• Cannabidiol (CBD) does not get users high; tetrahydrocannabinol (THC) does. CBD is a non-psychoactive cannabinoid abundant in hemp, while THC is abundant in marijuana, giving users a euphoric feeling(1).
  • Under the 2018 Farm Bill, hemp-derived products that contain no more than 0.3% THC are federally legal(2).
  • CBD may induce some side effects, such as dry mouth, diarrhea, drowsiness, and reduced appetite(3).
  • CBD does not show up on a drug test. However, some CBD products contain trace amounts of THC, which may accumulate through frequent use and appear on a drug test.
  • CBD users should consult their doctor and know each state’s laws before purchasing CBD products to ensure safety and legality.

CBD vs THC

CBD and THC are two of the hundred phytocannabinoids present in the Cannabis sativa plant. While CBD is found both in hemp and marijuana, it is more abundant in hemp.

THC is also found both in hemp and marijuana. However, the compound is more abundant in marijuana.

The main difference between the two chemical compounds is that CBD is non-psychoactive, while THC causes euphoric sensations. 

A 2019 study used rats to examine the role of a molecule in the brain’s hippocampus called extracellular-signal regulated kinase (ERK), which triggers THC’s neuropsychiatric effects(4)

Results showed that CBD may block THC to overstimulate the ERK pathway in the hippocampus, preventing THC’s psychiatric side effects.

Both CBD and THC are available in different forms, including vapes, oils, topicals, tinctures, edibles, lotions, creams, supplements, and pet products.

How CBD and THC Work with the Endocannabinoid System

Both CBD and THC interact with the endocannabinoid system (ECS), responsible for developing the central nervous system and regulating several body processes, such as mood, pain response, immune function, inflammation, anxiety, and sleep(5).

The human body naturally produces cannabinoids. However, many people do not generate enough cannabinoids, possibly leading them to develop different disorders(6).

Adding cannabinoids like CBD and THC to one’s diet can help make up for the deficiency and maintain the ECS’s functions in the body.

The ECS is composed of two types of cannabinoid receptors: CB1 and CB2. 

CB1 receptors are primarily located in the brain, spinal cord, nerves, reproductive organs, eyes, and other body parts. CB1 receptors play an important role in memory, mood, sleep, appetite, and pain sensation(7).

Meanwhile, CB2 receptors are mainly found within the immune system, and they are responsible for reducing inflammation and providing neuroprotective effects(8).

CB1 and CB2 receptors interact with CBD and THC differently. 

THC binds with CB1 receptors, causing a euphoric feeling among users.

However, CBD does not bind with either CB1 or CB2 receptors. Instead, it acts indirectly against cannabinoid agonists and changes the way THC and other cannabinoids bind to them(9).

Additionally, CBD interacts with different receptors, like the 5-HT1A receptor, which is linked to serotonin, a neurotransmitter that regulates one’s mood and helps create feelings of wellness and happiness(10).

While CBD and THC interact with the ECS through different receptors, both compounds help the ECS maintain homeostasis or balance and improve one’s health.

Other Psychoactive Cannabinoids

Cannabinol (CBN)

Although less popular than CBD and THC, cannabinol (CBN) is among the many phytocannabinoids present in the cannabis plant. 

CBN is often found in old or poorly stored cannabis plants as this compound is only created when THC is exposed to heat, oxygen, and light. Thus, marijuana strains do not contain high levels of CBN.

Like THC, CBN binds with CB1 receptors, creating the euphoric sensation linked to marijuana. However, the effect is much weaker compared to that of THC.

CBN is less researched than CBD and THC. One of these few studies mentioned CBN’s sedative effects(11).

However, it focused on CBN in relation to THC. Thus, more research is needed to explore CBN’s effects alone.

Tetrahydrocannabivarin (THCV) 

THCV is another minor cannabinoid found in marijuana strains. Like THC, THCV can produce psychoactive effects when taken in high doses.

A study showed THCV may be an appetite suppressant and potential treatment for obesity and type 2 diabetes(12).

Other studies showed THCV’s potential anti-inflammatory and anticonvulsant effects. Like CBN, THCV needs further research to explore its benefits and long-term effects(13-14).

Hemp vs. Marijuana

Hemp and marijuana are two varieties of the Cannabis sativa plant. Hemp plants are used to produce a wide variety of products, including foods and beverages, supplements, fabrics and textiles, paper, and construction materials(15).

Meanwhile, marijuana plants are cultivated as psychotropic drugs, either recreational marijuana or medical marijuana(16).

In December 2018, hemp was removed from controls under the Controlled Substances Act (CSA). Industrial hemp should contain 0.3% THC or less to become legal under federal law(17).

On the contrary, marijuana remains a Schedule I drug based on the CSA. Marijuana has a high potential for abuse because of its high THC content that produces psychoactive intoxicating effects(18).

CBD users, therefore, should make sure they are buying marijuana in states that allow its recreational use or medical use.

Types of CBD

CBD has three varieties: full-spectrum, broad-spectrum, and CBD isolates. Awareness of these types of CBD helps users determine the right product for them. 

Full-Spectrum

Full-spectrum CBD products contain all cannabinoids, including CBD and THC, flavonoids, terpenes, and other minerals found in the cannabis plant.

Terpenes are the ones that provide a distinct aroma and flavor to the cannabis plant. Flavonoids are responsible for the vivid colors of most plants. 

When these various compounds interact, they create an “entourage effect,” allowing users to maximize these compounds’ benefits. This synergistic effect also proved to be more effective than isolated compounds(19)

Broad-Spectrum

Broad-spectrum CBD is like full-spectrum CBD, except that it does not contain THC. Thus, CBD users can use these products if they do not want to experience THC’s psychoactive effects.

Like full-spectrum CBD, broad-spectrum CBD also produces an “entourage effect.”

CBD Isolates

CBD isolates are pure CBD extracted in isolation from all cannabinoids. Thus, it virtually does not contain the psychoactive compound, THC.

Users can then maximize the high CBD content of this variety. However, they cannot benefit from the “entourage effect.”

These products are available in CBD gummies, cookies, topicals, tinctures, vapes, and oils.

Health Benefits of CBD

CBD is becoming more popular because of its suggested therapeutic and medical benefits. These include(20):

  • Anti-anxiety
  • Anti-inflammatory
  • Anti-seizure
  • Anxiolytic
  • Antidepressive
  • Neuroprotective
  • Sleeping aid
  • Pain relief

A 2017 study of cannabidiol for drug-resistance seizures in the Dravet Syndrome published in The New England Journal of Medicine showed that CBD reduced seizure frequency by almost 50%(21).

The World Health Organization (WHO) also emphasized CBD’s benefits in the following(22):

  • Alzheimer’s disease
  • Parkinson’s disease
  • Multiple sclerosis
  • Huntington’s disease
  • Rheumatoid arthritis
  • Inflammatory bowel and Crohn’s disease
  • Cardiovascular diseases
  • Diabetic complications

However, research on the CBD’s benefits and risks in treating medical conclusions remains inconclusive. Thus, CBD users still need to consult health professionals before taking these products.

Health Benefits of THC

Like CBD, THC also provides potential therapeutic benefits. These include(23):

  • Increased appetite
  • Reduced nausea
  • Spasticity treatment
  • Neuropathic pain relief

The Food and Drug Administration (FDA) has also approved THC-based medications, such as Marinol and Cesamet. 

Prescribed as pills, these products contain dronabinol and nabilone, used to help reduce nausea in cancer patients undergoing chemotherapy and stimulate the appetite of patients with acquired immunodeficiency syndrome (AIDS)(24).

Sativex, which contains nabiximols, is a mouth spray used to treat spasticity and neuropathic pain associated with multiple sclerosis(25).

However, marijuana remains illegal in several states because of high levels of THC, the main psychoactive compound found in the plant. Thus, cannabis users should check whether their states allow recreational use or medical use of marijuana.

Side Effects of CBD

While CBD has shown promising therapeutic benefits, it also has its corresponding risks and side effects. According to Mayo Clinic, CBD can cause(26)

  • Diarrhea
  • Dry mouth 
  • Drowsiness
  • Fatigue
  • Reduced appetite

Another risk is that CBD can also interact with other medications that users are taking, such as blood thinners, antidepressants, and anti-seizure medications(27). However, any serious drug interactions or side effects have yet to be reported(28).

Side Effects of THC

Like CBD, THC can also induce some side effects on users. These include(29-30):

  • Red eyes
  • Increased heart rate
  • Orthostatic hypotension (head rush or dizziness)
  • Nausea and vomiting
  • Altered senses, like seeing brighter colors
  • Changes in mood
  • Memory impairment
  • Hallucinations when taken in high doses
  • Psychosis with regular use of high potency marijuana

In addition, according to the National Institutes of Health (NIH), marijuana use can affect adolescents’ brain development.

A longitudinal study in New Zealand noted how marijuana users who started as heavy smokers in their teens may lose an average of 8 IQ points between ages 13 and 38. 

According to the researchers, the lost IQ did not return for those who quit taking marijuana as adults(31).

Choosing the Right CBD Product

Given the various brands available, choosing the right CBD product may prove challenging to users. To ensure their safety, the following steps are recommended. 

Know the Different CBD Products

CBD users should know the difference among the three varieties of CBD products as they also produce different effects on the body. 

Choosing the right CBD product depends on which benefits users experience. If they do not want to avoid THC’s psychoactive effects, they can use CBD isolates and broad-spectrum products instead of full-spectrum CBD products.

Perform Research

To ensure that they are buying high-quality CBD products, users should research the brand and its CBD products. For instance, they should check where and how these CBD products are manufactured. 

Additionally, users should know whether the products undergo third-party lab testing and whether the results are available on the website. 

Checking these results will help CBD users verify if the information provided on the product labels are accurate.

Seek Professional Advice

While users can start using CBD products at lower doses, they should always consult their doctors or healthcare providers before purchasing, especially if they experience serious medical conditions or take other medications.

CBD and Drug Tests

While CBD does not show up on a drug test, some CBD products, like CBD oil, contain trace amounts of THC that can be detected on a drug test if taken in high doses.

A negative drug test result does not mean that one has never used drug or cannabis products. Instead, it means that the THC level is lower than the set cut-off value.

Some CBD users may get a false-positive drug test result because of cross-contamination. This result is possible when preparing both pure CBD products and those that contain a small amount of THC.

Secondhand smoking of marijuana is unlikely to get one a negative drug test result. However, a study on different ventilation and potency of marijuana showed how some nonsmoking participants exposed for an hour to an 11.3% THC concentration of marijuana in an unventilated room may test positive in urine tests, hours after exposure(32).

CBD Legality

In the United States, laws on cannabis use undergo continuous changes. Under the Agriculture Improvement Act of 2018 or the Farm Bill, hemp was removed from the CSA’s list.

Thus, hemp-derived products containing no more than 0.3% THC on a dry weight basis are considered legal. However, marijuana is still considered a Schedule 1 drug because of its high THC level, which can lead to abuse(33).

The FDA-approved products include Epidiolex, Marinol, Syndros, and Cesamet.

Epidiolex is used to treat two rare epilepsy cases, Lennox-Gastaut syndrome and Dravet syndrome(34). Epidiolex is also approved for seizures from tuberous sclerosis complex (TSC)(35).

Meanwhile, Marinol and Syndros contain dronabinol, a synthetic THC used to treat loss of appetite and weight loss in people with human immunodeficiency virus (HIV) or AIDS(36).

Cesamet also contains nabilone, a synthetic substance similar to THC

While these are the only FDA-approved CBD products, users may buy CBD in states that legalize recreational use or medical use of marijuana.

Conclusion

CBD does not make users feel high; THC does. However, some CBD products contain small amounts of THC, which may show up on a drug test if usage is frequent. 

Users should also note that hemp-derived products are rich in CBD, while cannabis-derived products are rich in THC, which causes psychoactive effects

CBD may be beneficial in alleviating symptoms of certain medical conditions, such as Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis, but much more research is needed for any conclusions to be drawn(37). Meanwhile, studies have shown that THC may help pain relief, improve sleep, and stimulate appetite(38)

However, CBD may still produce some side effects, like dry mouth, drowsiness, and diarrhea(39). THC may also cause nausea and vomiting, mood changes, and hallucinations(40)

CBD and THC users should always consult their physician and familiarize themselves with different states’ laws to make informed decisions.


  1. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. doi.org/10.7812/TPP/18-041. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/ 
  2. U.S. Food and Drug Administration. (2020, Oct. 1). FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). Retrieved from https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd 
  3. Bauer, B. A. (2018, Dec. 20). What are the benefits of CBD — and is it safe to use? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700 
  4. University of Western Ontario. (2019, September 30). Cannabis study reveals how CBD offsets the psychiatric side-effects of THC. ScienceDaily. Retrieved November 15, 2020 from www.sciencedaily.com/releases/2019/09/190930131115.htm 
  5. Education Collaboration Hope. (2017, Mar. 29). What Are the Differences Between CBD and THC? Retrieved from https://echoconnection.org/differences-cbd-thc/
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  11. Karniol, I. G., Shirakawa, I., Takahashi, R. N., Knobel, E., & Musty, R. E. (1975). Effects of delta9-tetrahydrocannabinol and cannabinol in man. Pharmacology, 13(6), 502–512. doi.org/10.1159/000136944. https://pubmed.ncbi.nlm.nih.gov/1221432/ 
  12. Wargent, E. T., Zaibi, M. S., Silvestri, C., Hislop, D. C., Stocker, C. J., Stott, C. G., Guy, G. W., Duncan, M., Di Marzo, V., & Cawthorne, M. A. (2013). The cannabinoid Δ(9)-tetrahydrocannabivarin (THCV) ameliorates insulin sensitivity in two mouse models of obesity. Nutrition & diabetes, 3(5), e68. doi.org/10.1038/nutd.2013.9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671751/ 
  13. Hill, A. J., Weston, S. E., Jones, N. A., Smith, I., Bevan, S. A., Williamson, E. M., Stephens, G. J., Williams, C. M., & Whalley, B. J. (2010). Δ⁹-Tetrahydrocannabivarin suppresses in vitro epileptiform and in vivo seizure activity in adult rats. Epilepsia, 51(8), 1522–1532. doi.org/10.1111/j.1528-1167.2010.02523.x. https://pubmed.ncbi.nlm.nih.gov/20196794/ 
  14. García, C., Palomo-Garo, C., García-Arencibia, M., Ramos, J., Pertwee, R., & Fernández-Ruiz, J. (2011). Symptom-relieving and neuroprotective effects of the phytocannabinoid Δ⁹-THCV in animal models of Parkinson’s disease. British journal of pharmacology, 163(7), 1495–1506. doi.org/10.1111/j.1476-5381.2011.01278.x. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165958/ 
  15. Congressional Research Service. (2019, Mar.) Defining Hemp: A Fact Sheet. Retrieved from https://fas.org/sgp/crs/misc/R44742.pdf
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  17. U.S. Food & Drug Administration. (2020, Oct. 1). FDA and Cannabis: Research and Drug Approval Process. Retrieved from https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
  18. U.S. Food & Drug Administration. (2020, Oct. 1). FDA and Cannabis: Research and Drug Approval Process. Op Cit.
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  20. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. Op Cit. 
  21. Devinsky, O., Cross, J. H., Laux, L., Marsh, E., Miller, I., Nabbout, R., Scheffer, I. E., Thiele, E. A., Wright, S., & Cannabidiol in Dravet Syndrome Study Group (2017). Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. The New England journal of medicine, 376(21), 2011–2020. doi.org/10.1056/NEJMoa1611618. https://pubmed.ncbi.nlm.nih.gov/28538134/ 
  22. World Health Organization. (2017, Nov.6). Cannabidiol (CBD) Pre-Review Report. Retrieved from https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf 
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  24. National Institute of Health. (2020, Jul.). Marijuana Research Report. Op Cit. 
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  28. Kerstin Iffland and Franjo Grotenhermen.Cannabis and Cannabinoid Research.Dec 2017.139-154.http://doi.org/10.1089/can.2016.0034
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  35. 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
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