Cannabidiol: Difference between revisions

{{Short description|Phytocannabinoid discovered in 1940}}

{{Distinguish|cannabinol|cannabinodiol}}

{{Use mdy dates|date=August 2024}}

{{cs1 config|name-list-style=vanc|display-authors=6}}

{{Infobox drug

| Verifiedfields = verified

| Watchedfields = verified

| verifiedrevid = 457636058

| image = Cannabidiol.svg

| width = 225

| alt =

| caption =

| width2 = 250

<!-- Clinical data -->| pronounce = {{IPAc-en|k|æ|.|n|ə|.|b|ə|.|ˈ|d|aɪ|.|əl}}

| tradename = Epidiolex, Epidyolex

| Drugs.com = {{drugs.com|monograph|cannabidiol}}

| MedlinePlus = a618051

| DailyMedID = Cannabidiol

| pregnancy_AU = B2

| pregnancy_AU_comment = <ref name="Epidyolex TGA">{{cite web | title=Epidyolex | website=Therapeutic Goods Administration (TGA) | date=September 29, 2020 | url=https://www.tga.gov.au/apm-summary/epidyolex | access-date=September 30, 2020 | archive-date=October 30, 2021 | archive-url=https://web.archive.org/web/20211030203454/https://www.tga.gov.au/apm-summary/epidyolex | url-status=live }}</ref>

| addiction_liability = None <ref name="fedreg-v">{{cite web |title=Schedules of Controlled Substances: Placement in Schedule V of Certain FDA-Approved Drugs Containing Cannabidiol; Corresponding Change to Permit Requirements|publisher=Federal Register, US Federal Government|url=https://www.federalregister.gov/documents/2018/09/28/2018-21121/schedules-of-controlled-substances-placement-in-schedule-v-of-certain-fda-approved-drugs-containing |date=September 28, 2018 |access-date=March 10, 2024}}</ref>

| routes_of_administration = [[By mouth]],<ref name="Epidiolex FDA label">{{cite web | title=Epidiolex – cannabidiol solution | website=DailyMed | date=August 26, 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec | access-date=September 11, 2020 | archive-date=February 25, 2021 | archive-url=https://web.archive.org/web/20210225194817/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec | url-status=live }}</ref> [[sublingual]], [[buccal administration|buccal]],<ref name="lipo">{{cite journal | vauthors = Itin C, Barasch D, Domb AJ, Hoffman A | title = Prolonged oral transmucosal delivery of highly lipophilic drug cannabidiol | journal = International Journal of Pharmaceutics | volume = 581 | pages = 119276 | date = May 2020 | pmid = 32243971 | doi = 10.1016/j.ijpharm.2020.119276 | s2cid = 214785913 }}</ref><ref name="MetaOpinion">{{cite journal | vauthors = Itin C, Domb AJ, Hoffman A | title = A meta-opinion: cannabinoids delivered to oral mucosa by a spray for systemic absorption are rather ingested into gastro-intestinal tract: the influences of fed / fasting states | journal = Expert Opinion on Drug Delivery | volume = 16 | issue = 10 | pages = 1031–1035 | date = October 2019 | pmid = 31393180 | doi = 10.1080/17425247.2019.1653852 | s2cid = 199505274 }}</ref><ref name="SativexLabel">{{cite web|url=https://omr.bayer.ca/omr/online/sativex-pm-en.pdf|title=Sativex (Cannabidiol/Tetrahydrocannabinol) Bayer Label|website=bayer.ca|access-date=June 28, 2018|archive-date=January 16, 2021|archive-url=https://web.archive.org/web/20210116114657/https://omr.bayer.ca/omr/online/sativex-pm-en.pdf|url-status=live}}</ref>[[inhalation]]

| class = [[Cannabinoid]]

| ATC_prefix = N03

| ATC_suffix = AX24

<!-- Legal status -->| legal_AU = S4

| legal_AU_comment =

| legal_BR = Synthetic: [[Brazilian Controlled Drugs and Substances Act#Class C3|C3]]; Oil with <0,2% THC: [[Brazilian Controlled Drugs and Substances Act#Class B1|B1]]; Oil <30mg/ml THC and <30mg/ml CBD: [[Brazilian Controlled Drugs and Substances Act#Class A3|A3]].

| legal_BR_comment = <ref>{{Cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=July 24, 2023 |title=RDC Nº 804 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 804 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-804-de-24-de-julho-de-2023-498447451 |url-status=live |archive-url=https://web.archive.org/web/20230827163149/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-804-de-24-de-julho-de-2023-498447451 |archive-date=August 27, 2023 |access-date=August 27, 2023 |publisher=[[Diário Oficial da União]] |language=pt-BR |publication-date=July 25, 2023}}</ref>

| legal_CA = Unscheduled

| legal_CA_comment =

| legal_DE = Anlage III <!-- Anlage I, II, III or Unscheduled -->

| legal_DE_comment =

| legal_NZ = Unscheduled <!-- Class A, B, C -->

| legal_NZ_comment =

| legal_UK = GSL

| legal_UK_comment = <ref name="Home Office"/>

| legal_US = Rx-only

| legal_US_comment = as Epidiolex.<ref name="Epidiolex FDA label"/> Unscheduled if derived from hemp with less than 0.3% Δ⁹-THC, otherwise [[Controlled Substances Act#Schedule I|Schedule I]].<ref>{{cite web | title=DEA announces steps necessary to improve access to marijuana research | website=DEA | date=26 August 2019 | url=https://www.dea.gov/press-releases/2019/08/26/dea-announces-steps-necessary-improve-access-marijuana-research | access-date=7 September 2024}}</ref><ref>{{cite web | title=7 U.S. Code § 1639o | website=LII / Legal Information Institute | url=https://www.law.cornell.edu/uscode/text/7/1639o | access-date=7 September 2024}}</ref><ref>{{cite web | last=Laurence | first=Emily | title=Your Guide To CBD Legalization By State | website=Forbes Health | date=31 May 2022 | url=https://www.forbes.com/health/cbd/cbd-legalization-by-state/ | access-date=7 September 2024}}</ref>

| legal_EU = Rx-only

| legal_EU_comment = <ref name="Epidyolex EPAR" /> and OTC in some member states

| legal_UN = Unscheduled<!-- N I, II, III, IV / P I, II, III, IV -->

| legal_UN_comment = {{cn|date=August 2024}}

| legal_status = Rx-only{{cn|date=August 2024}}

<!-- Pharmacokinetic data -->| bioavailability = {{ubl|[[Oral administration|Oral]]: 6% (fasted); 36–57% (fed-state)<ref name = Mechoulam2002>{{cite journal | vauthors = Perucca E, Bialer M | title = Critical Aspects Affecting Cannabidiol Oral Bioavailability and Metabolic Elimination, and Related Clinical Implications | journal = CNS Drugs | volume = 34 | issue = 8 | pages = 795–800 | date = June 5, 2020 | pmid = 32504461 | doi = 10.1007/s40263-020-00741-5 | s2cid = 219313952 }}</ref>|[[Inhalation]]: 31% (range 11–45%)<ref name=Scuderi2009>{{cite journal | vauthors = Scuderi C, Filippis DD, Iuvone T, Blasio A, Steardo A, Esposito G | title = Cannabidiol in medicine: a review of its therapeutic potential in CNS disorders | journal = Phytotherapy Research | volume = 23 | issue = 5 | pages = 597–602 | date = May 2009 | pmid = 18844286 | doi = 10.1002/ptr.2625 | url = https://zenodo.org/record/1067705 | type = Review | s2cid = 21836765 | access-date = May 22, 2020 | archive-date = April 11, 2021 | archive-url = https://web.archive.org/web/20210411045636/https://zenodo.org/record/1067705 | url-status = live }}</ref>}}

| protein_bound =

| metabolism =

| metabolites =

| onset =

| elimination_half-life = 18–32 hours<ref name=devinsky/>

| duration_of_action =

| excretion = <!-- Identifiers -->

| CAS_number_Ref = {{cascite|correct|CAS}}

| IUPHAR_ligand = 4150

| DrugBank = DB09061

| ChemSpiderID = 559095

| UNII_Ref = {{fdacite|correct|FDA}}

| KEGG_Ref =

| KEGG = D10915

| ChEBI_Ref = {{ebicite|correct|EBI}}

| ChEBI = 69478

| ChEMBL_Ref =

| ChEMBL =

| NIAID_ChemDB =

| PDB_ligand = P0T

| synonyms = CBD, cannabidiolum, (−)-cannabidiol<ref>{{cite web|url=https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:69478|title=cannabidiol (CHEBI:69478)|website=ebi.ac.uk|access-date=February 12, 2019|archive-date=May 12, 2021|archive-url=https://web.archive.org/web/20210512151607/https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:69478|url-status=live}}</ref>

<!-- Chemical data -->| IUPAC_name = 2-[(1''R'',6''R'')-6-Isopropenyl-3-methylcyclohex-2-en-1-yl]-5-pentylbenzene-1,3-diol

| C = 21

| H = 30

| O = 2

| SMILES = Oc1c(c(O)cc(c1)CCCCC)[C@@H]2\C=C(/CC[C@H]2\C(=C)C)C

| StdInChI_Ref = {PubChem}

| StdInChI = 1S/C21H30O2/c1-5-6-7-8-16-12-19(22)21(20(23)13-16)18-11-15(4)9-10-17(18)14(2)3/h11-13,17-18,22-23H,2,5-10H2,1,3-4H3/t17-,18+/m0/s1

| StdInChI_comment =

| StdInChIKey_Ref = {PubChem}

| StdInChIKey = QHMBSVQNZZTUGM-ZWKOTPCHSA-N

<!-- Physical data -->| density =

| density_notes =

| melting_high =

| melting_notes =

| boiling_point = 160-180

| boiling_notes = <ref name="projectcbd">{{cite web |url=https://www.projectcbd.org/sites/projectcbd/files/downloads/cannabinoid-boiling-points-thc-cbd.pdf |title=Phytocannabinoid Boiling Points |website=Project CBD |access-date=August 20, 2021 |url-status=live|archive-url=https://web.archive.org/web/20190408144226/https://www.projectcbd.org/sites/projectcbd/files/downloads/cannabinoid-boiling-points-thc-cbd.pdf |archive-date=April 8, 2019 }}</ref>{{Unreliable medical source|date=July 2024}}

| solubility = Insoluble

| sol_units =

| specific_rotation =

{{Cannabis sidebar}}

<!-- Definition and medical uses/non-uses -->

'''Cannabidiol''' ('''CBD''') is a [[phytocannabinoid]], one of 113 identified [[cannabinoid]]s in [[cannabis]] plants, along with [[tetrahydrocannabinol]] (THC), and accounts for up to 40% of the plant's extract.<ref name="pmid23108553" /> Medically, it is an [[anticonvulsant]] used to treat multiple forms of [[epilepsy]].<ref name="Epidiolex FDA label" /> It was discovered in 1940 and, {{as of|2022|lc=y}}, clinical research on CBD included studies related to the treatment of [[anxiety]], [[addiction]], [[psychosis]], [[movement disorders]], and [[pain]], but there is insufficient [[evidence-based medicine|high-quality evidence]] that CBD is effective for these conditions.<ref name="kirkland">{{cite journal |vauthors=Kirkland AE, Fadus MC, Gruber SA, Gray KM, Wilens TE, Squeglia LM |title=A scoping review of the use of cannabidiol in psychiatric disorders |journal=Psychiatry Research |volume=308 |issue= |pages=114347 |date=February 2022 |pmid=34952255 |pmc=8799523 |doi=10.1016/j.psychres.2021.114347}}</ref><ref name="black">{{cite journal | vauthors = Black N, Stockings E, Campbell G, Tran LT, Zagic D, Hall WD, Farrell M, Degenhardt L | title = Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis | journal = The Lancet. Psychiatry | volume = 6 | issue = 12 | pages = 995–1010 | date = December 2019 | pmid = 31672337 | pmc = 6949116 | doi = 10.1016/S2215-0366(19)30401-8 }}</ref><ref name="mayo">{{cite journal | vauthors = VanDolah HJ, Bauer BA, Mauck KF | title = Clinicians' Guide to Cannabidiol and Hemp Oils | journal = Mayo Clinic Proceedings | volume = 94 | issue = 9 | pages = 1840–1851 | date = September 2019 | pmid = 31447137 | doi = 10.1016/j.mayocp.2019.01.003 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Prud'homme M, Cata R, Jutras-Aswad D | title = Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence | journal = Substance Abuse | volume = 9 | pages = 33–38 | date = January 2015 | pmid = 26056464 | pmc = 4444130 | doi = 10.4137/SART.S25081 }}</ref> CBD is sold as an herbal [[dietary supplement]] and promoted with yet unproven claims of particular therapeutic effects.<ref name=sbm/>

<!-- Administration and effects -->

Cannabidiol can be [[route of administration|taken internally]] in multiple ways, including by [[Route of administration#Inhalation|inhaling]] cannabis [[cannabis smoking|smoke]] or [[vaporizer (inhalation device)|vapor]], [[Oral administration|swallowing it by mouth]], and through use of an [[aerosol spray]] into the [[buccal administration|cheek]].<ref name="lipo" /><ref name="MetaOpinion" /> It may be supplied as CBD oil containing only CBD as the active ingredient (excluding THC or [[terpene]]s), CBD-dominant [[hemp]] [[Chemical extraction|extract]] oil, capsules, dried cannabis, or prescription liquid [[Solution (chemistry)|solution]].<ref name="Epidiolex FDA label" /><ref name=mayo/> CBD does not have the same [[Psychoactive drug|psychoactivity]] as [[Tetrahydrocannabinol|THC]],<ref name="pmid28232276" /><ref name="Iseger2015">{{cite journal | vauthors = Iseger TA, Bossong MG | title = A systematic review of the antipsychotic properties of cannabidiol in humans | journal = Schizophrenia Research | volume = 162 | issue = 1–3 | pages = 153–161 | date = March 2015 | pmid = 25667194 | doi = 10.1016/j.schres.2015.01.033 | s2cid = 3745655 }}</ref> and can modulate the psychoactive effects of THC on the body if both are present.<ref name="pmid23108553">{{cite journal | vauthors = Campos AC, Moreira FA, Gomes FV, Del Bel EA, Guimarães FS | title = Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders | journal = Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences | volume = 367 | issue = 1607 | pages = 3364–3378 | date = December 2012 | pmid = 23108553 | pmc = 3481531 | doi = 10.1098/rstb.2011.0389 | type = Review }}</ref><ref name="pmid28232276">{{cite journal | vauthors = Pisanti S, Malfitano AM, Ciaglia E, Lamberti A, Ranieri R, Cuomo G, Abate M, Faggiana G, Proto MC, Fiore D, Laezza C, Bifulco M | title = Cannabidiol: State of the art and new challenges for therapeutic applications | journal = Pharmacology & Therapeutics | volume = 175 | pages = 133–150 | date = July 2017 | pmid = 28232276 | doi = 10.1016/j.pharmthera.2017.02.041 }}</ref><ref name="Boggs">{{cite journal | vauthors = Boggs DL, Nguyen JD, Morgenson D, Taffe MA, Ranganathan M | title = Clinical and Preclinical Evidence for Functional Interactions of Cannabidiol and Δ{{sup|9}}-Tetrahydrocannabinol | journal = Neuropsychopharmacology | volume = 43 | issue = 1 | pages = 142–154 | date = January 2018 | pmid = 28875990 | pmc = 5719112 | doi = 10.1038/npp.2017.209 }}</ref><ref name="pmid26836472">{{cite journal | vauthors = Aizpurua-Olaizola O, Soydaner U, Öztürk E, Schibano D, Simsir Y, Navarro P, Etxebarria N, Usobiaga A | title = Evolution of the Cannabinoid and Terpene Content during the Growth of Cannabis sativa Plants from Different Chemotypes | journal = Journal of Natural Products | volume = 79 | issue = 2 | pages = 324–331 | date = February 2016 | pmid = 26836472 | doi = 10.1021/acs.jnatprod.5b00949 | hdl = 1874/350973 | url = https://figshare.com/articles/journal_contribution/5028338 | access-date = November 27, 2022 | archive-date = January 5, 2023 | archive-url = https://web.archive.org/web/20230105025827/https://figshare.com/articles/journal_contribution/Evolution_of_the_Cannabinoid_and_Terpene_Content_during_the_Growth_of_Cannabis_sativa_Plants_from_Different_Chemotypes/5028338 | url-status = live }}</ref> [[Conversion of CBD to THC]] can occur when CBD is heated to temperatures between 250–300 °C, potentially leading to its partial transformation into THC.<ref name = "Czégény_2021">{{cite journal | vauthors = Czégény Z, Nagy G, Babinszki B, Bajtel Á, Sebestyén Z, Kiss T, Csupor-Löffler B, Tóth B, Csupor D | title = CBD, a precursor of THC in e-cigarettes | journal = Scientific Reports | volume = 11 | issue = 1 | pages = 8951 | date = April 2021 | pmid = 33903673 | pmc = 8076212 | doi = 10.1038/s41598-021-88389-z | bibcode = 2021NatSR..11.8951C }}</ref>

<!-- Regulation, control, pharmaceutical -->

In the United States, the cannabidiol drug '''Epidiolex''' was approved by the [[Food and Drug Administration]] (FDA) in 2018 for the treatment of two [[epilepsy|seizure disorders]].<ref name="Epidiolex FDA label" /> While the [[2018 United States farm bill|2018 United States Farm Bill]] removed hemp and hemp extracts (including CBD) from the [[Controlled Substances Act#Schedule I controlled substances|Controlled Substances Act]], the marketing and sale of CBD formulations for medical use or as an ingredient in dietary supplements or manufactured foods remains illegal under FDA regulation, {{as of|2024|lc=y}}.<ref name="Mead 2019">{{cite journal | vauthors = Mead A | title = Legal and Regulatory Issues Governing Cannabis and Cannabis-Derived Products in the United States | journal = Frontiers in Plant Science | volume = 10 | pages = 697 | date = June 14, 2019 | pmid = 31263468 | pmc = 6590107 | doi = 10.3389/fpls.2019.00697 | doi-access = free }}</ref><ref name="fdareg-hemp">{{cite web |title=FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). #2. How does the 2018 Farm Bill define hemp? What does it mean for FDA-regulated products? |url=https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd |publisher=US [[Food and Drug Administration]] (FDA) |access-date=February 6, 2024 |date=February 6, 2024}}</ref>

{{TOC limit}}

==Medical uses==

===Epilepsy===

{{See also|Charlotte's Web (cannabis)}}

In the United States, the FDA has [[Indication (medicine)|indicated]] only one brand of prescription cannabidiol called Epidiolex for the treatment of seizures associated with [[Dravet syndrome]], [[Lennox–Gastaut syndrome]], or [[Tuberous sclerosis|tuberous sclerosis complex]] in people one year of age and older.<ref name="Epidiolex FDA label" /><ref name="Office of the Commissioner_2020" /><ref name=stockings>{{cite journal | vauthors = Stockings E, Zagic D, Campbell G, Weier M, Hall WD, Nielsen S, Herkes GK, Farrell M, Degenhardt L | title = Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence | journal = Journal of Neurology, Neurosurgery, and Psychiatry | volume = 89 | issue = 7 | pages = 741–753 | date = July 2018 | pmid = 29511052 | doi = 10.1136/jnnp-2017-317168 | doi-access = free | hdl = 1959.4/unsworks_50076 | hdl-access = free }}</ref><ref name="Elliott">{{cite journal | vauthors = Elliott J, DeJean D, Clifford T, Coyle D, Potter BK, Skidmore B, Alexander C, Repetski AE, Shukla V, McCoy B, Wells GA | title = Cannabis-based products for pediatric epilepsy: An updated systematic review | journal = Seizure | volume = 75 | pages = 18–22 | date = February 2020 | pmid = 31865133 | doi = 10.1016/j.seizure.2019.12.006 | s2cid = 208878465 | doi-access = free }}</ref> While Epidiolex treatment is generally well tolerated, it is associated with minor adverse effects, such as [[gastrointestinal disease|gastrointestinal upset]], [[decreased appetite]], [[lethargy]], [[sleepiness]], and poor sleep quality.<ref name="Epidiolex FDA label"/><ref name=stockings/><ref>{{Cite journal |date=June 26, 2018 |title=Cannabis derivative may reduce seizures in some severe drug-resistant epilepsies, but adverse events increase |url=https://evidence.nihr.ac.uk/alert/cannabis-derivative-may-reduce-seizures-in-some-severe-drug-resistant-epilepsies-but-adverse-events-increase |journal=NIHR Evidence |type=Plain English summary |doi=10.3310/signal-000606 |s2cid=242083755 |access-date=March 15, 2022 |archive-date=July 24, 2021 |archive-url=https://web.archive.org/web/20210724033322/https://evidence.nihr.ac.uk/alert/cannabis-derivative-may-reduce-seizures-in-some-severe-drug-resistant-epilepsies-but-adverse-events-increase/ |url-status=live }}</ref><ref name=Elliott/>

In the European Union, '''Epidyolex''' is indicated for use as adjunctive therapy of seizures associated with Lennox–Gastaut syndrome or Dravet syndrome, in conjunction with [[clobazam]], for people two years of age and older.<ref name="Epidyolex EPAR">{{cite web | title=Epidyolex EPAR | website=[[European Medicines Agency]] (EMA) | date=June 24, 2019 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/epidyolex | access-date=September 11, 2020 | archive-date=August 9, 2021 | archive-url=https://web.archive.org/web/20210809152037/https://www.ema.europa.eu/en/medicines/human/EPAR/epidyolex | url-status=live }} Text was copied from this source which is copyrighted by the European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</ref> In 2020, the label for Epidiolex in the US was expanded to include seizures associated with tuberous sclerosis complex. Epidiolex/Epidyolex is the first prescription formulation of plant-derived cannabidiol approved by regulatory bodies in the US and Europe.<ref>{{Cite web|author=Office of the Commissioner|date=March 27, 2020|title=FDA Approves First Drug {{sic|Comprised |hide=y|of}} an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy|url=https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms|access-date=May 28, 2021|website=FDA|language=en|archive-date=April 23, 2019|archive-url=https://web.archive.org/web/20190423071605/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm611046.htm|url-status=live}}</ref>

===Other uses===

Research on other uses for cannabidiol includes several [[Neurological disorder|neurological disorders]], but the findings have not been confirmed to establish such uses in clinical practice.<ref name="devinsky">{{cite journal | vauthors = Devinsky O, Cilio MR, Cross H, Fernandez-Ruiz J, French J, Hill C, Katz R, Di Marzo V, Jutras-Aswad D, Notcutt WG, Martinez-Orgado J, Robson PJ, Rohrback BG, Thiele E, Whalley B, Friedman D | title = Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders | journal = Epilepsia | volume = 55 | issue = 6 | pages = 791–802 | date = June 2014 | pmid = 24854329 | pmc = 4707667 | doi = 10.1111/epi.12631 }}</ref><ref name=black/><ref name=mayo/><ref name="pmid28232276" /><ref name="prud">{{cite journal | vauthors = Prud'homme M, Cata R, Jutras-Aswad D | title = Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence | journal = Substance Abuse | volume = 9 | pages = 33–38 | year = 2015 | pmid = 26056464 | pmc = 4444130 | doi = 10.4137/SART.S25081 }}</ref><ref>{{cite journal | vauthors = Silva TB, Balbino CQ, Weiber AF | title = The relationship between cannabidiol and psychosis: A review | journal = Annals of Clinical Psychiatry | volume = 27 | issue = 2 | pages = 134–141 | date = May 2015 | pmid = 25954940 }}</ref><ref name="Blessing_2015">{{cite journal | vauthors = Blessing EM, Steenkamp MM, Manzanares J, Marmar CR | title = Cannabidiol as a Potential Treatment for Anxiety Disorders | journal = Neurotherapeutics | volume = 12 | issue = 4 | pages = 825–836 | date = October 2015 | pmid = 26341731 | pmc = 4604171 | doi = 10.1007/s13311-015-0387-1 }}</ref> In October 2019, the FDA issued an advisory warning that the effects of CBD during pregnancy or [[breastfeeding]] are unknown, indicating that the safety, doses, interactions with other drugs or foods, and [[side effect]]s of CBD are not [[evidence-based medicine|clinically defined]], and may pose a risk to the mother and infant.<ref>{{cite web |title=What You Should Know About Using Cannabis, Including CBD, When Pregnant or Breastfeeding |url=https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about-using-cannabis-including-cbd-when-pregnant-or-breastfeeding |publisher=US [[Food and Drug Administration]] (FDA) |access-date=October 17, 2019 |date=October 16, 2019 |archive-date=October 17, 2019 |archive-url=https://web.archive.org/web/20191017212718/https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about-using-cannabis-including-cbd-when-pregnant-or-breastfeeding |url-status=live }}</ref>

Many claims are made for the therapeutic benefit of cannabidiol that are not backed by sound evidence. Some claims, such as treatment of [[cancer]], are [[pseudoscience]].<ref name=sbm>{{cite web |publisher=[[Science-Based Medicine]] |vauthors=Novella S |author-link=Steven Novella |title=Where Are We With CBD? |url=https://sciencebasedmedicine.org/where-are-we-with-cbd/ |date=September 30, 2020 |access-date=October 1, 2020 |archive-date=August 12, 2021 |archive-url=https://web.archive.org/web/20210812120451/https://sciencebasedmedicine.org/where-are-we-with-cbd/ |url-status=live }}</ref>

In 2020, the label for Epidiolex in the US was expanded to include treatment of seizures associated with [[tuberous sclerosis]].<ref name="Office of the Commissioner_2020">{{Cite web|author=Office of the Commissioner|date=July 31, 2020|title=FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease|url=https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare|access-date=November 25, 2020|website=FDA|language=en|archive-date=September 29, 2021|archive-url=https://web.archive.org/web/20210929230838/https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare|url-status=live}}</ref>

Acclaimed for relieving [[chronic pain]], some researchers conclude that the evidence is insufficient to determine the effectiveness of CBD in pain relief, primarily due to the challenging access to pure CBD.<ref>{{cite journal | vauthors = Villanueva MR, Joshaghani N, Villa N, Badla O, Goit R, Saddik SE, Dawood SN, Rabih AM, Niaj A, Raman A, Uprety M, Calero M, Khan S | title = Efficacy, Safety, and Regulation of Cannabidiol on Chronic Pain: A Systematic Review | journal = Cureus | volume = 14 | issue = 7 | pages = e26913 | date = July 2022 | pmid = 35860716 | pmc = 9288157 | doi = 10.7759/cureus.26913 | doi-access = free }}</ref>

CBD oil is used for massage therapy as a substitute for body oil and for its health benefits.<ref>{{Cite web |date=2020-02-28 |title=Experience best massage - CBD Oil - body health benefits |url=https://thailotusbodywork.com/articles/massage-with-cbd-oil/ |access-date=2024-10-22 |language=en-US}}</ref>

===Non-intoxicating effects===

Cannabidiol does not appear to have any [[Substance intoxication|intoxicating]] effects<ref>{{cite journal | vauthors = Kicman A, Toczek M | title = The Effects of Cannabidiol, a Non-Intoxicating Compound of Cannabis, on the Cardiovascular System in Health and Disease | journal = International Journal of Molecular Sciences | volume = 21 | issue = 18 | page = 6740 | date = September 2020 | pmid = 32937917 | pmc = 7554803 | doi = 10.3390/ijms21186740 | doi-access = free }}</ref> such as those caused by ∆{{sup|9}}-THC in cannabis, but it is under preliminary research for its possible [[anti-anxiety|anxiolytic]] and [[anti-psychotic|antipsychotic]] effects.<ref name=black/><ref name=mayo/><ref name=Iseger2015/> As the legal landscape and understanding about the differences in medical cannabinoids unfolds, experts are working to distinguish "medical cannabis" (with varying degrees of psychotropic effects and deficits in executive function) from "medical CBD therapies", which would commonly present as having a reduced or non-psychoactive side-effect profile.<ref name=mayo/><ref name="Iseger2015" /><ref>{{cite journal | vauthors = Sachs J, McGlade E, Yurgelun-Todd D | title = Safety and Toxicology of Cannabinoids | journal = Neurotherapeutics | volume = 12 | issue = 4 | pages = 735–746 | date = October 2015 | pmid = 26269228 | pmc = 4604177 | doi = 10.1007/s13311-015-0380-8 }}</ref>

Various strains of "medical cannabis" are found to have a significant variation in the ratios of CBD-to-THC and are known to contain other non-psychotropic cannabinoids.<ref name="pmid19729208">{{cite journal | vauthors = Izzo AA, Borrelli F, Capasso R, Di Marzo V, Mechoulam R | title = Non-psychotropic plant cannabinoids: new therapeutic opportunities from an ancient herb | journal = Trends in Pharmacological Sciences | volume = 30 | issue = 10 | pages = 515–527 | date = October 2009 | pmid = 19729208 | doi = 10.1016/j.tips.2009.07.006 }}</ref> Any psychoactive cannabis, regardless of its CBD content, is derived from the flower (or bud) of the genus ''Cannabis''. As defined by US federal law, non-psychoactive hemp (also commonly termed "[[industrial hemp]]"), regardless of its CBD content, is any part of the cannabis plant, whether growing or not, containing a ∆{{sup|9}}-[[tetrahydrocannabinol]] concentration of no more than 0.3% on a dry-weight basis.<ref name="col">{{cite web|date=2018|title=Industrial hemp|url=https://www.colorado.gov/pacific/agplants/industrial-hemp|access-date=September 14, 2018|publisher=Department of Agriculture, State of Colorado|archive-date=August 26, 2018|archive-url=https://web.archive.org/web/20180826025810/https://www.colorado.gov/pacific/agplants/industrial-hemp|url-status=live}}</ref> In the United States, certain standards are required for legal growing, cultivating, and producing the hemp plant, but there are no federal standards for quality being enforced in the hemp industry. Certain state regulations are in place, but vary state to state.<ref>{{Cite web|title=Cannabinoid Clinical {{!}} Cannabinoids Research, Effects, and Uses|url=https://www.cannabinoidclinical.com/fda-regulation-cannabinoids|access-date=October 27, 2020|website=CannabinoidClinical.com|language=en|archive-date=June 26, 2021|archive-url=https://web.archive.org/web/20210626065243/https://www.cannabinoidclinical.com/fda-regulation-cannabinoids|url-status=live}}</ref> For instance, the Colorado Industrial Hemp Program registers growers of industrial hemp and samples crops to verify that the dry-weight THC concentration does not exceed 0.3%.<ref name=col/>

===Available forms===

CBD is present as an active constituent of [[cannabis (drug)|cannabis]], which is used both recreationally and medically.

[[Nabiximols]] (brand name Sativex), an oromucosal spray made of a complex botanical mixture containing cannabidiol (CBD), delta-9-tetrahydrocannabinol (THC), and additional cannabinoid and non-cannabinoid constituents from cannabis sativa plants, was approved by Health Canada in 2005, to treat central [[neuropathic pain]] in [[multiple sclerosis]], and in 2007, for cancer-related pain.<ref name="ReferenceA">{{cite journal | vauthors = Russo EB | title = Cannabinoids in the management of difficult to treat pain | journal = Therapeutics and Clinical Risk Management| volume = 4 | issue = 1 | pages = 245–259 | date = February 2008 | pmid = 18728714 | pmc = 2503660 | doi = 10.2147/TCRM.S1928 | doi-access = free }}</ref> In New Zealand, Sativex is "approved for use as an add-on treatment for symptom improvement in people with moderate to severe spasticity due to multiple sclerosis who have not responded adequately to other anti-spasticity medication."<ref>{{cite web|url=https://medsafe.govt.nz/profs/RIss/Sativex/Sativex.asp|title=Sativex Oromucosal Spray|publisher=Medsafe, New Zealand Medicines and Medical Devices Safety Authority|date=December 19, 2018|access-date=April 3, 2019|archive-date=July 27, 2020|archive-url=https://web.archive.org/web/20200727071731/https://medsafe.govt.nz/profs/RIss/Sativex/Sativex.asp}}</ref>

Epidiolex (''Epidyolex'' in Europe) is an orally administered cannabidiol solution.<ref name="Epidiolex FDA label"/><ref name="Epidyolex EPAR"/> It was approved in 2018 for treatment of two rare forms of childhood epilepsy, [[Lennox–Gastaut syndrome]] and [[Dravet syndrome]], and seizures associated with tuberous sclerosis complex.<ref name="Epidiolex FDA label"/><ref name="Epidyolex EPAR"/> In the US, it is approved in these indications for people one year of age and older.<ref name="Epidiolex FDA label"/>

==Side effects==

Research indicates that cannabidiol may reduce adverse effects of THC, particularly those causing [[Cannabis intoxication|intoxication]] and [[sedation]], but only at high doses.<ref name="fischer">{{cite journal | vauthors = Fischer B, Russell C, Sabioni P, van den Brink W, Le Foll B, Hall W, Rehm J, Room R | title = Lower-Risk Cannabis Use Guidelines: A Comprehensive Update of Evidence and Recommendations | journal = American Journal of Public Health | volume = 107 | issue = 8 | pages = e1–e12 | date = August 2017 | pmid = 28644037 | pmc = 5508136 | doi = 10.2105/AJPH.2017.303818 |doi-access=free}}</ref> Safety studies of cannabidiol showed it is well tolerated, but may cause [[fatigue]], [[somnolence]], sedation, [[diarrhea]], or changes in appetite as common adverse effects, with the most common being somnolence and sedation. Side effects of CBD are dose related.<ref name="Huestis Solimini Pichini Pacifici pp. 974–989">{{cite journal | vauthors = Huestis MA, Solimini R, Pichini S, Pacifici R, Carlier J, Busardò FP | title = Cannabidiol Adverse Effects and Toxicity | journal = Current Neuropharmacology | volume = 17 | issue = 10 | pages = 974–989 | date = September 13, 2019 | pmid = 31161980 | doi = 10.2174/1570159x17666190603171901 | publisher = Bentham Science Publishers Ltd. | pmc = 7052834 }}</ref> Epidiolex documentation lists sleepiness, [[insomnia]] and poor quality sleep, decreased appetite, diarrhea, and fatigue.<ref name="Epidiolex FDA label" /><ref>{{Cite web|title=Cannabidiol (CBD): MedlinePlus Supplements|url=https://medlineplus.gov/druginfo/natural/1439.html|access-date=January 15, 2021|website=medlineplus.gov|language=en|archive-date=October 20, 2021|archive-url=https://web.archive.org/web/20211020055709/https://medlineplus.gov/druginfo/natural/1439.html|url-status=live}}</ref>

In November 2019, the FDA issued concerns about the safety of cannabidiol, stating that CBD use has potential to cause [[hepatotoxicity]], interfere with the mechanisms of [[prescription drug]]s, produce [[gastrointestinal disorder]]s, or affect [[alertness]] and [[mood (psychology)|mood]].<ref name="fda11-26-19" /> Over 2020–23, the FDA updated its safety concerns about CBD,<ref name="fdareg">{{cite web |title=FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD)|url=https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd |publisher=US [[Food and Drug Administration]] (FDA) |access-date=October 29, 2023 |date=September 28, 2023}}</ref> acknowledging the unknown effects of protracted use, how it affects the developing brain, fetus, or infants during breastfeeding, whether it interacts with [[dietary supplement]]s or [[prescription drug]]s, whether [[male fertility]] is affected, and its possible [[side effect]]s, such as [[Somnolence|drowsiness]].<ref name="hahn">{{cite web |vauthors=Hahn SM |author-link1=Stephen Hahn (oncologist) |title=FDA Advances Work Related to Cannabidiol Products with Focus on Protecting Public Health, Providing Market Clarity |url=https://www.fda.gov/news-events/press-announcements/fda-advances-work-related-cannabidiol-products-focus-protecting-public-health-providing-market |publisher=US Food and Drug Administration |access-date=March 6, 2020 |date=March 5, 2020 |archive-date=September 29, 2021 |archive-url=https://web.archive.org/web/20210929230626/https://www.fda.gov/news-events/press-announcements/fda-advances-work-related-cannabidiol-products-focus-protecting-public-health-providing-market |url-status=live }}</ref>

{{As of|September 2019}}, 1,085 people contacted US [[poison control center]]s about CBD-induced illnesses, doubling the number of cases over the 2018 rate and increasing by 9 times the case numbers of 2017.<ref name="pcc">{{cite web|date=September 30, 2019|title=Cannabidiol (CBD)|url=https://aapcc.org/CBD-Alert|access-date=October 17, 2019|publisher=American Association of Poison Control Centers|archive-date=October 17, 2019|archive-url=https://web.archive.org/web/20191017161650/https://aapcc.org/CBD-Alert|url-status=live}}</ref> Of cases reported in 2019, more than 33% received medical attention and 46 people were admitted to a hospital [[intensive care unit]], possibly due to exposure to other products, or drug interactions with CBD.<ref name="dawn" />

In 2022, the FDA stated that "scientific studies show possible harm to the male reproductive system, including testicular atrophy, harm to the liver, and interactions with certain medications. The FDA has not found adequate information showing how much CBD can be consumed, and for how long, before causing harm. This is particularly true for vulnerable populations like children and those who are pregnant."<ref name=fda11-22/>

==Interactions==

Laboratory evidence indicated that cannabidiol may reduce THC [[Clearance (pharmacology)|clearance]], increasing plasma concentrations which may raise THC availability to [[receptor (biochemistry)|receptors]] and enhance its effect in a [[Dose–response relationship|dose-dependent manner]].<ref name="pmid7493549">{{cite journal | vauthors = Bornheim LM, Kim KY, Li J, Perotti BY, Benet LZ | title = Effect of cannabidiol pretreatment on the kinetics of tetrahydrocannabinol metabolites in mouse brain | journal = Drug Metabolism and Disposition | volume = 23 | issue = 8 | pages = 825–831 | date = August 1995 | pmid = 7493549 }}</ref><ref name="pmid21667074">{{cite journal | vauthors = Klein C, Karanges E, Spiro A, Wong A, Spencer J, Huynh T, Gunasekaran N, Karl T, Long LE, Huang XF, Liu K, Arnold JC, McGregor IS | title = Cannabidiol potentiates Δ⁹-tetrahydrocannabinol (THC) behavioural effects and alters THC pharmacokinetics during acute and chronic treatment in adolescent rats | journal = Psychopharmacology | volume = 218 | issue = 2 | pages = 443–457 | date = November 2011 | pmid = 21667074 | doi = 10.1007/s00213-011-2342-0 | s2cid = 6240926 }}</ref> ''[[In vitro]]'', cannabidiol inhibited the activity of [[Voltage-dependent ion channel|voltage-dependent]] [[Voltage-gated sodium channel|sodium]] and [[Voltage-gated potassium channel|potassium]] channels, which may affect neural activity.<ref name="Ghovanloo_2018">{{cite journal | vauthors = Ghovanloo MR, Shuart NG, Mezeyova J, Dean RA, Ruben PC, Goodchild SJ | title = Inhibitory effects of cannabidiol on voltage-dependent sodium currents | journal = The Journal of Biological Chemistry | volume = 293 | issue = 43 | pages = 16546–16558 | date = October 2018 | pmid = 30219789 | pmc = 6204917 | doi = 10.1074/jbc.RA118.004929 | doi-access = free }}</ref> A recent study using X-ray crystallography showed that CBD binds inside the sodium channel pore at a novel site at the interface of the fenestrations and the central hydrophobic cavity of the channel. Binding at this site blocks the transmembrane-spanning sodium ion translocation pathway, providing a molecular mechanism for channel inhibition, which could contribute to a reduced excitability.<ref name="Sait_2020">{{cite journal | vauthors = Sait LG, Sula A, Ghovanloo MR, Hollingworth D, Ruben PC, Wallace BA | title = Cannabidiol interactions with voltage-gated sodium channels | journal = eLife | volume = 9 | date = October 2020 | pmid = 33089780 | pmc = 7641581 | doi = 10.7554/eLife.58593 | doi-access = free }}</ref> A small [[clinical trial]] reported that CBD partially inhibited the [[CYP2C]]-catalyzed [[hydroxylation]] of THC to [[11-OH-THC]].<ref name="Nadulski_2005">{{cite journal | vauthors = Nadulski T, Pragst F, Weinberg G, Roser P, Schnelle M, Fronk EM, Stadelmann AM | title = Randomized, double-blind, placebo-controlled study about the effects of cannabidiol (CBD) on the pharmacokinetics of Delta9-tetrahydrocannabinol (THC) after oral application of THC verses standardized cannabis extract | journal = Therapeutic Drug Monitoring | volume = 27 | issue = 6 | pages = 799–810 | date = December 2005 | pmid = 16306858 | doi = 10.1097/01.ftd.0000177223.19294.5c | s2cid = 12979224 }}</ref> Little is known about potential drug interactions, but CBD mediates a decrease in [[clobazam]] metabolism.<ref name="Lucas_2018">{{cite journal | vauthors = Lucas CJ, Galettis P, Schneider J | title = The pharmacokinetics and the pharmacodynamics of cannabinoids | journal = British Journal of Clinical Pharmacology | volume = 84 | issue = 11 | pages = 2477–2482 | date = November 2018 | pmid = 30001569 | pmc = 6177698 | doi = 10.1111/bcp.13710 }}</ref> Work with human liver microsomes shows that cannabidiol inhibits [[CYP3A5]] and [[CYP3A4]] to some degree.<ref>{{cite journal | vauthors = Yamaori S, Ebisawa J, Okushima Y, Yamamoto I, Watanabe K | title = Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety | journal = Life Sciences | volume = 88 | issue = 15–16 | pages = 730–736 | date = April 2011 | pmid = 21356216 | doi = 10.1016/j.lfs.2011.02.017 }}</ref>

==Pharmacology==

===Pharmacodynamics===

''[[In vitro]]'', cannabidiol has low [[affinity (pharmacology)|affinity]] for, and acts as a [[negative allosteric modulator]] of the [[Cannabinoid receptor type 1|CB{{sub|1}}]] [[cannabinoid receptor]]<ref>{{Cite journal |title=Cannabidiol is a negative allosteric modulator of the cannabinoid CB1 receptor |date=2015 |pmc=4621983 |journal=British Journal of Pharmacology |volume=172 |issue=20 |pages=4790–4805 |doi=10.1111/bph.13250 |pmid=26218440 | vauthors = Laprairie RB, Bagher AM, Kelly ME, Denovan-Wright EM }}</ref><ref>{{Cite journal |title=Allosteric Modulation: An Alternate Approach Targeting the Cannabinoid CB1 Receptor |journal= Medicinal Research Reviews|date=2016 |pmc=5397374 |volume=37 |issue=3 |pages=441–474 |doi=10.1002/med.21418 |pmid=27879006 | vauthors = Nguyen T, Li JX, Thomas BF, Wiley JL, Kenakin TP, Zhang Y }}</ref>

Cannabidiol may be an antagonist of [[GPR55]], a [[G protein-coupled receptor]] and putative non-homologous CB₃ cannabinoid receptor shown by ''in vitro'' studies to be widely distributed in the brain.<ref name=schouten/><ref name="drugs">{{cite web |date=July 14, 2023 |title=Cannabidiol |url=https://www.drugs.com/npp/cannabidiol.html |access-date=February 12, 2024 |publisher=Drugs.com}}</ref><ref>{{cite journal | vauthors = Gray RA, Whalley BJ | title = The proposed mechanisms of action of CBD in epilepsy | journal = Epileptic Disorders | volume = 22 | issue = S1 | pages = 10–15 | date = January 2020 | doi = 10.1684/epd.2020.1135 | pmid = 32053110| doi-access = free }}</ref> Cannabidiol may interact with various [[neurotransmitter]]s, such as [[serotonin]], [[dopamine]], and [[GABA]].<ref name=schouten/><ref name=drugs/><ref name="PMID33384591">{{cite journal | vauthors = Martínez-Aguirre C, et al | title = Cannabidiol Acts at 5-HT1A Receptors in the Human Brain: Relevance for Treating Temporal Lobe Epilepsy | journal = Front. Behav. Neurosci. | volume = 14 | date = December 2020 | page = 611278 | pmid = 33384591 | doi = 10.3389/fnbeh.2020.611278 | pmc = 7770178 | doi-access = free }}</ref>

As of 2024, the cellular effects and mechanisms of cannabidiol ''[[in vivo]]'' are unknown,<ref name="Epidiolex FDA label"/><ref name="Epidyolex EPAR"/> as research to date has been inconclusive and based on laboratory studies.<ref name="schouten">{{cite journal |vauthors=Schouten M, Dalle S, Mantini D, Koppo K |title=Cannabidiol and brain function: current knowledge and future perspectives |journal=Frontiers in Pharmacology |volume=14 |issue= |pages=1328885 |date=2023 |pmid=38288087 |pmc=10823027 |doi=10.3389/fphar.2023.1328885|doi-access=free}}</ref> The [[anticonvulsant]] effects provided by cannabidiol (Epidiolex) in people with certain forms of [[epilepsy]] do not appear to involve [[cannabinoid receptor]]s.<ref name="Epidiolex FDA label"/> A possible mechanism for the effects of cannabidiol on seizures is by affecting the [[neuron|neuronal]] movement of [[calcium]] in brain structures involved in the excessive electrical activity of [[Seizure|seizures]].<ref name="Epidyolex EPAR"/>

===Pharmacokinetics===

The [[oral administration|oral]] [[bioavailability]] of cannabidiol is approximately 6% in fasting state and 36.5—57.3% in fed-state<ref name="Kolli_2024" /> in humans, while its bioavailability via [[inhalation]] is 11 to 45% (mean 31%).<ref name="Mechoulam2002" /><ref name="Scuderi2009" /><ref name="Kolli_2024">{{cite journal | vauthors = Kolli AR, Hoeng J | title = Cannabidiol Bioavailability Is Nonmonotonic with a Long Terminal Elimination Half-Life: A Pharmacokinetic Modeling-Based Analysis | journal = Cannabis and Cannabinoid Research | date = April 2024 | pmid = 38624257 | doi = 10.1089/can.2023.0214 }}</ref><ref name="O'Sullivan_2024">{{cite journal | vauthors = O'Sullivan SE, Jensen SS, Kolli AR, Nikolajsen GN, Bruun HZ, Hoeng J | title = Strategies to Improve Cannabidiol Bioavailability and Drug Delivery | journal = Pharmaceuticals | volume = 17 | issue = 2 | pages = 244 | date = February 2024 | pmid = 38399459 | pmc = 10892205 | doi = 10.3390/ph17020244 | publisher = MDPI | doi-access = free }}</ref> The oral bioavailability of cannabidiol varies based on several factors such as formulation,<ref name="O'Sullivan_2024" /> dose, and food intake.<ref name="Kolli_2024" /> The [[elimination half-life]] of cannabidiol in blood is 56 to 61 hours after oral doses twice per day over 7 days.<ref name="Epidiolex FDA label"/> Based on the pharmacokinetic analysis of long-term dosing of cannabidiol in humans, the terminal elimination half-life is estimated to be >134 h.<ref name="Kolli_2024" /> Cannabidiol is [[metabolism|metabolized]] in the [[liver]] as well as in the [[intestine]]s by [[cytochrome P450]] enzymes.<ref name="Epidiolex FDA label"/><ref name=drugs/>

==Chemistry==

{{See also|Conversion of CBD to THC}}

At room temperature, cannabidiol is a colorless crystalline solid.<ref>{{cite journal | vauthors = Jones PG, Falvello L, Kennard O, Sheldrick GM, Mechoulam R | title = Cannabidiol | journal = Acta Crystallogr. B | volume = 33 | pages = 3211–3214 | year = 1977 | doi = 10.1107/S0567740877010577 | issue = 10 | bibcode = 1977AcCrB..33.3211J | doi-access = free }}</ref> In strongly basic media and the presence of air, it is oxidized to [[Cannabinodiol]] (CBND) and a [[quinone]] called [[HU-331]].<ref>{{cite journal | vauthors = Mechoulam R, Ben-Zvi Z, Gaoni Y | title = Hashish – 13. On the nature of the Beam test | journal = Tetrahedron | volume = 24 | issue = 16 | pages = 5615–5624 | date = August 1968 | pmid = 5732891 | doi = 10.1016/0040-4020(68)88159-1 }}</ref> Under acidic conditions it [[Cyclization|cyclizes]] to THC,<ref>{{cite journal |vauthors=Gaoni Y, Mechoulam R | title = Hashish – VII The isomerization of cannabidiol to tetrahydrocannabinols | journal = Tetrahedron | volume = 22 | issue = 4 | pages = 1481–1488 | year = 1966 | doi = 10.1016/S0040-4020(01)99446-3 }}</ref> which also occurs during [[pyrolysis]],<ref>{{cite journal | vauthors = Küppers FJ, Bercht CA, Salemink CA, Lousberg RC, Terlouw JK, Heerma W | title=Cannabis – XV: Pyrolysis of cannabidiol. Structure elucidation of four pyrolytic products | journal=Tetrahedron| volume=31| issue=13–14| pages=1513–1516| doi=10.1016/0040-4020(75)87002-5| year=1975 }}</ref> and during smoking.<ref name = "Czégény_2021" /><ref>{{cite journal | vauthors = Quarles W, Ellman G, Jones R | title = Toxicology of marijuana: conditions for conversion of cannabidiol to THC upon smoking | journal = Clinical Toxicology | volume = 6 | issue = 2 | pages = 211–216 | date = 1973 | pmid = 4715204 | doi = 10.3109/15563657308990520 }}</ref> The synthesis of cannabidiol has been accomplished by several research groups.<ref>{{cite journal | vauthors = Petrzilka T, Haefliger W, Sikemeier C, Ohloff G, Eschenmoser A | title = [Synthesis and optical rotation of the (-)-cannabidiols] | journal = Helvetica Chimica Acta | volume = 50 | issue = 2 | pages = 719–723 | date = March 1967 | pmid = 5587099 | doi = 10.1002/hlca.19670500235 }}</ref><ref>{{cite journal |vauthors=Gaoni Y, Mechoulam R | title = Boron trifluoride etherate on alumuna&nbsp;– a modified Lewis acid reagent. An improved synthesis of cannabidiol | journal = Tetrahedron Letters | volume = 26 | issue = 8 | pages = 1083–1086 | year = 1985 | doi = 10.1016/S0040-4039(00)98518-6 }}</ref><ref>{{cite journal | vauthors = Kobayashi Y, Takeuchi A, Wang YG | title = Synthesis of cannabidiols via alkenylation of cyclohexenyl monoacetate | journal = Organic Letters | volume = 8 | issue = 13 | pages = 2699–2702 | date = June 2006 | pmid = 16774235 | doi = 10.1021/ol060692h }}</ref>

[[File:Intramolekulare cyklisierung von CBD zu Δ9-THC.png|thumb|upright=3.1|center|Possible mechanism of intramolecular cyclization of CBD to Δ{{sup|9}}-THC<ref>{{cite journal | vauthors = Gaoni Y, Mechoulam R | title = Hashish – VII: The isomerization of cannabidiol to tetrahydrocannabinols. | journal = Tetrahedron | date = January 1966 | volume = 22 | issue = 4 | pages = 1481–1488 | doi = 10.1016/S0040-4020(01)99446-3 }}</ref>]]

===Overview===

{| class="wikitable"

|-

! Category !! Compound !! Description

|-

| Analog || [[4'-Fluorocannabidiol]] || fluorinated cannabidiol derivative of CBD

|-

| Analog || [[Cannabidibutol]] (CBDB) || an analogue to tetrahydrocannabutol (THCB)

|-

| Analog || [[Cannabidiol diacetate]] || a semi-synthetic derivative of CBD

|-

| Analog || [[Cannabidiol dimethyl ether]] (CBDD) || an analog of CBD

|-

| Analog || [[H4-CBD]] || a structural analog of CBD

|-

| Analog || [[HU-320]] || a structural analog of CBD

|-

| Analog || [[KLS-13019]] || a structural analog of CBD

|-

| Homologue || [[8,9-Dihydrocannabidiol]] (H2CBD) || synthetic derivative of CBD

|-

| Homologue || [[Cannabidiorcol]] (CBD-C1) || a homologue of CBD

|-

| Homologue || [[Cannabidiphorol]] (CBDP) || the heptyl-homologue of CBD

|-

| Homologue || [[Cannabidivarin]] (CBDV) || a homologue of CBD

|-

| Homologue || [[CBD-DMH]] || synthetic homologue of CBD

|-

| Homologue || [[Δ-6-Cannabidiol]] || a positional isomer of CBD

|-

| Isomer || [[Abnormal cannabidiol]] || a synthetic regioisomer of CBD

|-

| Metabolite || [[7-Hydroxycannabidiol]] (7-OH-CBD) || an active metabolite of CBD

|-

| Precursor || [[Cannabidiolic acid]] (CBDA) || precursor to CBD

|-

|}

[[File:Cannabidiol and THC biosynthesis.svg|upright=1.3|thumb|Cannabidiol and THC biosynthesis<ref>{{cite journal | vauthors = Taura F, Sirikantaramas S, Shoyama Y, Yoshikai K, Shoyama Y, Morimoto S | title = Cannabidiolic-acid synthase, the chemotype-determining enzyme in the fiber-type Cannabis sativa | journal = FEBS Letters | volume = 581 | issue = 16 | pages = 2929–2934 | date = June 2007 | pmid = 17544411 | doi = 10.1016/j.febslet.2007.05.043 | s2cid = 20253070 | doi-access = free | bibcode = 2007FEBSL.581.2929T }}</ref>]]

''[[Cannabis]]'' produces CBD through the same [[metabolic pathway]] as THC, until the next to last step, where [[CBDA synthase]] performs catalysis instead of [[THCA synthase]].<ref>{{cite journal | vauthors = Marks MD, Tian L, Wenger JP, Omburo SN, Soto-Fuentes W, He J, Gang DR, Weiblen GD, Dixon RA | title = Identification of candidate genes affecting Delta9-tetrahydrocannabinol biosynthesis in Cannabis sativa | journal = Journal of Experimental Botany | volume = 60 | issue = 13 | pages = 3715–3726 | year = 2009 | pmid = 19581347 | pmc = 2736886 | doi = 10.1093/jxb/erp210 }}</ref>

===Isomerism===

{{See also|Tetrahydrocannabinol#Isomerism|Abnormal cannabidiol}}

[[File:Cannabidiol numbering.svg|center|250px|Cannabidiol numbering]]

{| class="wikitable sortable mw-collapsible mw-collapsed" style="<!--font-size:small;--> clear:left; width:50%;"

|+ class="nowrap" |Cannabidiol's 7 double bond isomers and their 30 stereoisomers

|-

! colspan="3" | Formal numbering !! colspan="2" | Terpenoid numbering !! rowspan="2" | Number of stereoisomers !! rowspan="2" | Natural occurrence !! rowspan="2" |[[Convention on Psychotropic Substances]] Schedule !! rowspan="2" | Structure

|-

! style="width:90px;" | Short name !! Chiral centers !! Full name !! style="width:90px;" | Short name !! Chiral centers

|-

| Δ{{sup|5}}-Cannabidiol || 1 and 3 || 2-(6-isopropenyl-3-methyl-5-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol || Δ{{sup|4}}-Cannabidiol || 1 and 3 || 4 || No || Unscheduled ||[[File:2-(6-Isopropenyl-3-methyl-5-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png|150px]]

|-

| Δ{{sup|4}}-Cannabidiol || 1, 3 and 6 || 2-(6-isopropenyl-3-methyl-4-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol || Δ{{sup|5}}-Cannabidiol || 1, 3 and 4 || 8 || No || Unscheduled ||[[File:2-(6-Isopropenyl-3-methyl-4-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png|150px]]

|-

| [[Δ-6-Cannabidiol|Δ{{sup|3}}-Cannabidiol]] || 1 and 6 || 2-(6-isopropenyl-3-methyl-3-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol || Δ{{sup|6}}-Cannabidiol || 3 and 4 || 4 || Yes || Unscheduled ||[[File:2-(6-Isopropenyl-3-methyl-3-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png|150px]]

|-

| Δ{{sup|3,7}}-Cannabidiol || 1 and 6 || 2-(6-isopropenyl-3-methylenecyclohex-1-yl)-5-pentyl-1,3-benzenediol || Δ{{sup|1,7}}-Cannabidiol || 3 and 4 || 4 || No || Unscheduled ||[[File:2-(6-Isopropenyl-3-methylenecyclohex-1-yl)-5-pentyl-1,3-benzenediol.png|150px]]

|-

|'''Δ{{sup|2}}-Cannabidiol'''||'''1 and 6'''||'''2-(6-isopropenyl-3-methyl-2-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol'''||'''Δ{{sup|1}}-Cannabidiol'''||'''3 and 4'''||'''4'''||'''Yes'''||'''Unscheduled'''||[[File:2-(6-Isopropenyl-3-methyl-2-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png|150px]]

|-

| Δ{{sup|1}}-Cannabidiol || 3 and 6 || 2-(6-isopropenyl-3-methyl-1-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol || Δ{{sup|2}}-Cannabidiol || 1 and 4 || 4 || No || Unscheduled ||[[File:2-(6-Isopropenyl-3-methyl-1-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png|150px]]

|-

| Δ{{sup|6}}-Cannabidiol || 3 || 2-(6-isopropenyl-3-methyl-6-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol || Δ{{sup|3}}-Cannabidiol ||1 || 2 || No || Unscheduled ||[[File:2-(6-Isopropenyl-3-methyl-6-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png|150px]]

|}

===Pyrolysis===

In the typical operating temperature range of e-cigarettes ({{cvt|250–400|C}}), 25–52% of CBD is transformed into other chemical substances: [[Δ9-THC]], Δ8-THC, [[cannabinol]] and [[cannabichromene]] as predominant pyrolysates. From a chemical point of view, [[CBD cigarette|CBD in e-cigarettes]] can be considered a precursor of THC.<ref name = "Czégény_2021" />

===Synthetic derivatives===

Numerous synthetic derivatives of CBD are known, and have been researched for generally similar applications as CBD itself.<ref name = "Nelson2020">{{cite journal | vauthors = Nelson KM, Bisson J, Singh G, Graham JG, Chen SN, Friesen JB, Dahlin JL, Niemitz M, Walters MA, Pauli GF | title = The Essential Medicinal Chemistry of Cannabidiol (CBD) | journal = Journal of Medicinal Chemistry | volume = 63 | issue = 21 | pages = 12137–12155 | date = November 2020 | pmid = 32804502 | doi = 10.1021/acs.jmedchem.0c00724 | pmc = 7666069 }}</ref>

==History==

Efforts to isolate the active ingredients in cannabis were made in the 19th century.<ref name="Adams" /> Cannabidiol was studied in 1940 from [[Minnesota]] wild hemp<ref name="Adams">{{cite journal | vauthors = Adams R, Hunt M, Clark JH | title=Structure of cannabidiol, a product isolated from the marihuana extract of Minnesota wild hemp.| journal=Journal of the American Chemical Society | volume=62 | issue=1 | year=1940 | issn=0002-7863 | doi=10.1021/ja01858a058 | pages=196–200}}</ref> and [[Egypt]]ian ''Cannabis indica'' resin.<ref name="Jacob">{{cite journal | vauthors = Jacob A, Todd AR | title=Cannabidiol and cannabol, constituents of ''Cannabis indica'' resin | journal=Nature | volume=145 | issue=3670 | year=1940 | issn=0028-0836 | doi=10.1038/145350a0 | pages=350| bibcode=1940Natur.145..350J | s2cid=4106662 | doi-access=free }}</ref><ref>{{cite journal | vauthors = Work TS, Bergel F, Todd AR | title = The active principles of Cannabis indica resin. I | journal = The Biochemical Journal | volume = 33 | issue = 1 | pages = 123–127 | date = January 1939 | pmid = 16746878 | pmc = 1264344 | doi = 10.1042/bj0330123 }}</ref> The chemical formula of CBD was proposed from a method for isolating it from wild hemp.<ref name="Adams" /> Its structure and [[stereochemistry]] were determined in 1963.<ref name="Mechoulam">{{cite journal | vauthors = Mechoulam R, Shvo Y | title = Hashish. I. The structure of cannabidiol | journal = Tetrahedron | volume = 19 | issue = 12 | pages = 2073–2078 | date = December 1963 | pmid = 5879214 | doi = 10.1016/0040-4020(63)85022-x }}</ref>

===Plant breeding===

Selective breeding of cannabis plants has expanded and diversified as commercial and therapeutic markets develop. Some growers in the US succeeded in lowering the proportion of CBD-to-THC to accommodate customers who preferred varietals that were more mind-altering due to the higher THC and lower CBD content.<ref name="Romney_2012">{{cite news|vauthors=Romney L|date=September 13, 2012|title=On the frontier of medical pot to treat boy's epilepsy|work=Los Angeles Times|url=https://www.latimes.com/health/la-xpm-2012-sep-13-la-me-customized-marijuana-20120914-story.html|access-date=April 16, 2020|archive-date=October 21, 2018|archive-url=https://web.archive.org/web/20181021190630/http://articles.latimes.com/2012/sep/13/local/la-me-customized-marijuana-20120914|url-status=live}}</ref> In the US, hemp is classified by the federal government as cannabis containing no more than 0.3% THC by dry weight. This classification was established in the 2018 Farm Bill and was refined to include hemp-sourced extracts, cannabinoids, and derivatives in the definition of hemp.<ref name="cornell">{{Cite web|title=7 U.S. Code § 5940 – Legitimacy of industrial hemp research|url=https://www.law.cornell.edu/uscode/text/7/5940|access-date=November 27, 2018|website=LII / Legal Information Institute|archive-date=December 22, 2020|archive-url=https://web.archive.org/web/20201222033600/https://www.law.cornell.edu/uscode/text/7/5940|url-status=live}}</ref>

==Society and culture==

===Names===

''Cannabidiol'' is the [[generic term|generic name]] of the drug and its {{Abbrlink|INN|International Nonproprietary Name}}.<ref>{{cite journal|year=2016|title=International Nonproprietary Names for Pharmaceutical Substances (INN)|url=https://cdn.who.int/media/docs/default-source/international-nonproprietary-names-(inn)/pl115.pdf|journal=WHO Drug Information|volume=30|issue=2|page=241|access-date=February 18, 2023|archive-date=February 5, 2018|archive-url=https://web.archive.org/web/20180205073351/http://www.who.int/medicines/publications/druginformation/innlists/PL115.pdf|url-status=live}}</ref>

===Foods and beverages===

[[File:CBD-infused cold brew coffee & tea at a grocery store in Los Angeles, California..png|alt=CBD-infused cold brew coffee and tea|thumb|An example of beverages claiming to contain CBD in a Los Angeles grocery]]

Food and beverage products containing cannabidiol were widely marketed in the United States as early as 2017.<ref>{{Cite news|url=https://www.wlwt.com/article/billboard-featuring-hemp-leaf-raises-questions-about-new-beverage-for-sale-in-cincinnati/12662040|title=Billboard featuring hemp leaf raises questions about new beverage for sale in Cincinnati {{!}} WLWT5|date=September 29, 2017|work=WLWT5|access-date=September 29, 2017|archive-date=December 26, 2020|archive-url=https://web.archive.org/web/20201226180044/https://www.wlwt.com/article/billboard-featuring-hemp-leaf-raises-questions-about-new-beverage-for-sale-in-cincinnati/12662040|url-status=live}}</ref> Hemp seed ingredients which do not naturally contain THC or CBD (but which may be contaminated with trace amounts on the outside during harvesting) were declared by the US [[Food and Drug Administration]] as [[generally recognized as safe]] (GRAS) in December 2018. CBD itself has not been declared GRAS, and under US federal law is illegal to sell as a food, dietary supplement, or animal feed.<ref name="fdareg" /> State laws vary considerably as non-medical cannabis and derived products have been legalized in various jurisdictions.<ref name=creswell/> Despite once having a promising market, the industry for CBD stalled out during the [[COVID-19 pandemic]] beginning in 2020, and, by 2024, it collapsed due to withdrawal of investors, the absence of a FDA ruling on efficacy and safety, inconsistent state-by-state legislation, and consumer ambivalence.<ref name="creswell">{{cite news |author1=Creswell, Julie |title=Companies were big on CBD. Not anymore |url=https://www.nytimes.com/2024/02/28/business/cbd-companies-regulations.html |access-date=March 25, 2024 |work=The New York Times |date=February 28, 2024}}</ref>

Similar to [[energy drinks]] and [[protein bars]] which may contain vitamin or herbal additives, food and beverage items can be infused with CBD as an alternative means of ingesting the substance.<ref name=creswell/> In the United States, numerous products are marketed as containing CBD, but in reality contain little or none.<ref name="fdareg" /><ref>{{cite web |title = Warning Letters and Test Results for Cannabidiol-Related Products |url = https://www.fda.gov/newsevents/publichealthfocus/ucm484109.htm |publisher = US [[Food and Drug Administration]] (FDA) |access-date = January 2, 2018 |date = November 2, 2017 |archive-date = January 26, 2018 |archive-url = https://web.archive.org/web/20180126014518/https://www.fda.gov/NewsEvents/PublicHealthFocus/ucm484109.htm |url-status = live }}</ref> Some companies marketing CBD-infused food products with claims that are similar to the effects of [[prescription drug]]s have received [[FDA warning letter|warning letters]] from the FDA for making unsubstantiated [[health claim]]s.<ref name="fdareg" /><ref>{{cite web | url = https://www.lexology.com/library/detail.aspx?g=fe616692-9e03-43bc-9149-8aa1a35a9d9e | title = Companies Marketing CBD Products Be Warned: FDA Is Watching | work = Lexology | vauthors = Fox A, Ravitz JR, Leongini EM, Malkin BJ | date = November 20, 2017 | access-date = December 14, 2017 | archive-date = August 3, 2020 | archive-url = https://web.archive.org/web/20200803230044/https://www.lexology.com/library/detail.aspx?g=fe616692-9e03-43bc-9149-8aa1a35a9d9e | url-status = live }}</ref> In February 2019, the [[New York City]] Department of Health announced plans to [[fine (penalty)|fine]] restaurants that sell food or drinks containing CBD, beginning in October 2019.<ref>{{Cite news|url=https://www.cnbc.com/2019/02/15/new-york-may-start-fining-restaurants-for-using-weed-related-cbd-.html|title=New York City plans to fine restaurants using CBD in food and drinks|vauthors=La Vito A, Franck T|date=February 15, 2019|newspaper=CNBC|access-date=February 19, 2019|archive-date=November 7, 2020|archive-url=https://web.archive.org/web/20201107233204/https://www.cnbc.com/2019/02/15/new-york-may-start-fining-restaurants-for-using-weed-related-cbd-.html|url-status=live}}</ref>

===Labeling and advertising===

Studies conducted by the FDA from 2014 through 2019 have determined that a majority of CBD products are not accurately labeled with the amount of CBD they contain.<ref name=FDAReport>{{cite web | title = Sampling Study of the Current Cannabidiol Marketplace to Determine the Extent That Products are Mislabeled or Adulterated Report in Response to Further Consolidated Appropriations Act, 2020 | publisher = United States Food and Drug Administration | date = July 2020 | url = https://hempindustrydaily.com/wp-content/uploads/2020/07/CBD-Marketplace-Sampling_RTC_FY20_Final.pdf | access-date = January 30, 2021 | archive-date = June 23, 2021 | archive-url = https://web.archive.org/web/20210623193320/https://hempindustrydaily.com/wp-content/uploads/2020/07/CBD-Marketplace-Sampling_RTC_FY20_Final.pdf | url-status = live }}</ref> For example, a 2017 analysis of cannabidiol content in oil, [[tincture]], or liquid [[Electronic cigarette|vape]] products purchased online in the United States showed that 69% were mislabeled, with 43% having higher and 26% having lower content than stated on [[product label]]s.<ref name="Bonn">{{cite journal | vauthors = Bonn-Miller MO, Loflin MJ, Thomas BF, Marcu JP, Hyke T, Vandrey R | title = Labeling Accuracy of Cannabidiol Extracts Sold Online | journal = JAMA | volume = 318 | issue = 17 | pages = 1708–1709 | date = November 2017 | pmid = 29114823 | pmc = 5818782 | doi = 10.1001/jama.2017.11909 }}</ref><ref name="dawn">{{cite news|vauthors=MacKeen D|date=October 16, 2019|title=Scam or Not: What Are the Benefits of CBD?|work=The New York Times|url=https://www.nytimes.com/2019/10/16/style/self-care/cbd-oil-benefits.html|access-date=October 17, 2019 |archive-date=October 16, 2019|archive-url=https://web.archive.org/web/20191016221458/https://www.nytimes.com/2019/10/16/style/self-care/cbd-oil-benefits.html|url-status=live}}</ref> In 2020, the FDA conducted a study of 147 CBD products and found that half contained THC.<ref name=FDAReport/><ref>{{cite journal | vauthors = Evans DG | title = Medical Fraud, Mislabeling, Contamination: All Common in CBD Products | journal = Missouri Medicine | volume = 117 | issue = 5 | pages = 394–399 | year = 2020 | pmid = 33311737 | pmc = 7723146 }}</ref>

From 2015 to November 2022, the FDA issued dozens of [[FDA warning letter|warning letters]] to American manufacturers of CBD products for false advertising and illegal interstate marketing of CBD as an unapproved [[prescription drug|drug]] to treat diseases, such as cancer, [[osteoarthritis]], symptoms of [[Drug withdrawal|opioid withdrawal]], Alzheimer's disease, and [[pet]] disorders.<ref name="fda11-22">{{cite web |title=FDA Warns Companies for Illegally Selling Food and Beverage Products that Contain CBD |url=https://www.fda.gov/food/cfsan-constituent-updates/fda-warns-companies-illegally-selling-food-and-beverage-products-contain-cbd |publisher=US Food and Drug Administration |access-date=November 23, 2022 |date=November 21, 2022 |quote=These companies are selling CBD containing products that people may confuse for traditional foods or beverages which may result in unintentional consumption or overconsumption of CBD. CBD-containing products in forms that are appealing to children, such as gummies, hard candies and cookies, are especially concerning. |archive-date=November 23, 2022 |archive-url=https://web.archive.org/web/20221123224059/https://www.fda.gov/food/cfsan-constituent-updates/fda-warns-companies-illegally-selling-food-and-beverage-products-contain-cbd |url-status=live }}</ref> Chemical analysis of CBD products found that many did not contain the levels of CBD claimed in advertising.<ref name=fda11-22/>

In December 2020, the [[Federal Trade Commission]] initiated a law enforcement crackdown on American companies marketing CBD products as unapproved drugs.<ref name="ftc">{{cite web|title=FTC Announces Crackdown on Deceptively Marketed CBD Products|url=https://www.ftc.gov/news-events/press-releases/2020/12/ftc-announces-crackdown-deceptively-marketed-cbd-products|publisher=US [[Federal Trade Commission]] (FTC)|access-date=January 12, 2021|date=December 17, 2020|archive-date=June 22, 2021|archive-url=https://web.archive.org/web/20210622223827/https://www.ftc.gov/news-events/press-releases/2020/12/ftc-announces-crackdown-deceptively-marketed-cbd-products|url-status=live}}</ref><ref name="rooted">{{cite web |vauthors=Ashley DD, Engle MK |title=Warning letter: Rooted Apothecary LLC |url=https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/rooted-apothecary-llc-585312-10102019 |publisher=Office of Compliance, Center for Drug Evaluation and Research, US Food and Drug Administration; US Federal Trade Commission |access-date=October 23, 2019 |date=October 22, 2019 |archive-date=December 12, 2019 |archive-url=https://web.archive.org/web/20191212105951/https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/rooted-apothecary-llc-585312-10102019 |url-status=live }}</ref> The warning also applied to hemp CBD [[capsule (pharmacy)|capsules]] and oil that were being marketed illegally while not adhering to the federal definition of a [[dietary supplement]].<ref name="rooted" />

===Sports===

{{See also|Cannabis and sports}}

Cannabidiol has been used by professional and amateur athletes across disciplines and countries, with the [[World Anti-Doping Agency]] removing CBD from its [[Doping in sport|banned substances]] list. The [[United States Anti-Doping Agency]] and United Kingdom-Anti-Doping Agency do not have anti-CBD policies, with the latter stating that, "CBD is not currently listed on the World Anti-Doping Agency Prohibited List. As a result, it is permitted to use in sport, though the intended benefits are unclear and not backed by clinical evidence. All other cannabinoids (including but not limited to cannabis, hashish, marijuana, and THC) are prohibited in-competition. The intention of the regulations is to prohibit cannabinoids that activate the same receptors in the brain as activated by THC."<ref>{{Cite web|url=https://www.ukad.org.uk/athlete-advisory-note-cannabidiol-cbd|title=Athlete Advisory Note: Cannabidiol (CBD)|publisher=United Kingdom Anti-Doping Agency|access-date=October 9, 2019|archive-date=October 9, 2019|archive-url=https://web.archive.org/web/20191009110419/https://www.ukad.org.uk/athlete-advisory-note-cannabidiol-cbd|url-status=live}}</ref><ref name="usada">{{cite web |title=Athletes: 6 things to know about cannabidiol |url=https://www.usada.org/spirit-of-sport/education/six-things-know-about-cannabidiol/ |publisher=US Anti-Doping Agency |access-date=February 17, 2020 |date=October 23, 2018 |archive-date=October 11, 2021 |archive-url=https://web.archive.org/web/20211011032929/https://www.usada.org/spirit-of-sport/education/six-things-know-about-cannabidiol/ |url-status=live }}</ref>

In 2019, the cannabis manufacturer [[Canopy Growth]] acquired majority ownership of [[BioSteel Sports Nutrition]], which is developing CBD products under endorsement by numerous professional athletes.<ref name="spencer">{{cite news |vauthors=Donna S |title=Canopy cannabis company buys ex-NHL player's sports nutrition business |url=https://www.ctvnews.ca/business/canopy-cannabis-company-buys-ex-nhl-player-s-sports-nutrition-business-1.4620013 |access-date=February 17, 2020 |work=CTV Business |publisher=The Canadian Press |date=October 2, 2019 |quote=BioSteel's brand ambassadors also include well-known athletes across major sports leagues in North America, which could be beneficial as the company's attempt to push regulated CBD nutrition products into the mainstream health and wellness segments |archive-date=November 26, 2020 |archive-url=https://web.archive.org/web/20201126082519/https://www.ctvnews.ca/business/canopy-cannabis-company-buys-ex-nhl-player-s-sports-nutrition-business-1.4620013 |url-status=live }}</ref> The [[National Hockey League]] Alumni Association began a project with Canopy Growth to determine if CBD or other cannabis products might improve neurological symptoms and quality of life in head-injured players.<ref name=spencer/> Some sports leagues have announced sponsorships with CBD companies, such as [[Major League Baseball]] (Charlotte's Web) and [[Ultimate Fighting Championship]] (Love Hemp).<ref>{{cite press release |date=October 12, 2022 |title=Major League Baseball, pioneering CBD brand Charlotte's Web strike groundbreaking deal |url=https://www.mlb.com/press-release/press-release-major-league-baseball-pioneering-cbd-brand-charlotte-s-web-strike- |publisher=Major League Baseball}}</ref><ref>{{cite press release |date=March 18, 2021 |title=UFC Names Love Hemp Official Global CBD Partner |url=https://www.ufc.com/news/ufc-names-love-hemp-official-global-cbd-partner |publisher=Ultimate Fighting Championship}}</ref> Numerous professional athletes use CBD, primarily for treating pain.<ref name=spencer/><ref name="loudin">{{cite news |vauthors=Loudin A |title=As more pro athletes use cannabis for aches and pain, the more they run afoul of rules |url=https://www.washingtonpost.com/health/as-more-pro-athletes-use-cannabis-for-aches-and-pain-the-more-they-run-afoul-of-rules/2019/12/06/7dbd82fc-00c7-11ea-8bab-0fc209e065a8_story.html |access-date=February 17, 2020 |newspaper=The Washington Post |date=December 7, 2019 |archive-date=November 24, 2020 |archive-url=https://web.archive.org/web/20201124094701/https://www.washingtonpost.com/health/as-more-pro-athletes-use-cannabis-for-aches-and-pain-the-more-they-run-afoul-of-rules/2019/12/06/7dbd82fc-00c7-11ea-8bab-0fc209e065a8_story.html |url-status=live }}</ref><ref name="harrison">{{cite magazine |vauthors=Harrison S |title=Lots of athletes say CBD Is a better painkiller. Is It? |url=https://www.wired.com/story/lots-of-athletes-say-cbd-is-a-better-painkiller-is-it/ |access-date=February 17, 2020 |magazine=Wired |date=September 28, 2019 |archive-date=July 12, 2021 |archive-url=https://web.archive.org/web/20210712160248/https://www.wired.com/story/lots-of-athletes-say-cbd-is-a-better-painkiller-is-it/ |url-status=live }}</ref>

===Legal status===

====Australia====

Prescription medicine (Schedule 4) for therapeutic use containing two percent (2.0%) or less of other cannabinoids commonly found in cannabis (such as ∆{{sup|9}}-THC). A Schedule 4 drug under the [[SUSMP]] is a Prescription Only Medicine, or Prescription Animal Remedy – Substances, the use or supply of which should be by or on the order of persons permitted by state or territory legislation to prescribe and should be available from a pharmacist on prescription.<ref>{{cite web |url=https://www.legislation.gov.au/Details/F2017L00605 |title=Poisons Standard June 2017 |publisher=Legislation.gov.au |access-date=December 4, 2016 |archive-date=December 13, 2020 |archive-url=https://web.archive.org/web/20201213060305/https://www.legislation.gov.au/Details/F2017L00605/ |url-status=live }}</ref>

In June 2020, the Australian Therapeutic Goods Administration (TGA) published a consultation on a proposal to pave the way to make "low dose" CBD available to consumer/patients via pharmacists only through moving products from Schedule 4 to 3.<ref>{{Cite web|author=Australian Government Department of Health Therapeutic Goods Administration|date=April 24, 2020|title=Consultation: Proposed amendments to the Poisons Standard – Joint ACMS/ACCS meetings, June 2020|url=https://www.tga.gov.au/consultation-invitation/consultation-proposed-amendments-poisons-standard-joint-acmsaccs-meetings-june-2020|access-date=November 25, 2020|website=Therapeutic Goods Administration (TGA)|language=en|archive-date=May 11, 2021|archive-url=https://web.archive.org/web/20210511053302/https://www.tga.gov.au/consultation-invitation/consultation-proposed-amendments-poisons-standard-joint-acmsaccs-meetings-june-2020|url-status=live}}</ref> Any products sold would need to have their safety, quality and efficacy pre-assessed by the TGA and be formally approved for sale (details to be outlined by TGA). They would be made available to over 18s only, with the maximum daily dose of 60{{nbsp}}mg/day, up to 2% THC finished product allowed, 30-day maximum supply, plant-derived or synthetic. This proposal is based on an initial literature review on the safety of low dose CBD published by the TGA in April 2020.<ref>{{cite web | title = Safety of low dose cannabidiol | date = April 2020 | agency = Therapeutic Goods Administration | publisher = Government of Australia | url = https://www.tga.gov.au/sites/default/files/review-safety-low-dose-cannabidiol.pdf | access-date = November 25, 2020 | archive-date = September 7, 2021 | archive-url = https://web.archive.org/web/20210907175547/https://www.tga.gov.au/sites/default/files/review-safety-low-dose-cannabidiol.pdf | url-status = live }}</ref> Epidyolex was approved for the adjunctive therapy of seizures associated with [[Lennox–Gastaut syndrome]] or with [[Dravet syndrome]] in September 2020.<ref name="Epidyolex TGA" />

====Bulgaria====

In 2020, Bulgaria became the first country in the European Union to allow retail sales of food products and supplements containing CBD, despite the ongoing discussion within the EU about the classification of CBD as a [[novel food]].<ref>{{Cite web|url=https://www.forbes.com/sites/javierhasse/2019/05/23/this-eu-country-has-apparently-become-the-first-to-allow-free-sale-of-cbd/|title=This EU country has become the first to allow free sale Of CBD|vauthors=Hasse J|work=Forbes|access-date=February 21, 2020|archive-date=October 6, 2021|archive-url=https://web.archive.org/web/20211006020147/https://www.forbes.com/sites/javierhasse/2019/05/23/this-eu-country-has-apparently-become-the-first-to-allow-free-sale-of-cbd/|url-status=live}}</ref> However, there exists a legal gap because of the lack of a legally-permissible minimum amount of THC in the products containing cannabinoids.<ref>{{Cite web|vauthors=Todorova SE|title=Growing cannabis in Bulgaria: Legal but still stigmatised|url=https://www.lexology.com/library/detail.aspx?g=b18a928d-6437-4544-b834-12cd169bd9b2|access-date=September 3, 2020|website=Lexology|date=July 29, 2019|archive-date=April 11, 2021|archive-url=https://web.archive.org/web/20210411021658/https://www.lexology.com/library/detail.aspx?g=b18a928d-6437-4544-b834-12cd169bd9b2|url-status=live}}</ref>

====Canada====

In October 2018, cannabidiol became legal for recreational and medical use by the federal ''[[Cannabis Act]]''.<ref name="cbdact">{{cite web |title=Cannabidiol (CBD) |url=https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/about/cannabidiol.html#a4 |publisher=Government of Canada |access-date=October 11, 2019 |date=August 13, 2019 |archive-date=September 18, 2019 |archive-url=https://web.archive.org/web/20190918124123/https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/about/cannabidiol.html#a4 |url-status=live }}</ref><ref>{{cite web |title=Health products containing cannabis or for use with cannabis: Guidance for the Cannabis Act, the Food and Drugs Act, and related regulations |url=https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/applications-submissions/guidance-documents/guidance-cannabis-act-food-and-drugs-act-related-regulations/document.html |publisher=Government of Canada |access-date=October 19, 2018 |date=July 11, 2018 |archive-date=October 19, 2018 |archive-url=https://web.archive.org/web/20181019121912/https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/applications-submissions/guidance-documents/guidance-cannabis-act-food-and-drugs-act-related-regulations/document.html |url-status=live }}</ref><ref>{{cite web|url=https://www.justice.gc.ca/eng/cj-jp/cannabis/|title=Cannabis Legalization and Regulation|publisher=Government of Canada|work=Department of Justice, Electronic Communications|date=June 20, 2018|access-date=November 24, 2018|archive-date=August 24, 2021|archive-url=https://web.archive.org/web/20210824170353/https://www.justice.gc.ca/eng/cj-jp/cannabis/|url-status=live}}</ref> {{as of|2019|August}}, CBD products in Canada could only be sold by authorized retailers or federally licensed medical companies, limiting their access to the general public.<ref name="cbc19">{{cite web |title='It should be available': Natural health food stores hope to cash in on CBD craze |url=https://www.cbc.ca/news/canada/ottawa/natural-health-food-retailers-cannabis-cbd-market-1.5237911 |work=CBC News |access-date=October 11, 2019 |date=August 6, 2019 |archive-date=October 12, 2019 |archive-url=https://web.archive.org/web/20191012060444/https://www.cbc.ca/news/canada/ottawa/natural-health-food-retailers-cannabis-cbd-market-1.5237911 |url-status=live }}</ref> Nonetheless, with online delivery services and over 2,600 authorized cannabis retail stores {{as of|October 2021|lc=y}}, accessibility has steadily increased over time.<ref>{{cite web |url=https://www.statista.com/statistics/1035996/number-of-cannabis-stores-by-region-canada/ |title=Number of cannabis stores in Canada as of June 2021, by region |vauthors=Conway J |publisher=Statista |date=September 17, 2021 |access-date=May 2, 2022 |archive-date=May 2, 2022 |archive-url=https://web.archive.org/web/20220502201541/https://www.statista.com/statistics/1035996/number-of-cannabis-stores-by-region-canada/ |url-status=live }}</ref><ref>{{cite news |vauthors=Armstrong M |url=https://theconversation.com/amp/cannabis-store-openings-in-canada-only-slightly-affected-the-number-of-users-169055 |title=Cannabis store openings in Canada only slightly affected the number of users |work=The Conversation |date=October 13, 2021 |access-date=May 2, 2022 |archive-date=May 2, 2022 |archive-url=https://web.archive.org/web/20220502201541/https://theconversation.com/amp/cannabis-store-openings-in-canada-only-slightly-affected-the-number-of-users-169055 |url-status=live }}</ref> The Canadian government states that CBD products "are subject to all of the rules and requirements that apply to cannabis under the Cannabis Act and its regulations."<ref name=cbdact/> It requires "a processing licence to manufacture products containing CBD for sale, no matter what the source of the CBD is, and that CBD and products containing CBD, such as cannabis oil, may only be sold by an authorized retailer or licensed seller of medical CBD."<ref name=cbdact/> Edible CBD products were scheduled to be permitted for sale in Canada on October 17, 2019, for human consumption.<ref name=cbdact/>

{{As of|August 2020}}, it was still illegal to carry cannabis and cannabis-derived products (including products containing CBD) across the Canadian border. If one carries any amount of cannabis for any purpose (including medical), it needs to be declared to the [[Canada Border Services Agency]]. Not declaring it is a serious criminal offence.<ref>{{Cite web |author=Canada Health |date=June 20, 2018 |title=Cannabis and Canadian borders |url=https://www.canada.ca/en/services/health/campaigns/cannabis/border.html |access-date=September 3, 2020 |website=aem |archive-date=August 14, 2021 |archive-url=https://web.archive.org/web/20210814083741/https://www.canada.ca/en/services/health/campaigns/cannabis/border.html |url-status=live }}</ref>

====Czech Republic====

As of May 2023, the [[Ministry of Agriculture (Czech Republic)|State Agricultural and Food Inspection]] of the Czech Republic is putting together broad regulations regarding a ban on CBD products.<ref>{{Cite web |title=Ministerstvo zemědělství informuje o chystaném zákazu uvádění na trh produktů obsahujících kanabidiol (CBD) a jiné kanabinoidy (eAGRI) |url=https://eagri.cz/public/web/mze/tiskovy-servis/tiskove-zpravy/x2023_ministerstvo-zemedelstvi-informuje-o.html |access-date=May 8, 2023 |website=eagri.cz |language=cs}}</ref> They will make it illegal to sell products containing cannabidiol and other cannabinoids derived from hemp, as a result of [[Novel Food Regulation|EU Novel Food Regulation]]. In case of Czech Republic, [[European Industrial Hemp Association]] has submitted an official request to the Czech Republic to recognize natural hemp extracts with cannabinoids as traditional food.<ref>{{Cite web | vauthors = Milosz F |date=May 6, 2023 |title=EIHA reacts about CBD and hemp extracts |url=https://cannabizeu.com/eiha-reacts-about-cbd-and-hemp-extracts/ | archive-url = https://web.archive.org/web/20230506175817/https://cannabizeu.com/eiha-reacts-about-cbd-and-hemp-extracts/ | archive-date = May 6, 2023 |access-date=May 8, 2023 |website=CannabizEU |language=en-US}}</ref>

====European Union====

[[File:CBD-Vending-Machine.jpg|thumb|alt=Photograph of CBD Vending machine in Italy|A CBD product vending machine in Italy.]]

In 2019, the [[European Commission]] announced that CBD and other cannabinoids would be classified as "[[novel food]]s",<ref name="chu">{{cite web | title=Updated EC ruling for CBD classes supplement ingredient as Novel Food | publisher=NutraIngredients.com, William Reed Business Media Ltd. | vauthors=Chu W | date=January 31, 2019 | url=https://www.nutraingredients.com/Article/2019/01/31/Updated-EFSA-ruling-for-CBD-classes-supplement-ingredient-as-Novel-Food | access-date=January 1, 2019 | archive-date=November 1, 2021 | archive-url=https://web.archive.org/web/20211101213517/https://www.nutraingredients.com/Article/2019/01/31/Updated-EC-ruling-for-CBD-classes-supplement-ingredient-as-Novel-Food | url-status=live }}</ref> meaning that CBD products would require authorization under the [[novel food#Revision of the EU novel food regulation|EU Novel Food Regulation]] stating that because "this product was not used as a food or food ingredient before May 15, 1997, before it may be placed on the market in the EU as a food or food ingredient, a safety assessment under the Novel Food Regulation is required."<ref name="ec2019">{{cite web | title=Cannabinoids, searched in the EU Novel food catalogue (v.1.1) | publisher=European Commission | url=http://ec.europa.eu/food/safety/novel_food/catalogue/search/public/index.cfm | access-date=February 1, 2019 | date=January 1, 2019 | archive-date=April 3, 2019 | archive-url=https://web.archive.org/web/20190403221542/http://ec.europa.eu/food/safety/novel_food/catalogue/search/public/index.cfm | url-status=live }}</ref> The recommendation – applying to CBD extracts, synthesized CBD, and all CBD products, including CBD oil – was scheduled for a final ruling by the European Commission in March 2019.<ref name=chu/> If approved, manufacturers of CBD products would be required to conduct safety tests and prove safe consumption, indicating that CBD products would not be eligible for legal commerce until at least 2021.<ref name=chu/> In December 2020, the European Commission concluded that CBD should not be considered as drug and can be qualified as food.<ref>{{Cite web|date=December 2, 2020|title=European Commission reverses course, says CBD should not be regulated as a narcotic|url=https://hempindustrydaily.com/breaking-european-commission-reverses-course-says-cbd-should-not-be-regulated-as-a-narcotic/|access-date=December 4, 2020|website=Hemp Industry Daily|language=en-US|archive-date=October 21, 2021|archive-url=https://web.archive.org/web/20211021163656/https://hempindustrydaily.com/breaking-european-commission-reverses-course-says-cbd-should-not-be-regulated-as-a-narcotic/|url-status=live}}</ref>

Cannabidiol is listed in the EU Cosmetics Ingredient Database (CosIng).<ref name="cos">{{cite web|url=http://ec.europa.eu/growth/tools-databases/cosing/index.cfm?fuseaction=search.details_v2&id=93486|title=CosIng – Cosmetics – Cannabidiol|publisher=European Commission|access-date=December 4, 2016|archive-date=January 13, 2019|archive-url=https://web.archive.org/web/20190113182333/http://ec.europa.eu/growth/tools-databases/cosing/index.cfm?fuseaction=search.details_v2&id=93486|url-status=live}}</ref> However, the listing of an ingredient, assigned with an [[International Nomenclature of Cosmetic Ingredients|INCI]] name, in CosIng does not mean it is to be used in cosmetic products or is approved for such use.<ref name=cos/>

Several industrial hemp varieties can be legally cultivated in [[Western Europe]]. A variety such as "Fedora 17" has a cannabinoid profile consistently around 1%, with [[tetrahydrocannabinol|THC]] less than 0.3%.<ref>{{cite journal | vauthors = Fournier G, Beherec O, Bertucelli S | title = Intérêt du rapport Δ-9-THC / CBD dans le contrôle des cultures de chanvre industriel |trans-title=The advantage of the Δ-9-THC / CBD ratio in the control of industrial hemp crops |language=fr | journal = Annales de Toxicologie Analytique | volume = 15 | issue = 4 | pages = 250–259 | year = 2003 | doi = 10.1051/ata/2003003 | doi-access = free }}</ref>

====Hong Kong====

In 2022, the [[HKSAR Government]] proposed a ban on any use of cannabidiol (including for academic research and by medical professionals) within the Hong Kong territory, making [[Hong Kong]] the first jurisdiction in the world to have complete prohibition of cannabidiol, starting from February 1, 2023,<ref>{{cite web |title=Orders to amend Dangerous Drugs Ordinance and Control of Chemicals Ordinance to be gazetted on October 21 and cannabidiol to become dangerous drug |url=https://www.info.gov.hk/gia/general/202210/20/P2022102000492.htm?fontSize=1 |publisher=Hong Kong SAR Government |access-date=October 20, 2022 |archive-date=October 20, 2022 |archive-url=https://web.archive.org/web/20221020134136/https://www.info.gov.hk/gia/general/202210/20/P2022102000492.htm?fontSize=1 |url-status=live }}</ref> in part due to the possible presence of THC which is illegal in Hong Kong, according to a research subsidized by the Hong Kong SAR Government.<ref>{{Cite web |date=June 11, 2022 |title=What you need to know about a proposed ban on CBD products in Hong Kong |url=https://www.scmp.com/news/hong-kong/health-environment/article/3181288/hong-kong-has-proposed-banning-cbd-products |access-date=September 25, 2022 |website=South China Morning Post |language=en |archive-date=September 25, 2022 |archive-url=https://web.archive.org/web/20220925034831/https://www.scmp.com/news/hong-kong/health-environment/article/3181288/hong-kong-has-proposed-banning-cbd-products |url-status=live }}</ref><ref>{{Cite web |vauthors=Leung H |date=August 21, 2022 |title=Hong Kong's zero-tolerance approach to drugs leaves budding CBD industry high and dry |url=https://hongkongfp.com/2022/08/21/hong-kongs-zero-tolerance-approach-to-drugs-leaves-budding-cbd-industry-high-and-dry/ |access-date=September 25, 2022 |website=Hong Kong Free Press HKFP |language=en-GB |archive-date=April 20, 2023 |archive-url=https://web.archive.org/web/20230420184936/https://hongkongfp.com/2022/08/21/hong-kongs-zero-tolerance-approach-to-drugs-leaves-budding-cbd-industry-high-and-dry/ |url-status=live }}</ref><ref>{{Cite web | author = Legislative Council Panel on Security | date = June 7, 2022 | publisher = Government of Hong Kong | title = Proposed Control of Cannabidiol through Legislation | url = https://www.legco.gov.hk/yr2022/english/panels/se/papers/se20220607cb2-380-3-e.pdf | access-date = October 24, 2022 | archive-date = September 28, 2022 | archive-url = https://web.archive.org/web/20220928210959/https://www.legco.gov.hk/yr2022/english/panels/se/papers/se20220607cb2-380-3-e.pdf | url-status = live }}</ref>

====New Zealand====

In 2017, the New Zealand government made changes to the regulations so that restrictions would be removed, which meant a doctor was able to prescribe cannabidiol to patients.<ref>{{cite web|title=Doctors now able to prescribe cannabidiol|date=June 2, 2017|url=https://www.radionz.co.nz/news/political/332137/doctors-now-able-to-prescribe-cannabidiol|access-date=June 2, 2017|publisher=radionz.co.nz|archive-date=June 1, 2017|archive-url=https://web.archive.org/web/20170601230111/http://www.radionz.co.nz/news/political/332137/doctors-now-able-to-prescribe-cannabidiol|url-status=live}}</ref>

The passing of the [[Misuse of Drugs (Medicinal Cannabis) Amendment Act]] in December 2018 means cannabidiol is no longer a controlled drug in New Zealand, but is a prescription medicine under the Medicines Act, with the restriction that "the tetrahydrocannabinols (THCs) and specified substances within the product must not exceed 2 percent of the total CBD, tetrahydrocannabinol (THC) and other specified substances."<ref>{{cite web|title=CBD products|url=https://www.health.govt.nz/our-work/regulation-health-and-disability-system/medicines-control/medicinal-cannabis/cbd-products|access-date=March 10, 2019|publisher=www.health.govt.nz|archive-date=February 4, 2019|archive-url=https://web.archive.org/web/20190204024704/https://www.health.govt.nz/our-work/regulation-health-and-disability-system/medicines-control/medicinal-cannabis/cbd-products|url-status=live}}</ref>

====Russian Federation====

According to a document received in response to an appeal to the Ministry of Internal Affairs of the Russian Federation, measures of state control in the Russian Federation regarding CBD have not been established. However, there is also a response from the Ministry of Health of the Russian Federation indicating that CBD can be considered as an isomer of restricted [[THC]]. The "[[isomer]]" argument is nonetheless vague, as [[progesterone]], which is freely sold in pharmacies, is also an isomer of THC, all three being {{chem|C|21|H|30|O|2}}.<ref>{{Cite web|url=https://pravoved.ru/question/2412784/|title=Является ли вещество CBD (каннабидиол) разрешенным к использованию на территории России? – Правовед.RU|access-date=February 19, 2021|archive-date=November 1, 2021|archive-url=https://web.archive.org/web/20211101213628/https://pravoved.ru/question/2412784/|url-status=live}}</ref> On February 17, 2020, the deputy of the Moscow City Duma [[Darya Besedina]] sent an official request to the Prime Minister of the Russian Federation [[Mikhail Mishustin]] with a request to eliminate that legal ambiguity by publishing official explanations and, if necessary, making required changes in the corresponding government decree.<ref>{{Cite web|url=https://besedina.moscow/messaging/242|title=Журнал переписки депутата Бесединой|access-date=February 19, 2021|archive-date=February 19, 2021|archive-url=https://web.archive.org/web/20210219064618/https://besedina.moscow/messaging/242|url-status=live}}</ref>

====Singapore====

Singapore allows medical cannabis on a case-by-case basis, usually as a last resort drug. Each case is evaluated by the government, and largely comes in the form of Cannabidiol. However, the country is flexible to what is required for patient treatment, despite having some of the strictest drug laws in the world.

====Sweden====

Cannabidiol is classified as a medical product in Sweden.<ref>{{cite web|url=https://lakemedelsverket.se/Alla-nyheter/NYHETER---2018/CBD-produkter-ska-folja-lakemedelslagen/|title=CBD products should follow the drug laws|publisher=Swedish Medical Products Agency|date=April 4, 2018|access-date=July 31, 2018|archive-date=July 24, 2018|archive-url=https://web.archive.org/web/20180724032251/https://lakemedelsverket.se/Alla-nyheter/NYHETER---2018/CBD-produkter-ska-folja-lakemedelslagen/|url-status=live}}</ref> However, in July 2019, [[Supreme Court of Sweden]] ruled that CBD oil with any concentration of THC falls under the narcotic control laws.<ref>{{Cite web|vauthors=Arnold M|date=July 30, 2019|title=Sweden Joins Italy In Path To Defining CBD Oil Regulations|url=https://cannabisindustryjournal.com/news_article/sweden-joins-italy-in-path-to-defining-cbd-oil-regulations/|access-date=September 3, 2020|website=Cannabis Industry Journal|archive-date=November 8, 2020|archive-url=https://web.archive.org/web/20201108021557/https://cannabisindustryjournal.com/news_article/sweden-joins-italy-in-path-to-defining-cbd-oil-regulations/|url-status=live}}</ref>

====Switzerland====

While THC remains illegal, cannabidiol is not subject to the Swiss Narcotic Acts because it does not produce a comparable psychoactive effect.<ref>{{Cite web|title=Cannabis: What is allowed, what is not allowed in Switzerland? – www.ch.ch|url=https://www.ch.ch/en/safety-and-justice/police/cannabis/|access-date=September 3, 2020|website=www.ch.ch|archive-date=January 21, 2021|archive-url=https://web.archive.org/web/20210121154628/https://www.ch.ch/en/safety-and-justice/police/cannabis/|url-status=live}}</ref> Cannabis products containing less than 1% THC can be sold and purchased legally.<ref>{{Cite web|collaboration=Vischer AG|vauthors=Kohler S, Benz AS, Pruschy D|title=Trends in the Swiss Cannabis Regulation {{!}} Lexology|url=https://www.lexology.com/library/detail.aspx?g=f50473b1-32a3-43a1-a05a-acafc5c937f6|access-date=September 3, 2020|website=www.lexology.com|date=April 11, 2019|archive-date=January 17, 2021|archive-url=https://web.archive.org/web/20210117113611/https://www.lexology.com/library/detail.aspx?g=f50473b1-32a3-43a1-a05a-acafc5c937f6|url-status=live}}</ref><ref>{{cite web|title=Cannabis à faible teneur en THC et CBD|url=https://www.bag.admin.ch/bag/fr/home/themen/mensch-gesundheit/sucht/cannabis/thc-armer-cannabis-cbd.html|url-status=dead|archive-url=https://web.archive.org/web/20170326123332/https://www.bag.admin.ch/bag/fr/home/themen/mensch-gesundheit/sucht/cannabis/thc-armer-cannabis-cbd.html|archive-date=March 26, 2017|access-date=May 20, 2017|publisher=BAG.Admin.ch|language=fr}}</ref>

====Ukraine====

On April 7, 2021, the Ukrainian government legalised use of isolated cannabidiol. Additionally, it approved [[Nabiximols]], a cannabidiol-containing drug, for medical use.<ref>{{cite news |url=https://life.pravda.com.ua/health/2021/04/9/244505/ |vauthors=Cross D |work=УП.Життя (UP.Life) |date=April 9, 2021 |language=Ukrainian |title=В Україні легалізували використання медичного канабісу, але не всього |trans-title=Ukraine has legalized the use of medical cannabis, but not all of it |access-date=April 10, 2021 |archive-date=April 9, 2021 |archive-url=https://web.archive.org/web/20210409202156/https://life.pravda.com.ua/health/2021/04/9/244505/ |url-status=live }}</ref>

====United Kingdom====

Cannabidiol, in an oral-mucosal spray formulation combined with [[delta-9-tetrahydrocannabinol]], is a product available by prescription for the relief of severe spasticity due to multiple sclerosis (where other anti-[[spasmodic]]s have not been effective) in the United Kingdom.<ref name="Sativex SmPC">{{cite web | title=Sativex Oromucosal Spray – Summary of Product Characteristics (SmPC) | website=(emc) | date=August 25, 2020 | url=https://www.medicines.org.uk/emc/product/602/smpc | access-date=September 11, 2020 | archive-date=February 4, 2021 | archive-url=https://web.archive.org/web/20210204162637/https://www.medicines.org.uk/emc/product/602/smpc | url-status=live }}</ref>

Until 2017, products containing cannabidiol marketed for medical purposes were classed as medicines by the UK [[Regulation of therapeutic goods|regulatory body]], the [[Medicines and Healthcare products Regulatory Agency]] (MHRA), and could not be marketed without regulatory approval for the medical claims.<ref>{{cite news|title=MHRA statement on products containing Cannabidiol (CBD)|url=https://www.gov.uk/government/news/mhra-statement-on-products-containing-cannabidiol-cbd|publisher=Gov.uk|date=December 14, 2016|access-date=December 14, 2016|archive-date=May 10, 2019|archive-url=https://web.archive.org/web/20190510061128/https://www.gov.uk/government/news/mhra-statement-on-products-containing-cannabidiol-cbd|url-status=live}}</ref><ref>{{Cite web|title=UK Classifies CBD Oil as a Medicinal Ingredient|url=https://www.buycbd.net/blog/uk-classifies-cbd-oil-as-a-medicinal-ingredient/|access-date=September 3, 2020|website=BuyCBD.net|archive-date=November 1, 2021|archive-url=https://web.archive.org/web/20211101213519/https://www.buycbd.net/blog/uk-classifies-cbd-oil-as-a-medicinal-ingredient/|url-status=live}}</ref> {{as of|2018}}, cannabis oil is legal to possess, buy, and sell in the UK, providing the product does not contain more than 1 milligram of THC and is not advertised as providing a medicinal benefit.<ref name="Home Office">{{cite news|vauthors=Stallworth J|title=Drug licensing factsheet: cannabis, CBD and other cannabinoids|newspaper=The Home Office|url=https://www.gov.uk/government/publications/cannabis-cbd-and-other-cannabinoids-drug-licensing-factsheet/drug-licensing-factsheet-cannabis-cbd-and-other-cannabinoids#the-exempted-product-definition---regulation-2-of-the-mdr-2001|access-date=December 10, 2020|archive-date=January 17, 2021|archive-url=https://web.archive.org/web/20210117213102/https://www.gov.uk/government/publications/cannabis-cbd-and-other-cannabinoids-drug-licensing-factsheet/drug-licensing-factsheet-cannabis-cbd-and-other-cannabinoids#the-exempted-product-definition---regulation-2-of-the-mdr-2001|url-status=live}}</ref> Individual police officers and others who are ill-informed of the exact legislature pertaining to cannabidiol, however, may erroneously consider it of dubious legality, reflecting lack of awareness.<ref>Ukaegbu O, Smith J, Hall D, Frain T, Abbasian C. Staff awareness of the use of cannabidiol (CBD): a trust-wide survey study in the UK. Journal of Cannabis Research. 2021 Dec;3(1):1-0.</ref>

In January 2019, the UK [[Food Standards Agency]] indicated it would regard CBD products, including CBD oil, as a ''[[novel food]]'' having no history of use before May 1997, and stated that such products must have authorisation and proven safety before being marketed.<ref name="chu" /><ref name="gunn">{{cite web | vauthors=Gunn L, Haigh L | title=British watchdog deems CBD a novel food, seeks to curtail sale on UK market | publisher=Nutrition Insight, CNS Media BV | date=January 29, 2019 | url=https://www.nutritioninsight.com/news/british-watchdog-deems-cbd-a-novel-food-seeks-to-ban-sale-on-uk-market.html | access-date=January 1, 2019 | archive-url=https://web.archive.org/web/20190202042806/https://www.nutritioninsight.com/news/british-watchdog-deems-cbd-a-novel-food-seeks-to-ban-sale-on-uk-market.html | archive-date=February 2, 2019 }}</ref> The deadline for companies with existing products to submit a full and validated novel foods application with the FSA was March 31, 2021; failure to do so before this date would exclude those companies from selling CBD.<ref name="fsa">{{cite web|date=September 24, 2020|title=Cannabidiol (CBD) guidance – Business guidance on cannabidiol (CBD) as a novel food|url=https://www.food.gov.uk/business-guidance/cannabidiol-cbd|access-date=December 8, 2020|publisher=UK Food Standards Agency|archive-date=October 30, 2021|archive-url=https://web.archive.org/web/20211030090033/https://www.food.gov.uk/business-guidance/cannabidiol-cbd|url-status=live}}</ref> New products containing CBD after this deadline would require a fully approved application.<ref>{{Cite web|vauthors=Marsat N|date=July 7, 2020|title=CBD and Novel Foods regulation in the UK: regulation then and now|url=https://www.healtheuropa.eu/cbd-and-novel-foods-regulation-in-the-uk-regulation-then-and-now/101187/|access-date=December 10, 2020|website=Health Europa|language=en-GB|archive-date=October 6, 2020|archive-url=https://web.archive.org/web/20201006014147/https://www.healtheuropa.eu/cbd-and-novel-foods-regulation-in-the-uk-regulation-then-and-now/101187/|url-status=live}}</ref>

In February 2020, the UK FSA advised vulnerable people, such as pregnant women, breastfeeding mothers, and those already taking medication for other medical concerns not to take CBD. The FSA further recommended that healthy adults should not consume more than 70{{nbsp}}mg CBD per day.<ref name="fsa" />

====United Nations====

Cannabidiol is scheduled under the [[Single Convention on Narcotic Drugs]] as cannabis. International Narcotics Control Board reminds Member States that, at the reconvened sixty-third session of the Commission on Narcotic Drugs, in December 2020, the States members of the Commission rejected the recommendation of WHO that a footnote be added to the entry for cannabis and cannabis resin in Schedule I of the 1961 Convention as amended to exempt from international control preparations containing predominantly CBD and not more than 0.2 per cent of delta-9-THC.<ref>{{Cite web |url=https://www.incb.org/documents/Publications/AnnualReports/AR2021/Annual_Report/E_INCB_2021_1_eng.pdf |title=Reports published by the International Narcotics Control Board for 2021 |access-date=December 1, 2022 |archive-date=November 30, 2022 |archive-url=https://web.archive.org/web/20221130103840/https://www.incb.org/documents/Publications/AnnualReports/AR2021/Annual_Report/E_INCB_2021_1_eng.pdf |url-status=live }}</ref>

====United States====

{{As of|2023}}, cannabidiol extracted from marijuana remains a [[Schedule I Controlled Substance]],<ref name="fdareg" /><ref name="Mead">{{cite journal | vauthors = Mead A | title = The legal status of cannabis (marijuana) and cannabidiol (CBD) under US law | journal = Epilepsy & Behavior | volume = 70 | issue = Pt B | pages = 288–291 | date = May 2017 | pmid = 28169144 | doi = 10.1016/j.yebeh.2016.11.021 | doi-access = free }}</ref><ref>{{Cite web|url=https://www.congress.gov/bill/115th-congress/house-bill/2/text|title=Text – H.R.2 – 115th Congress (2017-2018): Agriculture Improvement Act of 2018|vauthors=Conaway KM|date=December 20, 2018|website=Congress.gov|access-date=May 1, 2019|archive-date=October 6, 2021|archive-url=https://web.archive.org/web/20211006230238/https://www.congress.gov/bill/115th-congress/house-bill/2/text|url-status=live}}</ref> and is not approved as a [[prescription drug]] or [[dietary supplement]] or allowed for interstate commerce in the United States.<ref name="fda11-26-19">{{cite web |title=What You Need to Know (And What We're Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD |url=https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis |publisher=US Food and Drug Administration |access-date=June 23, 2022 |date=March 5, 2020 |archive-date=October 22, 2021 |archive-url=https://web.archive.org/web/20211022185821/https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis |url-status=live }}</ref> CBD derived from hemp (with 0.3% THC or lower) is legal to sell as a cosmetics ingredient or for other purposes not regulated by the FDA, but cannot be sold under federal law as an ingredient in food, dietary supplement, or animal feed.<ref name="fdareg" /><ref name="bell">{{cite web |publisher=[[Science-Based Medicine]] |url=https://sciencebasedmedicine.org/fda-no-cbd-in-dietary-supplements-or-foods-for-now-but-lets-talk/ |vauthors=Bellamy J |date=May 9, 2019 |title=FDA: No CBD in dietary supplements or foods for now, but let's talk |access-date=June 15, 2019 |archive-date=August 17, 2020 |archive-url=https://web.archive.org/web/20200817142121/https://sciencebasedmedicine.org/fda-no-cbd-in-dietary-supplements-or-foods-for-now-but-lets-talk/ |url-status=live }}</ref> It is a common misconception that the legal ability to sell hemp (which may contain CBD), and hemp extracts and derivatives (including CBD), makes CBD legal for sale as a supplement or medicine.<ref name="bell" /><ref name="fda-hemp">{{cite web |vauthors=Abernethy A, Schiller L |title=FDA is Committed to Sound, Science-based Policy on CBD |url=https://www.fda.gov/news-events/fda-voices-perspectives-fda-leadership-and-experts/fda-committed-sound-science-based-policy-cbd |publisher=US [[Food and Drug Administration]] (FDA) |access-date=October 17, 2019 |date=July 17, 2019 |archive-date=November 14, 2019 |archive-url=https://web.archive.org/web/20191114232749/https://www.fda.gov/news-events/fda-voices-perspectives-fda-leadership-and-experts/fda-committed-sound-science-based-policy-cbd |url-status=live }}</ref>

In September 2018, the [[GW Pharmaceuticals]] drug Epidiolex was placed in Schedule V of the [[Controlled Substances Act]] by the [[Drug Enforcement Administration]] (DEA),<ref name="CNBC">{{Cite news | url = https://www.cnbc.com/2018/09/27/dea-schedules-epidiolex-allowing-gw-pharma-to-start-selling-the-drug.html | title = DEA reschedules Epidiolex, marijuana-derived drug, paving the way for it to hit the market | publisher = CNBC | date = September 27, 2018 | access-date = October 3, 2018 | archive-date = April 26, 2021 | archive-url = https://web.archive.org/web/20210426202908/https://www.cnbc.com/2018/09/27/dea-schedules-epidiolex-allowing-gw-pharma-to-start-selling-the-drug.html | url-status = live }}</ref> following its approval by the FDA for rare types of childhood epilepsy.<ref name="Epidiolex FDA label"/> It was then removed from the Controlled Substances Act by the DEA in April 2020.<ref>{{cite news | vauthors = Wood S |title=DEA relaxes rules for the only federally approved drug derived from marijuana |url=https://www.inquirer.com/business/weed/epidiolex-cbd-cannabidiol-gw-pharma-roark-dea-fda-20200406.html |access-date=April 23, 2023 |work=The Philadelphia Inquirer |date=April 6, 2020 |archive-url=https://web.archive.org/web/20200609035500/https://www.inquirer.com/business/weed/epidiolex-cbd-cannabidiol-gw-pharma-roark-dea-fda-20200406.html |archive-date=June 9, 2020}}</ref> Epidiolex is available for prescription use in all 50 states.<ref>{{cite news | vauthors = Tinker B |title=First FDA-approved cannabis-based drug now available in the US |url=https://www.cnn.com/2018/11/01/health/marijuana-drug-epidiolex-prescription/index.html |access-date=April 23, 2023 |work=CNN |date=November 2, 2018}}</ref>

In 2013, a [[CNN]] program that featured [[Charlotte's Web (cannabis)|Charlotte's Web cannabis]] brought increased attention to the use of CBD for the treatment of seizure disorders in children.<ref name="MaaFigi2014">{{cite journal | vauthors = Maa E, Figi P | title = The case for medical marijuana in epilepsy | journal = Epilepsia | volume = 55 | issue = 6 | pages = 783–786 | date = June 2014 | pmid = 24854149 | doi = 10.1111/epi.12610 | s2cid = 4849160 | doi-access = free }}</ref><ref name="CNN charlotte">{{cite web | vauthors = Saundra Y | title = Marijuana stops child's severe seizures | url = http://www.cnn.com/2013/08/07/health/charlotte-child-medical-marijuana/index.html | website = CNN | date = August 7, 2013 | access-date = May 14, 2018 | archive-date = May 14, 2018 | archive-url = https://web.archive.org/web/20180514144200/https://www.cnn.com/2013/08/07/health/charlotte-child-medical-marijuana/index.html | url-status = live }}</ref> A number of states passed laws over the next few years to allow the use of low-THC, high-CBD cannabis oil in such situations.<ref name="ncsl states">{{cite web|title=State Medical Marijuana Laws|url=http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx|website=National Conference of State Legislatures|date=April 27, 2018|access-date=May 14, 2018|archive-date=December 11, 2018|archive-url=https://web.archive.org/web/20181211125951/http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx|url-status=live}}</ref> These states were in addition to the states that had already legalized cannabis for [[Medical cannabis in the United States|medical]] or [[Legalization of non-medical cannabis in the United States|recreational]] use.<ref name="ncsl states" /> Many states further relaxed their laws regarding CBD following the passage of the 2018 Farm Bill.<ref>{{cite news | vauthors = Schuman B, Fisher J, Radke B, Faldetta G |title=A Survey of State CBD & Hemp Regulation Since The 2018 Farm Bill |url=https://cannabisindustryjournal.com/feature_article/a-survey-of-state-cbd-hemp-regulation-since-the-2018-farm-bill/ |access-date=April 24, 2023 |work=Cannabis Industry Journal |date=October 22, 2020}}</ref><ref>{{cite news | vauthors = Gebhart F |title=The Evolution of the CBD Regulatory Landscape |url=https://www.drugtopics.com/view/the-evolution-of-the-cbd-regulatory-landscape |access-date=April 24, 2023 |work=Drug Topics Journal |date=September 13, 2022}}</ref>

The [[Agricultural Act of 2014|2014 Farm Bill]]<ref>{{Cite web|url=http://www.thefarmbill.com/the-bill|title=The 2014 Farm Bill|website=thefarmbill.com|access-date=November 27, 2018|archive-date=October 30, 2021|archive-url=https://web.archive.org/web/20211030111724/https://www.thefarmbill.com/the-bill|url-status=live}}</ref> legalized the sale of "non-viable hemp material" grown within states participating in the Hemp Pilot Program which defined ''hemp'' as cannabis containing less than 0.3% of THC.<ref>{{Cite news|url=https://www.forbes.com/sites/monazhang/2018/04/05/no-cbd-is-not-legal-in-all-50-states/|title=No, CBD Is Not 'Legal in All 50 States'|vauthors=Zhang M|work=Forbes|access-date=November 27, 2018|archive-date=December 5, 2020|archive-url=https://web.archive.org/web/20201205235942/https://www.forbes.com/sites/monazhang/2018/04/05/no-cbd-is-not-legal-in-all-50-states/|url-status=live}}</ref> The [[Agriculture Improvement Act of 2018|2018 Farm Bill]] removed the hemp plant and all "derivatives, extracts, cannabinoids, isomers, acids, salts, and salts of isomers, whether growing or not, with a delta-9 tetrahydrocannabinol concentration of not more than 0.3 percent on a dry weight basis," including CBD, from the [[Controlled Substances Act]], making them legal to manufacture in the United States.<ref name="Mead 2019"/><ref>{{USC|7|1639o}}</ref><ref>{{USC|21|802}}</ref> The FDA retains regulatory authority over hemp-derived CBD,<ref name="fda-hemp" /> while the [[Drug Enforcement Administration|DEA]] is not involved in the regulation of legally-compliant hemp and hemp products.<ref name="dea">{{cite web |title=DEA announces steps necessary to improve access to marijuana research |url=https://www.dea.gov/press-releases/2019/08/26/dea-announces-steps-necessary-improve-access-marijuana-research |publisher=United States Drug Enforcement Administration |access-date=October 18, 2019 |date=August 26, 2019 |archive-date=October 18, 2019 |archive-url=https://web.archive.org/web/20191018222642/https://www.dea.gov/press-releases/2019/08/26/dea-announces-steps-necessary-improve-access-marijuana-research |url-status=live }}</ref> The 2018 Farm Bill requires that research and development of CBD for a therapeutic purpose would have to be conducted under notification and reporting to the FDA.<ref name="fda-hemp" /><ref name="hahn" />

==Veterinary use==

===Research===

The number of research projects and scientific publications on cannabidiol and other cannabinoids in pets surged in the late 2010s; nonetheless, {{As of|December 2020|lc=y}}, there were no hemp-derived, cannabinoid-rich registered veterinary medicinal products in any of the major regions (see [[#Legal status]]).

In the US and other territories there are, however, numerous veterinary nutraceutical products available over the counter (OTC). The lack of clarity in the regulations governing veterinary hemp [[food supplement]]s allows for products of questionable quality to flood the market,<ref name="fda7-19">{{cite web |title=FDA warns company marketing unapproved cannabidiol products with unsubstantiated claims to treat cancer, Alzheimer's disease, opioid withdrawal, pain and pet anxiety |url=https://www.fda.gov/news-events/press-announcements/fda-warns-company-marketing-unapproved-cannabidiol-products-unsubstantiated-claims-treat-cancer |publisher=US Food and Drug Administration (FDA) |access-date=July 24, 2019 |date=July 23, 2019 |quote=Unlike drugs approved by the FDA, the manufacturing process of these products has not been subject to FDA review as part of the drug approval process, and there has been no FDA evaluation of whether these products are effective for their intended use, what the proper dosage is, how they could interact with FDA-approved drugs, or whether they have dangerous side effects or other safety concerns. |archive-date=August 14, 2019 |archive-url=https://web.archive.org/web/20190814014310/https://www.fda.gov/news-events/press-announcements/fda-warns-company-marketing-unapproved-cannabidiol-products-unsubstantiated-claims-treat-cancer |url-status=live }}</ref><ref name="Wakshlag_2020a">{{cite journal | vauthors = Wakshlag JJ, Cital S, Eaton SJ, Prussin R, Hudalla C | title = Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements | journal = Veterinary Medicine: Research and Reports | volume = 11 | pages = 45–55 | date = April 15, 2020 | pmid = 32346530 | pmc = 7169471 | doi = 10.2147/vmrr.s248712 | doi-access = free }}</ref> which may pose a risk to the wellbeing of pets and owners.

To understand better the benefits of CBD and associated compounds for the quality of life of animals, companies specialized in CBD products for animals have been funding research projects.<ref name="McGrath_2019">{{cite journal | vauthors = McGrath S, Bartner LR, Rao S, Packer RA, Gustafson DL | title = Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy | journal = Journal of the American Veterinary Medical Association | volume = 254 | issue = 11 | pages = 1301–1308 | date = June 2019 | pmid = 31067185 | doi = 10.2460/javma.254.11.1301 | s2cid = 148569810 }}</ref><ref name="Verrico_2020">{{cite journal | vauthors = Verrico CD, Wesson S, Konduri V, Hofferek CJ, Vazquez-Perez J, Blair E, Dunner K, Salimpour P, Decker WK, Halpert MM | title = A randomized, double-blind, placebo-controlled study of daily cannabidiol for the treatment of canine osteoarthritis pain | journal = Pain | volume = 161 | issue = 9 | pages = 2191–2202 | date = September 2020 | pmid = 32345916 | pmc = 7584779 | doi = 10.1097/j.pain.0000000000001896 }}</ref><ref name="Mogi_2019">{{cite journal|vauthors=Mogi C, Fukuyama T|title=Cannabidiol as a potential anti-epileptic dietary supplement in dogs with suspected epilepsy: three case reports|url=http://www.uco.es/ucopress/ojs/index.php/pet/issue/view/960|journal=Pet Behaviour Science|year=2019|issue=7|pages=11–16|doi=10.21071/pbs.v0i7|issn=2445-2874|doi-access=free|access-date=December 17, 2020|archive-date=September 3, 2020|archive-url=https://web.archive.org/web/20200903190519/https://www.uco.es/ucopress/ojs/index.php/pet/issue/view/960|url-status=live}}</ref><ref name="Wakshlag_2020">{{cite journal | vauthors = Wakshlag JJ, Schwark WS, Deabold KA, Talsma BN, Cital S, Lyubimov A, Iqbal A, Zakharov A | title = Pharmacokinetics of Cannabidiol, Cannabidiolic Acid, Δ9-Tetrahydrocannabinol, Tetrahydrocannabinolic Acid and Related Metabolites in Canine Serum After Dosing With Three Oral Forms of Hemp Extract | journal = Frontiers in Veterinary Science | volume = 7 | pages = 505 | date = September 4, 2020 | pmid = 33102539 | pmc = 7498943 | doi = 10.3389/fvets.2020.00505 | doi-access = free }}</ref>

===Canine osteoarthritis===

CBD's ability to help regulate the endocannabinoid system<ref>{{cite journal | vauthors = Ibrahim MM, Deng H, Zvonok A, Cockayne DA, Kwan J, Mata HP, Vanderah TW, Lai J, Porreca F, Makriyannis A, Malan TP | title = Activation of CB2 cannabinoid receptors by AM1241 inhibits experimental neuropathic pain: pain inhibition by receptors not present in the CNS | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 100 | issue = 18 | pages = 10529–10533 | date = September 2003 | pmid = 12917492 | pmc = 193595 | doi = 10.1073/pnas.1834309100 | bibcode = 2003PNAS..10010529I | doi-access = free }}</ref><ref>{{cite journal | vauthors = Hohmann AG, Farthing JN, Zvonok AM, Makriyannis A | title = Selective activation of cannabinoid CB2 receptors suppresses hyperalgesia evoked by intradermal capsaicin | journal = The Journal of Pharmacology and Experimental Therapeutics | volume = 308 | issue = 2 | pages = 446–453 | date = February 2004 | pmid = 14610224 | doi = 10.1124/jpet.103.060079 | s2cid = 17663780 }}</ref><ref>{{cite book | vauthors = Jung KM, Piomelli D | chapter = Cannabinoids and Endocannabinoids|date=2015 | title =Neuroscience in the 21st Century|pages=1–31| veditors = Pfaff DW, Volkow ND |place=New York|publisher=Springer New York|language=en|doi=10.1007/978-1-4614-6434-1_136-1|isbn=978-1461464341 }}</ref> and reduce the release of excitatory neurotransmitters could result in a retrograde inhibitory signal that lessens chronic pain responses. Studies in dogs with chronic pain associated with osteoarthritis showed an increase in level of activity in animals receiving CBD-rich [[food supplement]]s.<ref name="Gamble_2018">{{cite journal |vauthors=Gamble LJ, Boesch JM, Frye CW, Schwark WS, Mann S, Wolfe L, Brown H, Berthelsen ES, Wakshlag JJ |date=July 23, 2018 |title=Pharmacokinetics, Safety, and Clinical Efficacy of Cannabidiol Treatment in Osteoarthritic Dogs |journal=Frontiers in Veterinary Science |volume=5 |pages=165 |doi=10.3389/fvets.2018.00165 |pmc=6065210 |pmid=30083539 |doi-access=free}}</ref><ref name="Brioschi_2020">{{cite journal |vauthors=Brioschi FA, Di Cesare F, Gioeni D, Rabbogliatti V, Ferrari F, D'Urso ES, Amari M, Ravasio G |date=August 2020 |title=Oral Transmucosal Cannabidiol Oil Formulation as Part of a Multimodal Analgesic Regimen: Effects on Pain Relief and Quality of Life Improvement in Dogs Affected by Spontaneous Osteoarthritis |journal=Animals |volume=10 |issue=9 |pages=1505 |doi=10.3390/ani10091505 |pmc=7552307 |pmid=32858828 |doi-access=free}}</ref><ref name="Kogan_2020">{{Cite journal |vauthors=Kogan L, Hellyer P, Downing R |year=2020 |title=Hemp Oil Extract to Treat Canine Osteoarthritis-Related Pain: A Pilot Study |url=https://www.researchgate.net/publication/339698157 |url-status=live |journal=Journal of the American Holistic Veterinary Medical Association |volume=58 |pages=35–45 |archive-url=https://web.archive.org/web/20211101213526/https://www.researchgate.net/publication/339698157_The_Use_of_Cannabidiol-Rich_Hemp_Oil_Extract_to_Treat_Canine_Osteoarthritis-Related_Pain_A_Pilot_Study |archive-date=November 1, 2021 |access-date=December 17, 2020}}</ref><ref name="Verrico_2020" />

===Epilepsy===

From the results seen in humans with drugs such as Epidiolex and Sativex in scientific studies and reviews,<ref>{{Cite book| vauthors = Russo E |title=Handbook of psychotropic herbs: a scientific analysis of herbal remedies for psychiatric conditions|date=2001|publisher=Haworth Herbal Press|isbn=0789007185|location=New York|oclc=43810871}}</ref> it could be expected that CBD-based products would be helpful to manage seizures in dogs. However, despite the numerous case reports presented by veterinary neurologists supporting the benefits of CBD as adjunctive therapy, {{as of|December 2020|lc=y}}, published controlled studies have not shown a statistically significant decrease in the number of seizures across the groups receiving CBD.<ref name="McGrath_2019" /><ref name="Mogi_2019" />

===Pharmacokinetics===

The oral bioavailability of CBD varies greatly across species and it is linked to the presentation and the time of administration.<ref name="Deabold_2019">{{cite journal |vauthors=Deabold KA, Schwark WS, Wolf L, Wakshlag JJ |date=October 2019 |title=Single-Dose Pharmacokinetics and Preliminary Safety Assessment with Use of CBD-Rich Hemp Nutraceutical in Healthy Dogs and Cats |journal=Animals |volume=9 |issue=10 |pages=832 |doi=10.3390/ani9100832 |pmc=6826847 |pmid=31635105 |doi-access=free}}</ref><ref name="Wakshlag_2020" /><ref name="Vaughn_2020">{{cite journal | vauthors = Vaughn D, Kulpa J, Paulionis L | title = Preliminary Investigation of the Safety of Escalating Cannabinoid Doses in Healthy Dogs | journal = Frontiers in Veterinary Science | volume = 7 | pages = 51 | date = February 11, 2020 | pmid = 32118071 | pmc = 7029731 | doi = 10.3389/fvets.2020.00051 | doi-access = free }}</ref> A 24-hour kinetic examination in dogs showed that the absorption of the cannabidiolic acid (CBDA) does occur, and that this molecule is absorbed least twice as well as CBD post oral ingestion.<ref name="Deabold_2019" /><ref name="Wakshlag_2020" /><ref>{{cite journal | vauthors = Della Rocca G, Di Salvo A | title = Hemp in Veterinary Medicine: From Feed to Drug | journal = Frontiers in Veterinary Science | volume = 7 | pages = 387 | date = July 28, 2020 | pmid = 32850997 | pmc = 7399642 | doi = 10.3389/fvets.2020.00387 | doi-access = free }}</ref>

It was found that the major metabolites of CBD in humans ([[7-OH-CBD]] and 7-COOH-CBD) are not prevalent in dogs, while 6-OH-CBD was found to be the primary metabolite in dogs receiving a CBD-enriched cannabis-derived herbal extract,<ref>{{cite journal | vauthors = Chicoine A, Illing K, Vuong S, Pinto KR, Alcorn J, Cosford K | title = Pharmacokinetic and Safety Evaluation of Various Oral Doses of a Novel 1:20 THC:CBD ''Cannabis'' Herbal Extract in Dogs | journal = Frontiers in Veterinary Science | volume = 7 | pages = 583404 | date = September 29, 2020 | pmid = 33134364 | pmc = 7550466 | doi = 10.3389/fvets.2020.583404 | doi-access = free }}</ref> suggesting that canine and human CBD metabolic route might be somewhat different.<ref name="Vaughn_2020" />

==Research==

{{As of|2022}}, there was little evidence for cannabidiol having a benefits in [[psychiatric disorder]]s in humans.<ref name=kirkland/><ref name="black" /><ref name="mayo" /><ref name="prud" /><ref name="Hoch">{{cite journal | vauthors = Hoch E, Niemann D, von Keller R, Schneider M, Friemel CM, Preuss UW, Hasan A, Pogarell O | title = How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review | journal = European Archives of Psychiatry and Clinical Neuroscience | volume = 269 | issue = 1 | pages = 87–105 | date = February 2019 | pmid = 30706168 | pmc = 6595000 | doi = 10.1007/s00406-019-00984-4 }}</ref>

In the United States, federal illegality has made it difficult historically to conduct research on CBD.<ref>{{cite news | vauthors = Sanders L |title=The CBD boom is way ahead of the science |url=https://www.sciencenews.org/article/cbd-product-boom-science-research-hemp-marijuana |access-date=April 24, 2023 |work=Science News |date=March 27, 2019}}</ref>

==References==

{{Reflist}}

==Further reading==

{{Refbegin}}

* {{Cite news |title=Why Is CBD Everywhere? |vauthors=Williams A |work=[[The New York Times]] |date=October 27, 2018 |url=https://www.nytimes.com/2018/10/27/style/cbd-benefits.html |issn=0362-4331 |access-date=November 17, 2018 |archive-date=October 22, 2021 |archive-url=https://web.archive.org/web/20211022054134/https://www.nytimes.com/2018/10/27/style/cbd-benefits.html |url-status=live }}

* {{Skeptoid | id= 4780| number= 780| title=CBD for Everything: Cannabidiol is sold as an additive to just about every kind of product you can imagine. Why?| date=May 18, 2021| access-date=May 21, 2022}}

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