-related blood tests. Many nonprescription drugs, such as acetaminophen (Tylenol), have this same effect. You should let your doctor know if you are regularly using CBD so that he or she can check your liver enzymes periodically.

A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements, and no one, really, is regulating the CBD market. So you cannot be sure that the product you buy has active ingredients at the dose listed on the label.

In addition, the product may contain other unknown elements. If you buy CBD, it is safest to make sure that there is independent laboratory testing as attested to by a COA (certificate of analysis) that should accompany every CBD product.