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What Is CBD Oil?

This cannabis extract may help treat nerve pain, anxiety, and epilepsy

Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman’s World, and Natural Health.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles. She helped co-author the first integrative geriatrics textbook, “Integrative Geriatric Medicine.”

Cannabidiol (CBD) oil is an extract from hemp plants called Cannabis indica and Cannabis sativa . You might be more familiar with cannabis plants because they are grown for marijuana. However, CBD is not the same thing as marijuana.

CBD oil contains CBD that’s mixed with a base (carrier) oil, like coconut oil or hemp seed oil. These are called tinctures. You can get tinctures in different concentrations. The oil can also be put into capsules, gummies, and sprays.

People who support using CBD oil say that it can treat pain and anxiety; can help stimulate appetite and may help manage some types of seizures.

This article goes over what CBD is used for, the possible side effects, and what you should look for if you choose to buy CBD.

CBD vs. Marijuana

CBD is one component (called a cannabinoid ) that’s found in a hemp plant. Marijuana is a separate plant but it’s from the same species that hemp belongs to. Marijuana has CBD and hundreds of other compounds in it.

The main difference between hemp plants and marijuana plants is how much of a compound called tetrahydrocannabinol (THC) is in them. Hemp is grown to have less than 0.3% THC, while marijuana has more.

THC is what’s responsible for the psychoactive effects of cannabis—in other words, it’s what makes you feel “high.”

CBD oil generally does not have THC in it; however, a very small (trace) amount might be in products sold in certain states.

What Is CBD Oil Used For?

We’re not sure exactly how CBD works. Unlike THC, CBD doesn’t have a strong connection with the molecules in the brain that THC binds to create psychoactive effects. These are called cannabinoid receptors.

Instead, CBD works on other receptors, like the opioid receptors that help control pain. It also affects glycine receptors that control a brain chemical called serotonin which helps control your mood.

People that support the use of CBD claim that CBD oil can treat a variety of health problems, including:

  • Acne
  • Anxiety
  • Chronic pain
  • Depression
  • Drug use and withdrawal
  • High blood pressure
  • Muscle spasms
  • Poor appetite

As CBD has gained popularity, researchers have been trying to study it more. Still, there has not been a lot of clinical research to look for evidence in support of these health claims.

CBD is not a safe option for everyone. Talk to your healthcare provider if you want to try it for managing a health condition.

Anxiety

A 2015 review of research that was published in the journal Neurotherapeutics suggested that CBD might help treat anxiety disorders.

The study authors reported that CBD had previously shown powerful anxiety-relieving effects in animal research—and the results were kind of surprising.

In most of the studies, lower doses of CBD (10 milligrams per kilogram, mg/kg, or less) improved some symptoms of anxiety, while higher doses (100 mg/kg or more) had almost no effect.

The way that CBD acts in the brain could explain why this happens. In low doses, CBD might act the same as the surrounding molecules that normally bind to the receptor that “turns up” their signaling.

However, at higher doses, too much activity at this receptor site could produce the opposite effect.

There have not been many trials to look at CBD’s anxiety-relieving effects in humans. However, one was a 2019 study published in the Brazilian Journal of Psychiatry.

For the study, 57 men took either CBD oil or a sugar pill with no CBD in it (placebo) before a public-speaking event.

The researchers assessed the participants’ anxiety levels using measures like blood pressure and heart rate. The researchers also used a reliable test for mood states called the Visual Analog Mood Scale (VAMS).

The men who took 300 mg of CBD oil reported less anxiety than the men who were given a placebo; however, the men who took 100 mg or 600 mg of CBD oil did not experience the same effects.

Addiction

CBD oil might help people with substance use disorder, according to a 2015 review published in the journal Substance Abuse.

The review looked at the findings from 14 published studies. Nine of the studies looked at the effects of CBD on animals, and five studies looked at the effects on humans.

The researchers reported that CBD showed promise for treating people with opioid, cocaine, or psychostimulant use disorders.

However, the effects of CBD were quite different depending on the substance. For example, CBD without THC did not decrease withdrawal symptoms related to opioid use.

On the other hand, it did reduce drug-seeking behaviors in people using cocaine, methamphetamine, and other similar drugs.

Some experts suggest that CBD could help treat cannabis and nicotine dependence, but more research is needed to provide this theory.

High Blood Pressure

A 2017 study found that CBD oil may reduce the risk of heart disease because it can lower high blood pressure in some people.

For the study, nine healthy men took either 600 mg of CBD or the same dose of a placebo. The men who took CBD had lower blood pressure before and after experiencing stressors like exercise or extreme cold.

The study also looked at the amount of blood remaining in the heart after a heartbeat (stroke volume).

The stroke volume in the men who took CBD was lower than in was in the placebo group, meaning their hearts were pumping more efficiently.

The study suggested that CBD oil could be a complementary therapy for people with high blood pressure that is affected by stress and anxiety.

However, there is no evidence that CBD oil can treat high blood pressure on its own or prevent it in people at risk. While stress can complicate high blood pressure, it does not cause it.

Seizures

In June 2018, the U.S. Food and Drug Administration (FDA) approved a CBD oral solution called Epidiolex.

Epidiolex is used to treat two rare forms of epilepsy in children under the age of 2: Dravet syndrome and Lennox-Gastaut syndrome. These are very rare genetic disorders that cause lifelong seizures starting in the first year of life.

Other than for these two disorders, CBD’s effectiveness for treating seizures is not known. Even with Epidiolex, it’s not clear if the anti-seizure effects are from CBD or another factor.

However, there is some evidence that CBD interacts with seizure medicines like Onfi (clobazam) and raises their concentration in the blood. That said, more research is needed to understand the link.

Possible Side Effects

Clinical research has shown that CBD oil can cause side effects. The specific side effects a person has and how bad they are varies from one person to the next and from one type of CBD to another.

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Some common side effects people report from using CBD include:

  • Anxiety
  • Changes in appetite
  • Changes in mood
  • Diarrhea
  • Dizziness
  • Dry mouth
  • Nausea
  • Vomiting

CBD oil may also increase liver enzymes, which is a marker of liver inflammation.

People with liver disease should talk to their healthcare provider before taking CBD oil. They may need to have their liver enzymes checked regularly if they are using CBD.

Can You Use CBD If You’re Pregnant?

You should not use CBD oil if you’re pregnant or breastfeeding. Even though the effects of CBD are not fully understood, it does pass through the placenta.

The American Academy of Pediatrics (AAP) further states that pregnant people should not use marijuana because of the potential risks to a developing fetus.

Do not drive or use heavy machinery when taking CBD oil—especially when you first start using it or switch to a new brand. Remember that some products do contain THC, even in small amounts.

Interactions

CBD oil can interact with medications, including many that are used to treat epilepsy. One of the reasons for this has to do with how your body breaks down (metabolizes) drugs.

Cytochrome P450 (CYP450) is an enzyme your body uses to break down some drugs. CBD oil can block CYP450. That means that taking CBD oil with these drugs could make them have a stronger effect than you need or make them not work at all.

Drugs that could potentially interact with CBD include:

  • Anti-arrhythmia drugs like quinidine
  • Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
  • Antifungal drugs like Nizoral (ketoconazole) and Vfend (voriconazole)
  • Antipsychotic drugs like Orap (pimozide)
  • Atypical antidepressants like Remeron (mirtazapine)
  • Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
  • Immune-suppressive drugs like Sandimmune (cyclosporine)
  • Macrolide antibiotics like clarithromycin and telithromycin
  • Migraine medicine like Ergomar (ergotamine)
  • Opioid painkillers like Duragesic (fentanyl) and alfentanil
  • Rifampin-based drugs used to treat tuberculosis

Always tell your healthcare provider and pharmacist about all the medicines you take, including prescription, over-the-counter (OTC), herbal, or recreational drugs.

The interactions between these medications and CBD are often mild and you might not have to change your treatment.

However, in some cases, you might have to change medications or space out your doses to avoid a reaction. That said, never change or stop medication without talking to your provider.

Dosage and Preparation

There are no guidelines for using CBD oil. Each product works a bit differently, depending on the form.

For example, putting the oil under your tongue can produce effects more quickly than swallowing a capsule that needs to be digested.

Here are a few ways that you can take CBD oil:

  • Placing one or more drops under your tongue and holding it there for 30 to 60 seconds without swallowing. You can also use a spray that is spritz in your mouth/under your tongue.
  • Taking a capsule or chewing a gummy

There’s no “correct” dose of CBD oil. How much you take and the form you choose will depend on your needs and what you hope to get for effects. The average dose range is from 5 mg to 25 mg.

Most oils come in 30-milliliter (mL) bottles and include a dropper cap to help you measure.

That said, it’s hard to figure out the exact amount of CBD per milliliter of oil. Some tinctures have concentrations of 1,500 mg per 30 mL, while others have 3,000 mg per mL or more.

How to Calculate CBD Dose

To determine an exact dose of CBD, remember that each drop of oil equals 0.05 mL of fluid. This means that a 30-mL bottle of CBD oil will have about 600 drops in it.

If the concentration of the tincture is 1,500 mg per mL, one drop would have 2.5 mg of CBD in it. The math to figure that out looks like this: 1,500 mg ÷ 600 drops = 2.5 mg

What to Look For

CBD oil comes in different forms: isolates, broad-spectrum, and full-spectrum.

  • Isolates contain only CBD
  • Broad-spectrum oils nearly all of the components of the plan (e.g., proteins, flavonoids, terpenes, and chlorophyll), but does not have THC oils have all the compounds including THC (up to 0.3%)

Alternative medicine practitioners believe that the compounds provide more health benefits, but the is a lack of evidence to support these claims.

Remember that CBD oils are unregulated. There’s no guarantee that a product is what it claims to be on its packaging. You also can’t know for sure that it’s safe and effective.

A 2017 study reported that only 31% of CBD products sold online were correctly labeled. Most had less CBD in them than was advertised, and 21% had significant amounts of THC.

If you are interested in buying CBD products, here are a few tips to keep in mind:

  • Buy American: Domestically produced CBD oil might be a safer option than those that have been imported.
  • Go organic: Brands certified organic by the U.S. Department of Agriculture (USDA) are less likely to expose you to pesticides and other harmful chemicals.
  • Read the product label: Even if you choose a full-spectrum oil, don’t assume that every ingredient on the product label is natural. CBD products can also have preservatives, flavorings, or thinning agents in them. If you don’t recognize an ingredient, ask the dispenser what it is or check online.

Summary

Hemp plants can be grown for different purposes. Some species are made for marijuana but others are used to make CBD products.

Unlike marijuana, CBD oil does not “get you high.” Instead, it may help relieve stress, anxiety, drug withdrawals, and nerve pain.

While there are many claims about the health benefits of using CBD oil, the evidence is lacking. A lot of studies were done with animals, not humans.

If you want to try CBD oil, you should learn about the different dosages and preparations first.

You should also know that the products are not regulated, which means you can’t know for sure that a product will work and be safe.

Before you use CBD oil, talk to your provider. If you take certain medications or have a health condition, you may not be able to use these products.

Frequently Asked Questions

It would be hard to overdose on CBD oil. Research has shown that human tolerance for CBD is very high. One study reported the toxic dose would be about 20,000 mg taken at one time.

It depends on where you live, the type of product, how it was sourced (e.g., is it from hemp or marijuana), and its intended purpose (medical or recreational). In many states, you must be 18 or 21 to buy CBD oil. Check your state’s laws.

Not necessarily. While the names are sometimes used interchangeably, hemp oil can also refer to hemp seed oil, which is used for cooking, food production, and skincare products.

CBD oil is made from the leaves, stems, buds, and flowers of the Cannabis indica or Cannabis sativa plant. It should contain less than 0.3% THC.

Hemp oil is made from the seeds of Cannabis sativa and does not have TCH in it.

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Every Question You Have About CBD—Answered

Does CBD get you high? What are the actual benefits? Will it show up on a drug test? Here’s everything you need to know about the product that’s suddenly everywhere.

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There’s no question that CBD is the buzzy wellness product of the moment. If you live in a state where it’s currently legal, you might feel like CBD has gone from being sort of around to absolutely everywhere all at once. Coffee shops sell CBD lattes, spas offer CBD facials, beauty companies are rushing to release lotions with CBD or hemp oils in their formulas. And everyone from your anxious coworker to your arthritis-suffering dad wants to get their hands on some CBD gummies.

But even though it’s infiltrating pretty much every corner of the wellness world (hi, vegan CBD brownies!) many people still find CBD a little confusing—especially when it comes to figuring out the right way to use it and how to make sure the stuff you’re buying is, you know, actually legit. Below, we asked experts to answer the most pressing questions about CBD.

OK, first things first. What is CBD?

CBD, short for cannabidiol, is a chemical compound from the Cannabid sativa plant, whish is also known as marijuana or help, according to the US National Library of Medicine.

It’s a naturally occurring substance that’s used in products like oils and edibles to impart a feeling of relaxation and calm. Unlike its cousin, delta-9-tetrahydrocannabinol (THC), which is the major active ingredient in marijuana, CBD is not psychoactive.

So you’re saying CBD won’t get me high?

Nope. The cannabis plant is made up of two main players: CBD and THC. “CBD is the non-psychoactive portion of the plant, so what that means is you won’t have any effects like euphoria,” says Junella Chin, DO, an osteopathic physician and a medical cannabis expert for cannabisMD. “You won’t feel sedated or altered in any way.”

There are two possible exceptions to this. The first is that some people, for unknown reasons, just react differently to CBD. According to Dr. Chin, about 5% of people say they feel altered after taking CBD. “Usually they’re the same people who have side effects from Advil or Tylenol,” she says. You never know how your body will react to any new supplement, so when taking CBD for the first time, do so safely under supervision.

It’s also crucial to buy third-party-tested CBD for quality assurance (more on this later). Because the FDA doesn’t regulate CBD, it is possible to buy a product that is more or less potent than advertised, or even contains small amounts of THC.

Where does hemp come in to all this?

You’ve probably heard the terms cannabis, marijuana, and hemp all tossed around in relation to CBD. The plant Cannabis sativa has two primary species, hemp and marijuana. Both contain CBD, but there’s a much higher percentage in hemp, which also has very low (less than 0.3%) levels of THC compared to marijuana.

When people talk about hemp oil, they’re referring to oil extracted from the seeds of the hemp plant. There are no cannabinoids—CBD or THC—in hemp oil. This ingredient is packed with healthy fats and often appears in beauty products for its moisturizing benefits.

What are the health benefits of CBD?

The only CBD medication that is currently FDA-approved is Epidiolex, which the agency approved last year for the treatment of certain types of epilepsy. But many people swear CBD has helped with a slew of other health conditions, including back pain, osteoarthritis, even cancer.

“My practice has patients walking in every day asking about CBD,” says Houman Danesh, MD, director of integrative pain management for the Mount Sinai Hospital in New York City. But while there’s lots of anecdotal evidence, he says, “it’s still very difficult to say” what the real benefits are due to a serious lack of research.

“Right now, you just have pharmacies trying to make some sort of sense out of it and say, ‘Yes, it works for this,'” he says, “but that’s not the way medicine is practiced—it should be based on evidence, and there’s not a lot of evidence to really support these claims.”

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Still, is CBD worth trying for pain management?

There are two main types of pain, Dr. Danesh says: musculoskeletal and nerve. “There could be benefit for both conditions,” he says.

The tricky part is that there’s some evidence suggesting CBD works best for pain when combined with a little THC, says Dr. Danesh. “Depending on what type of pain you have, you might be able to do just CBD, but sometimes you need CBD and THC.” This makes accessing a product that will actually help you more difficult due to different regulations in each state. In New York, where Dr. Danesh practices, for example, CBD is available over the counter. But as soon as you add THC, you need a prescription.

Figuring out how much you should take is challenging as well; the dosage that alleviates one patient’s pain might do very little for someone else. “And until we can study it, it’s the wild west,” Dr. Danesh says.

The takeaway? “I think CBD is a safe thing to try,” says Dr. Danesh. But he urges patients to push for more research by putting pressure on representatives to get national bills passed that allow scientists to look closer at CBD and the conditions that respond to it.

What about my anxiety—can CBD help with that?

CBD might be worth trying to manage symptoms of anxiety. “[CBD] tells your body to calm down and reminds you that you’re safe,” Dr. Chin says. “It mellows out the nervous system so you’re not in a heightened ‘fight or flight’ response,” she says, so people with anxiety may find it helps them feel more relaxed.

Still, one of the biggest misconceptions about CBD is that it’s a wonder drug. “A lot of times people think CBD is a cure-all, and it’s not,” Dr. Chin says. “You should also have a healthy lifestyle with plenty of exercise and good nutrition—CBD is not going to fix everything.”

I’ve heard of edibles, tinctures, vape pens. What’s the best way to take CBD?

It really depends on what your goal is and why you’re taking CBD in the first place.

Some people don’t want to ingest anything and therefore prefer a topical CBD cream or ointment. “You can apply it to muscles, joints, and ligaments and still get a nice, localized release,” Dr. Chin says.

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The biggest differences between tinctures, edibles, and vape pens are speed of delivery and how long the effects last. Vape relief is faster but wears off faster too—usually in about two hours, says Dr. Chin. “Say you wake up in the morning and pulled your back out, you might want to take CBD through a vape pen, which delivers in 10 minutes.”

Tinctures and edibles take longer to work but last four or five hours. “A tincture looks like a little liquid that you put under your tongue, and you feel relief within half an hour,” Dr. Chin says. “If you prefer to taste something, you choose an edible, whether it’s a capsule, gummy, or baked good.”

What should I look for when shopping for CBD products?

“There are literally hundreds of CBD brands at this point,” says Brandon Beatty, founder and CEO of Bluebird Botanicals and an executive vice president of the U.S. Hemp Roundtable. Here are a few things you should keep in mind when shopping.

What does the label look like?

We don’t mean the color or millennial font. If it’s a dietary supplement, it should have a back panel with an FDA disclaimer and warning section, according to Beatty. “Ideally, it would be preferable to have access to their third-party lab testing results too.”

Speaking of which: Has it been third-party tested?

Nearly every expert Health spoke to agreed that your CBD products should be tested by a third party to confirm the label’s accuracy. This is a real concern in the industry—take the 2017 Journal of the American Medical Association study, for example, which tested 84 CBD products and found that 26% contained lower doses than stated on the bottle. Look for a quality assurance stamp or certificate of analysis from a third party (aka not the actual brand) or check the retailer’s website if you don’t see it on the product’s label.

What’s the dosing?

This is a confusing one for many people. “A lot of brands don’t do a good job of clearly instructing their consumer on the dosing,” says Chris Roth, CEO and co-founder of Highline Wellness. When thinking about dosing, also consider whether your CBD is full-spectrum or isolate: Full-spectrum could include other cannabinoids like cannabidivarin or cannabigerol (this is important, since “there’s something called the ‘entourage effect’ when all together, they’re more effective than any one of them alone,” Roth explains), while isolate is 100% CBD. “Some people might only need 10 milligrams of full-spectrum CBD, but with isolate, even taking 80 or 100 milligrams might not have the same effect,” he says.

Does it claim to cure any diseases?

If so, hard pass. “You should avoid any company that makes disease claims,” says Beatty. “If so, it means they’re either willing to break the rules or they’re not aware of the rules.”

Is there a batch number?

You know how you check your raw chicken or bagged lettuce every time there’s a recall to make sure the one you bought isn’t going to make you sick? You should be able to do that with CBD products too. “This is a huge indicator as to whether they are following good manufacturing practices,” says Beatty. “There should be a way to identify this product in case it was improperly made so the company can carry out a recall.”

Are there additional ingredients in there?

As with any supplement, you want to know everything you’re ingesting in addition to the main event. For example, “sometimes I notice that [CBD manufacturers] will add melatonin,” says Dr. Chin.

Are you buying it IRL?

You can find CBD products in shopping malls, convenience stores, even coffee shops in many states right now. But when in doubt, natural grocers are a safe brick-and-mortar place to buy CBD, Beatty says. “Typically they have a vetting process that does some of the legwork for you.”

That all sounds good, but is it legal?

First, a little background. Industrial hemp was legal in the United States until Congress passed the Marihuana Tax Act in 1937. (“Some of our early presidents grew hemp,” notes Sarah Lee Gossett Parrish, a cannabis industry attorney based in Oklahoma.) Nearly 80 years later, the 2014 Farm Bill took the position that states can regulate the production of hemp and, as a result, CBD. Then last year, President Trump signed a new Farm Bill that made it federally legal to grow hemp.

This means that “consumers everywhere, if they’re compliant with their state, can grow hemp and use hemp products,” Parrish explains, “and among those will be CBD.”

In other words, the latest bill removed hemp from the Drug Enforcement Administration, or DEA’s, purview. “Hemp can now be grown freely under federal law, which, of course, is huge,” Parrish says. “But while it’s legal under federal law, it’s up to each state to set their own policy.”

These policies vary widely. Marijuana and CBD are currently fully legal for both medicinal and recreational purposes in Alaska, California, Colorado, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, Washington, and Washington D.C. In 23 states, it’s legal in some form, such as for medicinal purposes. Another 14 states permit just CBD oil. But both are illegal in Idaho, Nebraska, and South Dakota. For more information, the organization Americans for Safe Access has a helpful guide to the specific laws in each state.

“It’s kind of ironic,” says Parrish. “With marijuana, we have got the federal government saying ‘No’ and a bunch of states saying ‘Yeah, it’s OK’—but with hemp, the feds say ‘Yeah, it’s OK,’ but we still have some states saying it’s not.”

Can you travel with CBD?

That same 2018 Farm Bill means you can now travel between states with legit CBD products. “Flying with CBD should pose no issues now,” Parrish says. However, if you’re traveling with a tincture, be mindful of TSA limits on how much liquid you can carry on an airplane, she adds. (You can also mail CBD products, just like “companies that comply with the Bill can ship their hemp-derived CBD products anywhere in the U.S.,” Parrish notes.)

Will CBD show up on a drug test?

It should not, as long as you’re buying third-party tested CBD with no added THC, says Dr. Chin. But she does point out that athletes, who often are required to take drug tests that are more sensitive, “could potentially test positive” for trace amounts of THC if they’ve been using CBD products.

Last question: Can I give it to my dog?

Tempted to give your pup one of those CBD dog biscuits? “Generally we expect CBD products to be safe, and they could show some benefit for anxiety in pets,” says John Faught, DVM, a veterinarian based in Austin, Texas.

But the challenge when considering CBD products for pets is the same as with people: lack of research. “I believe there are good products out there today, but I also don’t know how to distinguish them at this time,” Faught says.

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