How Do THC And CBD Work Together?
Medicinal marijuana has been around for centuries; in more recent years, you know about it because of your aunt’s glaucoma, your neighbor’s cancer treatment, or your roommate’s “insomnia” for their medical card. But many people who could benefit from cannabis medicine (there are zillions of potential healing properties, many of them are just beginning to get the scientific credit they deserve) are standing back because of one major drawback: the high.
For some people (obviously) the high, intoxication, euphoria — whatever you want to call it — is a plus. It can curb anxiety, mitigate depression, and help you laugh a little bit at the end of a stressful day. For others, it’s a massive interference for everyday responsibilities, and can inhibit one’s ability to drive, perform in their jobs, or care for their families. Again — not true for everyone, but realistically this has been a deterrent for a large group of people.
Is there a way to get the medical benefits without getting stoned?
As it turns out, CBD might be the “key” to this, says Dr. Perry Solomon, MD, a board-certified anesthesiologist and cannabis expert. In fact, cannabis users have been applying this trick for a while, but the evidence so far has been strictly anecdotal. However, Dr. Solomon says there’s a pretty significant catch.
“CBD modifying or modulating the effect of THC [read: reducing its intoxicating abilities] is not controversial, but depends on the person,” he said. “Sometimes CBD can reduce the effects of THC, and sometimes it can exacerbate it and make it stronger — it’s very inconsistent.” Sooo… bear that in mind; it could seriously decrease your high, or it could make you more stoned if you’re one of the unlucky few who have the opposite reaction.
Focusing on the way it could decrease the high, fellow physician and president of the Association of Cannabis Specialists Dr. Jordan Tishler told SVN a bit about how CBD might work with THC. “CBD’s main mechanism is to bind the CB receptors to which THC binds,” he explained. Note: these receptors are part of your body’s endocannabinoid system. “THC activates the receptor, but the CBD does not,” he said. “Instead, the CBD changes the way the receptor behaves when the THC comes along. The change to the action of the CBD receptors is why CBD seems to decrease the intoxication of THC.”
Dr. Solomon calls this a “negative allosteric modulator,” which essentially means it attenuates the effects of the agonist (in this case, the agonist is THC). Some evidence that supports the CBD-anti-high theory is the drug Marinol. “Marinol is an FDA-approved medication that has been available since the early 1990s,” said Dr. Tishler. “However, it is rarely used because it causes so much intoxication that patients rarely get to a level where they benefit. This, we believe, is because there’s no CBD (or other cannabinoids) to reduce the intoxication of THC.”
So how much CBD do you need to not get high with THC?
Both Dr. Solomon and Dr. Tishler emphasized that it’s not just the ratio of CBD to THC, but the dose. “The amount makes a huge difference,” said Dr. Solomon. He noted that a 1:1 CBD:THC ratio might be fine if you’re only taking one milligram of each, but if it’s 1000mg of each, you’re almost guaranteed to end up blitzed (our words, not his).
Dr. Tishler noted that it may not take a lot of CBD to attenuate the intoxication. “It’s important to understand that a tiny amount of CBD is needed to get the basic decease in intoxication,” he said, but he noted that there’s no evidence that it outright prevents intoxication. “There is some evidence from rodents that pre-treatment with CBD at very high doses can prevent intoxication.” This has yet to be evidenced in human studies, and he says it’s “unclear how pre-treatment would work in humans.”
In terms of finding the right ratio while you do your at-home DIY of the scientific method you learned in grade school, Dr. Solomon says it will depend on your goals. “When it comes to pain, [many patients] have found that a one-to-one combo of THC and CBD works better,” he told SVN. “With anxiety, [you’ll want a] more CBD heavy ratio; you might start with 10:1 CBD to THC or not even use THC. It works differently for everybody.”
Because of this, he reinforced the importance of working with a doctor when you’re using cannabis to treat something medical like pain or anxiety. “Definitely have the input of a physician,” he said. “At least tell the physician what you’re taking, especially if you’re taking medication — your medication won’t be metabolized correctly in the liver [if you’re experimenting with different levels of cannabis].” Note: if you’re concerned that your physician may not be versed enough in cannabis medicine to counsel you, Dr. Solomon shared that the Society of Cannabis Clinicians — based in California — has a set of “qualified physicians and healthcare practitioners” that you can go through to find someone to help with your treatment plan.
Anxiety—ranging from butterflies in your stomach, to the kind where your heart is racing and you’re up all night—is pretty common.