Effects of cannabidiol in cannabis flower: Implications for harm reduction

Abstract

Using a federally compatible, naturalistic at‐home administration procedure, the present study examined the acute effects of three cannabis flower chemovars with different tetrahydrocannabinol (THC) to cannabidiol (CBD) ratios, in order to test whether chemovars with a higher CBD content produce different effects. Participants were randomly assigned to ad libitum administration of one of three chemovars (THC‐dominant: 24% THC, 1% CBD; THC+CBD: 9% THC, 10% CBD; CBD‐dominant: 1% THC, 23% CBD); 159 regular cannabis users (male = 94, female = 65) were assessed in a mobile pharmacology lab before, immediately after, and 1 h after ad libitum administration of their assigned chemovar. Plasma cannabinoids as well as positive (e.g., high, elation) and negative (e.g., paranoia and anxiety) subjective effects were assessed at each time points. Participants who used the CBD‐dominant and THC + CBD chemovars had significantly less THC and more CBD in plasma samples compared to participants who used the THC‐dominant chemovar. Further, the THC + CBD chemovar was associated with similar levels of positive subjective effects, but significantly less paranoia and anxiety, as compared to the THC‐dominant chemovar. This is one of the first studies to examine the differential effects of various THC to CBD ratios using chemovars that are widely available in state‐regulated markets. Individuals using a THC + CBD chemovar had significantly lower plasma THC concentrations and reported less paranoia and anxiety while also reporting similar positive mood effects as compared to individuals using THC only, which is intriguing from a harm reduction perspective. Further research is needed to clarify the harm reduction potential of CBD in cannabis products.

A “Good” Smoke? The Off-Label Use of Cannabidiol to Reduce Cannabis Use

“…Highly-potent cannabis consumption has been associated with higher risks of cannabis use problems and anxiety disorders ( 38 ) as well as psychosis ( 39 , 40 ). Conversely, CBD seems to attenuate THC-related psychotic-like effects, memory problems (especially in light users), paranoia, anxiety and cannabis-related psychological wellbeing impairment ( 41 – 44 ). This could be due to functional interactions between THC and CBD ( 45 ).…”

“…Accordingly, for cannabis users in France—a population which must choose between illegal high-potency and legal CBD-rich cannabis—mixing both products may be a way for them to create low-risk cannabis, or to move toward creating a “smoking version” of nabiximols. Accordingly, Gibson et al, in the U.S., found that THC + CBD chemovar (9% THC, 10% CBD, from local and legal dispensary) was associated with similar levels of positive subjective effects, but significantly less paranoia and anxiety, as compared to the THC-dominant chemovar ( 44 ).…”

“…Moreover, results from previous studies on tobacco smokers suggested that the sensations which smoking creates in the airways contribute to short-term satisfaction, the rewarding effect, and reduced craving ( 49 – 51 ). One can therefore suppose that smoking CBD-rich cannabis may be “beneficial” as part of a strategy to lower exposure to THC: by preserving the smoking-related airway sensation as well as the terpene-related taste ( 52 – 54 ), a minimal reduction in the satisfaction experienced from the act of smoking may be derived from THC-low cannabis as compared to THC-high cannabis ( 44 ). In reality, smoking cannabis exposes persons to harmful substances, including carcinogens ( 55 – 57 ).…”

A Clinical Framework for Assessing Cannabis-Related Impairment Risk

“…Evidence is still varied on whether or not CBD can lessen the impact of THC-associated side effects ( 71 ), but using products that contain CBD may allow for a reduced THC dose required due to synergistic effects ( 72 ). THC and CBD combinations were also associated with positive effects on symptoms, while experiencing significantly less paranoia and anxiety than THC-only products ( 72 ). From a clinical and safety standpoint, CBD is a preferred choice for individuals that engage in safety-sensitive activities.…”

A First-Tier Framework for Assessing Toxicological Risk from Vaporized Cannabis Concentrates

“…Compare this to aspirin with a risk ratio of 1.6 vs. control, 2.2 for ibuprofen used with caffeine, and 5.3% of global deaths attributed to alcohol and 20% of U.S. deaths attributed to cigarette smoking [35,41,42]. Additionally, consumers tend to self-titrate inhaled THC doses [43,44]; therefore, the compounds at natural levels in the inflorescence relative to THC concentrations can be used in the risk assessment. The concentration of compounds in the cannabis plant can be identified from scientific literature and accredited cannabis testing labs [45].…”