As you may now know, low-dose cannabidiol has been legalised in Australia. The decision, which came from the Therapeutic Goods Administration (TGA) late in 2020, has come into effect this week (February 1, 2021). Prior to this point, CBD was only available in Australia with a doctor’s prescription.
CBD oil has skyrocketed in popularity in the United States, with reports of the product easing experiences of pain and feelings of anxiety. With increased accessibility here in Australia, it could be assumed we’ll see much the same result.
It’s worth pointing out here that CBD will not get you high. Although it does come from a cannabis plant, the compound that causes a high (THC) has been removed from CBD products.
Now, the news that Australia will now be able to sell CBD oil over the counter opens up a whole heap of opportunities. But what do we really know about CBD and relaxation?
The research on CBD and anxiety
Quieting anxiety is one of the best-understood effects of CBD — but that’s not saying much, because there have been very few studies in humans.
Studies of rats and mice have found that CBD usually, but not always, seems to make the rodents act less anxious. For example, researchers may put rats into an “elevated plus maze,” a structure where an animal can choose whether to be out in the open (which stresses them out) or in a more confined space.
So to be clear about what these studies were testing: they didn’t involve humans, and they didn’t involve anxiety disorders or human-relevant stresses like family drama and work deadlines. A review of the evidence on CBD and anxiety notes that sometimes CBD seemed to increase anxiety and that it may matter whether the rodent gets their CBD dose before or after feeling stress.
According to that same review, studies have found that CBD:
- reduces the anxiety that can come from THC
- doesn’t do much for your “baseline” anxiety level
- may reduce anxiety associated with the stress of public speaking or social anxiety disorder
Most of the studies involved healthy volunteers, so we don’t know if CBD works the same way in people with anxiety disorders or other underlying conditions. And the studies only looked at single CBD doses in a lab setting; we don’t know if the effects will be the same in the real world, including whether the effect will be more or less pronounced if you take CBD often.
CBD products’ doses are tiny compared to the ones used in studies
Before you celebrate with a CBD cocktail, there’s something you should know: none of those studies used low-dose products like the ones you typically see on the market (in the States).
For example, one study on CBD and public speaking anxiety used doses of 300 milligrams. Another used 600 milligrams. The doses used in mouse and rat studies varied widely, but were often in that ballpark or above.
People who relax with CBD tend to go by experience, not evidence
So if the science says CBD only works in certain situations, at high doses, why do people take smaller amounts and agree that they feel relaxed or that they feel a “sense of well being”?
I’m here as your sceptical reality check, so I have to point out this looks like a textbook example of the placebo effect. People often feel better without any pharmaceutical action of the thing they take.
That’s for a few reasons: first, if you expect to be relaxed, your brain is interpreting feelings and deciding if you actually became relaxed. A shift in perspective is all that’s needed, not a drug.
Secondly, if you feel that you’re in need of relaxation, are you going to just take some CBD, say in a pill? No, you’re probably going to find a calm place, do some deep breathing, and maybe treat yourself to the CBD in the form of a delicious dessert — something that makes it a pleasant experience. Maybe those actions, rather than the CBD, are responsible for the effect.
That said, if you’re looking for experiments on low doses of CBD in real-world conditions, you won’t find their results in scientific journals — you’ll just have to try it yourself, or talk to people who have. Anecdotally, some people feel that these doses work for them. And there’s no science to say, definitively, whether or not that’s true.
If you experiment, there are some caveats
So far CBD seems to be safe, especially in low doses. But, again, the evidence is lacking. There’s also a very real risk of “treating” your anxiety with CBD on your own when you should really be seeking therapy.
CBD was approved as a drug by the USA’s FDA (Epidiolex, for the treatment of certain seizure disorders), which means that a company had to do clinical trials and document its side effects. They range from decreased appetite and trouble sleeping, to aggression, a fast heartbeat, and trouble breathing.
When the drug is used to treat seizures, doctors are advised to start at 2.5 milligrams per kilogram of the patient’s body weight, which means 170 mg for a 68kg person, and then to increase the dose as needed, up to 20 mg/kg (about 1300 mg). The higher levels are associated with a greater risk of the serious side effects.
CBD is also known to interfere with some of the enzymes in your liver. People taking Epidiolex may need to have their liver enzymes monitored. For the rest of us, it’s probably just good to know that CBD can interfere with other drugs you take, the same way that grapefruit juice can. So if you do take CBD often, remember to mention it to your doctor.
This article was originally published in 2019 and has been updated to reflect current news.