Cannabidiol oil, often referred to as CBD oil, is a product of the marijuana plant. Does it really have any proven benefits for managing ADHD symptoms? CBD — often in the form of an oil, a tincture, or an edible — has been rumored to reduce anxiety, a common symptom among those diagnosed with ADHD symptoms. Learn if it’s proven safe to give CBD to your child with ADHD, along with common concerns about it.
Is CBD Oil Good For Adhd
Karen Sampson Hoffman
YOU’VE SEEN THE POP-UP ADS or you’ve heard a friend talk about CBD oil as an alternative treatment for ADHD. Every online community and social media platform seems to have someone praising the compound or offering to sell it. But what is it, and does it really have any proven benefits for managing ADHD symptoms?
Cannabidiol oil, most often referred to as CBD oil, is a product of the marijuana plant. The plant family is called cannabis, and cannabis products can include CBD oil along with smoked, vaped, or eaten products. CBD oil is just one of more than 85 compounds in cannabis and is regarded by some enthusiasts as having medicinal benefits.
It is not THC (tetrahydrocannabinol), the compound in cannabis that creates euphoria and delivers the “high” of marijuana use. CBD oil is not supposed to contain any THC, meaning the oil needs to be highly refined to make it suitable for use, and therefore is not a natural product. One reoccurring concern, however, is that some products on the market can have trace amounts of THC present, making them unsuitable for use by children and teens and by any adult concerned about possible addiction.
So what about CBD oil as an alternative approach for ADHD symptom management? Some claim that CBD oil, a cannabis product, can be used to treat the symptoms of ADHD. There is limited research showing an improvement for some people who have epilepsy and some people who experience anxiety who use CBD oil, so it is thought to also have benefits for people with ADHD.
What the research says
Researching CBD oil specifically for ADHD is relatively new. Some research has been conducted on smoked and ingested marijuana for ADHD, and the findings in general either do not indicate a benefit or are inconclusive. For both epilepsy and anxiety, there is more research that shows promise. A new medication made from cannabis for seizures caused by Lennox- Gastaut syndrome and Dravet syndrome was approved by an advisory committee for the FDA, but does not have FDA approval.
. This was a very small sample study of thirty people with ADHD who received a trial cannabinoid/CBD medication. The participants were evaluated for symptom levels and IQ performance on standardized tests. There was insignificant improvement on cognitive function and symptom reduction, and nominal improvement on impulsivity and hyperactivity. The researchers expressed concern that the participants did not follow instructions to avoid all other medications or alcohol use that could have affected the study results. The research authors stated that their results were inconclusive. . This study showed poor cognitive function outcome for young adults who began using cannabis before the age of sixteen, including young people with an ADHD diagnosis. When evaluated for working memory, verbal memory, decision-making and recall, these young users had poor performance on all points. They made more mistakes when asked to complete questions or tasks. Most concerning, the authors write, “Individuals who initiate use of cannabis before age sixteen may be at higher risk for developing persistent neuropsychological deficits because their brain is still developing, especially the prefrontal cortex which is associated with several executive functions including planning, verbal fluency, complex problem-solving, and impulse control, each with its own developmental trajectory.”
- Adverse Health effects of Marijuana Use. A review article for The New England Journal of Medicine by National Institute on Drug Abuse Director Nora Volkow, MD, and her colleagues, details the known health effects of marijuana use. THC is a concern for health, as are other components of the plant. Adverse effects include decreased cognitive abilities and exacerbated co-occurring mental health disorders and substance abuse. Dr. Volkow lists several health conditions that might be able to be treated by cannabis products, including chronic pain and inflammation, multiple sclerosis, and epilepsy. She does not include ADHD as a health concern that can be treated by cannabis products. In fact, she writes, “[H]eavy use of marijuana results in impairments in memory and attention that persist and worsen with increasing years of regular use.”
Not a natural product
Some advocates for CBD oil claim that its effects on the body are gentler and more effective than medications for ADHD because it is a natural product, made from a plant.
The cannabis plant has been selectively grown for generations, and grown in specific conditions, to maximize its different aspects. Industrial hemp is grown for its fibers, which are used for rope and different types of cloth. Another type of industrial hemp is grown specifically for its seeds, which are then used in some foods and in products contain hemp oil.
Contrary to some marketing claims, CBD oil is not made from industrial hemp plants. Hemp for fiber is harvested before the plant is mature, ensuring stronger fibers, and once a plant begins to form seeds, it stops producing cannabinoids to focus its energy into seed production.
Industrial hemp, because of these needs, cannot produce cannabidiol oil in sufficient amounts for commercial use. Instead it is often extracted from phytocannabinoid-rich hemp, which has ideally had THC bred out of it. This plant retains many of the characteristic of the marijuana plant. This plant is a recently developed variant of the cannabis family and only goes back to the 1990s. To the untrained observer, it resembles the marijuana plant.
CBD oil can be made from either PCR hemp or from the marijuana plant because of the similarity between the two variants. In the manufacturing process, the plant is broken into pieces and a chemical solvent, a grain or wood alcohol, petroleum, or naphtha, is used to extract the compounds in the plant. The whole material is decanted and the liquid is mechanically separated, drawing off the oils and resins. The solvent is then reused. There is also a process using carbon dioxide that bursts the plant cells and captures the oils and resins from through a series of filtering chambers. Other extraction methods use heated oils that “cook” both the oil and plant.
The oils and resins are then further refined to separate the CBD from other compounds; this could be a combined mechanical and chemical process. It must also be tested to make sure all THC has been removed, especially when the marijuana plant is used rather than PCR hemp.
The entire process relies on heavily refining the product to make it suitable for human consumption. And the more “pure” the product, the greater the amount of refining it must go through. So while synthesized from a plant, it must go through multiple mechanical and chemical processes to become usable and has very little resemblance to the plant it started from. The more “pure” the CBD product, the less natural it is–the final product does not exist in a natural form. You cannot chew on a leaf of a cannabis plant and receive any benefits from CBD oil.
Thoughts from an expert
John Mitchell, PhD, has heard all about ADHD and cannabis product use. He is a researcher and assistant professor at the Duke ADHD Program. He’s not surprised by the current interest in CBD oil for ADHD symptoms and is not impressed by arguments in its favor.
“There is some efficacy in childhood epilepsy,” he points out, “but when you look at the literature for anything else, especially psychiatric disorders, there’s not strong support to say yes, this should be a go-to treatment, especially for ADHD.”
He says the interest stems from people’s desire to have more choices in treating medical conditions and in the changing perceptions on marijuana use. He points to several states that have made medical marijuana legal and a few states that are considering legalizing recreational marijuana use.
“This interest in CBD is coming out more broadly in these perceptions of lack of harmfulness and the changing perceptions of marijuana use in general,” says Dr. Mitchell. “For a lot of different disorders—PTSD, ASD, some addictions—[some people] are interested because it might have therapeutic effects when you isolate the CBD. But those studies are preliminary. When you look at the published literature on CBD there’s nothing—it’s limited to one study.”
He reminds anyone interested in CBD oil or cannabis products that there have not been the studies showing effectiveness or safety for these products when it comes to ADHD management.
“When parents or adults look into CBD oil for someone with ADHD, it’s not just that there’s a lack of evidence out there right now,” he says. “There have been no treatment studies. There are no randomized trials that show it works. And there are other treatment options available for kids and adults with ADHD. These are unregulated products. If these are not well-regulated products, how do we know that we’re really getting what’s being advertised?”
“When parents or adults look into CBD oil for someone with ADHD, it’s not just that there’s a lack of evidence out there right now,” says researcher John Mitchell, PhD, from the Duke ADHD Program. “There have been no treatment studies. There are no randomized trials that show it works. And there are other treatment options available for kids and adults with ADHD. These are unregulated products. If these are not well-regulated products, how do we know that we’re really getting what’s being advertised?”
What about the question of CBD oil being a more natural option than a medication? It comes from a plant, after all.
“Natural doesn’t necessary means it’s less harmful,” says Dr. Mitchell. “If I were a parent, I would want it to be pure. Which means it’s actually less natural, because it has to be refined.”
Other considerations, he says, include how well-refined a CBD oil might be—are the THC and other potentially harmful components fully removed—and the fact that there are no longer-term studies on CBD oil use for children or adults. He adds that there are well-researched and effective non-medication treatment options, such as parent training and lifestyle adjustments, that are shown to be effective in managing ADHD symptoms.
There is also the question of CBD oil becoming a “gateway” to marijuana use by a young person. Dr. Mitchell says a young adult who took CBD oil as a child might not see the difference between it and marijuana use for symptoms management. Marijuana use has well-researched effects on physical and mental health and can make ADHD symptoms worse, he says.
“The literature shows there are harmful effects,” says Dr. Mitchell. “There are impacts on cognitive ability, motivation. Especially for those who are younger and smoking more, there is an impact on IQ.”
Leaping beyond the data
The research on CBD oil and other cannabis products as a possible intervention for ADHD does not show effectiveness for managing symptoms, and actually shows increased mental and physical health risks. There haven’t been any studies on the use of CBD oil in children; neither have there been studies on long-term effects. So while some people are using it and have shared their results publicly, researchers and medical professionals have not found evidence that it is an effective treatment for ADHD. The research does not show that CBD oil works for ADHD management.
“We don’t want to misrepresent things, and with CBD oil, it is getting misrepresented,” says Dr. Mitchell. “When people say this works for ADHD, this is going way beyond the data. That’s too big of a leap.”
CBD Oil for ADHD? Despite Scarce Research, Patients Are Trying It
Early research suggests that cannabidiol (CBD) may help patients with epilepsy. It is also believed to relieve pain, anxiety, mood disorders, and even acne. But what about ADHD or ADD? So far, research linking CBD oil to ADHD symptom relief does not exist. That isn’t stopping patients from trying it.
Verified Medically reviewed by Roberto Olivardia, Ph.D. Updated on January 5, 2022
UPDATE: On November 25, 2019, the Food and Drug Administration (FDA) published a revised consumer update regarding safety concerns about cannabidiol (CBD) products. Due to limited research data, the FDA is unable to declare CBD products safe, according to the updated statement. The FDA warns that CBD can cause liver damage, increased drowsiness, and a number of other side effects. The impact of daily CBD use over a sustained period of time is unknown. Likewise, the FDA says there is insufficient research on the effect of CBD on the developing brain, on fetuses, and on the male reproductive system. The FDA has approved only one CBD product, which treats two rare forms of epilepsy. In late November, it issued warning letters to 15 companies for illegally selling products containing CBD.
These days, it’s tough to find an online community or social media group not singing the praises of cannabidiol (CBD) oil. This helps to explain why so many people are exploring its benefits for diseases and disorders ranging from Alzheimer’s and Parkinsons to PTSD and, yes, attention deficit disorder (ADHD or ADD). Though research suggests that CBD oil may benefit patients with epilepsy and other disorders, any such claims around ADHD are only that: claims.
What Is CBD? Does It Help ADHD?
CBD is a product of the marijuana (cannabis) plant with the high-inducing THC (tetrahydrocannabinol) compound removed, which means it is not psychoactive. CBD — often in the form of an oil, a tincture, or an edible — has been rumored to reduce anxiety, a common symptom among those diagnosed with ADHD symptoms. No one, though — not even the drug’s most hardcore advocates — claims CBD is a treatment for ADHD.
According to Mitch Earleywine, professor of psychology at SUNY-Albany and an advisory-board member of the National Organization for the Reform of Marijuana Laws (NORML), there is “no published data, let alone randomized clinical trials, [that] support the use of CBD for ADHD.”
Even so, word of CBD’s potential benefits — proven or otherwise — are often enough to compel some patients with ADHD to experiment. Dr. John Mitchell of the Duke University ADHD Program says that one of his patients, an adult woman with ADHD, tried CBD. Twice. On her own. Without his approval or supervision.
“I bought one vial for $50 that contained 30 gel tablets, and I took all of them over a few weeks,” says Mitchell’s patient, who preferred to remain anonymous. “I’d never tried CBD or any type of cannabis before, and I felt no changes. But I didn’t have any adverse effects, either.”
Anecdotally, this outcome appears common for half of those trying CBD on their own — regardless of the quantity, quality, or type used. The other half claim some positives with regard to CBD and ADHD: “I was able to relax” or “I felt less manic” are common refrains. The problem, as Dr. Mitchell and the broader community of ADHD and CBD researchers point out, is a dearth of studies around CBD. No single research team has yet studied the possible effects — good or bad — of CBD oil for ADHD symptoms specifically.
“There are anecdotes that CBD may help with ADHD,” says Dr. Robert Carson, an assistant professor of neurology and pediatrics at Vanderbilt University who co-authored a 2018 study on the efficacy of CBD on epilepsy, “but this is true for many other symptoms or diseases. Thus, there may be patients whose ADHD symptoms improve after adding CBD, but we cannot generalize that anecdote more broadly. Secondly, the cases we’re most likely to hear about are the one where somebody had a great response — not the 10 who did not.”
“I am not aware of any scientific or clinical data that would speak to the safety or efficacy of using CBD in the treatment of ADHD,” says Ryan Vandrey, Ph.D., a member of John Hopkins University School of Medicine’s Behavioral Pharmacology Research Unit. “There is no scientific basis from which CBD should be recommended for use as a treatment for ADHD, nor is there any data that could speak to which product or dose would be appropriate.”
The American Academy of Pediatrics (AAP) recommends treating ADHD in children and adolescents aged 6 to 18 with FDA-approved medications, plus parent training in behavior modification and behavioral classroom interventions. Likewise, research confirms that “stimulant medications are most effective, and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.” All ADHD treatment decisions should be made in consultation and coordination with a licensed medical provider.
Is CBD Legal? Is It Safe?
To date, 33 states and the District of Columbia have passed laws broadly legalizing marijuana in some form; 10 other states and Washington, D.C., have adopted laws legalizing marijuana for recreational use. Even so, the U.S. Drug Enforcement Administration considers CBD, like all cannabinoids, a schedule 1 drug — making it as illegal as heroin and ecstasy. Despite this, one cannabis industry expert predicts that CBD products alone will comprise a nearly $3 billion market by 2021.
With all that profit on the horizon, why so few studies? At least partially to blame is the legality of CBD; it’s difficult to attain a federal grant to study a federally illegal drug. Politics also come into play, as do lingering public perceptions of cannabis as a gateway drug that may lead to serious mental disorders, lethargy, or both.
Nevertheless, Dr. Mitchell feels that “The perception that [CBD] can have a negative effect has gone down because it’s becoming more available.”
This is not a perception shared by all of Dr. Mitchell’s peers, who note professional resentment and stigma regarding funding for cannabis research. “There’s a lot of political opposition coming from the business and scientific communities,” asserts Dr. Jacob Vigil, director of the University of New Mexico’s Medical Cannabis Research Fund. “It’s still highly stigmatized, and we need more studies.”
The studies done on CBD and ADHD to date amount to… practically nothing. One 2011 study showed that, among a group of 24 people with social anxiety disorder, the half who’d taken CBD were able to speak in front of a large audience. In 2015, researchers in Germany examined the relationship between cannabis (CBD and THC) and ADD in 30 patients, all of whom said they experienced better sleep, better concentration, and reduced impulsivity while using the cannabis products. Finally, a 2017 study looking at CBD oil and ADHD in adults found that the oil improved some symptoms, but that more studies were needed to confirm its findings.
The Dangers of Experimenting with CBD for ADHD
The Netherlands’ self-professed “cannabis myth buster,” Arno Hazekamp stated in a recent paper, “While new CBD products keep entering the market virtually unchecked, effective regulatory control of these products has stayed far behind. As a result, unknown risks about long-term effects remain unaddressed, especially in vulnerable groups such as children.”
“During [a person’s] development, I worry about cannabinoids, both CBD and THC,” says UCLA’s Evans. “There are adenosine receptors (and CB2 receptors) on the microglia that are critical for brain development, and CBD inhibits adenosine uptake. This may be a beneficial factor for epilepsy and autoimmune and inflammatory diseases, but who knows for ADHD.”
And while CBD may potentially benefit some patients with ADHD, “One is doing an experiment on oneself by taking CBD for ADHD,” Evans adds. “CBD is anti-inflammatory and I’m not sure there is good evidence mechanistically that for ADHD it might be helpful.”
It’s also unknown how CBD may interact with other medications. “CBD in any form is a drug, and thus has a potential for side effects or interactions with other drugs, specifically those metabolized through the liver [CBD is metabolized by the same enzyme in the liver that metabolizes many other medicines and supplements],” Carson says. “And with other ADHD medications that have sedating qualities, such as guanfacine or clonidine, there may be additive effects that may not be beneficial.”
Also potentially harmful is the non-standard and wildly fluctuating amount of CBD in most CBD products, even those labeled as “pure CBD oil.” Some such products may also contain other ingredients — pesticides, additives, herbs, and even THC. “CBD alone has multiple actions on the cells in the brain and we don’t know which ones are clearly responsible for its known benefits,” Carson says. “It gets more complicated when we have less purified products that also include THC and CBDV [cannabidivarin].”
Dangers may also exist in the method of delivery. CBD is packaged and consumed in oils, tinctures, or edibles — each one absorbed differently by a person’s body. “The labeling in this industry,” says Vigil of UNM, “is horrific.”
‘Natural’ Doesn’t Necessarily Mean ‘Safe’
Once CBD enters the body, no one yet knows how it works. Its long-term effects are a mystery. Exactly how does CBD work — in the brain and over many years? As Dr. Carson bluntly puts it: “We don’t know and we don’t know.”
None of this will stop some people from self-medicating with CBD or trying it on their children. “Apparently there are products offering about 30mg of CBD per dose,” Earleywine says. “I rarely see published work with humans that shows much of an effect below 300mg, which… would get quite expensive… So it’s probably a waste of time and money.”
“The bottom line,” Evans says, “is that there is a dearth of research on all cannabinoid actions — because of its schedule 1 classification — and no clear scientific evidence I can find to endorse or not endorse CBD use for ADHD.”
Perhaps because researchers have documented no negative links between CBD and ADHD, some “patients go through trial and error with CBD,” Vigil says. “First they go on the Internet, where they start with an isolate CBD. Then they try the vanilla products — only to find they get more benefits when they add THC.
“They do that because cannabis is so variable that patients are forced to experiment. Also because clinical trials can’t really tell you anything about the decisions that patients actually make in the real world. And finally because there’s not going to be a uniform solution for everybody.”
“Families need to think very hard about potential risks versus benefits for treating other disorders, including ADHD,” Carson advises. “So please discuss what you are thinking about doing with your child’s physician. In the absence of good data, a dose of 1 milligram per kilogram of body weight per day is where most patients start when using CBD for epilepsy — and this seems to be well tolerated. But if the side effects from any medication are worse than the problem was to begin with, that patient might be on too much.
“I like to remind families,” Carson adds, “that just because something is natural does not mean it is safe.”
Is it Safe to Give a Child CBD for ADHD?
CBD, or cannabidiol, is gaining widespread popularity. A 2019 Gallup poll found that 14% of Americans use CBD for issues such as sleep, anxiety, and pain. A medicine that contains CBD, Epidiolex, is used in children with a certain kind of epilepsy. CBD is being promoted as an alternative treatment for ADHD. You may be wondering if it’s a safe and effective treatment for your child with ADHD.
What is CBD?
CBD is a component of cannabis and medical marijuana, but it’s derived from the hemp plant, a cousin of the marijuana plant. CBD by itself won’t get you high. It doesn’t contain THC, which is the chemical in marijuana that causes you to get high.
CBD products are available in a wide variety of products, including oil, gummies, vaping, and lotion. Because marijuana and cannabis products have been illegal in the US since 1970, there haven’t been many studies done on them. CBD derived from hemp is now federally legal. However, CBD derived from marijuana is still federally illegal.
Does CBD Help ADHD?
The research into whether CBD helps ADHD is very limited. Most of the available research has focused on cannabis products that also contain THC.
A small study in 2017 found that adults treated with Sativex, which contains CBD and THC, experienced a small reduction in ADD symptoms with no cognitive impairment. However, the improvement was not significantly better than the improvement with placebo.
Another study that was done in 2020 found that adults who took higher doses of medical cannabis took fewer ADHD medicines and reported lower ADHD scores.
There is no scientific proof that CBD works or is safe for children. Until there is some proof that CBD is safe or effective to treat ADD, stimulant medicines such as Adderall are still a better option. There is some evidence that CBD oil may help with anxiety, which some kids with ADHD also have. A 2018 study done on 60 children with autism showed that anxiety improved in 39% of the children.
Is CBD Safe for Children?
There is no evidence that the CBD products on the market are safe or effective for children. The FDA has only approved one CBD product, a prescription drug called Epidiolex that treats seizures associated with certain types of epilepsy in patients older than 1. Epidiolex has been studied in clinical trials. While it has proven to be effective at reducing seizures, it has shown significant risks and side effects including:
- Elevated liver enzymes
- Decreased appetite
- Sleep problems
- Increase in suicidal thoughts
- Interference in how other medicines including propofol, bupropion, morphine, clobazam, lorazepam, and phenytoin work
The long-term effects of CBD are not known. CBD oil has not been studied adequately in clinical trials for problems such as ADHD. The American Academy of Pediatricians of Pediatrics does not support any use of medical marijuana products that haven’t been approved by the FDA.
Problems with Unproven Medical Claims
Any CBD products other than Epidiolex making medical claims have not been evaluated by the FDA. They have also not been evaluated to determine the proper dose or for any dangerous side effects or other safety concerns. The FDA has tested the chemical of CBD in some products and found that they did not contain the amount of CBD in which they claimed.
Other Safety Concerns
In addition to possible side effects and unproven medical claims, there are some other safety concerns with CBD oil including:
- Products deliver an unreliable amount of CBD. There is no way to know how much you’re getting.
- There is no way to know how much is absorbed. Different delivery methods such as vaping, taking it orally, and eating it have different rates of absorption.
- Products contain other ingredients that may not be safe.
- There is no way to know what dose to give your child.
Child Mind Institute: “CBD: What Parents Need to Know.”
Contemporary Pediatrics: “Examining cannabidiol use in children.”
European Neuropsychopharmacology: “Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial.”
Gallup: “14% of Americans Say They Use CBD Products.”
Harvard Health Publishing: “Cannabidiol (CBD) — what we know and what we don’t.”
Pediatrics Northwest: “Medical Use of Cannabis and CBD in Children.”
Rambam Maimonides Medical Journal: “Cannabinoid and Terpenoid Doses are Associated with Adult ADHD Status of Medical Cannabis Patients.”
Scientific Reports: “Real life Experience of Medical Cannabis Treatment in Autism: Analysis of Safety and Efficacy.”
US Food and Drug Administration: “What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD.”