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Considering CBD Part 1: CBD Risks & Cautions

By Caitlin Nichols | April 17, 2023

Exploring CBD risks and drawbacks?

So you know the basics of CBD oil, or full spectrum hemp. But what are the CBD risks? There’s a wealth of articles on cannabis product benefits — CBD for sleep, anxiety, pain relief, and more. But maybe you’re looking for more nuance. 

Worried about CBD warnings?

Maybe you’re wondering, “what are the negatives of CBD?” Or maybe you’ve considered some of these other questions about CBD’s potential adverse effects:

  • Does CBD have side effects?
  • Can CBD oil be addictive?
  • Who should avoid taking CBD?

These questions and more are what we’re setting out to answer. We fully believe in the value of high-quality hemp products. We also believe you should have the complete picture of any wellness product, so that you can make the best decision for your health with total confidence.

If you’re on team “pro/con list”, this two-part series is for you. First, we’ll focus on CBD oil risks or “cons.” The list of cautions and considerations will include possible side effects, health risks, and potential negative impacts. Next, we’ll look at CBD “pros” — advantages, benefits, and potential positive impacts.

Let’s go:

Part 1: CBD risks and cautions

1. Side effects

While CBD is considered generally safe, side effects aren’t totally off the table. The good news is, side effects are generally mild. Plus, they only present only during active CBD use. Effects can vary greatly from person to person. Some might experience nothing unpleasant during CBD use. Others may have an experience that puts them off trying CBD again. 

Most people have little to no ill effect from CBD oil or other CBD products, but it’s up to each individual to be aware of potential risks and make an informed decision. 

These are some of the commonly reported symptoms:

  • Dry mouth
  • Low blood pressure and lightheadedness
  • Drowsiness, sluggishness, or sleepiness
  • Gastrointestinal distress like diarrhea or loss of appetite
  • Mood changes like irritability or agitation

2. Potential interactions with other medications and supplements (contraindication) 

One possible concern with taking CBD oil or other products containing cannabidiol is that it can mess with your body’s ability to properly metabolize your medications. 

The specific enzyme that works to metabolize CBD is also responsible for metabolizing about 60% of prescription medications. So if you take CBD while on these meds, there’s a fair chance something won’t be processed correctly. 

CBD interactions and your liver…

The FDA has published statements that CBD could potentially cause liver damage. Before you let that stop you, here’s the context: 

The statement was made in review of the seizure drug Epidiolex, which contains a much higher dose of CBD than standard. Some participants in the clinical study experienced elevated liver enzymes, which can be (but isn’t necessarily) a sign of liver damage. Also, the experience of elevated enzymes was more likely in participants who were taking other medications at the time. 

If you’re concerned about CBD oil contraindications, definitely talk to your pharmacist and your doctor before taking any new supplements.

And if you’re already taking a CBD oil product, but you’d still like to be on the safe side, our pharmacists can help you at any time with a medication review.

(To learn more about these specific reviews and research activities, check out the reference links below.)

3. Product inconsistency and labeling accuracy concerns

Since CBD products as a wellness supplement is a relatively new industry, there can be a lack of product regulation and standardization. 

For example: A recent-ish student analysis of 39 CBD products found that the majority were mis-labeled — only six had completely accurate labeling. All other products had either significantly more or less CBD than stated on the label. 

This can make taking CBD products tricky:

  • One brand might not offer the same potency as another
  • You may be unable to predict how a certain product will effect you
  • You might pay a premium for a product that doesn’t have the amount of beneficial compounds you expect
  • There may be higher amounts of THC than stated in the product

This leads us to the next caveat with CBD products…

4. Risk of failing a drug test

Here’s the thing: CBD itself can’t make you fail a drug test. But full-spectrum hemp and cannabis products usually contain trace amounts of THC. Even trace amounts can cause you to test positive for marijuana in a drug test.

Is drug testing a concern? Opt for CBD isolate over full-spectrum products. While full-spectrum products tend to have a reputation for being more effective (due to what’s called “the entourage effect,” which we discussed in a past article), CBD has lots of proven benefits and won’t cause you to fail a drug test on its own.

5. Uncertainty around long-term safety and efficacy

While plenty of sources exist which speak to the benefits of CBD oil and related products, there’s not a lot published around long-term safety and efficacy over time. That’s simply because CBD has only been widely available since about 2017. Hopefully, within the next decades, we will see a significant amount of research published using longer-term studies, larger numbers of participants and evaluation of long-term effects.

It’s worth noting that, because of limited research, the FDA advises against CBD use in all forms during pregnancy or breastfeeding. 

6. Risk of contamination through pesticides and heavy metals

While some localities do have regulatory agencies in place to test and verify the quality of cannabis products, many don’t. The State of Colorado, for example, requires testing for microbials, pesticides, heavy metals, mycotoxins and THC levels.

Cannabis or hemp plants growing in soil

 

But purity tests can be expensive, and many brands choose to forego such testing. This can be concerning because hemp easily absorbs toxins and heavy metals. 

If you’re concerned about harmful substances that might be hiding in your CBD oil, one easy way to be safe is to purchase from a reputable source. Sona Pharmacy’s Hemp Shop is stocked exclusively with the highest-quality, fully-tested, pharmacist-approved CBD-based products. 

One of our preferred brands at Sona Pharmacy is Charlotte’s Web. Charlotte’s Web goes above industry standard practices to ensure a safe, effective product with consistent results. According to their website:

“We perform a full battery of tests, including microbiological contamination, heavy metals, potency, and residual solvents. This includes a 60+ panel of testing for pesticides and herbicides, including glyphosate.”

7. Potential for addiction 

So, the scientific evidence that’s out right now suggests heavy cannabis use might lead to increased risk of dependency — that is, relying on a particular substance to get through your day. But, generally speaking, CBD by itself is not classified as an addictive substance. 

As long-term research is still lacking, there’s not a lot of evidence around whether or not addiction is possible with long-term use. Abuse is possible — the act of using a substance not within its intended parameters — although this is rare and typically only occurs with high doses or prolonged use. 

Worried about CBD oil withdrawal? The good news is there are no withdrawal symptoms associated with quitting CBD. In fact, CBD is often used as a tool for relief from withdrawal symptoms from other addictive substances.

CBD oil safety concerns in summary

There are no real known adverse effects associated with using CBD oil as a wellness supplement. But there’s always a benefit to being cautious. If you found this article helpful, stay tuned for Considering CBD Part 2: Pros, benefits & advantages.

 

References

7 CBD Oil Side Effects You Should Watch Out For. Self Decode. Sept. 9, 2021. Accessed online April 13, 2023. https://supplements.selfdecode.com/blog/cbd-oil-side-effects/ 

Cannabidiol Adverse Effects and Toxicity. National Library of Medicine. Oct. 2019. Accessed online April 13, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052834/ 

Cannabidiol (CBD) – Potential Harms, Side Effects, and Unknowns. SAMHSA Advisory. Feb. 2023. Accessed online April 16, 2023. https://store.samhsa.gov/sites/default/files/pep22-06-04-003.pdf 

Cannabidiol (CBD) – Uses, Side Effects, and More. WebMD. Accessed online April 13, 2023. https://www.webmd.com/vitamins/ai/ingredientmono-1439/cannabidiol-cbd 

CBD and Drug Interactions: What You Need to Know. Nov. 15, 2019. Accessed online April 16, 2023. https://www.healthline.com/health/cbd-and-drug-interactions-what-you-need-to-know 

CBD: Is it Addictive? Medical News Today. Sept. 25 2020. Accessed online April 16, 2023. https://www.medicalnewstoday.com/articles/is-cbd-addictive 

CBD Watchdog Finds 25% of Products Don’t Test for Microbials, Pesticides, or Heavy Metals. April 27, 2021. Accessed online April 16, 2023. https://www.nutraingredients-usa.com/Article/2021/04/27/CBD-watchdog-finds-25-of-products-don-t-test-for-microbials-pesticides-or-heavy-metals

CBD: What You Need to Know. CDC. Accessed online April 13, 2023. https://www.cdc.gov/marijuana/featured-topics/CBD.html 

How Does CBD Oil Affect the Liver? MedicalNewsToday. Oct. 31, 2022. Accessed online April 16, 2023. https://www.medicalnewstoday.com/articles/cbd-oil-side-effects-on-liver 

How Might CBD Make a Person Feel? Medical News Today. Nov. 22, 2022. Accessed online April 13, 2023. https://www.medicalnewstoday.com/articles/how-does-cbd-oil-make-you-feel#how-cbd-works 

Is CBD Bad for Your Heart, Liver, and Kidneys? GoodRX Health. Feb. 18, 2023. Accessed online April 16, 2023. https://www.goodrx.com/health-topic/cannabis/is-cbd-bad-for-your-body 

Label Accuracy of Unregulated Cannabidiol (CBD) Products: Measured Concentration vs. Label Claim. June 6, 2022. Accessed online April 16, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9169299/ 

UW-Madison School of Pharmacy PharmD Student-Led Analysis Finds That Just 15 Percent of CBD-infused Beverages, Oil, and Other Products Are Labeled Incorrectly. March 1,0 2023. Accessed online April 16. 2023. https://pharmacy.wisc.edu/non-prescription-cbd-product-labeling-largely-inaccurate-study-finds/ 

What You Need to Know about CBD and Drug Tests. March 30, 2023. Accessed online April 16, 2023. https://www.verywellhealth.com/cbd-oil-and-failing-drug-tests-4580277 

What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. FDA. Accessed online April 13, 2023. https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

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