• Cannabinoids, like CBD and THC, are chemical compounds that join with cannabinoid receptors of the brain and the body(1).
  • THC may boost CBD’s efficacy. Thus, the two compounds work better together(2)
  • In a 2019 study, it was noted that individuals with chronic pain who were given THC to CBD oromucosal spray reported more than 50% symptom improvement(3)
  • A mini-review discussed that a 1:1 ratio of CBD and THC may provide therapeutic benefits for individuals with multiple sclerosis. The compounds may deliver pain relief and bladder control and decrease muscle spasticity and spasms(4).  

Benefits of CBD and CBD With THC

Cannabinoids are naturally occurring chemical compounds that bind with cannabinoid receptors of the brain and the body. These substances may contain similar properties to compounds found in Cannabis sativa plants(5)

CBD (cannabidiol) and THC (tetrahydrocannabinol) are two main cannabinoids(6)

Below are studies investigating some of the purported therapeutic benefits of CBD and THC when taken together. 

Research or Studies on CBD With THC

A 2019 study investigated the efficacy and tolerability of THC to CBD in the form of oromucosal spray as an additional measure in individuals suffering from acute, chronic pain(7)

The research involves 800 participants who used THC to CBD oromucosal spray. The results showed that after 12 weeks, 70% of the individuals reported more than 50% improvement in pain levels(8)

Moreover, the oromucosal sprays were well tolerated, and individuals with neuropathic pain felt improvement in pain and relief(9).   

A recent study examined how CBD and THC may help with chronic pain relief. The research also outlined evidence related to the effectiveness of the cannabinoids, their side effects, and the optimal prescribing practices(10)

The study indicated nabixomols, an oromucosal spray that contain a 1:1 ratio of CBD and THC. This spray has shown promise in multiple sclerosis(11)

Multiple sclerosis is a disabling disorder of the central nervous system that causes fatigue, numbness all over the body, and muscle spasms(12)

CBD vs. THC: What Is the Difference?

CBD and THC are two ingredients that are found naturally in cannabis plants.  

However, the main difference is that CBD is nonpsychoactive, whereas THC may induce a euphoric high in users(13)

The Entourage Effect: How CBD and THC Work Together

THC may increase and complement the effectiveness of CBD. Thus, they work better together(14)

On the other hand, several studies have noted that CBD may offset the adverse effects of THC(15)

The entourage effect is the phenomenon wherein the integration of all the cannabis compounds, such as CBD and THC, may maximize the benefits of the compounds(16).   

A study from Frontiers in Plant Science hypothesized that the entourage effect in full-spectrum cannabis extracts may deliver better therapeutic results than pure cannabidiol(17).  

What Is CBD Oil?

Cannabidiol, more popularly called CBD, is an active cannabinoid found in hemp plants(18).

CBD oil is produced by infusing carrier oils such as olive oil, coconut oil, or hemp oil into CBD concentrates from cannabis or hemp plants(19).

CBD Usage for Pain

Individuals may use different forms of CBD for pain. Edibles like CBD gummies and capsules pass through the digestive system before the compound enters the bloodstream(20)

Meanwhile, CBD oil tinctures are administered sublingually (under the tongue) using a dropper or oromucosal sprays. CBD is directly absorbed into the bloodstream, which allows for a faster onset time(21)

Topical CBD products like CBD balms and creams are usually applied on the skin for localized pain relief(22).

Lastly, smoking or vaping CBD is the fastest way for users to feel the compound’s effects as CBD directly enters the bloodstream(23)

However, vaping is linked with severe pulmonary diseases, so caution is advised for this particular CBD administration format(24).

CBD Dosage for Pain

The FDA, also called the Food and Drug Administration, has not approved the use of CBD to treat any medical condition. Thus, there is no set dosage for CBD for pain. 

However, a study on the safety and side effects of CBD stated that humans may tolerate up to 1,500mg of CBD per day(25).

Still, individuals need to consult a medical practitioner before using CBD. These professionals may prescribe the optimal CBD dosage for pain or any health issues.

What Ratio of THC to CBD Is Best?

Full-spectrum CBD oil has all the extracts found in the cannabis plant, such as essential oils, terpenes, flavonoids, and other cannabinoids. Full-spectrum also has a less than 0.3% THC concentration(26)

Utilizing the whole plant or full-spectrum products delivers the most efficient results. However, one should also consider the CBD to THC ratio(27).  

CBD and THC may deliver more efficient benefits when used simultaneously. It is crucial to find the correct strength, percentage, and optimal ratio of CBD to THC for every specific medical issue, such as pain. These factors are essential parts of the full-spectrum approach to cannabinoid therapy. 

According to a mini-review from the Frontiers in Cellular Neuroscience, a 1:1 ratio of CBD and THC may help individuals diagnosed with multiple sclerosis. This ratio may provide pain relief and bladder control and decrease muscle spasms and spasticity(28).

Safeness

A review from the World Health Organization (WHO) indicated that CBD is well tolerated by the body, possesses a good safety profile, and is non-addictive(29).  

For THC, the WHO has proposed that the compound is classified as schedule IV of the United Nations Convention on Psychotropic Drugs, as THC does not cause any substantial risk to public health(30).

However, individuals using THC may experience impairments in space distances, memory, and cognitive performance. Moreover, the compound may also induce delusions, hallucinations, and panic reactions(31).

Side Effects of CBD and THC

In the case of CBD, using the compound may cause some mild side effects like(32):

  • Drowsiness
  • Fatigue 
  • Diarrhea
  • Dry mouth

Meanwhile, using THC may yield a different set of side effects, namely(33)

  • Lethargy
  • Increased appetite and heart rate
  • Coordination problems
  • Red eyes
  • Dry mouth
  • Slower reaction times
  • Memory loss
  • Anxiety and mood changes

CBD and THC Legality

The 2018 Farm Bill authorizes cannabis and cannabis-derived products like CBD as federally legal in the United States(34) as long the product contains less than 0.3% THC by dry weight. 

However, different states have varying laws regarding the use of CBD.

Therefore, individuals need to verify their state laws and check product labels before purchasing and using CBD products to avoid possible legal repercussions. 


  1. Cannabis (Marijuana) and Cannabinoids: What You Need To Know
    https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
  2. Healing With CBD, page 186.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  3. Effectiveness and tolerability of THC:CBD oromucosal spray as add-on measure in patients with severe chronic pain: analysis of 12-week open-label real-world data provided by the German Pain e-Registry
    https://pubmed.ncbi.nlm.nih.gov/31190969/
  4. Perspectives on Cannabis-Based Therapy of Multiple Sclerosis: A Mini-Review
    https://www.frontiersin.org/articles/10.3389/fncel.2020.00034/full#B71
  5. Cannabis, a complex plant: Different compounds and different effects on individuals
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736954/
  6. Cannabis (Marijuana) and Cannabinoids: What You Need To Know
    https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
  7. Effectiveness and tolerability of THC:CBD oromucosal spray as add-on measure in patients with severe chronic pain: analysis of 12-week open-label real-world data provided by the German Pain e-Registry
    https://pubmed.ncbi.nlm.nih.gov/31190969/
  8. Ibid.
  9. Ibid.
  10. Medicinal cannabis in the treatment of chronic pain
    https://www1.racgp.org.au/ajgp/2021/october/medicinal-cannabis
  11. Ibid.
  12. Multiple sclerosis
    https://www.nhs.uk/conditions/multiple-sclerosis/
  13. 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
  14. Healing With CBD, page 186.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  15. Does Cannabidiol Protect Against Adverse Psychological Effects of THC?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797438/
  16. CBD: A Patient’s Guide to Medicinal Cannabis, page 78.
    https://drive.google.com/file/d/1MILU_6ZjYkII-XMUPHLFPiPQbrz__5Sh/view
  17. The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: No “Strain,” No Gain
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334252/
  18. 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
  19. Healing with CBD page 205
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  20. Healing with CBD. page. 202
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  21. Healing with CBD. page. 205
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  22. Healing with CBD. page. 210.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  23. How to Safely Use CBD: Should You Inhale, Spray, Apply, or Eat It?
    https://www.consumerreports.org/cbd/how-to-use-cbd-inhale-spray-apply-eat/
  24. Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products
    https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
  25. Safety and side effects of cannabidiol, a Cannabis sativa constituent
    https://pubmed.ncbi.nlm.nih.gov/22129319/
  26. Cannabidiol primer for healthcare professionals
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/
  27. CBD: A Patient’s Guide to Medicinal Cannabis, page 91.
    https://drive.google.com/file/d/1MILU_6ZjYkII-XMUPHLFPiPQbrz__5Sh/view
  28. Perspectives on Cannabis-Based Therapy of Multiple Sclerosis: A Mini-Review
    https://www.frontiersin.org/articles/10.3389/fncel.2020.00034/full#B71
  29. Cannabidiol (CBD)
    https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
  30. The good and the bad effects of (-) trans-delta-9-tetrahydrocannabinol (Delta 9-THC) on humans
    https://pubmed.ncbi.nlm.nih.gov/15302527/
  31. Ibid.
  32. 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
  33. THC vs. CBD for Pain Relief: What’s Better?
    https://creakyjoints.org/alternative-medicine/thc-vs-cbd-for-pain-relief/
  34. New Congressional Farm Bill Legalizes Some Marijuana
    https://my.vanderbilt.edu/marijuanalaw/2018/12/new-congressional-farm-bill-legalizes-some-marijuana/
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