Your primer on all things cannabis, including how to make the most of the therapeutic benefits (with or without the high).
Photo: Beate Sonnenberg / Getty Images
Cannabis is one of the buzziest new wellness trends, and it's only gaining momentum. Once associated with bongs and hacky sacks, cannabis has made its way into mainstream natural medicine. And for good reason—cannabis has been proven to help with epilepsy, schizophrenia, depression, anxiety, and more, while pre-clinical trials are also proving its efficacy with preventing the spread of cancer.
Hands down, CBD is the most popular component of this herbal remedy. Why? Approachability. Because CBD doesn't have a psychoactive component, it appeals to a range of enthusiasts, including those who aren't trying to get high or who might have adverse reactions to THC (more on what that is, below). Not to mention, the World Health Organization reports that CBD has little to no negative side effects.
If you're a CBD or THC rookie (and these acronyms are totally throwing you off), don't worry: We've got a primer. Here are the basics—no bong required.
Cannabinoids (the compounds in cannabis plants)
Depending on the type of cannabinoid, it's either a chemical compound in a plant or a neurotransmitter in your body (part of the endocannabinoid system).
"A cannabis plant has over 100 components," says Perry Solomon, M.D., anesthesiologist, and chief medical officer of HelloMD. "The primary [components] that people talk about are the active cannabinoids in the plant, known as phytocannabinoids. The other cannabinoids are endocannabinoids, which exist in your body." Yes, you have a system in your body to interact with cannabis! "The phytocannabinoids you're used to hearing about are CBD and THC." Let's get to those!
CBD (short for "cannabidiol")
A compound (phytocannabinoid) found in cannabis plants.
Why is everyone so obsessed? In short, CBD is known to alleviate anxiety and inflammation without getting you high. And it's not addictive like some prescription anxiety medications can be.
"People are looking to use cannabis for medicinal purposes, but don't want to experience high or psychoactive effect," says Dr. Solomon. He did mention that CBD can be more effective when used with THC (more on that later). But on its own, it touts bonafide healing properties. (Here's a full list of CBD's proven health benefits.)
A couple things to keep in mind: "CBD is not a pain reliever," says Jordan Tishler, M.D., a cannabis specialist, Harvard-trained physician, and founder of InhaleMD.
There have been some studies that state otherwise, finding that CBD is effective in treating neuropathic pain (both studies were conducted with cancer patients, and CBD mitigated pain associated with chemotherapy). However, more studies need to be done to say definitively.
The World Health Organization lists several major diseases and conditions CBD can potentially treat, but notes that there is only enough research to prove its efficacy on epilepsy. That said, WHO reported that CBD can potentially treat Alzheimer's disease, Parkinson's disease, Huntington's disease, Crohn's disease, multiple sclerosis, psychosis, anxiety, pain, depression, cancer, hypoxia-ischemia injury, nausea, IBD, inflammatory disease, rheumatoid arthritis, infection, cardiovascular diseases, and diabetic complications.
The CBD compound can be put into oils and tinctures for sublingual (under-the-tongue) delivery, as well as in gummies, candies, and beverages for consumption. Looking for faster relief? Try vaporizing the oil. Some patients find that topical CBD products can provide anti-inflammatory relief for skin ailments (although there is no current research or reports to back up their success stories).
Because CBD is such a newcomer, there aren't set recommendations on how to use it: The dose varies based on the individual and the ailment, and doctors do not have a milligram-specific, universal dosing method for CBD in the way they do with classic prescription medication.
And although WHO says there are no significant side effects, CBD could potentially cause dry mouth or impact blood pressure. It is also contraindicated with certain chemotherapy medications—so it's important to talk to your doctor before adding any kind of medication into your regimen, including natural, plant-based medication. (See: Your Natural Supplements Could Be Messing with Your Prescription Meds)
THC (short for tetrahydrocannabinol)
A compound (phytocannabinoid) found in cannabis plants, THC is known to treat a number of maladies—and to be exceptionally effective. And yes, this is the stuff that gets you high.
"THC is commonly known and is helpful for pain relief, anxiety control, appetite stimulation, and insomnia," says Dr. Tishler. "However, we've learned that THC does not work alone. Many of those chemical [compounds in marijuana] work together to produce the desired results. This is called the entourage effect."
For example, CBD, though helpful on its own, works best with THC. Indeed, studies show the synergy of the compounds found in the entire plant deliver enhanced therapeutic effects versus when they're used solo. While CBD is often used as an isolated extract, THC is more frequently used for therapy in its whole flower state (and not extracted).
"Start low and go slow" is the term you'll hear from many doctors when it comes to medicinal THC. Because it's the psychoactive compound, it can cause feelings of euphoria, a head high, and in some patients, anxiety. "Everyone's reaction to THC is variable," says Dr. Solomon. "A tiny bit of THC for one patient won't make them feel anything, but another patient could have the same amount and have a psychoactive response."
Laws are continuing to change but, currently, THC is legal (regardless of medical necessity) in 10 states. In 23 additional states, you can use THC with a doctor's prescription. (Here's a full map of every state's cannabis rules.)
Cannabis (the umbrella term for marijuana or hemp)
A family (genus, if you want to get technical) of plants, comprising both marijuana plants and hemp plants, among others.
You'll often hear a doctor use the term cannabis in lieu of more casual terms like pot, weed, etc. Using the term cannabis also potentially creates a softer barrier to entry for those who have been a bit apprehensive when it comes to using marijuana or hemp as part of a wellness routine. Just know, when someone says cannabis, they could be referencing either hemp or marijuana. Keep reading for the difference between those.
Marijuana (a high-THC variety of cannabis plant)
Specifically the cannabis sativa species; typically has high amounts of THC and moderate amounts of CBD, depending on the strain.
Stigmatized and outlawed for decades, marijuana receives a bad rap thanks to government efforts to crack down on its use. The truth is that the only potentially "negative" effect of consuming medicinal marijuana is the intoxication—but for some patients, that's a bonus. (Keep in mind: There aren't enough long-term studies on marijuana to know if there are negative effects from prolonged use.) In certain cases, the relaxing effects of THC in marijuana can alleviate anxiety as well.
However, smoking marijuana could have negative implications, as with all types of smoking (this is as opposed to consuming marijuana via an edible form or tincture). The smoke itself "contains a similar range of harmful chemicals" that could lead to respiratory disease, according to the University of Washington. (See: How Pot Can Affect Your Workout Performance)
Side note: CBD is found in marijuana, but they're not the same thing. If you're interested in using CBD on its own, it can come from either a marijuana plant or from a hemp plant (more on that, next).
If you want to use marijuana therapeutically, you'll reap the benefits of the aforementioned entourage effect. Consult with your doctor (or any doctor you trust who's versed in cannabis) to determine the right combination for your needs.
Hemp (a high-CBD variety of cannabis plant)
Hemp plants are high in CBD and low in THC (less than 0.3 percent); a chunk of commercial CBD on the market now comes from hemp because it's super easy to grow (while marijuana needs to be grown in more controlled environments).
Despite the higher CBD ratio, hemp plants don't typically yield tons of extractable CBD, so it takes a lot of hemp plants to create a CBD oil or tincture.
Keep in mind: Hemp oil doesn't necessarily mean CBD oil. When shopping online, it's important to know the difference. What's even more important is to know where the hemp was grown. Dr. Solomon warns that this is imperative because CBD is not currently regulated by the FDA. If the hemp from which the CBD is derived was grown overseas, you could be putting your body at risk.
"Hemp is a bioaccumulator," he says. "People plant hemp to cleanse soil because it absorbs anything the soil has in it—toxins, pesticides, insecticides, fertilizers. There is a lot of hemp that comes from overseas, and it may not be grown in a [safe or clean] way." American-grown hemp—especially from states that produce both medically and recreationally legal cannabis—tends to be safer because there are stricter standards, according to Consumer Reports.
He advises that when buying and using a hemp-derived product, to make sure the product has been "independently tested by a third-party lab," and to "find the COA—certificate of analysis—on the company website," to ensure you're consuming a clean, safe product.
Some brands willingly provide the COA so you can ensure you're getting a safe (and potent) hemp- or marijuana-derived medicine. Leading the market is what's considered the Maserati of CBD, Charlotte's Web (CW) Hemp. Pricey but powerful, their oils are known for being effective and clean. If a gummy-vitamin style is more your speed, try Not Pot's CBD gummies (a portion of the proceeds go to The Bail Project in an effort to mitigate the effects of the criminalization of marijuana) or AUR Body's sour watermelons that are an exact replica of Sour Patch Watermelon—with CBD. If you'd rather try a beverage, try Recess's superfood-powered, full-spectrum hemp-derived CBD sparkling waters for a La Croix-meets-CBD refreshment.