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6 Common Myths and Controversies About High-CBD Cannabis

March 12, 2018
(Nastasic/istock)
Cannabidiol (CBD) is an exciting focus of medical research, popular media, and legislation related to cannabis. Its presence is becoming ubiquitous on the shelves of health food stores and search engine results for numerous medical conditions, but don’t believe everything you hear. While CBD is an incredibly safe and therapeutic component of cannabis, there are many myths and misconceptions associated with it. Let’s take a look at a few.

Related

CBD vs. THC: What’s the difference?

Myth #1: CBD is non-psychoactive and medical; THC is recreational.

Both lay and scientific literature have classified CBD as a “non-psychoactive” substance, meaning that it does not alter one’s consciousness. But how could CBD fail to impact consciousness when it’s been shown to have anti-anxiety, anti-psychotic, anti-craving, alerting, and mood-elevating effects in human studies?

CBD clearly impacts our psyche, often in beneficial ways. It does not, however, impair mental or physical function in most consumers, even very high doses. Thus, CBD can be considered psychoactive, but “non-impairing” or “non-intoxicating.”[i]

One doesn’t need to treat a serious medical condition in order to benefit from the use of CBD and to enjoy sharing it socially.

Most Leafly readers have already recognized and overcome the false dichotomy that CBD is the medical part of the plant and THC is for recreation. THC is clearly medicinal–hundreds of clinical trials have demonstrated that THC has remarkable and very relevant medicinal properties.

If THC is both medical and recreational, can the same be said about CBD?  Likely not. While CBD clearly has medicinal benefits, very few people would want to use it for recreation. CBD does not produce a “rewarding” or strongly pleasurable effect.  Its use in animal and human studies is not associated with euphoria, craving, compulsive use, or any other sign that would indicate it has recreational uses or drug abuse liability.

Related

CBD vs. THC: Why Is CBD Non-Intoxicating?

But this begs the question–where does recreation end and therapeutic use begin? If a group of friends shares a CBD-dominant spray or vape pen, they’re not likely to start giggling and telling long stories punctuated by periods of wondering what they were talking about. But they may be more likely to feel relaxed, focused, and resilient to stress. One doesn’t need to treat a serious medical condition in order to benefit from the use of CBD and to enjoy sharing it socially.

Myth #2: CBD is sedating.

While some early studies attributed a sedating effect to CBD-dominant cannabis preparations, CBD itself is not sedating; it is actually alerting. CBD has been shown to counteract the sedative effects of THC, delay sleep time, and reduce THC-associated “hangover.”[ii]  Even very high doses of pure CBD, such as 600 mg in a single dose, have not produced a sedating effect in healthy subjects.[iii] Why the confusion?  It may be that varieties of cannabis that contain high levels of CBD often also contain significant amounts of myrcene, a potentially sedating terpene.

I occasionally see patients who report that CBD can disturb their sleep.  More often, patients tell me that CBD makes them feel awake, but when they lay down and close their eyes, they have no trouble sleeping.

Myth #3: A little CBD is enough.

I’ve been known as a strong proponent of using very low doses of cannabis to treat medical conditions, enhance the endocannabinoid system, avoid side effects, and prevent tolerance to cannabis. So, it may surprise you that I often support using high doses of CBD, especially when it is used in the absence of significant quantities of THC.

Milligram for milligram, CBD is much less potent than THC at relieving symptoms.

Why? Milligram for milligram, CBD is much less potent than THC at relieving symptoms. For example, one of my patients who experiences pain or anxiety relief with 3 to 5 mg of THC may require 30 to 200 mg of CBD to produce similar results, if they can be achieved at all. And while there is significant overlap in the symptoms that can be treated with either THC or CBD, the way in which they relieve these symptoms and the individual responses to these two agents varies significantly.

Studies that have used pharmaceutical-grade CBD to treat anxiety, schizophrenia, and seizures have used hundreds of milligrams per dose. This would be simply unaffordable for most consumers. But could lower doses of CBD provide some benefit?  The answer is likely yes. Some of my patients report feeling more alert, focused, and clear-headed after using as little as 2 to 20 mg of CBD by mouth, or after a couple inhalations of CBD-dominant cannabis. 

Related

We Asked a Scientist: What’s the Right Dose of CBD?

Myth #4: CBD is the same from hemp, medical cannabis, or isolate.

A molecule of CBD is the same regardless of its origin in medical cannabis, hemp, or a laboratory. But do the various CBD products on the market have the same effects regardless of their origin? Likely not.

While CBD is a remarkable medicine, it clearly works best in the context of its phytochemical brothers and sisters from the plant cannabis, especially THC. When used together, CBD can enhance the therapeutic effects of THC while reducing the adverse effects. Even very low levels of THC, plus additional components of the cannabis plant, seem to enhance the benefits of CBD on pain and inflammation, at least in one rodent study.[iv]

While the distinction between medical cannabis and hemp varieties continues to blur, it is still likely that hemp is a less efficient source of CBD–much higher amounts of hemp starting material, compared to medical cannabis varieties, may be needed to extract CBD. This may increase the risk of contaminants in the final product. Furthermore, the hemp-based CBD industry is rampant with mislabeling. A recent study found that only 31% of 84 CBD products purchased online were accurately labeled for CBD content.

Related

Addressing Inconsistent Label Claims in the Hemp and Cannabis Industry

So, what’s the best source of CBD?  Whenever possible, I recommend locally grown, artisanal produced, laboratory-tested products acquired through a legal medical cannabis program. I realize that this is not possible for all readers. If you’re purchasing online, it can be hard to know what retailer to trust and, unfortunately, there’s no good solution unless you have access to third-party laboratory testing for cannabinoid potency and contaminants. I encourage hemp-based CBD consumers to ask for detailed answers about quality control–some companies will provide copies of a laboratory analysis that correlates with the batch in question.

Myth #5: Cannabidiol works by activating cannabinoid receptors.

We all have an endocannabinoid system as an essential part of life. It helps us respond to illness and injury, restoring balance at a cellular level, and is always functioning in all of our organs and tissues to keep us healthy. This system is thus a natural target for therapeutic interventions, including herbs, drugs, and lifestyle modifications, in almost every disease known to man.  The hard-to-believe efficacy of medical cannabis in the treatment of neurologic, inflammatory, gastrointestinal, psychiatric, infectious, and metabolic conditions is justified by the widespread presence and healing effects of the endocannabinoid system.

Related

How to Stimulate the Endocannabinoid System Without Cannabis

The therapeutic effects of CBD are similar in many ways to those of its close relative, THC. Both relieve pain, spasticity, nausea, anxiety, and seizures, and both decrease inflammation.[v] We know that THC works like our bodies’ endocannabinoids; both turn on the cannabinoid receptors and lead to cellular activities that restore physiologic balance.

One would assume that CBD works in a similar manner, but this is, in fact, a misconception. CBD does not directly stimulate the CB1 or CB2 receptors. Instead, when CBD comes into contact with these receptors, it actually turns down their activity level, causing a mild to moderate decrease in the effects of THC and endocannabinoid signaling at the CB1 receptor.[vi]

Despite its ability to directly decrease cannabinoid signaling, CBD also has the ability to indirectly increase cannabinoid signaling. It does this by inhibiting the breakdown and transport of our most abundant endocannabinoid, anandamide.[vii] One clinical study showed that patients with schizophrenia who were treated with 800 mg of CBD daily had significant increases in their levels of anandamide over 28 days.[viii]

If it’s hard to make sense of these two opposite properties of CBD, welcome to cannabinoid science, a field riddled with opposites and paradoxes. If you take CBD, is it going to inhibit or stimulate your endocannabinoid system? The answer is probably both, and it likely depends on your needs and the amount of CBD you take.

Related

CBD (cannabidiol): What does it do and how does it affect the brain & body?

Myth #6: CBD is legal in all 50 states.

Just because everyone says that CBD is legal, it’s for sale at your health food store or tobacco shop, available on Amazon, and has no abuse potential, you might think that it probably is legal. If you ask the DEA, however, you’ll find that they disagree.

Related

Is CBD Oil Legal? Depends on Where You Are and Who You Ask

Take a look at this 2015 memo from the Drug Enforcement Administration.[ix] According to the Controlled Substances Act, CBD is considered a member of the group of “tetrahydrocannabinols.”  The FDA has also stated that a CBD product cannot be considered a “dietary supplement” because it has been “authorized for investigation as a new drug for which substantial clinical investigations have been instituted and for which the existence of such investigations has been made public…”  This language can be found in the numerous letters the FDA has been sending to online CBD retailers.[x]

Fortunately, I don’t believe there is any real danger of legal consequences to the CBD supplement consumer. Retailers and producers of hemp-based CBD products still may face some risk, which depends on how motivated our federal agencies are to enforce these regulations that do nothing to protect public health.

Now that we’ve cleared up a few of the misperceptions about CBD, you might want to look at more myths about cannabis. Also, for more information on how to use cannabis therapeutically, you can access Healer’s free programs for new consumers, existing consumers looking for more benefits, and health providers needing support.


[i] Russo EB. Cannabidiol claims and misconceptions. Trends Pharmacol Sci. 2017;38(3):198-201.
[ii] Nicholson AN, et al. Effect of delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early- morning behavior in young adults. J Clin Psychopharmacol. 2004;24:305-313.
[iii] Borgwardt SJ, et al. Neural basis of delta-9-tetra-hydrocannabinol and cannabidiol: effects during response inhibition. Biol Psychiatry. 2008;64:966-973.
[iv] Gallily R, Yekhtin Z, Hanuš LO. Overcoming the bell-shaped dose-response of cannabidiol by using cannabis extract enriched in cannabidiol. Pharmacol Pharm. 2015;6:75-85.
[v] Russo E, Guy GW. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Med Hypoth. 2006;66(2):234-246.
[vi] Laprairie RB, et al. Cannabidiol is a negative allosteric modulator of the cannabinoid CB1 receptor. Br J Pharmacol. 2015;172(20):4790-4805.
[vii] McPartland JM, et al. Are cannabidiol and Δ9‐tetrahydrocannabivarin negative modulators of the endocannabinoid system? A systematic review. Br J Pharmacol. 2015;172(3):737-753.
[viii] Leweke FM, et al. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Transl Psychiatry. 2012;2(3): e94.
[ix] https://www.dea.gov/divisions/hq/2015/hq122315.shtml
[x] https://www.fda.gov/NewsEvents/PublicHealthFocus/ucm484109.htm

Dr. Dustin Sulak's Bio Image

Dr. Dustin Sulak

Dustin Sulak, DO, is the founder of Integr8 Health, a medical practice in Maine that follows over 8,000 patients using medical cannabis; Healer.com, a medical cannabis patient education resource; and Cannabis Expertise, a continuing medical education curriculum. Recognized as a leading clinician in the application of medical cannabis, Dr. Sulak is committed to providing education to clinicians and patients on the use of medical cannabis.

View Dr. Dustin Sulak's articles

  • Open Minds

    I learned a few new things, excellent article by a hands on expert. My one quibble would be on THC hangover (even though he’s citing it, not claiming it). THC doesn’t give you a hangover, combusting cannabis does. The process of combusting cannabis creates substances like benzene, carbon monoxide, naphthalene, toluene and polycyclic aromatic hydrocarbons (commonly known as PAHs). It’s these substances that cause the hangover. Vaporizing or edibles are the best way to consume cannabis.

    • I disagree strictly from experience. I don’t inhale cannabis or smoke cigarettes. My first THC hangover was a result of over-consuming a new batch of infused cream – infused at a temperature below 180 degrees and no, there were no other reasons to feel “hungover.” I’ve since experienced the hangover from other edibles as well and a cold brewed sublingual. I am also familiar with others who are not smokers and are experiencing THC hangovers. As a sidebar – with prohibition ending in Uruguay and now here in Canada we can expect science to explain exactly how the hangover is produced and in whom. Cheers.

  • farmerlion

    There is such a great level of exaggerated CBD levels in oils and bud content. Companies trying to gain sales and market share with dishonest tactics. This only undermines what we are working towards. Just because a bud tender gets high. This doesn’t mean that they know cannabis . Cannabis education is needed nation wide. Nice article peace

  • Anyone who has ever used or recommended a CBD sublingual tincture derived from pure unadulterated whole plant hemp extracts will attest to the fact that CBD has a near instantaneous onset calming, sedating and anxiolytic effect The hemp plant can contain up to 30 times more CBD than cannabis sativa flower and your argument that the sedating effects from high CBD flower is a terpene effect are not substantiated by research. Sedation is a CBD effect and it is the beneficial effect cannabis patients seek it for most often!

    • Open Minds

      “The hemp plant can contain up to 30 times more CBD than cannabis sativa flower…”. Sorry Ahimsa but you obviously don’t know anything about the difference between Hemp and Cannabis. Go to Project CBD’s website to find out the difference.

      • I know the difference. The hemp plant is cannabis sativa botannically with less than 0.3% THC and for that reason a Federal hemp law was passed making it legal. My point is that the unique cannabinoid CBD has accepted pharmacological properties and they include a sedating anxiolytic effect. Mr. Dean Winchester has been blocked for making insulting attacking comments and I will block anyone else on this or any other site who turns a professional dialogue into a defaming exchange. I am the owner of a cannabis clinic that has operated for a decade and have authored a book and several research articles on its use. More significantly I am a patient with cervical disc disease who benefits from a hemp derived CBD tincture.

        • Chip Dooley

          1st do not start off with your medical background, most docotr are looked as if they are crooks in our community, person had some points that could of been blown off the page and you wouldn’t have to block anyone, they will leave because they feel stupid if you have your facts right. START OFF with i was a patient who was cured by it and then your doc back ground will sound a lot better and people will listen more instead of agruing.
          CANNABIS OIL,, BUDS AND WAXES CURED ME FROM STAGE 4 sQUAUMOUS CELL, MAS(INTO MY LUNGS) ???(CAN’T REMEMBER THE REST) Please don’t be offended by people who don’t like doctors and think most are crooks and only in it for the money, which most are in my oppinion of being disable messing with doctors doing same test 2 time or not knowing the other doctors they want to do their own testing and stuff instead of reading other ones 1st and usually they match up because done with in months of each other, there is a lot of other reasons but major one is/was fighting docotrs last 90 years (i have been doing it for last 30years when i became disabled) on making the number one CURE of a lot of dieases, illness and disablities legit for medical use, most are still against us because it will hurt their bottom line in the end and we will get the last laugh, if still alive. Being the owner also give you alturntive too, like making money using as a add to sell your stuff and such. I am just saying let others handle people like him and we will shut him down and you come out smelling like a rose. Not everyone will agree but the guy did make a few points which could of been proven wrong, specially by someone like me, who was cured from stage 4 cancer, massive heart failure, all teath removed because of chemo and crap. I never got sick, lost any hair(mine grew and grew better) or any other immitly side effects that i know of, i can’t remember shit because chemo and side effect from treatmen i am still trying to figure it out. I have a lot of confussion and memory still not back and few tohers but pain/depression and stuff like that, like most goo through, chemo days where great, i had engery for a day or 2 and never got sick. The doctor once said it was a snake oil told me to keep on using it, he has never seen someone treat chemo/radaition like i did and told me I WAS CANCER FREE same day, walking out his door, he tells me to keep on using my oil, every apt. since last one a week or so ago, STILL CANCER FREE. Everything FROM CANCER to heart failure i have used cannabis oil to cure, not just treat stuff and it works. In other words fight with your illnesses/disabilties and stuff, not so much on your back ground, it will give you more support from people like me/us.

        • Charlie Salau

          I appreciate the information, we need more dialogue and more clinical research find the best medical approach to improve the quality of life of the patients. You’re doing fantastic work, thank you.

      • You are uninformed. There is a cannabis sativa flower strain AC/DC that can compete with the CBD concentrations found in unadulterated hemp but as any intelligent informed cannabis professional knows, CBD in most flower strains is lower than in cannabis sativa hemp.

        • Open Minds

          Ahimsa, sorry but you don’t know your cannabis. AC/DC is a phenotype of Cannatonic, and although the CBD to THC ratio is very high, AC/DC has way above the 0.3% THC threshold which would make it illegal by Federal standards. Lastly, why do you keep on saying Cannabis sativa FLOWER strain. That makes no sense. All cannabis types have a flowering stage.

    • Derek Landberg

      could the sedation possibly come from CBN that can show up in products. I personally think that some products contain more CBN then others regardless of labels. I don’t know about you but CBN is super sedating to me. And finally body chemistry is going to play the most crucial roll in the effects of the different cannibinoids in different people. For example sativa is widely known to give people a wakeful boost, whereas its the opposite for indica. That’s not the case with my dad. He needs to smoke hard hitting sativa like Durban poison at night to fall asleep. So I guess just like everything else it depends on the individual.

      • According to the Wikipedia definition of the phytocannabinoid cannabidiol or CBD is has a downregulating effect on anxiety and disordered thinking.

        • Rose Grossi

          I have used pure hemp derived CBD and CBD derived from cannabis sativa (marijuana)and have never been sedated by it! Perhaps it’s the placebo effect. I will tell you that the CBD from the cannabis flowers was much better than the tincture sold at the health food store or from the dispensary. That being said the best brand I’ve used was Yummi Carma but considering that so much of the hemp derirved CBD tincture being sold is adulterated with stuff like cold medicine and spice (the highly toxic artificial marijuana) I believe that you very well could be sedated with this trash! Not to mention that so few actually contain the amount of CBD they claim! That being said it would be wonderful if the high CBD cannabis wasn’t so hard to find even in a state where it is legal for recreational and medical use! I’ve had to travel 4 hours or more to the Bay area to find a high CBD strain. Also the argument is pretty absurd! Yes high THC cannabis contains less to zero CBD but high CBD cannabis has more than hemp it takes a lot of hemp plants to extract the same amount of CBD as AC/DC or Harlingen but hemp being legal is easier to grow. And the amount of THC really is needed to help with the pain. For some people the THC has been scientifically proven to alleviate pain, but the same cannot be said of CBD.

        • Richard Lamb

          Wow, an MD using Wikipedia as an authoritative source…

    • Payton Jett

      perhaps you didn’t read the article properly. CBD is not sedating but the cannabinoids that come along with the CBD probably are. I have had CBD that makes me very tired and I’ve also had some that makes me quite energized. It all depends on the strain. There are sativa CBD strains and indica. Do a bit more reading.

  • CLK1

    IF you try a CBD tint from Colorado and one from a local store you will see the difference, I prefer a High CBD Flower with very low THC for the pain relief and calming affect, AC/DC and a few others like it are probably some of the best medicine there is. Now I just need my state to make this all legal and improve their medical program and I will actually be a happy person…

    • Mary Monistere

      What is ac/dc? What brand do you recommend?

      • bullish_11

        Harlequin, or AC/DC are both good Strains of Pot to smoke, but the better for you would be AC/DC as it has a much lower THC with a higher CBD ratio. This helps to keep you mellow. It is harder to find, but if you use a web-site like weedmaps they show the local places to you and then you can go to that stores web-site and look at their menu and find if they have AC/DC or a similar flower with the same Ratio (usually around 15% CBD – to – 3% THC)… I wish you luck, and know all the Legal states have places that sell Low TCH bud, you just have to look…

  • Todd Burgess

    The entire plant must be considered. That is how it comes to us, that is how best to evaluate it. Stripping it down to it’s various components diminishes each as it relates to the other components. CBD is most effective when in combination with THC, sort of like, naturally. You can’t accurately measure anything that lives by destroying it.
    Mother Nature did not set it up for us to tear it down. She knows what she’s doing.

  • P.J. Rafter

    I started smoking cannabis in 1974 and it’s been keeping the doctor away since except for a pneumothorax and re-occurring acute pleuritis!

    When the painful pleuritis re-occurs a couple of tokes of a spliff of sativa buds nips it in the bud (ha!) within ten minutes every time…

    The “entourage effect” of full plant cannabis is what works best, and everyone should know this.

    • yashabird

      Wow…maybe after a pneumothorax and recurrent pleuritis, you might consider chronic smoking as the culprit?

  • briteleaf

    I’ve grown and used high THC and high CBD plants. Separately and together. My experience has been that they both work better WITH each other. I no longer load a vaporizer without including BOTH.

  • Ashley

    Is there ANY place to purchase actual edibles or bud online?

    • the one

      For what? THC or CBD?

  • I completely understand going about writing a piece from a different standpoint or approach, however using each title in a click-bait manner is rather unbecoming, If you know anything about the power of CBD & cannabinoids in general, the second your done reading the title your gears already start spinning instead of said title just having greased the wheels for an informative download.The ways each topics titles are worded is misleading. Most of these points are not controversial. Many great points we’re made here yes, but i feel a chemically conceptual preconceived attack is an unflattering directive to have when educating an audience.

  • curious if a tincture or oil might be used for dental desensitization?

  • Emily Jones

    How to sensibly buy LEGAL CBD oil? Because I got a letter saying customs have confiscated my package two times already and I’m pissed.

  • I appreciate the information, we need more dialogue and more clinical research to find the best medical method to improve patient quality of life. Do a fantastic job, thanks.

  • Mark

    Incorrect use of the phrase, “but this begs the question”. Begging the question is essentially assuming or embedding a conclusion into one’s premises. In the future, when asking a question in order to set up an analogy, use the phrase “but this raises the question” instead.

    This idea of “where does recreation end and therapeutic use begin” is actually begging the question in a way I don’t think the author intended, namely that it assumes that a recreational activity is not or cannot be therapeutic. It’s like stating, “where does physical exercise for recreational purposes end and for therapeutic purposes begin?”, when both purposes are clearly not mutually exclusive.