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All beings with a backbone have an endocannabinoid system. Is cannabis medicine a good option for the health of your dog or cat? An interview with Gary Richter, DVM Project CBD On April 19, 2017 (Updated on March 25, 2019) Any animal with a backbone (classified as a chordate) has an endocannabinoid system. The Kingdom of Chordata includes amphibians, reptiles, birds, fish, and mammals, including house pets. Many animal-owners treat their beloved pets like family members. When a dog or a cat gets sick and conventional options don’t work, people seek alternatives. In the realm of natural healing, cannabis for animals seems like a logical botanical pathway to explore. When it comes to CBD, or cannabis in general, little research has been done on cats and dogs. Are cannabis preparations safe for use in animals? Does marijuana affect pets the same way as humans? Many pet-owners are looking for something to support their animal’s health, but there is little quality control with respect to the numerous pet-focused CBD products that are available in the medical marijuana sector and the hemp CBD grey market. And there aren’t many trusted, educated individuals who can provide professional guidance on cannabinoid therapies for pets. To help pet-owners become better informed about the use of cannabis for their four-legged companions, Sarah Russo of Project CBD spoke with Gary Richter, DVM, an integrative medicine veterinarian based in Oakland, California. Richter considers cannabis to be part of a holistic approach to animal medicine. Due to marijuana’s proscribed Schedule I status, veterinarians are not allowed to write letters of recommendation for their clients or tell them where to obtain cannabis medicine. But Richter is able to speak about the benefits of CBD and cannabis therapeutics for pets. Project CBD: Can you tell us about your work? Based on what you’ve seen in your practice, what types of conditions may cannabis medicine alleviate in pets? Richter: My practice applies western, complementary, and alternative approaches. That could include acupuncture, chiropractic, Chinese and western herbs, nutritional supplementation, and more. Animals can benefit from medical cannabis for many of the same reasons it helps people—for pain, seizure control, gastrointestinal disorders, anxiety-related issues. We‘ve also seen positive results with cancer. Project CBD: Why is there a lack of research studies on cannabis in dogs and cats? What areas of cannabinoid medicine in animals would you like to see investigated more deeply? Richter: I think ultimately the reason for the lack of therapeutic-oriented research is because cannabis is federally illegal and there’s no funding. Generally, it’s pharmaceutical companies that are putting most of the money into medical research. Once there’s a legal pathway and money to be made in veterinary products, that research will happen. I would like to see more general research on the use of cannabis in animals, focusing on some of the ailments that it seems be the most effective for—especially gastrointestinal issues, pain, and inflammation. Many veterinary patients see dramatic effects with cannabis for these ailments. Cancer studies would be a much longer road and more challenging to put together. Project CBD: What is your response when veterinarians say: “There isn’t enough scientific data to show cannabis is safe and effective for treating animals.” Richter: In a perfect world, we would benefit from more scientific information. However, the case reports and anecdotal evidence about the efficacy of cannabis medicine are already overwhelming. In veterinary medicine, practitioners typically have no problem using off-label medications—those not explicitly approved for use in dogs or cats. But mention medical cannabis, which has a mountain of evidence for efficacy in humans, and they suddenly say, “You can’t do that, there’s been no research on dogs!” It’s disingenuous. Project CBD: Is there a difference between the endocannabinoid system in a dog or a cat as compared to a human? Richter: In the big picture, they’re very similar. One striking difference is there appears to be a greater concentration of cannabinoid receptors in the dog’s brain than there are in most other animals. This is significant because it makes dogs more susceptible to THC overdose, potentially giving them a certain amount of neurologic impairment in the short-term. This phenomenon is known as static ataxia. Otherwise, when cannabis medicine is used effectively, their endocannabinoid system will act in the same way it would for a human. Project CBD: Is THC combined with CBD beneficial for pets? If so, what CBD:THC ratios do you suggest for your clients? Richter: It depends on both the condition that’s being treated as well as the individual animal. Many people in the cannabis community have heard about the entourage effect. The ratio of THC to CBD is an important part of that. There are conditions that respond better to medicine with a certain amount of THC in it. The ratios that I have used include hemp-based CBD with very little THC, as well as CBD-rich marijuana with a 20:1 CBD:THC ratio and THC-dominant medicine with little CBD. The research suggests that patients with cancer and chronic pain benefit from products that have CBD and THC, rather than CBD alone. It really depends. Project CBD: Do you see animals coming into the veterinary hospital after having too much THC? How much of a problem is that? Richter: Obviously whenever we’re talking about THC and pets, dosing becomes very important. At no point is the goal for the pet to get stoned. If that happens, then it means they’ve gotten too much. The aim is to give them enough cannabis to be effective, but not so much that they’re going to be negatively compromised. It is extremely uncommon to see an animal show negative signs when they have been properly dosed with cannabis as medicine. The worst effect would be drowsiness. If that’s that case, the owner may have to decrease the dose. It’s not uncommon for a dog, or sometimes a cat, to show up at a veterinary hospital having eaten a cannabis-infused edible that belonged to the owner. The good news is that cannabis toxicity is nonfatal and does not cause long-term effects. However, those animals that get into their owner’s stash may require immediate medical care. I have seen and heard of a couple of cases where pets did not survive. Project CBD: But you just said that cannabis toxicity in nonfatal. You’ve seen cases where an animal ate too much cannabis and actually died? Richter: One case that I have personally seen was a dog that got into a bunch of cannabis edibles and the owner didn’t bring his dog to the veterinarian immediately. They called us the following day. Unfortunately, the dog had vomited and aspirated while at home, his lungs filled with fluid, and he wound up dying from a systemic infection related to that. To be honest, if this dog had received medical treatment the day he ate cannabis, he almost certainly would have been fine. It was only because the owner waited, and by that time it was too late. It was very sad. But this type of event is really quite rare. Project CBD: What’s your preferred way to administer cannabis medicine to animals? Richter: I prefer a liquid preparation, usually an oil. With liquids, it’s very easy to adjust the dosage. If you’re giving something like a pill or an edible, it can be difficult to figure out how to titrate the right amount. Furthermore, there’s every reason to believe that CBD and THC are going to be partially absorbed directly into the bloodstream through the tissues of the mouth, sublingually. If we put a liquid in an animal’s mouth, some of the medication will be absorbed directly and has a chance to be more effective. Project CBD: A lot of people say they want to start giving cannabis or CBD medicine to their pet, but they’re not quite sure about the right dose. Is there a good way to calculate the ideal amount for your animal? Richter: There’s a dosing range that you could start at. It’s best to begin at the low end. Every few days, slowly increase the dose. If you’ve achieved the desired effect for whatever is being treated, then you’re probably done. Just like people, animals will develop a tolerance for the psychoactive effects of the THC. Over time they will be able to take more medicine without any demonstrable side effects. Medical cannabis is not the answer for all pets. Some animals do better on it than others, just like people. Project CBD: In general, how knowledgeable are veterinarians about cannabis therapeutics? Richter: This is a big problem—the lack of education. The California Veterinary Medical Board is very much against the use of medical cannabis for pets. They don’t want veterinarians speaking with pet owners about it at all, except to say that it is bad and not to use it. Project CBD: What is the legal status of CBD as a medicine for animals? Richter: Cannabis is federally illegal across the board, including CBD from hemp. Even in California, a trailblazing medical marijuana state, as a veterinarian I’m not able to provide people with a medical marijuana recommendation for their pet. Nor am I able to provide them with cannabis products. But I can talk with people about how medical cannabis might benefit their animals. Unless something dramatic changes on the legal front, there’s still going to be access problems for people looking to get medicinal cannabis for their pets. Project CBD: Any words of advice for someone who wants to treat their pet with cannabis or CBD? Richter: If at all possible talk to a veterinarian. Cannabis is medicine and its dosing should be carefully calculated. It’s important to know the concentration of THC and CBD in milligrams for one’s pet. Once you have that information, you can look for a product that suits your pet’s needs. When in doubt, err on the side of under-dosing because you can always slowly increase the dose and monitor the effect. And make sure the medicine is free of mold, pesticides, and other contaminants. Project CBD: There are many hemp-based CBD products on the market for pets. How do you feel about the quality of these products in general? What are your thoughts about hemp-derived CBD? Richter: I don’t want to disparage hemp-based CBD products because I think they do have a positive medical effect. Many people start with hemp products because of their relative ease of accessibility. But in many cases, we don’t know the source of the CBD in these products. I recommend that people do their due diligence as they should with any vitamin or supplement. Call the company and ask where the product is coming from and how it’s being produced. There is no government oversight to make sure that these companies are selling authentic and safe products. A pet owner’s only other option is to get a card and go to a medical marijuana dispensary if they want something that may be more effective than hemp-derived CBD. Ideally, you would look for a product that is organic and produced locally. You want to know how the CBD was extracted and the full spectrum of cannabinoids that are present. Project CBD: Are there any guidelines or recommendations you have for people who want to make their own cannabis preparations for their pets? Richter: That’s tricky. You won’t know the concentration of cannabinoids in what you make at home, unless you have it analyzed. If you do use your own preparation, start with extremely minute dosing and slowly work your way up. You’d much rather under-dose than overdose. Project CBD: Sometimes people who don’t have medical complaints like to take cannabis as preventative medicine to maintain good health and well-being. Would you recommend something like that for an animal? Richter: That’s an excellent question I have often asked myself. The purpose of the endocannabinoid system is to maintain homeostasis within the body. It’s logical to consider using cannabis as preventative medicine much in the same way that a person would take a multivitamin. If that’s the case, I would consider keeping the dosage toward the very low end. We need to see more research on the use of cannabis as preventative medicine in people as well as animals. Project CBD: Are there any resources for people to educate themselves about cannabis medicine for pets or to find a cannabis friendly veterinarian in their area? Richter: Firstly, I would say talk to your regular veterinarian about cannabis. Even if they can’t give you the information, they may know someone in the area that can. Additionally, there is a national organization called the American Holistic Veterinary Medical Association (AHVMA). It isn’t a given that a member of the AHVMA incorporates medical cannabis into their practice, but most people who are open to it are also holistically minded. That would be a good place to find a veterinarian and to begin a conversation. For resources, a colleague of mine and I taught an online course for Greenflower Media. The class provides a comprehensive description of how medical cannabis works in pets, ways to dose, and how to find a good product. And I have a book coming out later this year. It’s called _Integrative Health Care for Dogs and Cats. It has a whole section on medical cannabis, with dosing guidelines. A colleague of mine, Rob Silver, released a book last year called _Medical Marijuana and Your Pet. Project CBD: Thank you for your time and information. Take-Home Message "If you decide to give your pet cannabis medicine, get informed. The medicine you give your animal should have the same standards for anything you would put in your own body. Make sure the product is safe and tested for cannabinoid content, quality, and is free from any contaminants or additives. Seek guidance from a vet, if at all possible. Start your furry friend off on a low dose of cannabis medicine. And monitor the effects that cannabis has on their experience because, as George Eliot wrote, “Animals are such agreeable friends―they ask no questions, they pass no criticisms.”—Project CBD Copyright, Project CBD. May not be reprinted without permission. Revision date: Mar 25, 2019

With the growing awareness of CBD as a potential health aid there's also been a proliferation of misconceptions. Find questions and responses to common misinformation. By Martin A. Lee On February 18, 2015 (Updated on February 2, 2019) Updated: February 2, 2019 It doesn’t get you high, but it’s causing quite a buzz among medical scientists and patients. The past year has seen a surge of interest in cannabidiol (CBD), a non-intoxicating cannabis compound with significant therapeutic properties. Numerous commercial start-ups and internet retailers have jumped on the CBD bandwagon, touting CBD derived from hemp as the next big thing, a miracle oil that can shrink tumors, quell seizures, and ease chronic pain—without making people feel “stoned.” But along with a growing awareness of cannabidiol as a potential health aid there has been a proliferation of misconceptions about CBD. #1 “CBD is medical. THC is recreational.” Project CBD receives many inquiries from around the world and oftentimes people say they are seeking “CBD, the medical part” of the plant, “not THC, the recreational part” that gets you high. Actually, THC, “The High Causer,” has awesome therapeutic properties. Scientists at the Scripps Research Center in San Diego reported that THC inhibits an enzyme implicated in the formation of amyloid beta plaque, the hallmark of Alzheimer’s-related dementia. The federal government recognizes single-molecule THC (Marinol) as an anti-nausea compound and appetite booster, deeming it a Schedule III pharmaceutical, a category reserved for drugs with little abuse potential. But whole plant cannabis, which is the only natural source of THC, continues to be classified as a dangerous Schedule I drug with no medical value. #2 “THC is the bad cannabinoid. CBD is the good cannabinoid.” The drug warrior’s strategic retreat: Give ground on CBD while continuing to demonize THC. Diehard marijuana prohibitionists are exploiting the good news about CBD to further stigmatize high-THC cannabis, casting tetrahydrocannabinol as the bad cannabinoid, whereas CBD is framed as the good cannabinoid. Why? Because CBD doesn’t make you feel high like THC does. Project CBD categorically rejects this moralistic, reefer madness dichotomy in favor of whole plant cannabis therapeutics. (Read the foundational science paper: A Tale of Two Cannabinoids.) #3 “CBD is most effective without THC.” THC and CBD are the power couple of cannabis compounds—they work best together. Scientific studies have established that CBD and THC interact synergistically to enhance each other’s therapeutic effects. British researchers have shown that CBD potentiates THC’s anti-inflammatory properties in an animal model of colitis. Scientists at the California Pacific Medical Center in San Francisco determined that a combination of CBD and THC has a more potent anti-tumoral effect than either compound alone when tested on brain cancer and breast cancer cell lines. And extensive clinical research has demonstrated that CBD combined with THC is more beneficial for neuropathic pain than either compound as a single molecule. #4 “Single-molecule pharmaceuticals are superior to ‘crude’ whole plant medicinals.” According to the federal government, specific components of the marijuana plant (THC, CBD) have medical value, but the plant itself does not have medical value. Uncle Sam’s single-molecule blinders reflect a cultural and political bias that privileges Big Pharma products. Single-molecule medicine is the predominant corporate way, the FDA-approved way, but it’s not the only way, and it’s not necessarily the optimal way to benefit from cannabis therapeutics. Cannabis contains several hundred compounds, including various flavonoids, aromatic terpenes, and many minor cannabinoids in addition to THC and CBD. Each of these compounds has specific healing attributes, but when combined they create what scientists refer to as a holistic “entourage effect” or “ensemble effect,” so that the therapeutic impact of the whole plant is greater than the sum of its single-molecule parts. The Food and Drug Administration, however, isn’t in the business of approving plants as medicine. (See the scientific evidence.) #5 “CBD is not psychoactive.” CBD is not an intoxicant, but it’s misleading to describe CBD as non-psychoactive. When a clinically depressed patient takes a low dose of a CBD-rich sublingual spray or tincture and has a great day for the first time in a long time, it’s apparent that CBD is a powerful mood-altering compound. Better to say, “CBD is not psychoactive like THC,” than to simply assert that CBD is not psychoactive. CBD won’t make a person feel stoned, but it can impact a person’s psyche in positive ways. #6 “Psychoactivity is inherently an adverse side effect.” According to politically correct drug war catechism, the marijuana high is an unwanted side effect. Big Pharma is keen on synthesizing medically active marijuana-like molecules that don’t make people high—although it’s not obvious why mild euphoric feelings are intrinsically negative for a sick person or a healthy person, for that matter. In ancient Greece, the word euphoria meant “having health,” a state of well-being. The euphoric qualities of cannabis, far from being an unwholesome side effect, are deeply implicated in the therapeutic value of the plant. “We should be thinking of cannabis as a medicine first,” said Dr. Tod Mikuriya, “that happens to have some psychoactive properties, as many medicines do, rather than as an intoxicant that happens to have a few therapeutic properties on the side.” #7 “CBD is sedating.” Moderate doses of CBD are mildly energizing (“alerting”). But very high doses of CBD may trigger a biphasic effect and can be sleep-promoting. If CBD-rich cannabis flower confers a sedating effect, it’s likely because of a myrcene-rich terpene profile. Myrcene is a terpene with sedative and painkilling properties. CBD is not intrinsically sedating, but it may help to restore better sleeping patterns by reducing anxiety. #8 “High doses of CBD work better than low doses.” CBD isolates require higher doses to be effective than whole plant CBD-rich oil extracts. But that doesn’t mean single-molecule CBD is a better therapeutic option than CBD-rich cannabis, which has a wider therapeutic window than a CBD isolate. Reports from clinicians and patients suggest that a synergistic combination of CBD, THC, and other cannabis components can be effective at low doses – as little as 2.5 mg CBD and/or 2.5 mg THC. Some patients may require significantly higher doses of CBD oil to obtain satisfactory results. Keep in mind that CBD and THC and cannabis in general have biphasic properties, meaning that low and high doses can produce opposite effects. An excessive amount of CBD could be less effective therapeutically than a moderate dose. #9 “CBD converts to THC in a person’s stomach.” Orally administered CBD is well-tolerated in humans. But concerns about possible harmful side effects, which might limit CBD’s therapeutic utility and market potential, were raised by misleading reports that CBD converts to high-causing THC in the stomach. It does not (read the evidence). There have been extensive clinical trials demonstrating that ingested CBD—even doses above 600 mg—does not cause THC-like psychoactive effects. On the contrary, CBD in sufficient amounts can lessen or neutralize the THC high. The World Health Organization studied the issue and gave CBD a clean bill of health in a 2017 report that asserted: “Simulated gastric fluid does not exactly replicate physiological conditions in the stomach [and] spontaneous conversation of CBD to delta-9-THC has not been demonstrated in humans undergoing CBD treatment.” #10 “CBD is fully legal in the United States because it’s no longer a controlled substance.” Not quite. The 2018 Farm Bill legalized the cultivation of industrial hemp (defined as cannabis with less than 0.3 percent THC) in the United States and removed various derivatives of hemp, including CBD, from the purview of the Drug Enforcement Administration (DEA) and the Controlled Substances Act. But the federal Food and Drug Administration (FDA) views CBD as a pharmaceutical drug. And because it has already approved CBD as a pharmaceutical (Epidiolex) for treating two forms of pediatric epilepsy, the FDA maintains that it is illegal to sell hemp-derived CBD as a dietary supplement. The DEA, meanwhile, retains jurisdiction over CBD derived from marijuana (cannabis with more than 0.3 percent THC), which is still prohibited under federal law. Rooted in reefer madness racism and enforced disproportionately against people of color, marijuana prohibition is akin to the Confederate statue still standing – a testament to enduring bigotry and social injustice. #11 “Legalizing CBD, but not cannabis, adequately serves the patient population.” Seventeen U.S. states have enacted “CBD only” (or, better said, “low THC” or “no THC”) laws. And 30 states have legalized medical marijuana (not just CBD) in one form or another. Some states restrict the sources of CBD-rich products and specify the diseases for which CBD can be accessed; others do not. But a CBD-rich remedy with little THC doesn’t work for everyone. Parents of epileptic children have found that adding some THC (or THCA, the raw, unheated version of THC) helps with seizure control. For some epileptics (and many other people), THC-dominant products are more effective than CBD-rich products. Most patients are not well served by CBD-only laws. They should have access to a broad spectrum of whole plant cannabis remedies, not just low THC medicine. Anything less is a national scandal. One size doesn’t fit all with respect to cannabis therapeutics, and neither does one compound or one product or one strain. (Read more: Prohibition’s Last Gasp: “CBD Only”.) #12 “CBD is CBD—It doesn’t matter where it comes from.” It may be possible to extract CBD oil from some low-resin industrial hemp cultivars, but fiber hemp is by no means an optimal source of CBD. Industrial hemp typically contains far less cannabidiol than high-resin CBD-rich cannabis flower tops. Huge amounts of industrial hemp are required to extract a small amount of CBD, thereby raising the risk of contaminants because hemp is a “bio-accumulator” that draws toxins from the soil. But the debate over sourcing CBD is quickly becoming moot, as plant breeders focus on developing high-resin cannabis varietals (marijuana) that satisfy the legal criteria for industrial hemp – with THC measuring less than 0.3 percent and CBD levels exceeding 10 percent by dry weight. “Pure” CBD extracted and refined from industrial hemp or synthesized in a lab lacks critical medicinal terpenes and other plant compounds that interact with CBD and THC to enhance their therapeutic benefits. (See also: Sourcing CBD: Marijuana, Industrial Hemp & the Vagaries of Federal Law.) Copyright, Project CBD. May not be reprinted without permission. Revision date: Feb 2, 2019

Project CBD has created a beginner’s guide for cannabidiol & cannabis therapeutics to address key questions of CBD users. A Beginner’s Guide to CBD & Cannabis Therapeutics In 2009, a handful of CBD-rich cannabis strains were discovered serendipitously in Northern California, America’s cannabis breadbasket, where certified patients could access medical marijuana legally. Thus began a great laboratory experiment in democracy involving CBD-rich cannabis therapeutics. The advent of whole plant CBD-rich oil as a grassroots therapeutic option has changed the national conversation about cannabis. It’s no longer a question of whether medical marijuana works—today the key question is how to use cannabis for maximum therapeutic benefit. But most health professionals have little experience in this area. So Project CBD has created a CBD User’s Manual for patients that addresses key questions about cannabidiol and cannabis therapeutics. What is CBD? Cannabidiol or CBD is a non-intoxicating component of the cannabis plant with enormous therapeutic potential. Although CBD doesn’t make people feel high like THC does, it’s causing quite a buzz among scientists, health professionals, and medical marijuana patients who are using CBD-rich products to treat a wide range of conditions—chronic pain, cancer, Crohn’s, diabetes, rheumatoid arthritis, PTSD, cardiovascular disease, anxiety, antibiotic-resistant infections, multiple sclerosis, schizophrenia, and more. Academic research centers in the United States and elsewhere are currently studying the effects of CBD on these and other ailments. Scientists refer to CBD as a “promiscuous” compound because it confers therapeutic benefits in many different ways while tapping into how we function physiologically and biologically on a deep level. Extensive preclinical research and some clinical studies have shown that CBD has strong anti-oxidant, anti-inflammatory, anticonvulsant, anti-depressant, anti-psychotic, anti-tumoral, and neuroprotective qualities. Cannabidiol can change gene expression and remove beta amyloid plaque, the hallmark of Alzheimer’s, from brain cells. Which Is Better CBD or THC? Cannabidiol and THC (The High Causer) are the power couple of cannabis therapeutics; they work best together. CBD and THC interact synergistically to potentiate each other’s curative qualities. CBD enhances THC’s painkilling and anticancer properties, while lessening THC’s psychoactivity. CBD can also mitigate adverse effects caused by too much THC, such as anxiety and rapid heartbeat. When both compounds are present in sufficient amounts in the same cannabis strain or product, CBD will lower the ceiling on the THC high while prolonging its duration. (“Relaxing but not intoxicating” is how one patient described CBD-rich cannabis.) CBD broadens the range of conditions treatable with cannabis, such as liver, cardiovascular and metabolic disorders, which may be less responsive to THC-dominant remedies. CBD and THC both stimulate neurogenesis, the creation of new brain cells, in adult mammals. What’s the Best Way to Take CBD? The most appropriate delivery system for CBD-rich cannabis is one that provides an optimal dose for a desired duration with few unwanted side effects. CBD-rich cannabis flower varietals for smoking or vaping are available in some medical marijuana dispensaries, but many CBD patients prefer non-inhalable products made with cannabis oil concentrates. Although banned by federal law, measurable doses of potent CBD-rich cannabis remedies are available in many non-smokable forms and can be utilized in various ways. The time of onset and duration of effect vary depending on the method of administration. CBD-rich cannabis oil products can be taken sublingually, orally (as edibles, lozenges, beverages, tinctures, and gel caps), or applied topically. Concentrated cannabis oil extracts can also be heated and inhaled with a vape pen. Inhalation is good for treating acute symptoms that require immediate attention; the effects can be felt within a minute or two and typically last for a couple of hours. The effects of orally administered CBD-rich cannabis oil can last for four hours or more, but the onset of effects is much slower (30-90 minutes) than inhalation. What is the Right CBD:THC Ratio for Me? Cannabis therapeutics is personalized medicine. There is no single ratio or strain or product that’s right for everyone. Optimize your therapeutic use of cannabis by finding the proper combination of CBD and THC that works best for you. A person’s sensitivity to THC is a key factor in determining the appropriate ratio and dosage of CBD-rich medicine. Many people enjoy the cannabis high and can consume reasonable amounts of any cannabis product without feeling too high or dysphoric. Others find THC to be unpleasant. CBD can lessen or neutralize the intoxicating effects of THC. So a greater ratio of CBD-to-THC means less of a high. In some states with medical marijuana laws, cannabis oil concentrates and other products with varying ratios of CBD:THC are available so users can adjust or minimize psychoactive effects to suit their needs and sensitivities. Those who don’t like THC have the option of healing without the high by using a CBD-rich remedy with only a small amount of THC. But a low THC remedy, while not intoxicating, is not always the most effective treatment option. Patients of all ages need access to a wide spectrum of whole plamnt cannabis remedies, not just high CBD oil. In essence, the goal is to administer consistent, measurable doses of a CBD-rich remedy that includes as much THC as a person is comfortable with. Are Specific CBD:THC Ratios Better for Different Conditions? Some patterns are beginning to emerge. For anxiety, depression, spasms, psychosis, and seizure disorders, many people report they do well starting with a small dose of a CBD-rich remedy with little THC. For cancer, autism, and many other diseases, some say they benefit more from a balanced ratio of CBD and THC. Extensive clinical trials conducted outside the United States have shown that a 1:1 CBD:THC ratio can be effective for neuropathic pain. Note: The CBD:THC ratio in not an indication of how much CBD or THC is present in a given cannabis product or strain. Some people use cannabis products with different CBD:THC ratios at different times of the day (more CBD for sunlight hours, more THC at night). Almost any cannabis strain or product theoretically could benefit a wide range of autoimmune and inflammatory disorders because THC and other cannabis components activate the CB2 cannabinoid receptor, which regulates immune function. What Is the Optimal Dosage of CBD? An effective dosage can range from as little as a few milligrams of CBD-enriched cannabis oil to a gram or more. Begin with a small dose of high CBD/low THC oil, especially if you have little or no experience with cannabis. Take a few small doses over the course of the day rather than one big dose. Use the same dose and ratio for several days. Observe the effects and if necessary adjust the ratio or amount. Don’t overdo it. Cannabis compounds have biphasic properties, which means that low and high doses of the same substance can produce opposite effects. Small doses of cannabis tend to stimulate; large doses sedate. Too much THC, while not lethal, can amplify anxiety and mood disorders. CBD has no known adverse side effects, but an excessive amount of CBD could be less effective therapeutically than a moderate dose. “Less is more” is often the case with respect to cannabis therapy. What Should One Look for When Choosing a CBD-Rich Product? Look for products with clear labels showing the quantity and ratio of CBD and THC per dose, a manufacturing date, and a batch number (for quality control). Select products with quality ingredients: No corn syrup, transfats, GMOs, artificial additives, thinning agents or preservatives. CBD-rich products should be lab tested for consistency and verified as being free of mold, bacteria, pesticides, solvent residues, and other contaminants. Best to avoid products extracted with toxic solvents like BHO, propane, hexane or other hydrocarbons. Opt for products that utilize safer extraction methods such as supercritical CO2 or food-grade ethanol. If CBD Is So Good, Won’t Pure CBD Be Even Better? Epidiolex, a CBD isolate, is a federally approved pharmaceutical for intractable pediatic seizure disorders. Unregulated, hemp-derived products infused with a crystalline CBD isolate are also available through internet storefronts and varioius retail outlets. But single-molecule CBD is less effective therapeutically than whole plant CBD-rich oil extract. Scientific studies have established that synthetic, single-molecule CBD has a very narrow therapeutic window and requires precise, high doses for efficacy, whereas lower dose, whole-plant, CBD-rich treatment regimens are already showing efficacy for many conditions among patients in medical marijuana states. Whether synthesized in a Big Pharma lab or derived from industrial hemp, single-molecule CBD lacks critical secondary cannabinoids and other medicinal compounds found in high-resin cannabis strains. These compounds interact with CBD and THC to enhance their therapeutic benefits. Scientists call this the “entourage effect.” Numerous cannabis compounds have medicinal attributes, but the therapeutic impact of whole plant cannabis is greater than the sum of its parts. Is There a Difference Between CBD Derived from Hemp and CBD Derived from Marijuana? If you live in a state where medical marijuana is legal and available, look for CBD products made from high-resin cannabis (rather than low resin industrial hemp) that are sold in state-licensed dispensaries. Unregulated hemp-derived CBD-infused products of varying quality are also available via dozens of internet storefronts and retail locations. Many of these products are mislabeled. Compared to whole plant CBD-rich cannabis, industrial hemp grown for fiber or seed is typically low in cannabinoid content. A huge amount of fiber hemp is required to extract a small amount of CBD, thereby raising the risk of contaminants because hemp, a bioaccumulator, draws toxins from the soil. That’s a great feature for restoring a poisoned ecosystem, but it’s not recommended for extracting medicinal oil. Heavily refined CBD paste or terpene-free CBD isolate crystal is poor starter material for formulating CBD-rich oil products. The debate over sourcing CBD from cannabis rather than hemp is becoming moot as plant breeders succeed in developing high-resin CBD-rich cannabis varietals with lass than 0.3% THC, the arbitrarily designated legal limit for hemp. Is It Safe to Inhale Hemp CBD Oil Fumes From a Vape Pen? Many cannabis- and hemp-derived CBD vape oil products include a thinning agent, which dilutes the oil that is heated and inhaled by vape pen users. Beware of vape pen oil that contains propylene glycol. When overheated, this chemical additive produces formaldehyde, a carcinogen, as a byproduct, according to a 2015 report in the New England Journal of Medicine. Other additives to avoid: polyethylene glycol (another thinning agent) and, in general, flavoring agents, especially cream and cinnamon flavors as these are very toxic and should never be heated and inhaled. Look for cartridges that contain only natural, cannabis-derived terpenes. That means that the flavor of your vape cartridge came directly from the cannabis flower from which it was extracted. Does CBD Have Any Adverse Side Effects? What About Drug Interactions? CBD is a very safe substance, but it can interact with many common pharmaceuticals. At sufficient dosages, CBD will deactivate cytochrome P450 enzymes, thereby altering how we metabolize painkillers, statins, blood thinners, insulin & more. CBD-drug interactions can be dangerous, but they can also help mitigate side effects while synergistically improving a patient’s quality of life. Cannabinoid-opioid interactions show great therapeutic potential. THC enhances the painkilling effects of opiates, while CBD can reduce withdrawal and dependence. Patients taking Big Pharma meds should monitor changes in blood levels and, if need be, adjust dosage. Problematic interactions are more likely when consuming high doses of CBD isolate products. Copyright, Project CBD. May not be reprinted without permission. Revision date: Mar 25, 2019

What is CBD? Definition of Cannabidiol & CBD Oil