CBD

CBD (cannabidiol) is one of the main compounds in cannabis, but unlike THC it does not produce a high. It is marketed widely as oils, gummies, capsules, and topical products for anxiety, pain, and sleep, though most such uses are not FDA-approved. One purified prescription form, Epidiolex, is FDA-approved to treat certain rare seizure disorders, which is the strongest evidence base for any CBD use.

CBD's mechanism is complex and not fully understood. Unlike THC, it does not strongly activate the CB1 cannabinoid receptor, which is why it is non-intoxicating. Instead it interacts with a range of targets — including serotonin 5-HT1A receptors and the endocannabinoid system indirectly — and influences several drug-metabolizing liver enzymes, which is the basis of many of its drug interactions.

CBD is generally reported to produce mild calming or anti-anxiety effects without intoxication. Common side effects, most clearly documented at the higher doses used medically, include drowsiness, diarrhea, changes in appetite, and fatigue. Effects from consumer products are inconsistent because potency and actual CBD content vary widely and are often mislabeled.

CBD is not intoxicating and has a relatively favorable safety profile, but it is not risk-free. At higher doses it can cause liver enzyme elevations signaling potential liver injury, a risk flagged in the Epidiolex labeling. Its most important hazard is drug interactions: CBD inhibits liver enzymes that metabolize many medications, and can raise blood levels of drugs including certain blood thinners and anti-seizure medicines, potentially to dangerous levels — anyone on regular medication should treat this as a real interaction risk. The consumer market is poorly regulated: products are frequently mislabeled, containing more, less, or different cannabinoids than stated, and some have been found to contain THC (enough to cause intoxication or a positive drug test) or contaminants such as heavy metals or pesticides. Products are not a substitute for evidence-based medical treatment. Anyone with signs of liver problems (yellowing skin or eyes, severe abdominal pain) or a serious medication interaction should seek medical care; Poison Control at 1-800-222-1222 can advise on exposures. This page has not yet been medically reviewed.