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There’s no getting around it: CBD is officially everywhere . Its popularity has skyrocketed. What started as a niche alternative health treatment has become a nationwide craze. And it doesn’t just show up as oils and tinctures anymore. There is whole array of curious CBD products, including lattes, makeup, bedsheets, bath bombs, and even dog treats.
But is CBD a wonder drug, or just another health fad? There’s no shortage of opinions out there, but we can discern a lot from CBD statistics. We’ve compiled reliable research and conducted a CBD survey to put the prevalence of CBD use and its potential health benefits into perspective.
What is CBD?
When some people hear “CBD,” their minds immediately jump to marijuana. And while there is a connection, it’s not as close as one might think. Since recreational and medical cannabis is available in several states now, it’s important to note the differences. CBD is primarily a hemp derivative, which is like a cousin to marijuana, but not the same plant.
Let’s take a step back. Both hemp and marijuana fall into the cannabis genus. Cannabis plants contain two naturally-occurring compounds: cannabidiol (CBD) and tetrahydrocannabinol (THC). CBD and THC are both cannabinoids but have different effects on the body. Most prominently, THC has psychoactive effects and CBD doesn’t, which is why CBD doesn’t make you feel high.
Marijuana and hemp each contain both compounds but in different ratios. Hemp has much lower levels of THC and larger amounts of CBD, which is why it’s often used for CBD products. Marijuana, on the other hand, has significantly more THC.
People use CBD for almost everything. Name a medical condition and there’s likely someone out there treating it with CBD or other cannabis products. But when someone claims that CBD cured their migraines or skin rash, take it with a grain of salt. Because the CBD industry is so new, there simply hasn’t been enough research to fully understand its effects yet.
While it shows plenty of promise in treating various conditions, “it is not a one-size-fits-all [remedy] to treat specific conditions or symptoms of those conditions for every individual,” says Manisha Singal, MD, the founder of Aethera Beauty . “Research on the benefits and action of CBD in topical formulations as well as ingestible forms is ongoing. That experimentation is in its preliminary stages and there is a long way to go. The medical potential for CBD and other cannabinoids is undeniable, but medical research takes time and careful analysis.”
That said, it has shown efficacy in treating chronic pain and anxiety (two of its most common uses), as well as insomnia and arthritis. And the only FDA-approved medication that contains cannabidiol so far is Epidiolex , which treats childhood seizures associated with Dravet Syndrome or Lennox-Gastaut Syndrome in patients two years of age and older.
How common is CBD use?
- 33% of American adults have used CBD once or more. (SingleCare, 2020)
- 64% of Americans are familiar with CBD and/or CBD products. (Gallup, 2019)
- An estimated 64 million Americans have tried CBD in the last 24 months. (Consumer Reports, 2019)
- Of those who use CBD, 22% said it helped them supplement or replace prescription or over-the-counter drugs. (Consumer Reports, 2019)
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- Hemp-derived CBD products are legal in all 50 states, as long as they contain no more than 0.3% THC. (Food and Drug Administration, 2020)
- In overall cannabis sales, Colorado tops the list, having sold over $1 billion since 2014. (CNN, 2019)
- The top states for CBD sales in 2019 are California ($730 million), Florida ($291 million), and New York ($215 million). (Statista, 2019)
- Of the Americans who use CBD, the most common uses are for pain relief (64%), anxiety (49%), and insomnia (42%). (SingleCare, 2020)
- CBD web searches increased by 125.9% from 2016 to 2017 and 160.4% from 2017 to 2018. ( JAMA Network , 2019)
- United States hemp farmland increased from 25,713 acres in 2017 to 78,176 acres in 2018. (Food Business News, 2019)
CBD statistics by age
CBD user demographics skew young. Of all age groups, Americans age 18-29 are most likely to use CBD consistently, and its popularity decreases with age. (Gallup, 2019):
- 20% of people ages 18-29 use CBD
- 16% of people ages 30-49 use CBD
- 11% of people ages 50-64 use CBD
- 8% of people age 65 and older use CBD
And the numbers nearly double for adults who have tried it once or more. According to a 2019 Consumer Reports CBD survey:
- 40% of people ages 18-29 have tried CBD
- 32% of people ages 30-44 have tried CBD
- 23% of people ages 45-59 have tried CBD
- 15% of people 60 and older have tried CBD
CBD statistics by method
According to our SingleCare survey, nearly half of CBD users prefer oils/tinctures, lotions/balms, and gummies. But there’s a growing market for CBD edibles.
- 18% are interested in capsules/tablets
- 18% are interested in topical sprays
- 17% are interested in CBD-infused food, such as chocolate
- 13% are interested in vaping products
- 12% are interested in soap
- 11% are interested in non-alcoholic, CBD-infused drinks
- 9% are interested in CBD bath bombs and salts
- 8% are interested in skincare products
- 8% are interested in patches
- 1% are interested in other CBD products
When it comes to where CBD users get their products, a 2019 Consumer Reports study says:
- 40% purchase CBD from a dispensary
- 34% purchase CBD from a retail store
- 27% purchase CBD from an online retailer
- 12% purchase CBD from another source
CBD and overall health
CBD enthusiasts will tell you that it changed their lives, citing all sorts of positive effects. Skeptics will tell you that it’s all hype and has no actual benefits. The truth falls somewhere in between. Our survey found that 32% of people who’ve used CBD did not find it effective. While there hasn’t been extensive research on its effects, it shows promise as an anti-inflammatory , anti-anxiety treatment, as well as a sleep aid . And this can give us some insight into CBD’s appeal as a new addition to holistic wellness routines.
People tout CBD as a miracle treatment for heart disease, cancer, autoimmune diseases, Alzheimer’s, acne, and much more. Researchers haven’t found substantial evidence that it can effectively treat any of these conditions, but we also know that inflammation and stress can be contributing factors to these conditions. So, there may be some truth to the claims that CBD is beneficial to everyday health. Whether it’s in a morning smoothie, part of a skincare routine, or something else entirely, regular CBD use can potentially be beneficial for some people, although it comes with risks too.
Recreational vs. medical cannabis use
Recreational cannabis use isn’t quite the same as medical use. CBD oil and other products intended for medical use typically come in smaller doses and aren’t full-spectrum CBD (or “whole plant” CBD), which contains THC as well.
“CBD can have varying strengths depending on if it is used in isolation or if used in conjunction with THC for entourage effects,” says Dr. Singal. And some people want these compound effects. However, there are a ton of CBD producers and retailers out there, and not all of them are reliable. Although 47% of the Americans that we surveyed think the government regulates CBD, it does not.
A recent study by Penn Medicine revealed that almost 70% of cannabidiol products sold online are mislabeled. So, products from online retailers that haven’t been properly vetted could contain higher levels of THC or other compounds. Our survey found that 22% of people won’t try CBD because they don’t trust the product or manufacturer.
CBD side effects
Like other medications, CBD can have side effects, too. In one study , one-third of CBD users reported a non-serious side effect, including dry mouth, euphoria, hunger, irritated eyes, and/or fatigue. And according to Michael Hall, MD, the founder of the Hall Longevity Clinic , the spectrum of side effects is even broader.
“CBD contains multiple oil-based terpenes, which can excite the immune system,” says Dr. Hall. “The most common side effects associated with CBD-based products include sleepiness, sedation, and lethargy; elevated liver enzymes; decreased appetite; diarrhea; rash; fatigue, malaise, and weakness; insomnia, and possible interaction with some prescription medications.”
Typically, these effects aren’t dire, but they can be inconvenient and disruptive to a person’s everyday routine.
As far as drug interactions go, there hasn’t been a ton of research and testing, so it’s hard to say. CBD can potentially interfere with tacrolimus , an immunosuppressive medication. Because there are a lot of unknowns, anyone looking to supplement their current medications with CBD should consult a healthcare provider first.
The cost of CBD
America’s CBD market has a near-vertical trajectory. With the legalization of recreational and medical marijuana in numerous states, an increasing number of people are looking into the benefits of cannabis, and CBD sales reflect that interest.
- The United States CBD market value was just over $4 billion in 2019 and may top $25 billion by 2025. (Brightfield Group, 2019)
- The cannabis- and hemp-derived CBD market may see a compound annual growth rate (CAGR) of 49% by 2024. (BDSA, 2019)
- 44% of regular CBD users spend $20-$80 per month on CBD products. 13% spend more than $160 per month. (Brightfield Group, 2019)
CBD law and restrictions
Here’s the big question: is CBD legal or not? The laws around cannabis are frequently changing and vary from state to state. CBD derived from hemp is legal, as long as it meets certain requirements. The Agriculture Improvement Act of 2018 (AKA the 2018 Farm Bill) allowed for the production and marketing of hemp-derived CBD products without federal regulation as long as they contain no more than 0.3% THC. But these products should not be labeled or marketed as medications. The FDA has only approved one CBD-based drug (Epidiolex), so the sale of other CBD products as drugs for the treatment of specific medical conditions is not yet legal.
Additionally, the FDA has not approved products that contain cannabis or cannabis-derived compounds for medical use. In fact, at the federal level, all marijuana is illegal (medical or otherwise). It’s still classified as a Schedule I substance (along with heroin and LSD) by the DEA under the Controlled Substances Act . However, 33 states have legalized it for medical purposes, and 11 of those have approved recreational use for adults 21 and older. Technically, federal law supersedes state law, but the federal government has not chosen to prosecute businesses and/or individuals selling or using cannabis in states where it’s been legalized.
CBD questions and answers
How many people know what CBD is?
In a recent Gallup poll, 64% of U.S. adults said that they were familiar with CBD and/or CBD products. In a 2020 SingleCare survey, we found that one-third of Americans have used CBD.
Why do people use CBD?
People claim that CBD can treat everything from acne to cancer. But the most common uses are for pain, inflammation, anxiety, and insomnia.
What age group uses CBD the most?
CBD use is most common in populations ages 18-34, according to a recent SingleCare survey.
How much money is spent on CBD?
The CBD market exceeded $4 billion in 2019, according to a study by the Brightfield Group, and they expect the industry to top $25 billion by 2025.
How many people have died from ingesting CBD oil?
CBD oil consumption has not been directly linked to any deaths. One of the most popular CBD products is vape cartridges, however, and the FDA has linked vaping to certain lung injuries and death .
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I n case you haven’t heard, CBD is a cure for whatever ails you, from insomnia and inflammation to pandemic angst. Or at least that’s what retailers, supermarkets, mini-marts, beauty stores, and coffee and smoothie shops across America would have you believe. There are CBD-infused creams. CBD-infused oils. CBD-infused tinctures, gummies, juices, lollipops, lattes, nutritional supplements, and even a CBD oil–infused pillow! What’s next, CBD-infused tampons? (Actually, that already exists. Really.)
According to the Brightfield Group, a market research firm, CBD sales were estimated to exceed $4 billion at the end of 2021, and by 2025, the industry’s total market value could reach a whopping $16 billion.
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But does CBD work?
That’s a question worthy of a Talmudic scholar, because the CBD world is complicated.
Some believe that it may have an important role to play in certain health outcomes.
Raphael Mechoulam, PhD, a professor of medicinal chemistry at Hebrew University in Jerusalem, Israel, has been studying the health benefits of cannabis and CBD since the early 1960s. Long considered the grandfather of cannabis research, Dr. Mechoulam and his team developed a process for synthesizing certain acids found in the cannabis plant. These acids — otherwise known as cannabidiolic acid (CBDA), and a methylated version of CBDA (CBDA-ME) — have been since studied for a variety of purposes, and might ultimately be used to develop new drugs for everything from arthritis and anxiety to inflammatory bowel disease and psoriasis.
Others believe CBD is unproven and risky.
The U.S. Food and Drug Administration (FDA) continues to investigate its potential harms, noting that while it recognizes the potential opportunity that cannabis-derived compounds (like CBD) can offer, it remains concerned about CBD products being marketed as supplements. (According to the FDA, THC and CBD products do not fit the definition of a dietary supplement.)
“FDA is aware that some companies are marketing products containing cannabis and cannabis-derived compounds in ways that violate the Federal Food, Drug, and Cosmetic Act (FD&C Act), and that may put the health and safety of consumers at risk,” the Agency wrote in its 2021 update, noting that it’s illegal to market CBD by adding it to a food or labeling it as a dietary supplement.
Among a number of problems with CBD, the FDA says, is that it can cause liver damage and diarrhea, it may impact the metabolism of other drugs, and it may cause male reproductive toxicity in humans, as has been found in animal studies.
Still, many consumers continue to believe CBD’s potential benefits. A report (PDF), also from the Brightfield Group, that analyzed 2,400 members of an online community of medical cannabis users found that 59 percent of CBD users say they use it for insomnia and 66 percent for anxiety, while 44 percent have taken it for depression and 49 percent for joint pain and inflammation.
With so much CBD noise out there, we’re feeling a little overwhelmed and confused about CBD. We want to know the real deal. For starters, is CBD the same as cannabis? Should we spend our hard-earned money on the stuff, or is it a scam? Is there any science to back up the claims that CBD is helping people sleep better, feel better, look better, or be an all-around better human? If so, is that in the form of CBD oil, tinctures, lotions, or should we vape it? But wait — isn’t vaping bad for you?
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Common Questions & Answers
Endocannabinoids are molecules produced by the body to maintain homeostasis — stability — in response to changes in the environment. The endocannabinoid system interacts with all of the major systems and organs in the body to enable and restore optimal functioning.
The word “cannabinoid” usually refers to a chemical found in the cannabis (marijuana or hemp) plant. “Endo,” in this context, refers to substances produced inside the body. Endocannabinoids are, in effect, the body’s own source of cannabis-like substances.
CBD and THC are plant cannabinoids, which operate much as endocannabinoids do, by attaching to certain receptors on the outsides of cells and altering the behavior of those cells or the bodily systems they are a part of.
Cannabinoids and endocannabinoids can affect pain perception, memory, mood, appetite, and many other bodily systems. The endocannabinoid system regulates the release of other neurotransmitters — that’s how it maintains homeostasis — and helps the body heal from any damage it sustains. Plant cannabinoids can similarly enhance feelings of well-being, but they can have undesirable side effects as well, particularly in young people.
Research suggests that endocannabinoids can be boosted by certain foods, such as those containing essential fatty acids, chocolate, herbs, spices, and teas, as well as by stress-reducing activities.
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Before we get too much into the, er, weeds, it’s important to understand what CBD is and where it comes from.
Cannabis refers to a group of three varieties of marijuana plants with psychoactive properties: Cannabis sativa, Cannabis indica, and Cannabis ruderalis.
Cannabis contains more than 400 compounds, known as cannabinoids (pronounced keh-NAB-eh-noyd). The most well-known and researched are cannabidiol (CBD), and delta-9-tetrahydrocannabidiol (THC). Other lesser known components — THCA, CBN, CBC, and CBG — play different roles and have different effects in the body. (See our CBD glossary for details.)
The component in cannabis that is linked to its intoxicating effects (in other words, the “high,”) is THC. Conversely, CBD won’t get you high. Depending on your goals, this is either a good or a bad thing.
“Hemp” (which incidentally, is considered part of the CBD family) refers to non-intoxicating varieties that are high fiber or high seed-yielding and often used for rope, clothing, or sails. (Cocktail party fact: “The word ‘canvas’ comes from ‘cannabis,’ as it was made from cannabis fiber varietals,” says Will Kleidon, the CEO of Ojai Energetics in Ojai, California..)
In the United States, the legal definition of hemp is any cannabis plant whose delta-9 THC is below 0.3 percent.
What’s the Endocannabinoid System and How Does It Work?
The endocannabinoid system (ECS) is a biological system first described in the 1990s, and it plays a big role in brain, endocrine, and immune function. Its main role, however, is to maintain homeostasis, the internal biological balancing mechanism of the brain and body.
Two main elements of the system are endocannabinoid receptors, classified as CB1 and CB2. The body makes its own cannabinoids, known as endocannabinoids, that can act upon these receptors. But other varieties of cannabinoids, such as CBD, can interact with them, too.
What Are Cannabinoid Receptors?
Cannabinoid receptors are laced throughout the body, brain, and nerves.
- Cannabinoid 1 (CB1) Receptors Most of these are in the central nervous system, especially neurons (nerve cells) in the brain.
- Cannabinoid 2 (CB2) Receptors These are located mainly on immune cells but are also found in the central nervous system.
Both receptor types are activated by cannabinoids, which can be generated naturally inside the body (known as endocannabinoids) or can be introduced through a form of cannabis.
What’s the ‘Entourage Effect’?
The entourage effect refers to a theory that the whole is more effective than each part — or that the various compounds of the cannabis plant work best synergistically.
“It’s the theory that the cannabinoids, flavonoids, terpenes, and fatty acids all work together like an orchestra, in which all the instruments complement each other so you get the maximum effect of the plant,” says the cannabis researcher Monica Taing, PharmD. “CBD by itself can be a pain reliever, and THC can be a pain reliever by itself, but when combined, they work better for pain relief. That’s the entourage or ensemble effect.”
Now that that’s out of the way, let’s get into the nitty-gritty.
What Are the Legal Implications of Using CBD?
The legality of CBD is confusing.
In 2018, the Agriculture Improvement Act of 2018 (aka that year’s Farm Bill), legalized CBD derived from hemp — with the important caveat that it could only contain 0.3 percent of THC by dry weight, to be grown legally. This type of CBD is legal in 47 U.S. states with some restrictions, but totally illegal in Idaho, South Dakota, and Mississippi. Plants with more than 0.3 percent of THC are considered marijuana, which is legal for recreational use in 19 states, Washington, DC, and Guam.
Despite state laws legalizing the sale of cannabis for recreational or medicinal use, the Drug Enforcement Administration (DEA) (PDF) still classifies it as a Schedule 1 drug: “substances or chemicals [that] are defined as drugs with no currently accepted medical use and a high potential for abuse.” So, while marijuana is illegal on a federal level, states have different laws regarding marijuana and CBD.
Only one cannabis-derived drug product has been FDA approved: cannabidiol sold under the brand name Epidiolex, which contains a purified form of high-dose CBD to treat a rare, hard-to-treat form of epilepsy in children ages 1 and up.
How Do I Find Safe CBD Products? How Do I Know What I’m Getting?
Short answer: You often don’t.
The situation is not unlike that of dietary supplements, except for in the case of supplements, the FDA has defined a very clear set of restrictions — and the Federal Trade Commission, strict reinforcement of health claims. While the FDA has sent warning letters to certain companies selling CBD products, many products slip under the radar. In addition, state and Federal CBD regulations are at odds, so oversight can be difficult. What’s more, every state where medical or recreational marijuana is legal has its own testing rules and regulations, so something that passes muster in Massachusetts might not in California.
People often buy their products online or at the local drugstore or gas station, meaning that they often don’t know what they’re getting.
“Some CBD products don’t contain CBD, but they contain THC and heavy metals, so we need strong regulations,” says Dr. Taing. Indeed, as of May 21, 2022, poison control centers have managed 2,652 cases related to CBD, per the American Association of Poison Control Centers.
Some people have failed drug tests because they’ve unwittingly taken THC that was in a product that was supposed to contain only CBD. A study published in the Journal of the American Medical Association (JAMA) in November 2017 found that 21 percent of CBD products derived from hemp and sold online contained THC, even though THC wasn’t listed on the packaging.
A more recent study in JAMA Psychiatry showed that even a high-quality, high-potency cannabidiol product labeled as carrying as much as tenfold less than the legal limits of THC permissible under law might still result in positive urine drug tests.
Findings from another study, published June 2022 in the Journal of Cannabis Research, showed that of the 80 products evaluated, 37 contained CBD concentrations that were at least 10 percent higher or lower than the concentration listed on the label: 12 products contained less than 90 of what was listed, while 25 products contained more than 110 percent.
Even more worrisome, a study published in January 2019 in Forensic Science International examined nine liquids that were advertised as 100 percent natural CBD extract and found they contained potentially problematic compounds. One contained dextromethorphan, which is used in over-the-counter cough medication and is considered addictive when abused. Four others had a synthetic cannabinoid that can cause, among other things, anxiety, psychosis, and even death.
“As with any other product you would ingest, you have to be smart,” says Jahan Marcu, PhD, the editor in chief of the American Journal of Endocannabinoid Medicine, and the cofounder and chief science officer at the International Research Center on Cannabis and Mental Health.
What’s more, he says, every product should have a certificate of analysis, or COA — a document generated by a laboratory certifying its legitimacy and also listing the ingredients.
The Mayo Clinic uses the following checklist to identify high-quality products, as described in a 2019 issue of Mayo Clinic Proceedings:
- Does it meet the following quality standards? These include Current Good Manufacturing Practices (CGMP) certification from the FDA; European Union (EU), Australian (AUS), or Canadian (CFIA) organic certification; National Science Foundation (NSF) International certification.
- Does the company have an independent adverse event reporting program?
- Is the product certified organic or eco-farmed?
- Have their products been laboratory tested by batch to confirm tetrahydrocannabinol levels below 0.3 percent and no pesticides or heavy metals?
For more information, Project CBD, Certified Kind, Clean Green, and WeedMaps offer information on dispensaries, cannabis products, and brands.
Does It Matter if the CBD Is Organic?
In theory, yes, because without an organic label, there’s a potential for ingesting pesticides and chemical fertilizers. If you have a COA, then you’ll know what’s in the product.
But here’s the rub: Organic products are regulated by the U.S. Department of Agriculture (USDA), which is a federal agency. Since cannabis is considered a Schedule 1 drug, technically, medical cannabis couldn’t be designated as “organic,” unless it’s made from hemp.
In May 2018, Palmetto Grow became the first company to have USDA Organic certification for hemp flower and seed. Since then, other organic growers have joined the market. You can find a list of some of the best organic CBD products from EcoWatch and The Honest Consumer.