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CBD (cannabidiol) and THC (tetrahydrocannabinol) are the two major compounds found in the cannabis plant. Each has unique properties, potential health benefits, and side effects. The following article covers CBD and THC, their effects, their legal status, and their safety considerations. CBD and THC are known as cannabinoids. They have very similar chemical structures and activate the same receptors within the body’s endocannabinoid system. Despite their similarity in structure, CBD and THC exert entirely different effects. The most significant difference between these two compounds is that THC is psychoactive. This means it can affect how the brain works. THC activates the body’s "reward" pathways to produce the "high" that’s associated with marijuana use. It does this by activating a cannabinoid receptor called CB1. When THC activates this type of receptor, things like movement, body temperature, and brain function are affected. In contrast, CBD is not considered psychoactive. It does not cause euphoria or a "high," even at large doses.
Much of the research on CBD and THC is preclinical, meaning it’s been studied in animal models. Large-scale human trials are necessary to determine if CBD or THC can help treat most of these conditions. Though it does act on cannabinoid receptors, CBD mainly affects other receptors, including serotonin receptors. It may help counteract some of the negative effects of THC, including serious side effects like psychosis. CBD has many purported therapeutic properties. Pain. Overall, there isn’t enough evidence that CBD by itself helps with pain. Some research has shown that high doses can improve neuropathy (nerve pain), though more data is necessary. Anxiety. So far, the results are mixed. Some studies show that CBD can improve symptoms of social anxiety disorder and post-traumatic stress disorder (PTSD), while others show no effect. Seizures. Epidiolex, a purified CBD oil, is approved by the Food and Drug Administration (FDA) for some hard-to-treat types of childhood epilepsy.
Brain protection. Animal studies have shown that CBD may have benefits for those who have Alzheimer’s disease or Parkinson’s disease, but human clinical trials are necessary to verify these effects. Effects on animals may or may not translate into benefits for humans. THC is the psychoactive ingredient from the marijuana plant. The possession and use of marijuana and THC-containing products are not legal in all U.S. THC is effective for increasing appetite and for nausea and vomiting related to cancer chemotherapy. Pain. Prescription THC products have been shown to improve neuropathy and quality of life. Spasticity (muscle tightness). Sativex (nabiximols), a mouth spray that combines THC and CBD, is approved for spasticity in Europe. PTSD. A very small trial found that Cesamet reduced nightmares in 10 military personnel with PTSD. Irritable bowel syndrome (IBS). Smoking THC was found to improve symptoms of IBS, but benefits may be only short-lived. People who used THC long-term were more likely to ultimately require surgery for IBS.
Notably, most of the research into THC’s effects has used standardized THC prescription medications. Other THC-containing products available at dispensaries may or may not be beneficial for any of these conditions. More research is undoubtedly necessary. Understanding how CBD and THC are regulated in the United States is a bit tricky. Basically, it comes down to the source of the product, whether it comes from the marijuana plant or hemp plant. In 2018, the U.S. CBD that contains less than 0.3% THC. Plants that contain this low concentration of THC are known as hemp. Historically, hemp has been used to make things like fiber and paper. Notably, marijuana (which comes from a cannabis plant with more than 0.3% THC) remains a Schedule 1 controlled substance. This means that the FDA considers it to have a high risk of abuse and no accepted medical use. Accordingly, CBD and THC that come from a marijuana plant are also Schedule 1 controlled substances.