CBD oil: Is it safe?

CBD oil: Is it safe?

As an increasing number of states legalize medicinal and/or recreational use of marijuana, the market for cannabis products has exploded. One of these products, cannabidiol (CBD) oil, has gained recent popularity for its purported ability to reduce pain, insomnia and anxiety without producing any “highs” like its psychoactive cousin tetrahydrocannabinol (THC).

But is it as safe and effective as its advocates say it is?

CBD is an active ingredient derived from cannabis. With the passage of the 2018 Farm Bill in late December 2018, industrial hemp (containing less than 0.3% THC), from which CBD oil can be made, is now considered legal. The FDA, however, will continue to regulate any marijuana- or hemp-based cannabis products marketed to have therapeutic benefits.

“CBD oil has reportedly had benefits in behavioral conditions such as anxiety and PTSD along with helping with sleep disorders and pain management. However, the use of CBD has only been approved for safety and effectiveness by the FDA for specific childhood epilepsy conditions,” cautions Dr. Desler Javier, an internal medicine physician at Advocate Illinois Masonic Medical Center in Chicago.

Dr. Javier adds that though there have been studies citing benefits of CBD oil in multiple medical conditions ranging from anxiety to even skin disorders, much more research needs to be done to validate the safe and effective use of CBD oil for conditions other than epilepsy.

There are also risks with taking CBD products. In addition to experiencing side effects such as drowsiness, lethargy and sedation, CBD has also been associated with liver toxicity, especially when taken with other types of drugs. For this reason, consumers interested in purchasing CBD products should speak with their physician about the potential risks with its use, Dr. Javier says.

*Editor’s note: A previous version of this article did not include the 2018 Farm Bill legislation around the legality of CBD. 

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  1. If you are going to state that CBD is associated with live toxicity, please share the sources of your information. This is propaganda all the way.

  2. This is a very misleading article. If you are going to state that CBD oil is associated with liver toxicity, please provide specifics. Also, which known drugs don’t mix well with CBD oil? Of course you should know, especially with all the doctors around that are signing the forms for people to receive the medical marijuana cards.

  3. I’m glad that you said that Jesse Taylor. It definitely raised an eyebrow when I read it and I was close to forwarding it to my grandfather who has raved about the benefits he’s experienced after its use. While I agree that more research should be done (for CBD oil and many others) the article should have cited its source to save many of us the leg work.

  4. Totally agree with Jesse Taylor on liver toxicity and CBD. Give us your sources “experts”. Also disagree with most of the article. Desler Javier appears to be just another cog in the wheel of big pharma rejecting the positive results out of hand associated with CBD use. Shame on Advocate for spewing such fake news.

  5. I’ve also not heard of the liver toxicity claim… I would think it would be big news if a large-scale study from a reputable academic research group found this information to be true. Would love a source as well.

  6. I agree with Jesse. If you are willing to just throw out liver toxicity, please site. I can guarantee that there is a lot more out there for studies on CBD oil. I can also state that “chemical based” pharmaceutical medicine has done more damage than stated and “natural” medicines like CBD oil should not be a taboo since it is used for more than just childhood epilepsy. Really would like to see a two side or another article from Ms. Oh after a little more reseach on CBD.

  7. Liver toxicity can occur from taking several different pharmaceutical drugs as well. What are the sources of your research? If there isn’t enough research done on other conditions except epilepsy, how are you sure CBD caused it? The people who have done these studies, are they on other pharma drugs to treat other conditions? That’s the key factor/details we want to know regarding this “research” you mention.

  8. Toxicity with other drugs; like the synthetic Pharmacological lab produced, expensive, so called medicines that are pushed by every corporate entity involved in the so called Health Care Industry in this country. Site your sources please when you purport to give educated advice.

    Propaganda, anyone?

  9. It does appear as if CBD has an effect on drug metabolism within the liver. … Overall, an increase in liver enzymes is a possible sign of inflammation or damage to the liver. While CBD by itself is more likely to help than harm your liver, it can cause problems when used in conjunction with other drugs.Feb 11, 2019
    https://www.marijuanabreak.com › is-cbd…
    Is CBD Bad for Your Liver? [Understanding the FACTS]

  10. Dear Mr. Taylor, I don’t believe this is propaganda at all.
    All you have to do is research and see the many articles on possible liver damage, especially if someone is on certain. Prescription drugs. See the article I posted.

  11. Scott M Dresden June 13, 2019 at 2:54 pm · Reply

    This article is clearly outdated and in some instances just plain wrong. It does not portray AdvocateAuroraHealth as anything close to experts. Please tell me you will concur with the experts on the Aurora side when you label something with AdvocateAurora branding. Thank you.

  12. This article really simply skirts the issues regarding the use of CBD oil. CBD oil is legal in both WI And IL as long as it is made from Hemp and it is very low in THC. If you are going to make statements regarding safety and efficacy, you need to be able to site articles and research and site those that are statistically significant.

  13. Michael McNett, MD June 13, 2019 at 3:14 pm · Reply

    In fact, CBD products are now legal on the national level, having been made so in the Farm Bill of 2018. They are still technically illegal in WI under the CBD Possession Act but can be carried if a patient has a letter from a physician (not NP or PA) stating the patient has a condition CBD would be expected to benefit. The liver toxicity has only been seen in extremely high doses, with the prescription form now available called Epidolex (50-100x more potent than virtually all OTC products). CBD can interact with other drugs by affecting their metabolic enzymes, particularly CyP3A4. Typically, this would increase the blood levels of other medications using this enzyme, because CBD binds it tightly, preventing it from metabolize the other medicine.

  14. I’ve never taken pot in any form/CBD or otherwise, but I’m interested in it for pain control, possibly. It sounds a lot better than the Hydrocodone I was hooked on. Since the drug companies won’t do the testing because they won’t make enough money why doesn’t the NIH do some comprehensive testing. We already pay for them.

  15. Sarah Hammer, BS, RN June 13, 2019 at 3:49 pm · Reply

    I think nearly every prescription advertised has liver or kidney failure listed as a possibility, but yet they are used every single day. Take for instance Epidiolex (cannabidiol) which is FDA approved for children as young as 2 yrs old for seizures. Marinol (dronabinol) which is FDA approved and used for loss of appetite associated with weight loss in AIDS patients as well as an antiemetic for cancer patients during chemotherapy. BOTH of these approved medications, like CBD oil, are derived from the cannabis plant. I just find it funny how someone with a degree in journalism is giving healthcare advice. Furthermore, the irony of the stigma associated with a very beneficial, healing plant used for thousands of years is laughable considering our own government has approved variations of it’s chemical benefits made into marketable pharmaceuticals. Perhaps that is the true issue here, when it is affordable to the general public there is a safety outcry because how else do the rich continue to oppress a divided society.

  16. Is CBD oil in the medication lists formulary, and if not, can it be added??
    RN’s doing medication reconciliation can better inform patients who have the courage to admit they are using CBD oil products of any of those drug interactions referenced in this article.

  17. Connie M McKeag June 13, 2019 at 8:27 pm · Reply

    If the vehicle is water based, storage in the liver should not be that big of a problem. When evaluating a product, the delivery system is key. If it is water soluable, the product should get to the cell much faster, requiring a lower dose, reducing any toxicity. Also, the Farm Act of 2018, did legalize the sale of CBD which comes from the hemp plant. A good product is organically grown, otherwise the plant contains toxins from the soil, uses the full spectrum of the plant, and contains far less than the 0.3% THC required by law for the sale. I would be interested in knowing when this article was written, and what products were used in the determination of safety and efficacy.

  18. I agree with the all of the comments listed here! Very interesting. I’d assume if people are chosing to supplement their “medicines” with CBD Oil, its usually after long time use with Zero success, not to mention the multiple side effects these lab created medicines likely already produced in ones body.

    Most “pharma” commercials go thru an extreme list of side effects and counter effects “if used with other meds” along with the the disclaimer of “even fatal” affects.

    Again long time use of lab meds , now transitioning to marijuana would likely show signs of liver toxicity, However I highly doubt it was due to CBD oil. I’d love to read a credible source with studies on a 100% holistic patient who chose marijuana, CBD, or THC as their treatment v’s labs meds in comparison…

  19. Vernard Alsberry Jr. June 14, 2019 at 7:24 am · Reply

    This article should have never been allowed. Very misleading without any fact.

  20. Eric Smiltneek, MD June 14, 2019 at 8:42 am · Reply

    I always think it is fun how contentious the threads get. There are some CBD experts in the system. I spoke as a Keynote Speaker at the Wisconsin Psychological Association meeting in April, along with Eric Marsh from NORML Wisconsin. We are in agreement that CBD in Wisconsin is a mess. Hemp derived CBD is legal as a farm product as Dr McNett said. There is also FDA approved marijuana derived high potency CBD in the form of Epidolex. All other marijuana derived CBD is federally illegal, but the DEA and local law enforcement seem to have better things to do than arrest people for CBD. Most CBD sold at gas stations, video stores, campgrounds, etc is either relatively low potency, low quality or marijuana packaged as CBD. (Yesterday, I had I patient that brought in a package of CBD he got from the gas station with a statement of less that 30% THC on the label. This is clearly a typo – as it should be less 0.3% to be classified as hemp product. He tested positive on his drug screen for THC, so who knows what he actually bought.) For those looking for studies, it is really hard to know what people are actually purchasing when they are buying CBD, so it is very hard to discuss risks and benefits. At the current time, I feel that CBD is more in the supplement realm than an actual regulated medication. For people interested in trying CBD in Wisconsin, I have been recommending going to Hometown Pharmacy. They carry the Ananda brand, a hemp derived CBD available as an oil, capsules and ointments from Kentucky. Hometown has pharmacists that can discuss dosing and possible interactions with other medications that a patient may be taking. I wish our pharmacies would carry some CBD products, so that we would have a safe and reliable option for patients that are sold by professionals that we work with. But until that occurs, I have need to look outside our tent. I do not have any financial interest in Hometown or Ananda, but I am worried about people buying crap that could be contaminated and dangerous. Patients are trying CBD, whether or not it works and whether or not we recommend it.

  21. Scot Wilfong D.O. June 19, 2019 at 1:09 pm · Reply

    I appreciate Jaimie Oh’s writing. This is a nice concise article quickly explaining CBD and it’s current status in the marketplace. It is is fair in mentioning that there are not good studies avaialbe on the effectiveness or safety of CBD oil.
    Production is not regulated, nor the drug concentrations guaranteed, since CBD falls under the category of supplements. The comment about liver injury is fair and just makes the point that you cannot consider CBD to be completely benign just because it is a supplement. there are potential drug interactions with CBD due to the P-450 / CYP enzymes affected by CBD.
    Why bring “Big Pharma” into the discussion.
    Jaimie Oh appropriately has a hyperlink in the sentence ” CBD has also been associated with liver toxicity” which allows readers to review articles about CBD. I would hope people could review these before jumping up and down about fairness in the article.
    By the way we use “cite” (verb) when providing references (short for citation)
    We do not “site” references.

About the Author

Jaimie Oh
Jaimie Oh

Jaimie Oh, health enews contributor, is regional manager of public affairs and marketing at Advocate Health Care. She earned her Bachelor’s Degree in Journalism from the University of Missouri-Columbia and has nearly a decade of experience working in publishing, strategic communications and marketing. Outside of work, Jaimie trains for marathons with the goal of running 50 races before she turns 50 years old.