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CBD, a cannabis extract touted for its potential health benefits, can now be found in a dizzying array of products and forms.
In dozens of states, health food stores, pharmacies, and even supermarkets and restaurants are carrying CBD products. That includes pills, oils, balms, vaping devices (like e-cigarettes), and edibles, including gummy bears, honey, coffees, and alcoholic beverages, among others.
But how do you choose among the different forms, such as smoking or eating your CBD? Experts we contacted say there are pros and cons to each, and settling on the one that works for you may require close scrutiny of the products and a little trial and error.
CBD has become so widely used in part because early research suggests that it may offer possible health benefits—potentially reducing pain and anxiety, for example.
While this chemical compound comes from marijuana or its close relative hemp, CBD does not get users high, unlike another compound from the marijuana plant, tetrahydrocannabinol, or THC. The Food and Drug Administration this summer approved a CBD-based drug to treat two serious seizure disorders.
Still, the legality of CBD remains murky, particularly when it comes from hemp, which has kept the compound from being more widely studied and available to consumers. (See “What is CBD? What to Know Now About This Cannabis Product.”)
Thirteen percent of Americans say that they have used CBD to help with symptoms related to a health issue, according to a recent Consumer Reports nationally representative survey of 1,003 American adults. And nearly 90 percent of those who have used CBD say it helped ease symptoms related to their health issue.
Perhaps even more challenging for those looking for treatment is discovering the dose that might work best for their particular condition. That’s because so much remains unknown about CBD, including how it works, says Norbert Kaminski, Ph.D., a professor of pharmacology and toxicology at Michigan State University and director of the Institute for Integrative Toxicology.
For problems such as anxiety, depression, and insomnia, “the quickest way to deliver CBD to the brain is by smoking it,” Kaminski says. “The next quickest way is by using a tincture. Eating it, and especially a topical, will take longer before there is an effect.”
“CBD’s effectiveness has only really been established for Lennox-Gastaut and Dravet syndrome,” Kaminski says, referring to the two seizure disorders that can be treated with Epidiolex, the CBD-based drug the FDA recently approved.
Even with so many unknowns about CBD’s effectiveness, retailers are popping up across the country. Tia Tagliaferro is chief operating officer for Hemp Garden, which sells hemp-based CBD products at its stores in New York City and Wilmington, N.C. She says the potential healing benefits of CBD and its popularity are what spurred the company to open its latest shop in New York earlier this summer, with plans to expand into other East Coast locations in the coming months.
Ashley Garris, 28, of Wilmington, N.C., says she started using CBD three months ago to treat her fibromyalgia, anxiety, and headaches. “It was a complete life-changer for me.” She says she prefers vaping or rolling cigarettes using hemp flowers, and she has had good success with CBD topicals for immediate pain and muscle cramp relief.
Several people in CR’s recent survey also said CBD helped them deal with a variety of health problems. Among them, a 42-year-old woman in Eugene, Ore., who says she uses CBD to relieve severe menstrual cramps, a 60-year-old woman in Phoenix who takes it for better sleep, a 74-year-old man in Casper-Riverton, Ill., who says it helps his arthritis, and a 26-year-old man from Denver who finds CBD “very helpful” in easing symptoms of anxiety.
We spoke to experts about the different CBD forms, how they work, and what you can reasonably expect from the experience. And remember: If you want to try CBD to treat health problems, talk with your doctor first, especially if you’re seeking relief from a serious health problem that could be helped by more proven medical care.
Some people get CBD by smoking the flowering parts of the hemp plant, similar to the way people may smoke marijuana in rolled cigarettes. But increasingly CBD is available via e-cigarette vaporizer devices, or “vape pens,” says Amanda Reiman, Ph.D., a cannabis policy and public health expert based in California who also works for Flow Kana, a cannabis company.
The device heats up a small portion of concentrated CBD oil until it boils, allowing you to inhale the vapor, says Michael Backes, an expert in cannabis science and policy, and author of “Cannabis Pharmacy” (Hachette). He has also worked with the nonprofit educational and research group Project CBD.
Pros: Inhaled CBD tends to enter the bloodstream faster than other forms—in as quickly as 30 seconds or less, according to Mitch Earleywine, Ph.D., a professor of psychology at the State University of New York, Albany, and an adviser to the marijuana advocacy group NORML. He is also the author of “Understanding Marijuana” (Oxford University Press). The quick action means it should affect the body sooner, which could be especially useful to ease immediate pain or anxiety, for example.
Vape pens are easy to use and can go undetected because they produce little smoke, Raiman says. (Note that Oregon and certain other states have laws that prohibit vaping in the same places where smoking cigarettes is prohibited.)
Cons: The CBD cartridges used in vape pens can contain a solvent called propylene glycol, which is also used in e-cigarettes containing nicotine, Earleywine says. At high temperatures, propylene glycol can degrade into formaldehyde, a chemical that can irritate the nose and eyes and could increase the risk of asthma and cancer. Earleywine suggests looking for CBD vape pens that advertise “solvent-free oils.”
Also, controlling dosing can be particularly difficult with vape pens. How much CBD you absorb depends on how hard and long you inhale, Earleywine says. In addition, labels on vaping devices can be especially confusing, he says. “You might get a vape oil that says it has 1,000 mg of CBD, but it’s not clear if that’s how much is in the whole bottle or in each inhalation. It can be hard to guess what your dosage really is under some of those situations.”
Finally, even if you’re using a vape pen without propylene glycol, it’s important to know that the long-term safety of smoking CBD in any form, including vaping, is unknown. Backes particularly emphasizes that vaping high concentrations of CBD—and even THC in marijuana products—“has not been studied at all.”
Good to know: Consider trying the lowest dose first—in this case, a single inhale—then wait a few minutes and see whether there is an effect, such as pain relief or reduced anxiety. If not, try another. And avoid holding your breath after inhaling, because that can irritate the lungs.
Tinctures (Drops or Sprays)
Tinctures (usually in oil form) are taken by dropper or spray, straight into your mouth. The CBD used in these forms is extracted from marijuana or hemp plants using pressurized carbon dioxide gas or a solvent such as ethanol. The solvent is then removed under vacuum, Backes says. The remaining CBD is diluted with an oil, such as sesame or coconut oil, to improve the taste and preserve the cannabidiol.
Pro: Tinctures are the second-quickest method to absorb CBD, after smoking, Earleywine says, typically taking about 15 to 30 minutes. The quick action could make it especially useful in treating pain or anxiety.
Cons: It also could be challenging with tinctures to determine how much CBD you’re getting, either from the bottle dropper or from each spray, especially if the bottle shows only total CBD content and doesn’t list the per-dose amount. If needed, ask a retail salesperson for help or get out your calculator to calculate the amount of CBD per dose. The price per bottle could be more for a product with a higher CBD content per dose.
Good to know: Earleywine suggests you drop a dose of tincture under your tongue and hold it there for 30 seconds before swallowing, or apply a single spray of the tincture on the inside of your cheeks. Doing so speeds up the effects of the CBD. If you put the tincture on the top of your tongue, you’re likely to swallow it sooner, sending it into your digestive tract, which will absorb the CBD more slowly. If you add a CBD tincture to foods or drinks, it could take up to 30 minutes for it to enter your bloodstream.
Earleywine suggests starting “with a small dose, perhaps 10 mg, to see how sensitive you are.” But don’t be surprised if you don’t feel any effect until you reach, say, 30 mg per dose. And ongoing conditions such as chronic pain are likely to better respond with daily doses, he says.
Shake the bottle well before using, Backes says, because CBD often gets stuck on the side of the bottle.
Topical Rubs and Balms
Topicals are rubbed directly onto sore muscles or joints, where they may ease pain by reducing inflammation, Earleywine says. CBD balms typically include extracts mixed into a fat, such as beeswax or coconut oil. That recipe not only makes it easier to spread the product on your skin but also allows the CBD to penetrate.
Pro: Topicals aren’t absorbed into the entire body, as other forms can be. That could make them safer—which could be important if you use CBD on a regular basis—considering how little is known about the long-term safety of CBD and other cannabis products.
Cons: To be effective, products probably need to have a lot of CBD—which can make them expensive, Backes says. For example, Hemp Garden in Manhattan sells a topical called Full Spectrum that has 500 mg of CBD per 4 ounces for $50. Another company, PlusCBD Oil, sells its Extra Strength topical in a smaller but still concentrated dose of 1.3 ounces that contains 100 mg of CBD for $52. The company sells a less concentrated version for $32.
Good to know: In a retail store, ask whether you can sample the product first, says Tagliaferro of Hemp Garden. She says some people start feeling effects almost immediately after rubbing it on. Others say they notice relief later in the day, and return to buy the products. Some don’t get any relief at all.
Edibles and Pills
When eaten or consumed in a drink, CBD from hemp in particular may have an aroma or a flavor of “newly cut grass,” Earleywine says. But flavors in some cocktails or coffees might overpower CBD so that it’s undetectable, while other food products, such as cookies and brownies, may try to feature it. Most pills will be tasteless, Earleywine says.
Pros: In some states finding CBD-infused food and drinks at a retailer, restaurant, or café can be fairly easy. At Inday, an East Indian-inspired restaurant in Manhattan, as a promotion, customers could order CBD-infused ghee (clarified butter) to be added to any dish. In San Diego, cocktail lovers can order “The Mr. Nice Guy”—a vodka and mezcal mixed drink that includes CBD—at the restaurant Madison on Park.
Kickback, a maker of bottled CBD-infused cold-brew coffees and ice teas, sells its products in California, New York, and Texas.
Hemp Garden's Tagliaferro sells gummies and caramel candies infused with CBD. These sweets may have a longer shelf life if kept in a cool, dry location, so they don’t degrade, plus they’re easy to take along with you in a bag or purse. Other baked foods, such as brownies and cookies, may have a shorter shelf life and need to be placed in a refrigerator to keep the CBD oil fresh, says Backes, an expert in cannabis science and policy.
Cons: Edibles might seem a fun way to take CBD, but it’s a particularly inefficient method, says Kaminski, the pharmacology and toxicology professor at Michigan State. That’s because eating or drinking your CBD means it will enter the bloodstream through the digestive system, so it will take a while—30 minutes or longer—before you feel it. Plus, the food it’s in, as well as other foods you consume, could affect how the body absorbs it, and undermine its potential effect.
Good to know: You can also consume CBD in pill form. Similar to ingesting CBD in an edible, pills can take upward of 30 minutes or more to digest before you experience an effect, Earleywine says. One benefit though is that the per-pill CBD dose should be clearer on packaging than for other forms. And for chronic conditions such as fibromyalgia, where you might be trying to maintain consistent CBD levels in your body, pills may be an easier solution.
Cannabis Laws by State
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Rules for CBD from hemp may differ.
Source: NORML (the National Organization for Reform of Marijuana Laws). Data reflects regulations for marijuana. The legality of shipping CBD across state lines is ambiguous. This information is for educational purposes and is not legal advice. Updated as of July 3, 2018.
Source: NORML (the National Organization for Reform of Marijuana Laws). Data reflects regulations for marijuana. Regulations for CBD from hemp may differ. The legality of shipping CBD across state lines is ambiguous. This information is for educational purposes and is not legal advice. Updated as of July 3, 2018.
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