Amid speculation on whether cannabidiol (CBD) can influence the intoxicating effects of d9-tetrahydrocannabinol (THC), a new study supports this idea, along with another unexpected and interesting finding related to a serious mental health disorder. Published in the Journal of Clinical Psychopharmacology in September 2021, researchers concluded that CBD could lessen the psychoactive effects of THC when taken together. 1
The study found that consuming 65mg of THC was less intoxicating when combined with CBD in a 2:1 ratio than when taken alone, suggesting that CBD places a ceiling on some of the effects of THC. This is especially relevant for medical cannabis patients, who may need to medicate around the clock and for anyone who does not want the high for whatever reason.
Conducted in Spain, the study was a collaborative effort between researchers Jose’ Bouso, PhD from the International Center for Ethnobotanical Education, Research and Service, and Alberto Sainz-Cort, MSc from Universitat Oberta de Catalunya and GH Medical, among several other distinguished authors.
Their aim was to explore whether CBD had anti-intoxicating effects. CBD is often referred to as non-psychoactive, but it is indeed because it can affect mood and relieve anxiety. However, it is not psychoactive in the way most people think of, in the sense that it does not cause intoxication or the feeling of being high.
In order to participate, all subjects had to be over the age of 21 and be experienced cannabis users, consuming at least three times per week. Participants also had to be free of psychiatric or chronic disease, understand the study protocol, and agree to abstain from cannabis, alcohol, and other drugs for at least 12 hours prior to the study. These conditions are aimed to control any factors that might influence the results, also known as confounding variables.
The strength of a research study lies in its design. Most studies are conducted in a laboratory setting with rigid controls aimed at yielding verifiable, reproducible, and most importantly to the average reader, trustworthy results. Just as effective and sometimes more appropriate, are ecological studies in which the study subjects participate in a more natural environment to enhance any positive influences of their surroundings.
Naturalistic study mimics real-life situations better
When doing research, a natural environment also helps to eliminate any negative influences of a tightly controlled laboratory setting, such as a subject being less forthcoming. Subjects in a naturalistic study may have a more authentic experience and response, as the natural environment mimics the real-life experience. As this was a crossover study, each subject’s results were not compared to anyone else, reducing the potential and influence of any confounding variables.
The study was set up such that each subject participated in a total of four individual sessions during which they were given a precise dose of cannabis concentrate via a Volcano vaporizer made by Storz & Bickel. The participant received either CBD, THC, THC+CBD or a placebo and was assessed every 10 minutes for psychoactive effects of the cannabis. Neither the researchers nor the subjects knew which substance was being self-administered (double-blinded). Subjects completed questionnaires measuring symptoms such as relaxation, negative mood or perception and appetite at specific intervals throughout each 80-minute session. Each session was separated by at least a week as a “wash-out period” for any substances in the body to minimize any carry-over to the next session.
The dose consumed during the sessions were as follows: CBD 130 mg, THC 65 mg, CBD 130 mg + THC 65 mg combined (2:1 ratio CBD:THC) and a hemp placebo <0.05 mg total cannabinoids. The authors noted that previous studies used THC in the range of 8 mg, so the THC amount in this study (65mg) was a better representation of real-life, adult-use consumption. This makes the results to be generalizable, or more applicable to a broader population and not just the study participants.
CBD alters the subjective effects of THC
Researchers analyzed the data self-reported by the 18 participants and found statistically significant differences (which adds power and confidence to the results) between the experimental conditions in many of the items and scales used. In general, subjects scored higher when under the influence of THC than the placebo for items such as drowsiness, dreaminess, and time perception.
THC scores were also higher than placebo scales for psychotomimetic (psychotic-like) conditions such as mania, paranoia, and cognitive disorganization. While the researchers acknowledge that evidence supporting the subjective effects of CBD alone is unclear, they believe that variables such as cannabis use frequency, dose, and route of administration are key factors. For example, in another cited study by O’Neill, et al., it was found that a 600 mg oral dose of CBD showed a decrease in psychotic symptoms. 2
What role THC and CBD may play in the relationship with schizophrenia is one of the most interesting findings in this study. It is speculated that heavy cannabis use starting in adolescence is associated with an earlier onset of genetically predisposed schizophrenia. In his book Cannabis Pharmacy, author Michael Backes writes that the benefit may outweigh the risk when using cannabis to treat conditions such as inflammatory bowel disease or migraines in adolescents, especially when combined with high dose CBD to help mitigate the effects of THC. Backes contends that CBD shows promise as an antipsychotic both on its own and in combination with standard antipsychotic medications. And while good clinical evidence is lacking, there is growing evidence that CBD may be used in this fashion. 3
What does it mean for the average person who consumes cannabis?
The main conclusion is that CBD has the potential to lessen the intoxicating effects of THC as well as THC-induced symptoms like paranoia. The study also suggests CBD may have a protective role, helping to reduce some of the psychoactive effects of THC, and potentially even reducing the risk for those predisposed to schizophrenia, a contraindication to THC therapy. A higher ratio of CBD:THC as with a Type II chemovar may be a desirable choice for those who want the therapeutic effect while minimizing intoxication or other negative symptoms brought on by higher doses of THC. For long-term cannabis users whether recreational or medicinal, a higher ratio of CBD:THC may help to reduce the possibility of developing Cannabis Use Disorder or even Cannabis Hyperemesis Syndrome, though this topic requires more research. 4
This study, along with significant previous research, suggests that consuming CBD alongside THC mediates the intoxicating effects of cannabis, and may influence other aspects of a THC high. The researchers note that further studies using cannabis-naïve subjects, exploring multiple ratios of CBD:THC, analyzing compounds for terpenes and collecting physiological samples to measure blood serum levels would contribute further to the existing body of evidence.
In order to individualize and optimize therapy, clinicians, medical patients, and adult users should take this information and feel empowered to experiment using different cannabis chemotypes to facilitate the most effective therapeutic response and most rewarding experience.
- Sainz-Cort, Alberto MSc∗,†,‡; Jimenez-Garrido, Daniel MSc†; Muñoz-Marron, Elena PhD∗; Viejo-Sobera, Raquel PhD∗; Heeroma, Joost PhD‡; Bouso, Jose Carlos PhD† Opposite Roles for Cannabidiol and δ-9-Tetrahydrocannabinol in Psychotomimetic Effects of Cannabis Extracts, Journal of Clinical Psychopharmacology: 9/10 2021 – Volume 41 – Issue 5 – p 561-570
- O’Neill, A., Wilson, R., Blest-Hopley, G., Annibale, L., Colizzi, M., Brammer, M., Giampietro, V., & Bhattacharyya, S. (2021). Normalization of mediotemporal and prefrontal activity, and mediotemporal-striatal connectivity, may underlie antipsychotic effects of cannabidiol in psychosis. Psychological medicine, 51(4), 596–606. https://doi.org/10.1017/S0033291719003519
- Batalla A, Janssen H, Gangadin SS, Bossong MG. The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review. J Clin Med. 2019;8(7):1058. Published 2019 Jul 19. doi:10.3390/jcm8071058
- Navarrete F, García-Gutiérrez MS, Gasparyan A, Austrich-Olivares A, Manzanares J. Role of Cannabidiol in the Therapeutic Intervention for Substance Use Disorders. Front Pharmacol. 2021;12:626010. Published 2021 May 20. doi:10.3389/fphar.2021.626010
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