• CBD (cannabidiol) and THC (tetrahydrocannabinol) are two of about 60 cannabinoids, which are the active components found in the cannabis plant(1)
  • THC is responsible for the euphoric, intoxicating effect commonly associated with cannabis use(2), while CBD has no psychoactive properties(3).
  • Hemp-derived CBD oil products should have less than 0.3% THC content to comply with federal laws. This amount of THC is not enough to induce a “high”(4).
  • Full-spectrum CBD oil may contain trace amounts of THC. Full-spectrum CBD products utilize the synergy between all active cannabinoids to produce the entourage effect, which may enhance the benefits of CBD(5).

Comparing CBD and THC

Cannabidiol (CBD) and tetrahydrocannabinol (THC) are both cannabinoids—active substances found in the cannabis plant associated with multiple potential health benefits(6).

The cannabis plant’s two most known strains are Cannabis sativa and Cannabis indica. Each plant differs from the other through their physical characteristics and THC content

Researchers discovered Cannabis sativa to contain higher THC levels, making it the more popular choice for cannabinoid extraction(7).

These cannabinoids affect the human body by triggering cannabinoid receptors linked to the endocannabinoid system (ECS). 

The ECS is involved in regulating neurological and physiological functions for reaching homeostasis in the body. These functions include(8):

  • Sleep
  • Mood
  • Appetite
  • Memory
  • Cognition
  • Addiction
  • Neural development
  • Motor control
  • Insulin resistance
  • Cardiac function
  • Muscle formation
  • Energy metabolism
  • Energy balance

There are two types of these receptors that communicate different needs to the ECS

CB1 receptors, which mainly react to THC, are primarily located in the brain and are also scattered throughout the body. CB2 receptors are found to settle in the immune system’s cells and tissue(9).

CBD’s different health benefits are distributed through this mechanism.

Differences Between CBD and THC

Researchers consider CBD and THC to be the two major cannabinoid compounds of the cannabis plant and have found both compounds to have opposing behaviors.

A 2012 study found in Therapeutic Advances in Pharmacology noticed CBD’s ability to neutralize some of THC’s physiological effects, including THC-generated increase in anxiety levels and THC-induced increase in appetite(10).

The most significant difference between these two compounds is that THC has psychoactive effects, while CBD does not have the same mind-altering, psychotropic effects.

Some studies also observed that heavy doses of THC may reduce motor and behavioral activity, significantly lower body temperature, and impair spatial and verbal short-term memory

Meanwhile, CBD was noted not to affect body temperature and incite any of the other effects(11).

Differences Between Hemp and Marijuana

Although commonly mistaken for the other, hemp and marijuana plants are not identical. While they are both associated with the cannabis plant and share physical characteristics(12), they have genetic differences that do not make them interchangeable(13).

According to the National Center for Complementary and Integrative Health (NIH), marijuana refers explicitly to cannabis that contains significant levels of THC. Cannabis that has minuscule amounts of THC is referred to as “industrial hemp(14).

Besides a difference in THC content, studies also noted that hemp plants have higher amounts of CBD(15).

Under the Agricultural Improvement Act of 2018 (2018 Farm Bill), hemp, also referred to as Cannabis sativa L with less than 0.3% THC, was reclassified as a legal substance and set apart from marijuana under the Controlled Substances Act (CSA)(16)

Marijuana is currently still considered a controlled substance and illegal on a federal level. However, local laws permit medical marijuana use in 33 states with varying accessibility levels, and recreational use is legal in 14 states(17).

Benefits of CBD and THC

CBD and THC are linked to many potential therapeutic benefits, whether used on their own or combined with other hemp-derived compounds and each other.

  • Analgesic properties: CBD is known for having analgesic or pain-relieving properties.
    Researchers highlighted the use of full-spectrum CBD for the treatment of neuropathic pain for the synergistic analgesic effects of each cannabinoid for better efficacy(18).
    According to research published in the Journal of International Association for the Study of Pain, topical application of CBD may inhibit pain perception. CBD was also found to have synergistic effects with spinal and supraspinal activation of the ECS(19).
    Medical marijuana is primarily used for pain management by people who suffer from chronic and cancer-related pain. It was also found to relieve pain caused by multiple sclerosis (MS)(20).
    Smoking strains with higher levels of THC than CBD may produce a more significant reduction of pain compared to varieties with higher CBD content. However, CBD was noted to have analgesic effects independent from THC(21).
  • Anti-inflammatory properties: Trials using animal models showed CBD’s potential in reducing joint swelling by targeting cannabinoid receptors(22).
    A study included in the Journal of Pharmacology and Experimental Therapeutics noted, through several experimental models, the effectiveness of CBD and other non-psychoactive cannabinoids in curbing inflammation(23).
  • Anticonvulsant: Cannabinoids were observed to have beneficial effects on seizure control, with CBD being more stable in anticonvulsant efficacy than THC(24).
    In a 2017 study for epilepsy research using mice and rats, researchers noted CBD’s ability to produce protection against electroshock-induced seizures in its test subjects(25).
    The same study also found CBD intake to significantly reduce the frequency of drop seizures in patients suffering from Lennox-Gastaut syndrome(26).
    Another trial sought to discover CBD’s possible efficacy against Dravet syndrome, a drug-resistant childhood epilepsy disorder. CBD use resulted in reduced frequency in average monthly convulsive seizures(27).
    In 2018, the US Food and Drug Administration (FDA) approved Epidiolex, a cannabidiol-based treatment for epileptic seizures associated with Lennox-Gastaut syndrome and Dravet syndrome(28).
  • Antispastic properties: CB1 receptors located in the central nervous system were discovered to deliver antispastic or anti-muscle spasm effects when triggered.
    According to a study published in Neurological Advances in Neurological Disorders, this finding led to the development of an approved add-on MS treatment with a fixed 1:1 ratio of THC and CBD, targeting MS-specific muscle spasms and pain(29).
  • Anxiolytic (anti-anxiety) properties: A 2019 study observed a steady and stable decrease in anxiety levels in 79.2% of its subjects who were given 25mg of CBD over some time(30).
    Another 2019 study on teenagers with social anxiety disorder found a considerable decrease in anxiety levels in subjects who were administered CBD over two weeks(31).
  • Sleep assistance: Cannabidiol was discovered to have potential therapeutic effects on sleep quality, which may help treat insomnia, excessive daytime sleepiness, sleep apnea, and sleep disruptions associated with post-traumatic stress disorder (PTSD) and chronic pain(32).
  • Antiemetic (anti-nausea) properties: Cannabinoids were found to help regulate and treat nausea and vomiting in cancer patients caused by chemotherapy.
    A study included in the British Journal of Pharmacology observed delta-9-tetrahydrocannabinol (Δ-9-THC)’s effect on CB1 receptors to be a significant cause in emetic suppression (regulation of vomiting and nausea)(33).

Side Effects of CBD and THC

Research on cannabinoid benefits has also discovered potentially antagonistic effects through clinical trials using animal and human models.

  • Fatigue:A clinical trial using three different medicinal cannabis strains with high CBD content found fatigue as the most common adverse effect mentioned by the subjects involved(34).
  • Somnolence: Some studies have noted drowsiness as a reported side effect in multiple cannabinoid clinical trials(35-36).
  • Appetite stimulation: Studies indicated that some cannabinoids, primarily THC(37), triggers a significant release of ghrelin, a hormone directly linked to hunger cues(38).
    The Society for the Study of Ingestive Behavior acknowledges that this effect may be used to address anorexia, metabolic disorders, and severe appetite loss caused by chronic illnesses, such as cancer, heart disease, and HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome)(39).
  • Appetite loss: A 2017 study conducted using animal specimens observed that hemp with high volumes of CBD may significantly decrease feelings of hunger, potentially reducing the chance of weight gain.
    CBD content may also counteract THC’s appetite-stimulating effects(40).
  • Cognitive impairment: Short-term deteriorations in cognitive functions, such as memory, learning, and attention are commonly associated with controlled high-THC cannabis usage.
    Data collected from the Dunedin Multidisciplinary Health and Development Study pointed to a decline in an average of six IQ points from long-term cannabis abuse, which is comparable to the detrimental effects of lead exposure(41).
  • Behavioral changes: THC-heavy cannabis use has been linked to behavioral changes, including decreased motivation and apathy(42) and increased impulsive behavior due to an addiction to THC’s intoxicating effects(43).
  • Risk of addiction: A 2018 study found in the Journal of Neuroimmune Pharmacology discovered chronic cannabis use may produce structural changes in the brain leading to cannabis dependency(44).
    Heavy, long-term use of high-THC cannabis may also cause addiction by inducing cannabis cravings after periods of abstinence and a loss of intake-control(45) with a disregard for quality of life deterioration(46).

The Different Types of CBD Products

There are three types of hemp oil CBD sold on the market, all marketed towards assisting physical and psychological wellness through the potential therapeutic benefits of CBD.

  • CBD isolates, or crystalline isolates, are pure CBD substances derived from industrial hemp, usually through the CO2 extraction method. This method uses pressurized carbon dioxide to isolate cannabidiol from other compounds.
    Isolates are commonly sold as a crystal solid or powder used to make tinctures and vaping solutions.
  • Broad-spectrum CBD is a form of hemp extract that utilizes other compounds, such as terpenes, flavonoids, and other cannabinoids sans THC, to provide additional health benefits to its users.
  • Full-spectrum CBD is like broad-spectrum but includes THC. The full spectrum of cannabinoids, including terpenes, flavonoids, and fatty acids, results in the entourage effect, wherein all active compounds work in harmony to amplify the benefits of each cannabinoid.
    For full-spectrum products to be considered legal, THC content should be no greater than 0.3%.

With a growing interest in CBD and a rise in CBD production(47), prospective CBD users may acquire hemp products in a wide range of concentration strengths, forms of administration, cannabinoid combinations, and flavor profiles.

Popular products in the CBD industry include oil-based and water-soluble tinctures, gummies, capsules, vaping solutions, and topicals, such as lotions, creams, and balms. There are also CBD formulations for pets in the market.

CBD products may easily be purchased online or through dispensaries in states where CBD is legal.

To determine whether a CBD product is safe and of high quality, it is important to check product certificates of analysis (COA) from third-party laboratories. 

These documents present detailed information on CBD and THC potency.  COAs also confirm if a product meets its specification on cannabinoids, terpenes, microbiological levels, and possible contaminants.

Hemp-derived CBD was declared legal in the United States under the 2018 Farm Bill (Agricultural Improvement Act of 2018), with the stipulation that these products contain no more than 0.3% THC. Marijuana-derived CBD products are still illegal(48).

According to the Food and Drug Administration (FDA), it is illegal to market any kind of cannabis product as dietary supplements, make claims regarding CBD benefits, or sell food and drink containing CBD(49).

CBD legality has yet to reach the federal level due to individual state laws regarding controlled substances(50).

Can THC Be Detected in a Drug Test?

Clinical trials, published in the Journal of Analytical Toxicology, were done on CBD dosing and its effects on urine drug testing(51)

The results showed that substantial doses of THC-free CBD products do not produce positive results using federal drug-testing standards.

The same study also found that CBD products containing small amounts of THC may yield positive drug test results(52)

According to John Hopkins Medicine, regular use of such products may result in THC accumulating in the body(53).


While full-spectrum CBD products are formulated with THC, companies may only include trace amounts. Federal laws require all CBD products on the market to contain less than 0.3% THC in dry weight to be lawfully sold and transported within the United States.

  1. Atakan Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241–254. https://doi.org/10.1177/2045125312457586
  2. Weir, K. (2015, Nov.). Marijuana and the developing brain. Retrieved from https://www.apa.org/monitor/2015/11/marijuana-brain
  3. Pellati, F., Borgonetti, V., Brighenti, V., Biagi, M., Benvenuti, S., & Corsi, L. (2018). Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer. BioMed research international, 2018, 1691428. https://doi.org/10.1155/2018/1691428
  4. The US Food and Drug Administration (FDA) (2020, Oct. 10). 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
  5. Russo E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British journal of pharmacology, 163(7), 1344–1364. https://doi.org/10.1111/j.1476-5381.2011.01238.x
  6. National Center for Complementary and Integrative Health (NIH) (2019, Nov.). Cannabis (Marijuana) and Cannabinoids: What You Need To Know. Retrieved from https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
  7. Atakan, Z. op. cit.
  8. Zou, S., & Kumar, U. (2018). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International journal of molecular sciences, 19(3), 833. https://doi.org/10.3390/ijms19030833
  9.       Kendall, D. A., Yudowski, G. A. (2017, Jan. 4). Cannabinoid Receptors in the Central Nervous System: Their Signaling and Roles in Disease. https://doi.org/10.3389/fncel.2016.00294
  10.   Atakan, Z. op. cit.
  11.   Atakan, Z. op. cit.
  12.   United States Department of Agriculture. Identification: Industrial Hemp or Marijuana? Retrieved from https://www.ers.usda.gov/webdocs/publications/41740/15852_ages001eb_1_.pdf?v=0
  13.   University of Minnesota. (2015, July 17). Why hemp and marijuana are different. ScienceDaily. Retrieved October 21, 2020 from www.sciencedaily.com/releases/2015/07/150717131014.htm
  14.   National Center for Complementary and Integrative Health (NIH). op. cit.
  15.   van Bakel, H., Stout, J. M., Cote, A. G., Tallon, C. M., Sharpe, A. G., Hughes, T. R., Page, J. E. (2011, Oct. 20). The draft genome and transcriptome of Cannabis sativa. https://doi.org/10.1186/gb-2011-12-10-r102
  16.   The US Food and Drug Administration (FDA) (2019, Jul. 25). Hemp Production and the 2018 Farm Bill. Retrieved from https://www.fda.gov/news-events/congressional-testimony/hemp-production-and-2018-farm-bill-07252019
  17.   National Conference of State Legislatures (2020, Oct. 12). State Medical Marijuana Laws. Retrieved from https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
  18.   Elikkottil, J., Gupta, P., & Gupta, K. (2009). The analgesic potential of cannabinoids. Journal of opioid management, 5(6), 341–357. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728280/
  19.   Dogrul, A., Gul, H., Akar, A., Yildiz, O., Bilgin, F., & Guzeldemir, E. (2003). Topical cannabinoid antinociception: synergy with spinal sites. Pain, 105(1-2), 11–16. https://doi.org/10.1016/s0304-3959(03)00068-x
  20.   Grinspoon, P. (2018, Jan. 15). Medical marijuana. Retrieved from https://www.health.harvard.edu/blog/medical-marijuana-2018011513085
  21.   van de Donk, T., Niesters, M., Kowal, M. A., Olofsen, E., Dahan, A., van Velzen, M. (2019, Apr.). An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. doi: 10.1097/j.pain.0000000000001464
  22.   McDougal, S. N. (2011, Jun. 13). The abnormal cannabidiol analogue O-1602 reduces nociception in a rat model of acute arthritis via the putative cannabinoid receptor GPR55. https://doi.org/10.1016/j.neulet.2011.06.004
  23.   Petrosino, S., Verde, R., Vaia, M., Allarà, M., Iuvone, T., & Di Marzo, V. (2018). Anti-inflammatory Properties of Cannabidiol, a Nonpsychotropic Cannabinoid, in Experimental Allergic Contact Dermatitis. The Journal of pharmacology and experimental therapeutics, 365(3), 652–663. https://doi.org/10.1124/jpet.117.244368
  24.   Perucca E. (2017). Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last?. Journal of epilepsy research, 7(2), 61–76. https://doi.org/10.14581/jer.17012
  25.   Ibid.
  26.   Ibid.
  27.   Koubeissi M. (2017). Anticonvulsant Effects of Cannabidiol in Dravet Syndrome. Epilepsy currents, 17(5), 281–282. https://doi.org/10.5698/1535-7597.17.5.281
  28.   The US Food and Drug Administration (FDA) (2020, Mar. 27). FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
  29.   Zettl, U. K., Rommer, P., Hipp, P., & Patejdl, R. (2016). Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis. Therapeutic advances in neurological disorders, 9(1), 9–30. https://doi.org/10.1177/1756285615612659
  30.   Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
  31.   Masataka, N. (2019, Nov. 8). Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders. https://doi.org/10.3389/fpsyg.2019.02466
  32.   Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current psychiatry reports, 19(4), 23. https://doi.org/10.1007/s11920-017-0775-9
  33.   Parker, L. A., Rock, E. M., & Limebeer, C. L. (2011). Regulation of nausea and vomiting by cannabinoids. British journal of pharmacology, 163(7), 1411–1422. https://doi.org/10.1111/j.1476-5381.2010.01176.x
  34.   Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034
  35.   Ibid.
  36.   Elikkottil, J. et al. op. cit.
  37.   National Institute on Drug Abuse (NIH) (2020, Jul.) Is marijuana safe and effective as medicine? Retrieved from https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine
  38.   Society for the Study of Ingestive Behavior (2018, Jul. 17). How cannabis affects appetite: Brain changes. Retrieved from https://www.sciencedaily.com/releases/2018/07/180717094747.htm
  39.   Iffland, K. et al. op. cit.
  40.   Iffland, K. et al. op. cit.
  41.   Weir, K. op. cit.
  42.   Volkow, N. D., Swanson, J., Evins, A. E., Delisi, L., Meier, M., Gonzalez, R., Bloomfield, G., Curran, H. V., Baler, R. D. (2016, Feb.). Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review. Retrieved from https://www.researchgate.net/deref/http%3A%2F%2Fdx.doi.org%2F10.1001%2Fjamapsychiatry.2015.3278
  43.   Ansell, E. B., Laws, H. B., Roche, M. J., & Sinha, R. (2015). Effects of marijuana use on impulsivity and hostility in daily life. Drug and alcohol dependence, 148, 136–142. https://doi.org/10.1016/j.drugalcdep.2014.12.029
  44.   Zehra, A., Burns, J., Liu, C. K., Manza, P., Wiers, C. E., Volkow, N. D., & Wang, G. J. (2018). Cannabis Addiction and the Brain: a Review. Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology, 13(4), 438–452. https://doi.org/10.1007/s11481-018-9782-9
  45.   Ibid.
  46. National Institute on Drug Abuse (NIH) op. cit.
  47.   Global News Wire (2020, Jul. 30) Global Cannabidiol Oil (CBD Oil) Market 2020 | Growing Rapidly with Modern Trends, Development Status, Investment Opportunities, CAGR of 33.5%, Revenue, Demand and Forecast to 2026 Says Industry Research Biz. Retrieved from https://www.globenewswire.com/news-release/2020/07/30/2070078/0/en/Global-Cannabidiol-Oil-CBD-Oil-Market-2020-Growing-Rapidly-with-Modern-Trends-Development-Status-Investment-Opportunities-CAGR-of-33-5-Revenue-Demand-and-Forecast-to-2026-Says-Indu.html
  48.   The US Food and Drug Administration (FDA). FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). op cit.
  49.   The US Food and Drug Administration (FDA). FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). op cit.
  50.   The US Food and Drug Administration (FDA). FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). op cit.
  51.   Spindle, T. R., Cone, E. J., Kuntz, D., Mitchell, J. M., Bigelow, G. E., Flegel, R., & Vandrey, R. (2020). Urinary Pharmacokinetic Profile of Cannabinoids Following Administration of Vaporized and Oral Cannabidiol and Vaporized CBD-Dominant Cannabis. Journal of analytical toxicology, 44(2), 109–125. https://doi.org/10.1093/jat/bkz080
  52.   Ibid.
  53. Johns Hopkins Medicine. (2019, November 4). Some CBD products may yield cannabis-positive urine drug tests. ScienceDaily. Retrieved October 21, 2020 from www.sciencedaily.com/releases/2019/11/191104141650.htm
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