Therapeutic Use of CBD: A Comprehensive Guide
In 2009, medical professionals studying the therapeutic properties of cannabis unexpectedly discovered several strains with genetics predisposed to producing high concentrations of CBD in Humboldt County, Northern California. Since then, this region—long considered a hub of the underground cannabis cultivation industry—has also become a global center for the production and research of therapeutic cannabis varieties, supplying plants rich in cannabinoids highly effective for treating various chronic conditions to the country and the world.
Even before the discovery of unique CBD-rich cannabis strains, doctors were already aware of the therapeutic potential of plant oils containing high concentrations of this compound. Today, most medical professionals in the US and Europe recognize the therapeutic properties of cannabis and continue to study the effects of specific plant compounds on human physiological and psychological processes.
Despite progress in legalizing therapeutic cannabis and related products, most practicing physicians in countries that have adopted reforms still lack a deep understanding of the nuances of using cannabis for therapeutic purposes, as few regions offer comprehensive retraining programs for doctors on medical cannabis use. For this reason, the international CBD Project has created its own guide to using CBD in medicine, the main points and recommendations of which are discussed below.
Brief Overview of CBD and Its Properties
CBD is one of the active compounds in cannabis, known for its pronounced calming and analgesic effects. This has led to its widespread use in medicine, particularly for treating chronic diseases. Unlike its close relative, the psychoactive cannabinoid THC, CBD does not cause the characteristic cannabis-induced intoxication. Because of these factors, CBD has become a popular alternative therapy for a range of severe and chronic conditions, from neuropathic pain and arthritis to alleviating symptoms associated with AIDS, cancer, and neurodegenerative diseases like Parkinson’s and Alzheimer’s.
Currently, research centers in the US, Israel, and several European countries are testing CBD extracts for various diseases, conducting experiments with both animals and human volunteers. Scientists note that CBD’s broad and multifaceted effects on the body are due to its ability to directly interact with receptors of the endocannabinoid system, which helps balance and modulate the function of all other biological components in the human body. Additionally, CBD’s biological effects include strong anti-inflammatory and antioxidant properties, which not only relieve different types of pain but also provide neuroprotective effects on brain cells. Medical professionals consider CBD metabolites to be the only known compounds that successfully remove amyloid protein buildup from nerve cells in the brain’s cognitive and motor centers, helping prevent the progression and symptoms of serious neuropathic diseases like Alzheimer’s and Parkinson’s.
Which Has a Stronger Therapeutic Effect: CBD or THC?
In practice, CBD and its more famous counterpart, THC, often work together, enhancing each other’s therapeutic properties when consumed together. Numerous studies and user reports indicate that when used in combination, both cannabinoids amplify each other’s effects, resulting in a more noticeable and longer-lasting impact. Specifically, CBD modulates the psychoactive effects of THC, reducing the characteristic intoxication while significantly boosting its analgesic and anti-cancer effects. CBD can also reduce the level of intoxication caused by excessive THC consumption, making it a kind of antidote for cannabinoid overdose during recreational use.
Many users report that when mixed with CBD, THC produces a more prolonged and sedative effect, which is beneficial in palliative and psychiatric therapy. THC also has neuroprotective and neurogenesis properties, and in combination with CBD, helps the body better protect and restore lost neural connections, making such mixtures highly effective for treating diseases that lead to dementia.
Methods of Consuming CBD
CBD can be consumed in several forms, which can be divided into “fast but short-acting” and “slow but long-acting” groups. For the fastest and strongest effect, CBD products should be smoked or vaporized. However, such products may not be available in regions where cannabis cultivation remains criminalized. In most countries, it is easier to access plant oil extracts intended for oral or topical use. In the form of capsules, edibles, or beverages infused with cannabis oil, active compounds are absorbed more slowly (therapeutic effects appear within 30–90 minutes, depending on stomach fullness and individual tolerance), but the effects last longer (with large doses, one use can provide effects for up to a day and a half). When smoked or vaporized, the effects are felt faster but typically last no more than 3–4 hours.
CBD Use in Epilepsy Therapy
Historical records show that many cultures have used cannabis and its extracts to treat various forms of epilepsy since ancient times. As early as the mid-19th century, American and British pharmacopeias noted that oil from “Indian cannabis” was an effective natural remedy for suppressing different types of epileptic seizures. In recent years, as criminalization has eased in some countries, scientists have confirmed the high effectiveness of CBD-rich cannabis in treating both adult and childhood epilepsy, including syndromes that are resistant to other medications. Recent US trials show that in 10–15% of cases, CBD therapy helps children with epilepsy become seizure-free within weeks. In other cases, CBD significantly reduces the frequency, intensity, and duration of seizures. However, in rare cases (about 5%), CBD increased seizure activity in children. Doctors later noted that such incidents can be avoided by using cannabis oil extracts containing small amounts of THC or THCA (the effectiveness of the latter is still being studied). In other words, while CBD is undoubtedly powerful in epilepsy therapy, its effects are greatly enhanced when used in combination with its natural entourage—THC and terpenes.
Determining the THC to CBD Ratio in Mixtures
As noted, using CBD for chronic disease therapy can carry certain risks, as each patient’s body reacts uniquely to cannabinoids. Therefore, to determine the most effective and safe concentration of THC and CBD in a therapeutic mixture or product, it is best to consult a medical specialist or carefully review other users’ experiences online. Of course, dosages can be adjusted independently by gradually increasing cannabinoid concentrations. Some people, even those with no prior cannabis experience, can tolerate high concentrations without noticeable intoxication or side effects. Others may be physiologically unable to tolerate THC, which can lead to negative outcomes even with weak extracts or strains. For such patients, increasing the CBD concentration relative to THC is advisable, as CBD can modulate (i.e., reduce) the more pronounced effects of THC.
In some US states where therapeutic cannabis is legal, consumers have no trouble measuring cannabinoid concentrations, as ready-made extracts for vaporizers are sold in pharmacies and general stores. Unfortunately, despite its non-psychoactive nature, many countries ban the import of such products. Additionally, the concentration of active compounds in these extracts may be insufficient for treating more severe conditions, leading to a “gray market” of homemade medical mixtures.
Effects of Different Cannabinoid Ratios on Symptoms
Doctors specializing in cannabis therapy have found that different THC to CBD ratios in extracts and special cannabis strains can have varying effects on specific symptom groups of the same disease. Some combinations are more effective for certain types of symptoms. Mixtures with higher CBD content are more effective for treating epileptic seizures, muscle spasms, psychosis, anxiety, paranoia, and depression than extracts with higher THC. On the other hand, neuroprotective, anti-cancer, and calming effects for autism therapy are more pronounced in mixtures with equal CBD and THC ratios. Pure THC or THC-dominant mixtures are better at suppressing pain and relieving muscle lethargy and spasticity.
Some people using cannabis for chronic or palliative care of terminal illnesses use different cannabinoid mixtures throughout the day to target various symptom groups. Many prefer CBD products during the day for their non-intoxicating and sedative effects, saving THC for nighttime relaxation and sleep. In general, it is always better to add a little THC to CBD extracts, as THC can activate CB2 receptors, which in turn stimulate the immune system.
Calculating the Optimal Active CBD Dosage
Ignoring individual differences, the minimum effective CBD dosage ranges from just a few milligrams to one gram. For those with no experience using psychoactive THC, it is best to start with extracts high in CBD relative to THC. Once an effective dosage is found, it should be tested over several days to ensure it is suitable for regular use. Remember, all active cannabis compounds have biphasic properties—at low doses, cannabinoids can have effects very different from those at high doses. While CBD generally does not show much difference between low and high doses (except for overall sedation), high doses of THC can cause panic, disorientation, or even intensify certain types of pain. In cannabis medicine, a lower dose is often more effective and safer than a large one.
How to Choose CBD Products
In addition to the THC to CBD ratio, when purchasing cannabis extracts for therapeutic use, it is important to check the product’s production date and terpene profile. In legalized regions, also pay attention to the batch number for quality assurance. Ideally, look for products with minimal non-cannabinoid additives. Products containing flavorings, fructose syrup, or preservatives may be of poor quality and could cause discomfort. Legal or professionally made products should be tested for purity: oils should not contain solvent residues, pesticides, or harmful fungi or bacteria. When dealing with underground products, choose those made without butane or other strong, dangerous solvents. Oils extracted with compressed CO2 or alcohol are preferable.
Why Isolated CBD Is Less Effective Than Cannabinoid Mixtures
Currently, many pharmaceutical companies hold patents for synthetic CBD production. Such products, made from industrial cannabis, are often available by prescription or through gray-market online dealers. Consumer reviews and medical studies agree that isolated CBD molecules do not have as pronounced a therapeutic effect as the same compound in the presence of other cannabinoids and terpenes. Isolated CBD has a very narrow effective dosage range, which is difficult to determine. For this reason, many prefer full-spectrum cannabis oil extracts, even if legal access to the plant is unavailable. This ability of CBD to work synergistically with other cannabis compounds is called the “entourage effect,” which also applies to other cannabinoids.
Are There Differences Between CBD Extracts from Industrial and Specialized Plants?
Although both types of oils are often legally sold in the same market, for therapeutic purposes (especially for chronic illness), it is best to use extracts from specialized cannabis strains rather than industrial plants. These products can be distinguished by name: the first type is called “high-resin cannabis extract,” while the second is “low-resin cannabis extract.” The main difference is the average concentration of active cannabinoids: industrial plant oils have much lower CBD concentrations (and almost no THC) compared to specialized strains. Industrial plants are also grown under less strict quality standards, increasing the risk of extracts containing pesticides or other contaminants from the soil (cannabis is also highly effective at cleaning soil of heavy metals and radioactive elements). In general, pure CBD crystals or paste from industrial plants are lower-quality alternatives to professional extracts from medical cannabis strains. As a rule of thumb: any extract with less than 0.3% THC is unlikely to be highly effective for therapeutic use.
Is It Safe to Use CBD Oils in Electronic Vaporizers?
Every cannabis extract used in electronic vaporizers contains a thinning agent to maintain liquid consistency. The main risk of using cannabis oils in e-cigarettes is the presence of potentially harmful thinning agents. Even in legal markets, avoid products containing propylene glycol. While safe at room temperature, when heated, it breaks down and releases formaldehyde vapors, a toxic and carcinogenic substance. Such products are often residues from butane extraction, so as a precaution, choose products made with safer solvents (like alcohol or CO2).
Avoid polyethylene glycol (a related compound also used as a thinning agent in some consumer products) and artificial flavorings, especially those with cinnamon or cream scents, as they can release many toxic vapors when heated. In any case, the inclusion of artificial flavorings indicates a low-quality extract. Natural and safe products should contain only a natural terpene profile, with no artificial additives.
Does CBD Have Side Effects and How Does It Interact with Other Medications?
Although CBD is extremely safe and non-toxic, it can cause negative side effects when used with certain medications. Do not use CBD together with painkillers, as in certain concentrations, it deactivates cytochrome P450 enzymes responsible for metabolizing analgesics. This can accelerate the absorption of opioid painkillers, blood thinners, and insulin, increasing the risk of overdose. If you wish to use CBD with painkillers, consult your doctor. The risk of negative interactions is lower when using extracts containing not only CBD but also other cannabinoids.