From the Guidelines
CBD is preferred over THC for therapeutic use due to its non-intoxicating effects and potential benefits in reducing adverse effects of THC, as evidenced by its role as a negative allosteric modulator of the cannabinoid receptor 1. When considering the use of cannabinoids for medical purposes, it's essential to understand the differences between CBD and THC. CBD has been shown to increase endocannabinoid signalling, enhance adenosine signalling, and activate transient receptor potential cation channel Subfamily V Member 1 receptors, which detect thermal and nociceptive stimuli 1.
Key Differences Between CBD and THC
- CBD is non-intoxicating and does not produce a "high," making it suitable for therapeutic use without impairment.
- THC is psychoactive and produces euphoric effects, which may be beneficial for certain medical conditions but can also have adverse effects.
- CBD has been found to reduce the adverse effects of THC in human studies, suggesting a potential therapeutic benefit of using CBD in conjunction with THC 1.
Therapeutic Applications
- CBD is commonly used for anxiety, pain, inflammation, and seizure disorders, with FDA-approved Epidiolex (CBD) prescribed for certain forms of epilepsy.
- THC is used medically for pain, nausea, appetite stimulation, and muscle spasticity, with products like Marinol (dronabinol) prescribed at specific doses.
Mechanism of Action
- THC directly activates cannabinoid receptors, while CBD works through multiple mechanisms, including indirect effects on these receptors.
- The "entourage effect" suggests that cannabinoids work synergistically, which may be beneficial for some users, but this also means accepting some level of intoxication with THC-containing products. In summary, CBD is a safer and more preferred option for therapeutic use due to its non-intoxicating effects and potential benefits in reducing adverse effects of THC, as supported by the most recent and highest quality study 1.
From the Research
Comparison of CBD and THC
- CBD and THC are two components of cannabis that have been proposed as potential treatments for various health conditions, including chronic pain, anxiety, and depression 2, 3, 4.
- THC is considered the main psychoactive component of cannabis, producing a "high" or "euphoria," while CBD has been shown to have medical potential, including anxiolytic and antiepileptic implications 4, 5.
- The combination of THC and CBD has been found to enhance the analgesic effect of THC while counteracting some of its adverse effects, such as anxiety and psychosis 2, 3.
Therapeutic Effects of CBD and THC
- CBD has been found to have substantial evidence for treating stress, moderate evidence for anxiety and insomnia, and minimal evidence for depression and pain 2, 5.
- THC has been found to have substantial evidence for treating chronic pain, especially neuropathic and nociplastic pain or pain with an inflammatory component 2, 6.
- The combination of THC and CBD has been found to have a good tolerability and safety profile, with negligible dependence and abuse potential, but should be avoided in patients predisposed to depression, psychosis, and suicide 2, 3.
Adverse Effects of CBD and THC
- The most common adverse effects of CBD and THC include dry mouth, somnolence, and fatigue, with the inclusion of THC in a formulation significantly associated with experiencing gastrointestinal adverse effects 3.
- CBD has been found to have a good tolerability and safety profile, with few adverse effects, making it an appropriate initial treatment for chronic pain and mental health conditions 2, 5.
- THC and CBD can inhibit several Phase I and II metabolism enzymes, increasing the exposure to a wide range of drugs, and requiring appropriate care to be taken 2, 6.