From the Guidelines
Long-term use of THC oil is associated with a higher risk of adverse effects, including dependence, cognitive impairment, and psychological issues, compared to CBD oil, which has a better safety profile with minimal risk of dependence. According to the 2024 ASCO guideline 1, cannabis and cannabinoid use can lead to various long-term side effects, including gastrointestinal, cardiovascular, respiratory, oncologic, and psychiatric risks. The guideline highlights that chronic cannabis use carries long-term psychiatric risks, which may be correlated with cumulative exposure, including age of first use.
Key Considerations
- THC oil contains the psychoactive component of cannabis, which can lead to dependence, cognitive impairment, and psychological issues with extended use 1.
- CBD oil, being non-psychoactive, has a better long-term safety profile with fewer side effects and minimal risk of dependence.
- Daily THC use may result in tolerance, withdrawal symptoms upon cessation, and potentially cannabis use disorder in susceptible individuals 1.
- CBD is generally well-tolerated even with prolonged use, with common side effects being mild and including fatigue, diarrhea, and changes in appetite or weight.
Recommendations
- For chronic pain, anxiety, or sleep issues, starting with CBD oil at 10-25mg daily and gradually increasing as needed is recommended.
- If considering THC for specific conditions like severe pain or muscle spasticity, using products with balanced THC:CBD ratios (1:1 or 1:2) at low doses (2.5-5mg THC) can minimize adverse effects.
- Regular breaks from THC use can help prevent tolerance development.
- Always purchase from reputable sources with third-party testing to ensure product quality and safety, and consult healthcare providers before beginning any long-term cannabinoid regimen, especially if taking other medications due to potential drug interactions 2.
From the Research
Long-term THC Oil vs CBD Oil Use
- The effectiveness of THC/CBD combination medicines for chronic pain, especially neuropathic and nociplastic pain or pain with an inflammatory component, has substantial evidence 3.
- CBD-only medication has substantial evidence for stress, moderate evidence for anxiety and insomnia, and minimal evidence for depression and pain 3.
- THC/CBD combination medicines have a good tolerability and safety profile relative to opioid analgesics and have negligible dependence and abuse potential 3.
- However, THC/CBD combination medicines should be avoided in patients predisposed to depression, psychosis, and suicide as these conditions appear to be exacerbated 3.
- Low-dose CBD appears effective for chronic pain and mental health, with good tolerability and safety, and few adverse effects 3.
- The use of CBD in chronic pain management is difficult to recommend due to the lack of approved pharmaceutical products that contain CBD alone and the difficulty in attributing therapeutic properties to CBD alone when administered with THC 4.
- A systematic review of literature found that CBD may be useful in treating chronic pain, with pain reduction ranging from 42% - 66% with CBD alone and CBD with Tetrahydrocannabinol 5.
- However, the findings should be interpreted with caution due to the small number of included studies and heterogeneity brought about by different study designs and outcome measures 5.
- There is clear evidence supporting the utility of CBD to treat epilepsy, but for other health conditions, evidence was often mixed and/or there was a general lack of well-powered randomized, placebo-controlled studies to draw definitive conclusions 6.
- Medical cannabis, which contains THC and CBD, has been shown to be effective for chronic nonmalignant pain management, with the ability to decrease nociception and symptom frequency via the endocannabinoid system 7.