- The quality, potency, and delivery method of CBD (cannabidiol) can influence dosing. Other factors include a person’s body weight and composition, metabolism, diet, tolerance to CBD, previous experience with CBD, and the severity of health conditions.
- CBD dosage can be computed easily using an online dosage calculator. Manually calculating it is also simple.
Step-by-step procedures, with formulas based on one’s weight and desired CBD strength, are explained in detail in this article.
- Seniors with back pain can benefit from the purported therapeutic properties of CBD.
Scientific studies and research have shown that CBD may help with pain(1) and inflammation(2), sleep problems(3), anxiety(4), depression(5), high blood pressure(6), Alzheimer’s disease(7), and dementia(8).
- A 2017 World Health Organization report stated that CBD dosages in clinical research studies usually range from 100mg to 800mg per day(9).
A study on CBD safety and side effects suggested that doses of up to 1,500mg a day are safe and well tolerated(10).
- Potential CBD side effects include drowsiness, dry mouth, fatigue, and nausea(11). Seniors looking to try CBD for specific symptoms should first consult with their doctor.
A doctor experienced in cannabis use can give their patients advice on dosing safely and avoiding possible CBD-drug interactions.
According to a Gallup survey, one in five American seniors (age 50 and above) use CBD products despite the lack of guidelines and regulations from the US FDA (United States Food and Drug Administration)(12).
Without the proper regulations, CBD dosing has become a common cause of confusion as people try to determine the ideal CBD dose that is safe and beneficial.
How much CBD is too much? How does one compute the starting dose that gives an individual the optimal benefits of CBD?
To clarify any confusion, Health Report Live gives the elderly everything they need to know about the health benefits and potential side effects of CBD, along with the latest research.
Finding the right amount of CBD for specific medical conditions is easy using an online dosage calculator.
However, a straightforward method of manually calculating CBD dosage is also discussed in this article.
Tables backed by medical experts are included to make computations as easy and simple as possible.
Factors that Determine the Ideal CBD Dose
The typical serving size of CBD is between 20mg and 40mg per dose. Some people take CBD at a lower dose of 1mg, while others take up to 600mg.
Depending on the potency or strength of the CBD product that one is using, a dose could be anywhere from a few drops to several milliliters of CBD oil.
In capsules or gummies, that could be anywhere from one to five pieces per dose.
Several factors, like quality and potency, influence the CBD dosage that may benefit an individual user. Other factors to consider include:
The endocannabinoid system (ECS) is a molecular system primarily responsible for regulating and balancing many processes in the body.
It is through the ECS that cannabinoids, like CBD, interact with the body and trigger therapeutic effects.
According to a 2016 study, the ECS is highly present in the body’s fat cells(13). When consuming CBD edibles, body size and digestion play a role in determining the proper dosage.
The process, speed, and turnaround with which it travels and accumulates may vary based on body weight and body chemistry.
The weight of an individual is crucial in deciding how much CBD oil one has to take. In general, heavier people are advised to take higher doses of CBD to experience the desired effects.
Likewise, people with lighter body weight should take a smaller dosage in order to avoid adverse side effects.
The aging process can change how a substance is absorbed, used in the body, and exits the body.
Changes that reduce the body’s ability to break down or remove certain medications from the system may mean that substances like CBD can remain in the bloodstream longer.
Older people may need a lower dose or concentration of CBD that is safer. In most cases, older adults need lower doses of medications than younger adults.
Generally, the effects of CBD can last from two to six hours. However, metabolism also affects how long the effects of CBD can last.
For example, depending on an individual’s metabolism, the effects of CBD capsules can last between 6 and 12 hours. In this case, one dose is probably all that is needed during the day.
A study was conducted to find out what effect a fatty meal would have on CBD absorption(14).
Results indicated that the type of food could make a significant difference in the amount of CBD absorbed by the body.
Although fatty foods can increase the absorption of CBD, they can also increase the variability since not all meals contain the same amount of fat.
The researchers also found that when compared to fasting, consuming CBD with food increased the amount of CBD in the body by four times.
Delivery Method or CBD Form
CBD form and delivery method can impact dosing. For seniors and beginner users, CBD oil capsules and edibles, like brownies and lozenges, are a convenient and straightforward way to take CBD.
While topically applying CBD is convenient, sublingual (under the tongue) application improves the compound’s bioavailability.
Bioavailability is the rate and quantity of a compound’s initial dose that enters the bloodstream.
This format is also easy to work into a schedule, and the dose is consistent, making it ideal for older people who tend to be forgetful.
CBD creams, salves, and balms may be applied to target areas for relief as needed. Dosing instructions vary depending on the brand.
Desired Effects From CBD
People use CBD products for different reasons. Some want to benefit from the compound’s calming effects on a daily basis. Others may use CBD occasionally, like mixing it in with their food and drinks or applying it on their face to counter acne.
For those trying CBD for the first time, a starting point with a low dose is recommended. For example, a typical dose in CBD gummies is about 5mg (5 milligrams of CBD) per gummy. Tinctures and oils contain about 1mg per drop.
Tolerance to and Previous Experience With CBD
Scientists do not agree on what effects repeated use of CBD can have.
Some studies suggest that the more exposed an individual is to CBD, the higher their tolerance becomes(15). Thus, they may need a larger dose for the same effects.
Other studies show that the consistent use of CBD does not lead to a tolerance for CBD oil(16).
Individuals need to discuss with their doctor if they are beginner CBD users or have already used CBD in the past.
The Severity of Health Condition
Individuals taking medications for a health condition should see their doctor before self-medicating with CBD.
CBD may interact with other drugs and supplements. Thus, it is important to ensure that CBD does not interfere with how it works in the body.
Medications currently taken may dictate one’s CBD dosage. Certain adjustments have to be made in order to achieve a fine balance between the medication and CBD.
Generally, the more severe the condition being treated, the higher the CBD amount one needs to take to feel its benefits.
Some CBD dosages that have been used in research studies for different conditions include:
|Bowel movement disorders||10mg per day(17)|
|Sleep problems||25mg per day(18)|
|Type 2 diabetes||100mg twice per day(19)|
|Cancer-related pain||50mg to 600mg per day(20)|
|Parkinson’s disease||75mg to 300mg per day(21)|
|Anxiety||300mg to 600mg(22)|
|Psychosis||600mg per day(23)|
According to a World Health Organization report, dosages in clinical research studies usually range from 100 – 800 mg of CBD per day(24).
How to Calculate the Ideal CBD Dose
The easiest way to find one’s optimal dose of CBD is to use an online CBD dose calculator to identify the appropriate low strength dose for their weight.
A CBD dosage calculator usually gives a general recommendation based on a person’s body weight, health condition, and severity.
Another option is to compute the ideal dosage based on body weight manually.
Ultimately, the right amount of daily CBD one should take requires some experimentation at first.
Step 1: Finding the Optimal CBD Dose
Finding the right CBD dosage begins by knowing the CBD strength needed based on weight.
Below is the general rule of thumb for dosing based on weight and preferred strength.
CBD Dosing According to Weight and Strength
|Weight||Low Strength||Medium Strength||High Strength|
|In pounds||1mg every 10lbs
|3mg every 10lbs
|6mg every 10lbs
|In kilograms||2mg every 10kg
|7mg every 10kg
|13mg every 10kg
To calculate the dose based on weight and desired strength:
weight x desired strength = CBD dose in mg
For example, John, a man weighing 100kg, would like a low-strength CBD dose.
To get his ideal low-strength dose, John should simply multiply his weight (100kg) by the low-strength dose (0.2mg/kg, as shown in the table above).
Using the given formula:
100kg x 0.2mg/kg = 20mg CBD
In this case, a good starting dose for him is about 20mg of CBD per day.
Next, John needs to know how much CBD oil he is going to need to get this dose. He can measure this in drops or ml (milliliters) of CBD oil.
Step 2: Knowing the CBD Oil Potency
CBD hemp oil potencies can range from 100mg to 5,000mg for a single 30-mL (1-oz) bottle, which is an industry-standard size.
When people talk about strength, they are talking about potency, which means the amount of CBD in one unit (or bottle).
For example, there are two CBD oils, both in 30ml bottles. One contains 1,000mg of CBD, and the other has 2,000mg of CBD.
In this case, the more potent oil is 2,000mg of CBD per 30ml bottle. Because it is twice as strong, the user has to take twice as much of the less potent oil to achieve the same dose.
CBD consumers save money by going with the more potent bottle. They do not have to take as much CBD because of the higher potency.
CBD manufacturers usually indicate their product’s CBD concentration on the bottle or on their website.
If this information is not given, one can use this formula to calculate potency:
CBD in mg ÷ bottle size in ml = CBD in mg/ml
Suppose John buys a 30ml bottle of hemp extract containing 1,200mg of CBD as indicated on the label.
Using the given formula, the CBD potency is computed as:
1,200mg ÷ 30ml = 40mg/ml CBD
Since 1ml = one full dropper, John gets 40mg of CBD for every ml or one dropper of the CBD oil he bought.
However, his optimal low-strength CBD dose is only 20mg of CBD per day, as computed in Step 1.
So, John needs to take only a half dropper of the CBD oil he bought to get his low-strength CBD dose. Half of 40mg is 20mg.
Step 3: (Optional) Converting the Dose into Drops
Converting the dose into drops can make dosing easier. Most of the droppers that come with every bottle dispense 30 drops for every ml of oil.
This formula converts the dose into drops:
CBD potency per ml ÷ 30 drops = mg/drop
To convert the CBD potency (computed in step 2) into drops:
40mg/ml ÷ 30 drops = 1.33mg CBD per drop
Step 4: Altering the Dose Until the Desired Effect Is Achieved
The last but most important step is for the user to start taking this dose and slightly modify the amount until they find what works best for them.
For example, if John took 20mg CBD (his starting dose) and he did not find any relief in his symptoms, the logical step is to increase the dosage to the next strength tier and reassess again.
In John’s case, he could go for medium-strength next. Using the same formula and the values in the table, John’s optimal medium-strength dose is computed as:
weight x desired strength = 100kg x 0.7mg/kg = 70mg CBD
As computed in step 2, the potency of John’s CBD product is 40mg/ml CBD, where 1ml = one full dropper.
Given that his optimal medium-strength CBD dose is 70mg of CBD per day, he needs to divide 70mg by 40mg/ml, which gives him 1.75.
The answer, 1.75, means he needs to take 1 ¾ droppers (or almost two droppers full) of the CBD oil he bought to get his medium-strength CBD dose.
John can continue to adjust his dose until he achieves the effects or results he needs.
To make calculations easier, there are online calculators available for free.
A 2020 study published in the Journal of Clinical Medicine Research mentioned that several dose-calculators are available (www.mydosage.com, for example) for guidance on CBD dose recommendations(25).
The authors of the study believe that online dose calculators can guide patients in dosing safely and avoiding adverse effects.
Still, it is important to note that the data to support the accuracy of such calculators remains unclear.
How Much Is Too Much CBD?
Starting doses vary from as low as 20mg per day up to 1,500mg per day.
A study on the safety and side effects of CBD suggested that doses of up to 1,500mg a day are safe and well tolerated(26).
However, experts do not yet fully understand the potential long-term effects of CBD usage. Individuals are advised to consult with their doctor and discuss their CBD use.
The best course of action is to start at a low dose, like 20mg, and gradually increase the amount in small increments, like 5mg per dose each week, until the desired effect is achieved or a specific symptom is relieved.
Also, it helps to match the potency of the oil with the most likely dose that one is going to use.
For example, if one’s goal is to use a high-strength CBD, they should buy a high-potency CBD oil.
Typically, a high-potency CBD oil contains at least 50mg of CBD per 1ml serving.
CBD Health Benefits for Seniors with Back Pain
Manufacturers of CBD products are now coming up with new products specifically formulated to suit the needs of the seniors market.
CBD can be delivered in multiple ways, including oil, topical cream, ingestible tinctures or edibles, salves, balms, lotions, bath bombs, and face masks.
Because CBD delivers all of the benefits of marijuana without the high, CBD can be particularly welcoming to seniors.
In some cases, CBD products may be used in conjunction with other medications. When used properly and upon the medical advice of a doctor experienced in cannabis use, CBD may even reduce or replace the use of harmful and addictive prescription drugs.
However, research on CBD is still in its infancy, and the results of studies are inconclusive. For proper guidance and safety, seniors are advised to consult with their doctor before turning to CBD for their health issues.
Below is a discussion on how CBD may help with some of the issues common among the elderly with back pain.
CBD may help with pain and inflammation.
Low back pain (LBP) is one of the major disabling health conditions among older adults 60 years or older(27).
The three most common reasons for developing back pain after age 50 are(28):
- Degenerative changes in discs and joints
- Spinal stenosis, or narrowing of the canal through which the spinal cord passes
- Spondylolisthesis, where one spinal vertebra can slip forward onto the vertebra below
Any of these conditions can cause pain or inflammation or pressure on the nerves.
In a 2020 review, researchers examined the main biological effects of CBD, focusing on its antioxidant and anti-inflammatory properties(29).
Findings from experiments conducted on various preclinical models suggest that CBD shows anti-inflammatory activity and antioxidant effects by activating specific hormone receptors in the body.
Osteoarthritis, caused by joint inflammation, is the most common type of arthritis among older people and one of the most prevalent causes of physical disability among seniors(30).
Meanwhile, cannabinoids in Cannabis sativa are becoming increasingly popular as a potential treatment for inflammatory bowel disease (IBD)(31).
IBD is a chronic inflammatory condition that includes ulcerative colitis (UC) and Crohn’s disease (CD).
Results from a 2016 study published in The European Journal of Pain suggested that applying CBD topically may help relieve arthritis pain-related behaviors and inflammation in animal subjects without noticeable side-effects(32).
In a study using animal models with induced colitis, researchers observed that CBD helped reduce colon injury and the expression of inflammatory markers(33).
Sativex, a medicine constituted by CBD (cannabidiol) and THC (delta-9 tetrahydrocannabinol) in a 1:1 ratio, may help with pain management.
Sativex may benefit those with pain due to nerve damage, advanced cancer pain, chronic neuropathic pain, peripheral neuropathy, rheumatoid arthritis, and spasticity due to multiple sclerosis (MS)(34).
CBD may help with sleep problems.
Studies show that 40% to 70% of older adults have chronic sleep issues, and up to 50% of those cases may be undiagnosed(35).
Sleep patterns tend to change as people age, and many find that aging makes it increasingly difficult for them to fall asleep(36).
The transition between sleeping and waking up is abrupt, making older people feel like they sleep lighter than when they were younger.
Older people wake up more often as they spend less time in a deep sleep. Other causes include having to get up and urinate, anxiety, and discomfort or pain from chronic illnesses.
Back pain is strongly associated with sleep problems. Studies have shown that back pain interferes with going to sleep and staying asleep(37).
The lack of restorative, quality sleep adds to pain. This connection can lead to a downward spiral of less sleep and increased pain.
CBD may benefit people with insomnia. Results of studies have suggested CBD’s potential in helping those dealing with excessive daytime sleepiness and REM (rapid eye movement) sleep behavior disorder (RBD)(38).
A study on CBD use among insomnia patients compared the side effects of cannabidiol with nitrazepam, a hypnotic type of benzodiazepine drug(39).
The researchers compared CBD (given in 40mg, 80mg, and 160mg) with placebo and nitrazepam (5mg) among 15 volunteers with insomnia.
Results showed that sleep duration notably increased after the participants took the high-dose (160mg) CBD.
A 2019 study indicated that 25mg to 75mg of CBD may help improve sleep quality when taken daily(40).
A participant who had schizoaffective disorder and a trauma history was given a daily CBD dosage of 175mg to improve sleep.
Most CBD companies give their dosage recommendations for sleep. Still, seniors looking to alleviate their sleep-related health issues with cannabidiol should first consult with their physician before taking CBD.
Note that there have been no official CBD dosage guidelines or recommendations released by the FDA or any official organization.
CBD may help with anxiety and depression.
Anxiety symptoms in older people are sometimes subtle as they often develop gradually(41).
An older person may be depressed if they feel sad for more than two weeks, if they feel miserable most of the time, or if they have lost interest or pleasure in most of their usual activities.
The overlap of pain, anxiety, and depression is quite apparent in chronic and sometimes disabling pain syndromes, such as low back pain, nerve pain, headaches, fibromyalgia, and irritable bowel syndrome(42).
Psychiatric disorders not only intensify pain but also increase disability risk.
In 2015, a group of researchers conducted experiments to see how CBD can help with anxiety(43).
They noted that the animal studies conducted demonstrated how CBD may effectively reduce anxiety behaviors associated with several disorders.
The disorders examined include generalized anxiety disorder (GAD), social anxiety disorder (SAD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and panic disorder (PD).
Data was also gathered from experiments conducted with human participants. The researchers obtained similar findings, suggesting CBD’s excellent safety profile and mild calming effects.
Unlike THC, another cannabis compound, CBD is non-addictive. Because CBD does not get users high, it may be an appealing option for people with anxiety.
A 2019 review investigated the effects of CBD on anxiety and stress(44). Results showed that CBD may help reduce a person’s response to stressful environmental factors when given in specific doses.
Compared to placebo, pretreatment with 300mg of CBD notably decreased anxiety levels during speech activity.
The researchers did not observe remarkable differences in the moods of the participants receiving 150mg of CBD, 600mg of CBD, and placebo.
A 2018 study showed CBD as a potential remedy to depression(45).
The authors of the study investigated the therapeutic potential of CBD. They believe that CBD’s purported anti-anxiety, antipsychotic, and anti-epileptic properties may help with stress-related depression.
CBD may help with Alzheimer’s disease and dementia.
Chronic pain often occurs in the elderly, especially in individuals with neurodegenerative disorders like Alzheimer’s disease (AD).
In a study, researchers examined the connection between chronic pain, cognitive impairment, and dementia(46). They noted that cognitive deficits can be observed in those with chronic back pain.
In a clinical review, scientists examined how Alzheimer’s disease (AD) is linked to aging(47). They wanted to see how the research in the two fields could impact and support each other at the cellular, molecular, and system levels.
Based on the results of their experiments, the scientists believe that systemic inflammation is strongly linked to AD.
Scientists have explored and studied CBD’s purported benefits for Alzheimer’s disease(48):
- Anti-inflammatory (reduces inflammation)
- Neuroprotective (protects nerve cells)
- Antioxidant (protects cells from the damage caused by free radicals)
Results of studies suggested that CBD may offset the hyperactivity of specific proteins’ inflammatory and neurochemical effects in AD(49).
However, the promising benefits of cannabinoids in Alzheimer’s disease require further research.
The symptoms of dementia are similar to that of Alzheimer’s: forgetfulness or memory loss, changes in behavior, and increasing difficulty in walking and talking(50).
A systematic review limited to dementia patients 65 years or older was conducted to see how cannabinoids like CBD can help with their condition(51). Cannabis oil containing varying doses of CBD was orally administered to the patients.
While the data collected by the authors was inconclusive, it was clear that a well-designed, randomized, controlled trial is needed to confirm the effectiveness of medical cannabis for the treatment of dementia.
Mayo Clinic uses the term medical cannabis (also called medical marijuana) to describe Cannabis sativa plant derivatives used to relieve serious and chronic symptoms(52).
CBD may help with high blood pressure.
Researchers believe there is a link between chronic pain and hypertension (blood pressure).
A study in the Clinical Journal of Pain showed that high blood pressure is often associated with elevated acute and chronic pain sensitivity(53).
Aging is a contributing factor to hypertension(54). Even if an individual does not have hypertension by age 55 to 65, their lifetime risk for developing the condition is 90%, says an article published by Johns Hopkins Hospital.
Research suggested that cannabidiol is a natural vasodilator(55). As such, CBD may help improve cardiovascular health by widening the blood vessels, allowing the blood to flow smoothly.
The researchers explored the link between CBD and a reduction in blood pressure. They noted that a single dose of CBD oil significantly reduced blood pressure in healthy human volunteers, both under stress and at rest.
A study suggested that CBD may interfere with cortisol (the “stress” hormone) secretion(56). Theoretically, CBD oil may be beneficial in hypertension caused by increased stress levels.
A review examined the blood flow (hemodynamic) effects of CBD(57). According to the authors’ findings, CBD may be useful in the treatment of cardiovascular disorders, like hypertension and stroke.
However, much of the data was gathered from animal studies. More studies on the effects of CBD on hemodynamics need to be conducted with humans as subjects.
Potential CBD Side Effects
A clinical review on CBD’s side effects reported that cannabidiol generally has a safer and better profile compared to other drugs(58).
However, when using CBD, individuals need to be cautious of the compound’s side effects, which may negatively impact the quality of life.
While several studies highlight CBD’s potential benefits, there are also investigations looking into its adverse side effects.
Some of the common adverse effects of CBD include(59):
- Dry mouth
- Changes in appetite
- Changes in weight
CBD products are not regulated. Thus, the unreliability of the purity and dosage of CBD in products is a cause for concern.
A 2017 study compared ingredients listed on the CBD product labels sold online to their actual constituents assessed by laboratory analysis(60).
Of the 84 products tested, 26% had less CBD than the amount indicated on the label. Also, THC was found in 18 of the CBD products tested.
Mislabeling of products can negate any potential clinical response.
CBD may interact with other products, including OTC (over-the-counter) medications, herbal supplements, and prescription medications.
Seniors are more susceptible to drug interactions because of age-related physiological changes that affect how their bodies process medications.
Also, older people often take multiple medications and supplements. The medicines they take may interact with each other and with their body in harmful ways. The medicines can increase their negative side effects or decrease their benefits.
CBD may reduce or increase another drug’s effects(61). Thus, some medicines should never be taken with CBD. Doses may need to be adjusted or reduced to prevent serious complications.
The impact of drug interactions depends on other factors, including an individual’s current health condition, the CBD dose taken, and the dose of another medication that an individual is taking.
In a 2020 study, Penn State College of Medicine researchers analyzed some prescription medications containing CBD and THC(62).
Results showed that there are 139 medications that may be affected by cannabinoids CBD and THC. The list included a variety of drugs, from heart medications to antibiotics and antifungals.
Not all the listed drugs may be affected by CBD-only products; some are only affected by THC.
For 57 medications, altered concentration can be fatal, as they may not function as intended when used with hemp or marijuana.
Drugs that have potentially serious drug interactions with CBD include(63):
- Warfarin, that prevents harmful blood clots from forming
- Levothyroxine, a thyroid medication
- Amiodarone, a heart rhythm medication
- Clobazam, valproate, and lamotrigine, which are seizure medications
A comprehensive list of the 139 medications examined is available online and can be viewed by clicking here.
For more information on CBD interactions with other medications, herbs, supplements, and some foods, one may visit MedlinePlus’ website by clicking here.
MedlinePlus operates under the National Library of Medicine (NLM), which is part of the National Institutes of Health (NIH).
Is CBD Legal?
Industrial hemp is the derivative of Cannabis sativa. Hemp naturally contains a low amount of THC and abundant quantities of CBD.
Under the 2018 Farm Bill, it is federally legal in the United States to manufacture CBD-rich hemp products(64).
Congress expanded the definition for hemp, amending the 2014 Farm Bill definition of industrial hemp. The new definition further distinguished hemp and marijuana under US law.
Hemp is described in Section 297A of the Agricultural Marketing Act of 1946 as the Cannabis sativa L. plant and any of its parts, including its seeds and all derivatives, extracts, and cannabinoids, with a THC concentration of not more than 0.3% percent on a dry weight basis.
Delta-9 THC is marijuana’s primary psychoactive chemical. Psychoactive (also called psychotropic) substances can alter a person’s mental state by changing the way the brain and nervous system work.
Meanwhile, approved measures in some states allow the use of low-THC, high-CBD products for medical reasons in limited situations or as a legal defense.
These states are Alabama, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming(65).
The National Conference of State Legislatures (NCSL) website provides more links and resources to anyone looking for more information on state medical marijuana laws. Click here.
Useful CBD Facts
The National Center for Complementary and Integrative Health (NCCIH) explains the difference between cannabis and marijuana(66).
Although the words “cannabis” and “marijuana” are often used interchangeably, strictly speaking, they do not mean exactly the same thing.
“Cannabis” refers to any product derived from the Cannabis sativa plant.
“Marijuana” refers to any part of or product derived from the Cannabis sativa plant that contains significant amounts of the cannabinoid THC (tetrahydrocannabinol).
THC is primarily responsible for the effects of marijuana’s psychoactive effects, which can alter a person’s mental state.
Cannabis plants contain very little THC and are abundant in CBD. Under US law, these plants are considered “industrial hemp” and not marijuana.
A level of about 1% THC is generally considered the threshold for cannabis to have a psychotropic effect or an intoxicating potential.
Despite the huge variety of cannabis plants available these days, over 99% of them are ultimately derived from only two cannabis family species: Cannabis sativa and Cannabis indica(67).
The indica and sativa species differ in medicinal properties.
Sativa strains induce more of a euphoric high, lifting the consumer’s mood and relieving stress.
Indica strains relax muscles and work as general pain relievers, helping with sleep.
The US Food and Drug Administration (US FDA) has approved only one CBD-infused drug, Epidiolex(68).
Epidiolex is used for the treatment of rare forms of childhood epilepsy, like Lennox-Gastaut syndrome and Dravet syndrome.
When to Talk to a Doctor for CBD Dosing
Approximately 20% of Americans age 50 and above use CBD products, says a 2019 Gallup poll(69). They are doing so despite the total lack of FDA oversight or guidelines.
The statistics raised some concerns among healthcare professionals and medical practitioners. To what extent does CBD become a public health problem for seniors? What do older adults need to consider when they start using CBD?
The survey indicated that seniors tend to prefer ingesting CBD tinctures or CBD in oils. They also prefer vaping CBD using vape cartridges and consuming CBD edibles.
All of these CBD forms require much label-reading for seniors.
Mislabeling often causes much confusion as some CBD manufacturers make false and exaggerated claims about their products.
Dosing is a gray area that complicates CBD use for most people. Seniors particularly have to understand that dosing is not a one-size-fits-all matter.
Serving size is influenced by many factors beyond body weight and potency preference. Dosing in older people may be different from that of younger adults.
Seniors contemplating taking CBD to improve wellness should consult with their doctor before taking CBD, especially if:
- They are trying CBD for the first time.
- They have tried taking CBD and then stopped.
- They are taking other medications for specific medical conditions, either acute or chronic.
- They do not have a complete understanding of CBD, its therapeutic potential, and possible adverse effects.
- They are confused about the different CBD types and formulations available in the market, not knowing which ones are high-quality and safe for them to use.
An open and truthful discussion with a doctor is going to benefit seniors and help prevent any unwarranted consequences.
- Perez J. Combined cannabinoid therapy via an oromucosal spray. Drugs Today (Barc) 2006;42:495–503.
- Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2019). Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants (Basel, Switzerland), 9(1), 21. https://doi.org/10.3390/antiox9010021
- Babson, K.A., Sottile, J. & Morabito, D. (2017, Mar. 23). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Curr Psychiatry Rep 19(23). https://www.med.upenn.edu/cbti/assets/user-content/documents/s11920-017-0775-9.pdf
- Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Braz J Psychiatry. 2019;41(1):9–14. DOI:10.1590/1516-4446-2017-0015.
- Crippa JA, Guimarães FS, Campos AC, Zuardi AW. Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Front Immunol. 2018;9:2009. Published 2018 Sep 21. DOI:10.3389/fimmu.2018.02009.
- Jadoon KA, Tan GD, O’Sullivan SE. A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI Insight. 2017;2(12):e93760. Published 2017 Jun 15. doi:10.1172/jci.insight.93760. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470879/
- Watt, G., and Karl, T., (February 2017), In vivo Evidence for Therapeutic Properties of Cannabidiol (CBD) for Alzheimer’s Disease, Behavioural Neuroscience, Western Sydney University, retrieved from https://www.frontiersin.org/articles/10.3389/fphar.2017.00020/full
- Peprah K, McCormack S. Medical Cannabis for the Treatment of Dementia: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Jul 17. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546328/
- World Health Organization. Cannabidiol (CBD). Published November 2017. Retrieved from https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
- Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JA. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011;6(4):237-249. doi:10.2174/157488611798280924
- Bauer, B. A., (n.d.), What are the benefits of CBD — and is it safe to use?, https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
- Gallup Poll. (2019, Aug 7). 14% of Americans Say They Use CBD Products. Retrieved from https://news.gallup.com/poll/263147/americans-say-cbd-products.aspx?utm_source=twitter&utm_medium=o_social&utm_term=&utm_content=&utm_campaign=
- Isabelle Matias, Ilaria Belluomo, and Daniela Cota.Cannabis and Cannabinoid Research. Dec 2016.176-185.http://doi.org/10.1089/can.2016.0014
- University of Minnesota. (2019, August 13). High fat foods can increase oral cannabidiol absorption into the body. ScienceDaily. Retrieved March 17, 2021 from www.sciencedaily.com/releases/2019/08/190813130426.htm
- Orrin Devinsky, Chloe Verducci, Elizabeth A. Thiele, Linda C. Laux, Anup D. Patel, Francis Filloux, Jerzy P. Szaflarski, Angus Wilfong, Gary D. Clark, Yong D. Park, Laurie E. Seltzer, E. Martina Bebin, Robert Flamini, Robert T. Wechsler, Daniel Friedman,
- Kazuhide Hayakawa et al. Repeated treatment with cannabidiol but not Δ9-tetrahydrocannabinol has a neuroprotective effect without the development of tolerance.
- Neuropharmacology, 2007. https://doi.org/10.1016/j.neuropharm.2006.11.005 (https://www.sciencedirect.com/science/article/pii/S0028390806003923)
- Fasinu PS, Phillips S, ElSohly MA, Walker LA. Current status and prospects for cannabidiol preparations as new therapeutic agents. Pharmacotherapy. 2016;36(7):781-796. doi:10.1002/phar.1780
- Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: a large case series. Perm J. 2019;23:18‐041. doi:10.7812/TPP/18-041
- Khalid A. Jadoon, Stuart H. Ratcliffe, David A. Barrett, E. Louise Thomas, Colin Stott, Jimmy D. Bell, Saoirse E. O’Sullivan, Garry D. Tan. Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Pilot Study. Diabetes Care Oct 2016, 39 (10) 1777-1786; DOI: 10.2337/dc16-0650
- Good, P., Haywood, A., Gogna, G. et al. Oral medicinal cannabinoids to relieve symptom burden in the palliative care of patients with advanced cancer: a double-blind, placebo controlled, randomised clinical trial of efficacy and safety of cannabidiol (CBD). BMC Palliat Care. 2019;18:110. doi: 10.1186/s12904-019-0494-6
- Peres FF, Lima AC, Hallak JEC, Crippa JA, Silva RH, Abílio VC. Cannabidiol as a promising strategy to treat and prevent movement disorders?. Front Pharmacol. 2018;9:482. doi:10.3389/fphar.2018.00482
- Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825-836. doi:10.1007/s13311-015-0387-1
- Fasinu PS. op. cit.
- World Health Organization. op. cit.
- Larsen, C., & Shahinas, J. (2020). Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials. Journal of clinical medicine research, 12(3), 129–141. https://doi.org/10.14740/jocmr4090
- Bergamaschi MM. op. cit.
- Wong, A. Y., Karppinen, J., & Samartzis, D. (2017). Low back pain in older adults: risk factors, management options and future directions. Scoliosis and spinal disorders, 12, 14. https://doi.org/10.1186/s13013-017-0121-3
- Atalay, S.op. cit.
- National Institute on Aging. (2017, May 1). Osteoarthritis. Retrieved from https://www.nia.nih.gov/health/osteoarthritis
- Ahmed, W., & Katz, S. (2016). Therapeutic Use of Cannabis in Inflammatory Bowel Disease. Gastroenterology & hepatology, 12(11), 668–679.
- Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European journal of pain (London, England), 20(6), 936–948. https://doi.org/10.1002/ejp.818
- Borrelli F, Aviello G, Romano B, et al. Cannabidiol, a safe and non-psychotropic ingredient of the marijuana plant Cannabis sativa, is protective in a murine model of colitis. J Mol Med (Berl). 2009;87(11):1111–1121.
- Perez J. op. cit.
- Miner, B., & Kryger, M. H. (2017). Sleep in the Aging Population. Sleep medicine clinics, 12(1), 31–38. https://doi.org/10.1016/j.jsmc.2016.10.008
- MedlinePlus Connect. Changes in sleep. Retrieved from https://medlineplus.gov/ency/article/004018.htm
- Alsaadi SM, McAuley JH, Hush JM, Maher CG. Prevalence of sleep disturbance in patients with low back pain. European Spine Journal. 2011; 20: 737–743.
- Babson, K.A. op. cit.
- Zhornitsky, S., & Potvin, S. (2012). Cannabidiol in humans-the quest for therapeutic targets. Pharmaceuticals (Basel, Switzerland), 5(5), 529–552. https://doi.org/10.3390/ph5050529
- Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
- Beyond Blue. Signs and symptoms of anxiety and depression in older people. Retrieved from https://www.beyondblue.org.au/who-does-it-affect/older-people/signs-and-symptoms-of-depression-in-older-people
- Harvard Health Publishing. (2010, August). The pain-anxiety-depression connection. Retrieved from https://www.health.harvard.edu/healthbeat/the-pain-anxiety-depression-connection
- Blessing EM. op. cit.
- Linares IM. op. cit.
- Crippa JA,. op. cit.
- Cao, S., Fisher, D.W., Yu, T. et al. The link between chronic pain and Alzheimer’s disease. J Neuroinflammation 16, 204 (2019). https://doi.org/10.1186/s12974-019-1608-z
- Xia, X., Jiang, Q., McDermott, J., & Han, J. J. (2018). Aging and Alzheimer’s disease: Comparison and associations from molecular to system level. Aging cell, 17(5), e12802. https://doi.org/10.1111/acel.12802
- Watt, G. op. cit.
- Bisogno, T., Di Marzo, V., (2008), The Role of the Endocannabinoid System in Alzheimer’s Disease: Facts and Hypotheses, Current Pharmaceutical Design, vol.14:23, pp. 2299-2305(7), https://doi.org/10.2174/138161208785740027
- World Health Organization, (September 2020), Dementia, retrieved from https://www.who.int/news-room/fact-sheets/detail/dementia#:~:text=Dementia%20is%20a%20syndrome%20in,million%20new%20cases%20every%20year.
- Peprah K. op. cit.
- Mayo Clinic. (2019, Nov. 27). Medical Marijuana. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855
- Bruehl, S., Chung, O. Y., Jirjis, J. N., & Biridepalli, S. (2005). Prevalence of clinical hypertension in patients with chronic pain compared to nonpain general medical patients. The Clinical journal of pain, 21(2), 147–153. https://doi.org/10.1097/00002508-200503000-00006
- Johns Hopkins Medicine. Hypertension: What You Need to Know as You Age. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-blood-pressure-hypertension/hypertension-what-you-need-to-know-as-you-age
- Jadoon KA. op.cit.
- Zuardi, AW, Guimarães FS, and Moreira, AC. Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers. Braz J Med Biol Res. 1993 Feb; 26(2): 213–217.
- Sultan SR, Millar SA, England TJ, O’Sullivan SE. A Systematic Review and Meta-Analysis of the Haemodynamic Effects of Cannabidiol. Front Pharmacol. 2017;8:81. Published 2017 Feb 24. doi:10.3389/fphar.2017.00081. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323388/
- Iffland, K., Grotenhermen, F., (June 2017), An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies, retrieved from https://www.liebertpub.com/doi/full/10.1089/can.2016.0034
- Bauer, B. A. op. cit.
- Bonn-Miller, M. O., Loflin, M., Thomas, B. F., Marcu, J. P., Hyke, T., & Vandrey, R. (2017). Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA, 318(17), 1708–1709. https://doi.org/10.1001/jama.2017.11909
- Medline Plus, (n.d.), Cannabidiol (CBD), retrieved from https://medlineplus.gov/druginfo/natural/1439.html
- Harvard Health Publishing. (2021, Jan 11). CBD and other medications: Proceed with caution. Retrieved from https://www.health.harvard.edu/blog/cbd-and-other-medications-proceed-with-caution-2021011121743
- Congressional Research Service, (n.d.), Defining Hemp: A Fact Sheet, retrieved from https://fas.org/sgp/crs/misc/R44742.pdf
- National Conference of State Legislatures. (2021, March 1). State Medical Marijuana Laws. Retrieved from https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
- The National Center for Complementary and Integrative Health (NCCIH). (2019, Nov). Cannabis (Marijuana) and Cannabinoids: What You Need To Know. Retrieved from https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
- ProCon.org. (2008, May 30). What Are the Differences between Cannabis Indica and Cannabis Sativa, and How Do They Vary in Their Potential Medical Utility? Retrieved from https://medicalmarijuana.procon.org/questions/what-are-the-differences-between-cannabis-indica-and-cannabis-sativa-and-how-do-they-vary-in-their-potential-medical-utility/
- USFDA. (2018, June 25). FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
- Gallup Poll. op. cit.