In just a few years, cannabidiol (CBD) has become immensely popular around the world. After initially being discovered as an effective self-medication for Dravet syndrome in children, CBD is now sold and used to treat a wide range of medical conditions and lifestyle diseases. The cannabinoid CBD, a non-psychoactive isomer of the more infamous tetrahydrocannabinol (THC), is available in a growing number of administration modes, but the most commonly known is CBD oil. There are currently dozens, if not hundreds, of producers and sellers of CBD oils active in the market, and their number is increasing rapidly. Those involved vary from individuals who prepare oils on a small scale for family and (Facebook) friends to compounding pharmacies, pharmaceutical companies, and licensed cannabis producers. Despite the growing availability of CBD, many uncertainties remain about the legality, quality, and safety of this new “miracle cure.” As a result, CBD is under scrutiny on many levels, ranging from national health organizations and agricultural lobbyists to the WHO and FDA. The central question is whether CBD is simply a food supplement, an investigational new medicine, or even a narcotic. This overview paper looks into the known risks and issues related to the composition of CBD products, and makes recommendations for better regulatory control based on accurate labeling and more scientifically supported health claims. The intention of this paper is to create a better understanding of the benefits versus the risks of the current way CBD products are produced, used, and advertised.
Last year, the National Academies of Sciences, Engineering and Medicine released a nearly 500-page report on the health effects of cannabis and cannabinoids. A committee of 16 experts from a variety of scientific and medical fields analyzed the available evidence — more than 10,000 scientific abstracts in all. Because so few studies examine the effects of CBD on its own, the panel did not issue any findings about CBD specifically, but it did reach some conclusions about cannabis and cannabinoids more generally. The researchers determined that there is “conclusive or substantial evidence” supporting the use of cannabis or cannabinoids for chronic pain in adults, multiple sclerosis-related spasticity (a kind of stiffness and muscle spasms), and chemotherapy-induced nausea and vomiting. The committee also found “moderate” evidence that cannabis or cannabinoids can reduce sleep disturbances in people with obstructive sleep apnea, fibromyalgia, chronic pain and multiple sclerosis, as well as “limited” evidence that these substances can improve symptoms of Tourette’s syndrome, increase appetite and stem weight loss in people with HIV/AIDs, and improve symptoms of PTSD and anxiety.

Further explanation is in order. The difference between psychoactive cannabis (“marijuana,” by the increasingly disfavored traditional term) and hemp is a question of THC content — and legal classification. The federal government defines hemp as cannabis with 0.3 percent THC or less in terms of dry weight. The 2014 federal Farm Bill legalized state pilot programs for hemp, and 40 of the 50 states now have defined industrial hemp as distinct from cannabis and removed barriers to its production — including California. However, California’s hemp pilot program is overseen by the California Department of Food and Agriculture (CDFA) — not either the CDPH or Bureau of Cannabis Control.

^ Hayakawa K, Mishima K, Hazekawa M, Sano K, Irie K, Orito K, Egawa T, Kitamura Y, Uchida N, Nishimura R, Egashira N, Iwasaki K, Fujiwara M (January 2008). "Cannabidiol potentiates pharmacological effects of Delta(9)-tetrahydrocannabinol via CB(1) receptor-dependent mechanism". Brain Research. 1188: 157–64. doi:10.1016/j.brainres.2007.09.090. PMID 18021759.
THC, an intoxicating and illegal substance, is responsible for causing marijuana users to get “high.” Unlike THC, CBD is non-psychoactive because it does not act on the same pathways as THC. Thus, it is impossible to get “high” by smoking or ingesting CBD or CBD oil extracted from industrial hemp plants, as they only have minuscule traces of THC (<0.3%).
Before I even checked the ingredients list and saw that cocoa seed butter was involved, my first impression was that this body butter smelled like chocolate, so much so that my stomach rumbled with hunger because it was 4pm and I hadn’t eaten lunch yet. Don’t the “whipped” descriptor fool you—unlike most body butters you’ve used, this formula is solid to the touch, a balm rather than a cream. But that might be exactly what you want if you’re looking for a CBD-infused treatment anyway—something that feels extra-nourishing and almost medicinal. Luckily, it smells incredible in a subtle, natural way, not like other body butters with artificial tropical fruit scents.
An important issue in the discussion around cannabis-derived oils is: how much THC is a legal CBD product allowed to contain in order not to be considered a narcotic? Authorities sometimes choose to deal with these regulations in a pragmatic way, recognizing that laws once designed to control marijuana abuse may not be fully applicable to hemp. For example, in the Netherlands, a maximum level of 0.05% THC is allowed in CBD products, even though, formally, any detectable trace of THC is illegal according to Dutch narcotics laws. This approach is based on the fact that even hemp varieties of cannabis produce a small amount of THC, and therefore naturally derived CBD extracts will carry some THC in the final products.
Like many of my fellow New York City residents, I’ve recently grown aware of the presence of CBD in my surroundings. In particular, CBD at coffee shops. It started when some friends of mine were discussing a pilgrimage out to Flower Power Coffee Co., known for its “artisanal CBD-infused coffee.” Then, at a fancy matcha cart I went to for Instagram-related purposes, I noticed that alongside health food add-ins like oat milk was the option to include a one-dollar shot of CBD. I didn’t do it, because weed in most forms tends to make me sleepy and it was 1 p.m. on a Saturday in the middle of Brooklyn's trendiest neighborhood.

Topicals are cannabis-infused lotions, balms, and oils that are absorbed through the skin for localized relief of pain, soreness, and inflammation. Because they’re non-intoxicating, topicals are often chosen by patients who want the therapeutic benefits of marijuana without the cerebral euphoria associated with other delivery methods. Other transdermal innovations are fast arriving in the cannabis market, including long-lasting patches and tingly lubricants for patients and recreational consumers alike.

Donald Abrams was a member of the committee that reviewed the evidence that went into producing the report, and he said that the studies they reviewed overwhelmingly used pharmaceutically available preparations that contain THC, including dronabinol, nabilone and the whole-plant extract spray nabiximols, which contains equal parts CBD and THC. It’s impossible to know whether the benefits of cannabis can also be obtained from CBD alone, Abrams said, because CBD is just one of 400 chemicals present in the plant. So far, CBD in isolation has been studied in only a handful of randomized, placebo-controlled trials (considered the gold standard of evidence in medical research), and the evidence remains sparse.


Stephanie, generally, I have patients take 20 to 150mg a day for sleep +/- anxiety. Start low and go slow. Know the dosages of your product. Usually 2/3 to 3/4 of the daily dose is 1-2 hours before bedtime, and the other portion is upon waking (to improve wakefulness during the day). Other factors such as stress, hormone replacement, other meds & medical conditions, etc. play a role along with individual differences. I own a compounding pharmacy, so we see a lot of unique needs. I can't give more specific advice in this forum, but there is help!

Cannabis-infused topicals have become a popular item among patients treating a variety of aches and pains. Applied directly to the skin, topicals deliver localized relief and often contain a variety of therapeutic compounds, not just CBD. Because balms and salves are non-intoxicating, topicals are a great choice for patients needing relief with a clear head.

If you don't live in a legalized state, you can typically still get CBD-infused creams. Since there's no regulation or standardized testing, your best bet is to find trustworthy brands who use creams free of toxins but with additional pain relievers like menthol, capsaicin, lemongrass, or camphor. Try Mary's Nutritionals Muscle Freeze ($70; marysnutritionals.com) or Elixinol's CBD Rescue Balm ($40; elixinol.com).
This is a whole new idea to me and I can use any help you can offer. I suffer from post stroke pain in my thigh which sounds similar to the pain diabetics feel in their feet (sort of electric shocks shooting through my skin). I’ve had this 24/7 for about 5 years now. The 600 mg Gabapentin 3 times a day is no longer helping. A friend just suggested marijuana topicals which I had never heard of! Any recommendations?

Multiple studies showed that CBD has properties that reduce inflammation. As such, it can be used to decrease sebum production. In other words, CBD oil might be good for your acne problem. One test-tube study showed that CBD had a noticeable effect on the sebaceous cells. When they came into contact with CBD, these cells stopped secreting any excess sebum. On top of that, CBD also lowered inflammation and stopped the so-called inflammatory cytokinesis before it manifested. Another separate study yielded similar results.


Of course, CBD oil can be added to any type of beverage, not necessarily just coffee, but I've come to love the calm yet ultra-productive effect it has on my morning mood when combined with cold brew. I feel happier and less worried or encumbered by stress. Essentially, it helps me feel like I can take on the world or, at the very least, the inevitable deluge of emails, deadlines, meetings, and maybe even an evening Spin class, that await. Keep scrolling for the morning recipe I swear by and all the essential ingredients.
Cannabidiol is insoluble in water but soluble in organic solvents such as pentane. At room temperature, it is a colorless crystalline solid.[44] In strongly basic media and the presence of air, it is oxidized to a quinone.[45] Under acidic conditions it cyclizes to THC,[46] which also occurs during pyrolysis (smoking).[47] The synthesis of cannabidiol has been accomplished by several research groups.[48][49][50]
In addition to positively affecting the endocannabinoid system, CBD has been the focus of more than 23,000 published studies about cannabinoids in relation to various medical indications including anxiety, epilepsy, inflammation, cancer and chronic pain to name few. For a more comprehensive look at these and other studies, visit our medical research and education page.
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^ Devinsky, Orrin; Cilio, Maria Roberta; Cross, Helen; Fernandez-Ruiz, Javier; French, Jacqueline; Hill, Charlotte; Katz, Russell; Di Marzo, Vincenzo; Jutras-Aswad, Didier; Notcutt, William George; Martinez-Orgado, Jose; Robson, Philip J.; Rohrback, Brian G.; Thiele, Elizabeth; Whalley, Benjamin; Friedman, Daniel (22 May 2014). "Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders". Epilepsia. 55 (6): 791–802. doi:10.1111/epi.12631. PMC 4707667. PMID 24854329.
If you don't live in a legalized state, you can typically still get CBD-infused creams. Since there's no regulation or standardized testing, your best bet is to find trustworthy brands who use creams free of toxins but with additional pain relievers like menthol, capsaicin, lemongrass, or camphor. Try Mary's Nutritionals Muscle Freeze ($70; marysnutritionals.com) or Elixinol's CBD Rescue Balm ($40; elixinol.com).
Cannabidiol is currently a class B1 controlled drug in New Zealand under the Misuse of Drugs Act. It is also a prescription medicine under the Medicines Act. In 2017 the rules were changed so that anyone wanting to use it could go to the Health Ministry for approval. Prior to this, the only way to obtain a prescription was to seek the personal approval of the Minister of Health.

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