CBD Oil for Mental Health - April 2024

How CBD May Work for Mental Health

Cannabidiol (CBD) is a nonpsychoactive substance extracted from the Cannabis sativa plant. The substance is typically used for pain and various psychiatric and medical conditions, such as anxiety, depression, post-traumatic stress disorder (PTSD), Alzheimer’s disease, or other cognitive illnesses⁽⁵⁾.

PTSD is a psychiatric disorder affecting individuals who witnessed or experienced a traumatic event, such as an accident, war, or death⁽⁶⁾.

Individuals with PTSD may experience intense feelings and thoughts, have nightmares or flashbacks, or feel sadness, fear, or anger⁽⁷⁾. The disorder may occur with related conditions like memory problems, depression, and other mental health problems.

Alzheimer’s disease is a variety of dementia that affects memory, thought, and language. The disease usually starts with mild memory loss and possibly progresses to loss of the ability to hold a conversation⁽⁸⁾.

Dementia is one of the disorders affecting mental health. The World Health Organization (WHO) estimates that about 50 million individuals worldwide have dementia⁽⁹⁾.

One mechanism for CBD to work in the system is through oral ingestion. When an individual ingests CBD, it undergoes first–pass metabolism in the liver.

The first pass effect occurs when the body metabolizes a drug and reduces the drug’s concentration upon reaching the systemic circulation or site of action⁽¹⁰⁾.

CBD binds to the cannabinoid receptors normally activated by endogenous cannabinoids (endocannabinoids) such as anandamide (AEA) and 2-arachidonoylglycerol (2-AG)⁽¹¹⁾.

These cannabinoid receptors, including the CB1 and CB2 receptors, are found in the endocannabinoid system (ECS).

CB1 receptors are present within the brain and spinal cord and may be involved in memory, emotional processing, pain, and appetite regulation⁽¹²⁾.

Changes in the activation of CB1 receptors may regulate anxiety in multiple regions of the brain⁽¹³⁾. Blocking the activity of CB1 receptors may produce an anxiogenic (anxiety-producing) effect, possibly supporting the hypothesis that CB1 receptor activation may help reduce anxiety.

Thus, CBD may potentially affect anxiety by binding with the CB1 cannabinoid receptors.

On the other hand, CB2 receptors are found in the peripheral nervous system, typically in immune cells, liver, and spleen, and may have an effect on inflammation⁽¹⁴⁾.

CB2 receptors may be involved in modulating dopamine neurotransmission and microglial activation, which are brain processes that may be related to schizophrenia⁽¹⁵⁾.

Dopamine is a neurotransmitter and hormone that acts as a “reward system” and provides individuals with a feeling of pleasure⁽¹⁶⁾.

Schizophrenia is a mental illness defined as a chronic brain disorder that causes hallucinations, delusions, thinking difficulties, disorganized speech, and lower motivation⁽¹⁷⁾.

Therefore, acting on the CB2 receptors may give CBD a potential role in managing schizophrenia. However, researchers must conduct additional studies to confirm whether CBD positively affects this disorder or its symptoms.

Regarding AEA, it exerts a modulatory effect on the brain’s reward circuitry⁽¹⁸⁾. One study suggested that AEA may help predict acute stress-induced anxiety and that inhibiting fatty acid amide hydrolase (FAAH), an anandamide-degrading enzyme, may help reverse stress-induced anandamide deficiency⁽¹⁹⁾.

Meanwhile, 2-AG signaling helps regulate anxiety and depressive-like behaviors, wherein a 2-AG deficiency may be associated with mood and anxiety disorders⁽²⁰⁾.

CBD also acts on other receptor types such as serotonin (5HT) receptors, transient receptor potential vanilloid (TRPV) receptors, alpha-1 adrenergic receptors, and mu–opioid receptors⁽²¹⁾.

Serotonin receptors are essential neurotransmitters that influence mental health and are a potential target for pharmacological treatments⁽²²⁾. Serotonin may be linked with mood disorders, anxiety disorders, depressive disorders, addiction, schizophrenia, autism, and attention deficit hyperactivity disorder (ADHD).

Meanwhile, vanilloid receptors, specifically the TRPV1 receptors, are distributed in various brain areas and interact with essential neurotransmitter systems, such as the ECS and opioid systems, which are linked to mental disorders⁽²³⁾.

Alpha-1 adrenergic (A1A) receptors, on the other hand, regulate the sympathetic nervous system, which directs the body’s involuntary response to stressful events.

Clinical trials suggest that A1As may have a promising role in treating various psychiatric disorders, including PTSD, cocaine dependence, alcohol dependence, dementia-related agitation, and nicotine cessation⁽²⁴⁾.

Mu–opioid receptors (MORs) are part of the body’s opioid system that helps regulate pain, reward, and addictive behavior⁽²⁵⁾. When opioids bind to the receptors, this interaction produces a chemical change that creates feelings of pleasure and pain relief.

In addition to interacting with these receptors, CBD may act on adenosine levels by providing adenosine reuptake reduction associated with anti-inflammatory processes and neuroprotection in the brain⁽²⁶⁾.

Adenosine plays a role in various neural functions, including⁽²⁷⁾:

• Sleep and arousal regulation
• Neuroprotection
• Locomotor effect
• Seizure susceptibility regulation
• Analgesia
• Chronic drug use
• Ethanol effect mediation

CBD may also act directly on the cerebral vascular system by helping inhibit nitric oxide synthase protein expression and calcium transport across membranes⁽²⁸⁾. Inhibition of such activities may help improve vasodilation.

Vasodilation is the expansion of blood vessels due to the relaxation of their muscle walls. This mechanism helps enhance blood flow to various body areas that lack oxygen or nutrients⁽²⁹⁾.

Research on CBD for Mental Health

Studies suggest that CBD may help manage various anxiety disorders⁽³⁰⁾. These disorders include social anxiety disorder (SAD), panic disorder, generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and PTSD.

Anxiety disorders are a classification of mental illnesses affecting an individual’s thinking, feeling, mood, and behavior⁽³¹⁾.

GAD is the excessive and persistent worry over numerous things⁽³²⁾. Individuals with GAD may have difficulty controlling their worries over money, family, health, work, or disaster anticipation.

One study using animal models of generalized anxiety showed that CBD at low doses of 10 milligrams for every kilogram of body weight (mg/kg) may produce an anxiolytic effect⁽³³⁾. However, high CBD doses at 100mg/kg may be ineffective.

Although animal studies do not immediately represent CBD’s effects on humans, such research may provide essential information that may aid further human clinical trials.

In another animal study, CBD may produce an anxiolytic effect when administered to animals previously subjected to stressful events⁽³⁴⁾. Stress may contribute to anxiety disorders, and exposure to traumatic stress may lead to the development of PTSD.

Results suggest that CBD’s capacity to modulate anxiety may depend on previous stressful experiences and 5HT1A-mediated neurotransmission.

5HT1A receptors are a serotonin receptor subtype that helps mediate anxiety and depression-like behaviors⁽³⁵⁾.

Systemically administered CBD may reduce heart rate and blood pressure increases caused by induced stress⁽³⁶⁾. Systemic CBD administration may also help prevent increased anxiety due to chronic unpredictable stress.

Another study showed that CBD may help reduce anxiogenic effects caused by stress and promote the extinction of fear memories⁽³⁷⁾.

Regarding panic disorder, escape responses may be indicative of panic attacks. One study showed that CBD may help activate the 5HT1A receptors to impair escape behavior⁽³⁸⁾.

Results suggest that CBD may produce panicolytic effects by inhibiting escape response.

Panic disorder is an anxiety disorder that gives individuals panic attacks or sudden feelings of terror even when there is no real threat⁽³⁹⁾. Symptoms include having a fast heartbeat, sweating, stomach pain, chest pain, breathing difficulty, or tingly hands.

Additionally, CBD may help modulate panic-like defensive behavior through the mediation of the CB1 receptors⁽⁴⁰⁾. Defensive reactions may be associated with PTSD, such as those caused by violence-related threats⁽⁴¹⁾.

Studies also showed that CBD may also help enhance the extinction of conditioned fear responses⁽⁴²⁾. Administering CBD immediately before training may significantly increase fear extinction depending on the activation of CB1 receptors.

Extinction training involves repeatedly exposing an individual to conditioned stimuli to help form new memories that help inhibit fear responses and reduce freezing.

In a randomized controlled trial in the Journal of Psychopharmacology, researchers led by José Alexandre Crippa analyzed CBD’s anxiolytic effects on SAD⁽⁴³⁾.

Crippa is a physician and psychiatry professor at the University of São Paulo. 

Studies are still ongoing on the antianxiety potential of CBD. Hence, individuals interested in the topic can access other research published and identifiable online by visiting doi.org or the National Institutes of Health’s National Library of Medicine website.

Based on the study’s findings, researchers linked CBD with significantly reduced subjective anxiety compared to placebo. This effect may be associated with the activities in the brain’s limbic and paralimbic areas.

The brain’s limbic system is involved with emotional and behavioral responses. On the other hand, the paralimbic area is involved in emotional processing, motivation, and self-control.

SAD, sometimes called social phobia, causes individuals to experience significant anxiety, embarrassment, or self-consciousness through daily interactions⁽⁴⁴⁾.

Individuals with SAD may encounter intense fear or anxiety during public speaking or performing. These behaviors may lead to avoidance that can disrupt an individual’s life and cause stress that affects daily routines, school, work, or relationships.

Prescription medications such as antidepressants or antianxiety medicines may help manage social anxiety symptoms⁽⁴⁵⁾. Thus, if proven to have effective anxiolytic properties, CBD may have the potential to help with SAD or other anxiety disorders.

Despite the numerous literature on CBD’s potential effects on mental health and anxiety disorders, most of these studies were conducted on animals or had limited access to human trials.

Researchers must conduct more extensive human clinical studies to conclusively determine CBD’s health benefits, such as if the compound has any antipsychotic effect on an individual’s mental health and well-being.

Usage and Dosage of CBD for Mental Health

Individuals may choose a CBD product depending on their preferred method of administering CBD to help manage mental health. These methods include:

• Ingestion: In this method, individuals take CBD orally or through the mouth. The drug passes through the body’s digestive tract before getting absorbed into the bloodstream.

Oral products include edibles like CBD chews, gummies, candies, or cookies. CBD capsules also belong in this category.

CBD brands may add various flavors to edibles to make these products more appealing to individual tastes. These flavors include peppermint, chocolate, lemon, or other artificial flavors.

• Sublingual administration: The sublingual use of CBD involves applying CBD oil under the tongue to let the substance bypass the digestive tract and enter the bloodstream directly.

Tinctures are one type of sublingual CBD product administered using a calibrated dropper for accurate dosing.

CBD oil tinctures may have a grassy or earthy taste. Some consumers may prefer mixing these products with food or drinks⁽⁴⁶⁾. Many CBD brands sell tinctures in 30-milligram (ml) bottles.

CBD oil tinctures often contain carrier oils to help dilute the CBD concentrate. Manufacturers may use olive oil, medium-chain triglyceride oil (MCT oil), hempseed oil, or coconut oil as carrier oils.

Hemp seeds usually have no CBD content⁽⁴⁷⁾. Thus, hempseed oil derived from hemp seeds contains little or no CBD.

Other sublingual CBD products include high-potency oils, oromucosal sprays, and tablets.

• Topical application: The topical route typically involves applying CBD products to the skin. In this method, CBD topicals are not absorbed into the bloodstream. However, they provide pain relief to the area the product is applied⁽⁴⁸⁾.

CBD topicals have a wide product selection to cater to numerous individual preferences. These products include CBD creams, lotions, salves, and ointments.

Other topical items include roll-on sticks and lip balms.

• Inhalation: This delivery route provides a quick way to administer cannabis, making inhalation appropriate for problems such as nausea or acute pain⁽⁴⁹⁾.

Inhalation allows CBD to affect the lungs, then the heart and brain, before spreading the drug in the body⁽⁵⁰⁾.

However, individuals are advised against using vapes as these products can cause health risks linked to lung disease⁽⁵¹⁾. Before smoking or vaping CBD, consumers must exercise caution and be wary of these risks.

In addition, individuals, especially those with existing medical conditions, must consult a doctor or healthcare professional for a diagnosis and effective treatment before using any CBD products.

The Food and Drug Administration (FDA) has not provided or endorsed any standard CBD dosing guidelines specifically for mental health.

Additionally, scientists have not conducted extensive studies determining a suitable dose of CBD to administer to individuals with mental health disorders.

However, one recommendation is to take CBD, beginning with a low dose and slowly increasing the dosage⁽⁵²⁾.

For example, individuals using CBD-rich products for the first time may start with a 10mg dose of CBD per day⁽⁵³⁾.

One study on the use of cannabinoids in pediatrics suggested that administering 200mg to 300mg of CBD over a short period may be considered safe⁽⁵⁴⁾.

In another study on the anxiolytic effects of CBD on generalized social anxiety disorder, a 400mg oral dose of CBD may help reduce anxiety⁽⁵⁵⁾.

Overall, CBD dosage may vary between individuals because of several factors such as diet, exercise, genetics, stress levels, and health conditions⁽⁵⁶⁾.

Before deciding on a specific CBD dose, individuals should consult a doctor, preferably one well versed in CBD or cannabis use, to determine a CBD dosage appropriate for the individual’s needs.

Like most drugs, CBD takes time before individuals can start feeling its effects after administration. However, researchers have not performed extensive clinical trials determining CBD’s onset times specifically for mental health.

Still, the drug’s onset times may vary depending on the chosen delivery method, such as the following⁽⁵⁷⁾:

• Oral ingestion: 30 to 90 minutes
• Sublingual administration: 15 to 30 minutes
• Topical application: 15 to 30 minutes
• Inhalation: 2 to 15 minutes

Different administration routes may also determine how long CBD may continue being effective.

For example, CBD administered through the oral route may last about six to eight hours, while administering the substance through sublingual administration, topical application, or inhalation may take around two to four hours⁽⁵⁸⁾.

Individuals planning to purchase a CBD product may base their decision on their preferred administration method, product type, or other personal preferences.

For instance, some consumers may choose non-GMO or gluten-free CBD products. Others may buy products that use organic hemp supplied by hemp farms certified by the U.S. Department of Agriculture (USDA).

Other individuals may choose products based on what special offers brands provide to their customers. These offers, such as discounts, money-back guarantees, free shipping, or free complimentary products, may entice individuals to purchase the company’s products.

What Is CBD Oil?

Cannabidiol (CBD) is a phytocannabinoid (plant-derived cannabinoid) extracted from cannabis plants. CBD typically comes from hemp, a cannabis variety rich in CBD and containing about 0.3% tetrahydrocannabinol (THC)⁽⁵⁹⁾.

THC is a cannabis plant-derived compound known for its psychoactive effects or a feeling of “high” associated with marijuana use⁽⁶⁰⁾.

The compound has been the subject of numerous research regarding the substance’s therapeutic potential to address various health issues.

For example, studies showed that CBD may also help manage chronic pain, insomnia, addiction, and epilepsy⁽⁶¹⁾.

CBD also interacts with the body’s ECS⁽⁶²⁾. According to preclinical and clinical data, ECS signaling may help regulate depression and anxiety⁽⁶³⁾.

Further research and clinical trials are necessary to conclusively determine how CBD’s therapeutic effects may help manage the symptoms of anxiety.

Cannabis is a plant-based compound whose origins date back to about 5,000 years ago in present-day Romania(64). Evidence found in ashes indicated that the substance was first used for medicinal purposes around 400 A.D.

During the 19th and 20th centuries in the United States, individuals used cannabis as a patent medicine⁽⁶⁵⁾. In 1937, cannabis sale and use became federally restricted with the enactment of the Marihuana Tax Act.

With the enactment of the Compassionate Use Act in 1996, California became the first state to legalize botanical cannabis access and use for medicinal purposes, provided such use was under physician supervision⁽⁶⁶⁾.

In June 2020, the FDA approved Epidiolex, an oral medication containing a purified form of CBD⁽⁶⁷⁾. This drug is the only CBD treatment used for seizures linked to two forms of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome.

Before turning CBD oil into the final product, manufacturers first obtain the CBD extract and various plant compounds from cannabis or hemp plants using various extraction methods depending on the manufacturer’s preferences. These methods include carbon dioxide (CO2), hydrocarbon, or ethanol extraction.

• CO2 extraction: Manufacturers utilizing this extraction method use highly pressurized carbon dioxide to obtain CBD oil from hemp.

Carbon dioxide is an odorless, colorless, and noncombustible gas. The FDA affirms CO2 as generally recognized as safe (GRAS) for food use⁽⁶⁸⁾.

• Hydrocarbon extraction: In the hydrocarbon technique, CBD manufacturers use hydrocarbons such as propane or butane as solvents for CBD extraction.

However, hydrocarbons are neurotoxic and flammable, making handling these compounds a significant safety issue. Hydrocarbons can pose a health risk if not wholly removed from the CBD extract.

Thus, individuals operating the equipment and handling the solvents must follow the proper safety and handling procedures to minimize risks associated with hydrocarbons.

However, manufacturers consider hydrocarbon extraction effective in separating cannabinoids from unwanted cannabis compounds⁽⁶⁹⁾. 

• Ethanol extraction: In this method, manufacturers use ethyl alcohol, also called ethanol, as a solvent to extract CBD from the cannabis plant.

Manufacturers consider ethanol a more efficient compound than CO2 and may be a safer compound to work with than butane⁽⁷⁰⁾.

Despite these advantages, ethanol is considered an “exhaustive” solvent, meaning it may require extra refinement to remove unneeded compounds. This additional process can reduce the final product’s potency⁽⁷¹⁾.

Many cultures throughout the centuries have used this method to extract medicinal compounds from cannabis⁽⁷²⁾.

Once manufacturers have obtained the CBD extract, it is processed and categorized as full-spectrum CBD oil, broad-spectrum CBD oil, or CBD isolate.

• Full-spectrum CBD oil: This product contains all essential compounds of the cannabis plant. 

The presence of these compounds in full-spectrum CBD oil may produce an “entourage effect.” This effect is characterized by the cannabis compounds’ synergistic activity, which may provide better therapeutic results⁽⁷³⁾.

A full-spectrum CBD variant may include terpenes, flavonoids, essential oils, and other cannabinoids like THC. 

Terpenes give cannabis plants a distinct aroma and are considered essential oil constituents that may have therapeutic benefits, especially in aromatherapy⁽⁷⁴⁾.

Meanwhile, flavonoids are plant substances that may function as antioxidants and antimicrobials⁽⁷⁵⁾.

• Broad-spectrum CBD oil: This product contains most cannabinoids and other compounds also found in full-spectrum CBD oil products. However, broad-spectrum CBD oil has no THC content.
• CBD isolates: CBD isolates are made from pure CBD.  

Individuals interested in getting the full benefits of CBD or the entourage effect may opt to take full-spectrum CBD oil.

However, consumers who have an aversion to THC or its psychoactive effects and prefer THC-free CBD products instead may consider purchasing broad-spectrum CBD oil products or CBD isolates.

Benefits of CBD

Cannabidiol (CBD) is purported to have anti-inflammatory, anxiolytic, antioxidant, and anticonvulsant properties⁽⁷⁶⁾. These potential therapeutic effects may help reduce anxiety, manage psychotic disorders, and relieve spasms.

However, most of these benefits need to be thoroughly investigated, and more extensive human clinical trials are needed to help conclude that such benefits are helpful for various health conditions.

The most substantial, scientifically-proven effect of cannabidiol is its effectiveness in managing childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome, which usually do not respond to antiseizure medicines⁽⁷⁷⁾.

In June 2020, The FDA approved Epidiolex, an oral medication containing purified CBD used for treating seizures associated with epilepsy⁽⁷⁸⁾.

Safeness and Effectiveness of CBD

The World Health Organization (WHO) acknowledges that CBD has low toxicity levels⁽⁷⁹⁾. In their expert committee report, the agency mentioned that the compound does not seem to exhibit the same effects as THC.

The WHO also stated that CBD has a good safety profile and may be well tolerated in humans, according to several open-label and controlled trials evaluating CBD’s therapeutic effects⁽⁸⁰⁾.

One study showed that humans may tolerate high CBD doses of up to 1,500mg per day⁽⁸¹⁾.

However, despite CBD being deemed generally safe, scientists need to conduct additional studies to determine the compound’s long-term effects⁽⁸²⁾.

Part of a CBD brand’s objective to provide customers with a safe product is by having these products analyzed by third-party labs. These labs provide certificates of analysis (COAs) that show the actual content of a CBD product.

Third-party testing and analysis are industry-standard practices necessary to reduce concerns about falsely labeled products⁽⁸³⁾.

Reputable CBD brands typically promote transparency by uploading the COAs on the company’s product website. CBD brands claiming to provide high-quality products also ensure these COAs are regularly updated and publicly accessible.

Third-party labs can also test CBD products for harmful contaminants, such as pesticides, solvents, or heavy metals that can cause a health risk to consumers.

Individuals looking for high-quality CBD products should consider purchasing from CBD brands that provide detailed, updated, and readily available COAs. 

Consumers may also compare the CBD product’s label with the COA to ensure that the information on the label is consistent with the lab test results.

Risks and Considerations

Scientists have not thoroughly studied CBD’s side effects and risks on individuals with mental health disorders.

However, CBD may cause appetite loss, drowsiness, fatigue, and dry mouth, which may be considered tolerable side effects in humans⁽⁸⁴⁾.

Other side effects of CBD commonly reported include diarrhea, tiredness, and changes in body weight⁽⁸⁵⁾.

One study mentioned that some individuals taking prescription CBD oil may experience sedation and vivid dreams⁽⁸⁶⁾.

Another consideration when taking CBD is its potential interaction with other drugs.

CBD may interfere with cytochrome P450 enzyme activity. This enzyme group comprises more than 50 enzymes, six of which metabolize about 90% of drugs⁽⁸⁷⁾. Preventing the activity of these liver enzymes may affect the effectiveness of various medicines⁽⁸⁸⁾.

Some medications that may interact with CBD through the cytochrome P450 enzymes include beta-blockers and antidepressants⁽⁸⁹⁾. Individuals often take these drugs as anxiety medication⁽⁹⁰⁾.

Legality

The legality of medical marijuana or CBD oil products varies from one state to another. Before purchasing CBD products, consumers must review and understand their state’s CBD laws.

The 2018 Farm Bill excludes hemp-derived CBD products, whose THC content is no more than 0.3%, from the Controlled Substances Act’s definition of “marijuana”⁽⁹¹⁾. The law also mandates the USDA to establish a regulatory hemp production framework in the United States⁽⁹²⁾.

Thus, under U.S. federal law, CBD products that exceed 0.3% THC content are considered illegal⁽⁹³⁾.

As of February 3, 2022, about 37 U.S. states have implemented regulated cannabis programs. These states include Washington, Arizona, Colorado, California, Michigan, and New York⁽⁹⁴⁾.

The FDA warns that labeling or marketing CBD products as food additives or dietary supplements is illegal⁽⁹⁵⁾. The agency also mentions that it has limited data on CBD’s safety and advises that consumers consider the real risks before using CBD.

SAMHSA’s National Helpline

For more information on how to help reduce the impact of mental illness and substance abuse in American communities, individuals may visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website at samhsa.gov.

Concerned individuals may also go to SAMHSA’s office at 5600 Fishers Lane, Rockville, MD 20857, or call 1-877-SAMHSA-7 (1-877-726-4727).

SAMHSA is an agency under the U.S. Department of Health and Human Services. This agency leads public health efforts to advance the nation’s behavioral health⁽⁹⁶⁾.

Established in 1992, SAMHSA is tasked with making mental disorder and substance abuse information, research, and services more accessible.

The website offers various mental health services, such as treatment locators, practitioner training, federal grants, and public information regarding mental health and substance abuse issues.

Treatment locators help individuals look for treatment facilities and programs within the U.S. or its territories.

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    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
47. Page 252 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
48. Page 210 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
49. Best Way to Take CBD
    https://www.projectcbd.org/guidance/best-way-take-cbd
50. Ibid.
51. Can Vaping Damage Your Lungs? What We Do (and Don’t) Know
    https://www.health.harvard.edu/blog/can-vaping-damage-your-lungs-what-we-do-and-dont-know-2019090417734
52. CBD Dosing
    https://www.projectcbd.org/guidance/cbd-dosing
53. Page 218 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
54. Cannabinoids in Pediatrics
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473390/
55. Neural Basis of Anxiolytic Effects of Cannabidiol (CBD) in Generalized Social Anxiety Disorder: A Preliminary Report
    https://pubmed.ncbi.nlm.nih.gov/20829306/
56. CBD Dosing
    https://www.projectcbd.org/guidance/cbd-dosing
57. Page 190-193 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
58. Ibid.
59. Cannabidiol Primer for Healthcare Professionals
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/
60. Tetrahydrocannabinol
    https://www.sciencedirect.com/topics/neuroscience/tetrahydrocannabinol
61. Cannabidiol (CBD)-What We Know and What We Don’t
    https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
62. Page 103 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
63. Role of Endocannabinoid Signaling in Anxiety and Depression
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808114/
64. Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/
65. Ibid.
66. Ibid.
67. FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease
    https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare#
68. CFR – Code of Federal Regulations Title 21
    https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1240
69. CBD Oil: An Introduction
    https://www.projectcbd.org/wellness/cbd-oil-introduction
70. Page 243 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
71. Ibid.
72. CBD Oil: An Introduction
    https://www.projectcbd.org/wellness/cbd-oil-introduction
73. Page 92 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
74. The Cannabis Terpenes
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763918/
75. Flavonoids as Antioxidants
    https://pubmed.ncbi.nlm.nih.gov/10924197/
76. Cannabidiol Primer for Healthcare Professionals
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/
77. Cannabidiol (CBD)-What We Know and What We Don’t
    https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
78. FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease
    https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare#
79. WHO Expert Committee on Drug Dependence: Fortieth Report
    https://apps.who.int/iris/bitstream/handle/10665/279948/9789241210225-eng.pdf
80. Ibid.
81. Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent
    https://doi.org/10.2174/157488611798280924
82. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101100/
83. Page 260 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
84. What are the benefits of CBD — and is it safe to use?
    https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
85. Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092763/
86. Cannabidiol Prescription in Clinical Practice: An Audit on the First 400 Patients in New Zealand
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330185/
87. The Effect of Cytochrome P450 Metabolism on Drug Response, Interactions, and Adverse Effects
    https://www.aafp.org/pubs/afp/issues/2007/0801/p391.html
88. Page 114-115 of Healing With CBD
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
89. Ibid.
90. Anxiety Medication
    https://www.helpguide.org/articles/anxiety/anxiety-medication.htm
91. Hemp Production and the 2018 Farm Bill
    https://www.fda.gov/news-events/congressional-testimony/hemp-production-and-2018-farm-bill-07252019
92. Hemp Production
    https://www.ams.usda.gov/rules-regulations/hemp
93. CBD & THC: Myths and Misconceptions
    https://www.projectcbd.org/guidance/cbd-thc-myths-and-misconceptions
94. State Medical Cannabis Laws
    https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
95. What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD
    https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
96. About Us
    https://www.samhsa.gov/about-us

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