If you want to try CBD go ‘Low & Slow,’ says expert

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UBC’s Dr. M-J Milloy, appearing on the season-opener of the award-winning CBC program White Coat, Black Art, was asked by the show’s host, Dr. Brian Goldman, What would you say to a friend or family member who says they want to give CBD a try? to which Milloy replied:

The best advice is to start low – with a very low dose – and to go slow. Only increase that dose very slowly until they’ve either reached the effects they want to experience – whether that’s with pain relief, nausea, or anxiety – and, of course, discontinue if they’re suffering from adverse effects .

Adverse risks Milloy cited were diarrhea, vomiting, & fatigue, that have been reported in children treated with very high doses of CBD for epilepsy (20 mg CBD/kg of bodyweight/day). His other concern is drug interactions – that CBD could affect the metabolism of anti-depressants like opioids and benzodiazepines: “These are obviously very serious medications with very serious risks, and so it’s very concerning,” he said.

The good news is that although a survey of 2,409 CBD users found that nearly 1 out of 3 users experienced some side effect, all the effects were minor, as this table from their study shows:

Adverse effectMedical condition (n=1483) n (%)General health and well-being (n=926) n (%)Total (n=2409) n (%)
Dry mouth174 (11.73%)94 (10.15%)268 (11.12%)
Euphoria59 (3.98%)96 (10.37%)155 (6.43%)
Hunger80 (5.39%)73 (7.88%)153 (6.35%)
Other46 (3.10%)11 (1.19%)57 (2.37%)
Red eyes34 (2.29%)32 (3.46%)66 (2.74%)
Sleepy/groggy29 (1.96%)14 (1.51%)43 (1.78%)
Total adverse effects422 (28.46%)320 (34.56%)742 (30.80%)

‘Medical condition’ refers to people using CBD for an identified medical problem like pain, inflammation, or depression. ‘General health and well-being’ refers to people who simply want to feel better but have no specific physical complaint.

The point about side effects, says Milloy, is to diasabuse ourselves of the notion that just because something comes from a plant that it means it’s safe: “Even though something is natural or comes from the natural world, it does not mean that it does not carry risks.”

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