The Rise of CBD and the Need for Caution
Cannabidiol (CBD) has surged in popularity, with the market expected to generate over $7.4 billion in worldwide revenue in 2025 [1.10.1]. Found in everything from oils and gummies to skincare, CBD is sought for its potential to help with anxiety, pain, and sleep issues [1.6.5, 1.10.5]. However, its widespread availability and lack of regulation by the FDA (except for one prescription drug) create significant risks for consumers [1.3.1, 1.6.3]. Many products are inaccurately labeled, containing more or less CBD than advertised, and some even contain undeclared THC or harmful contaminants like heavy metals and pesticides [1.3.1, 1.5.4]. Understanding what not to do when using CBD is crucial for navigating this complex market safely.
1. Don't Skip a Doctor's Consultation
Before starting CBD, a conversation with a healthcare provider is essential, especially if you have underlying health conditions or take other medications [1.3.3, 1.7.3]. CBD can cause liver injury and interact with many common drugs [1.6.4]. A doctor can help you assess the risks, manage potential drug interactions, and monitor for side effects like elevated liver enzymes, which might not have obvious symptoms [1.6.4, 1.7.4]. People with liver disease, Parkinson's disease, and those who are pregnant or breastfeeding are specifically advised to be cautious or avoid CBD altogether [1.7.3, 1.7.5].
2. Don't Mix CBD with Certain Medications
One of the biggest risks of using CBD is its interaction with other drugs [1.2.1]. CBD is metabolized by the CYP450 enzyme system in the liver, which is responsible for breaking down about 60% of prescription medications [1.2.1, 1.4.4]. By inhibiting these enzymes, CBD can cause levels of other drugs to increase in the blood, leading to heightened side effects or toxicity [1.2.2, 1.4.3]. Conversely, some drugs can affect CBD levels, reducing its effectiveness [1.2.1]. A simple guideline is the "grapefruit test": if your medication warns against consumption with grapefruit, you should also avoid CBD, as they inhibit the same enzymes [1.4.1, 1.7.3].
Common medications that can interact with CBD include:
- Blood Thinners: (e.g., Warfarin) - Mixing with CBD can increase the risk of bleeding [1.2.1, 1.7.5].
- Antidepressants and Antipsychotics: (e.g., SSRIs) - Can lead to increased side effects like drowsiness and sedation [1.2.1, 1.2.2].
- Seizure Medications: (e.g., Clobazam, Valproic Acid) - Interactions can lead to elevated liver enzymes or altered medication levels [1.2.1, 1.4.5].
- Benzodiazepines: (e.g., Xanax, Valium) - Greatly increases the risk of sedation and drowsiness [1.4.4].
- Opioids: - Can amplify CNS side effects like sedation and fatigue [1.2.1].
- Blood Pressure Medications: - Can cause blood pressure to drop too low, leading to dizziness and fainting [1.2.1, 1.4.4].
- Statins: - Taking CBD with cholesterol-lowering statins can increase the risk of side effects and liver damage [1.4.4].
3. Don't Use If You Are Pregnant or Breastfeeding
The FDA strongly advises against the use of CBD, THC, and marijuana in any form during pregnancy or while breastfeeding [1.9.1, 1.9.2]. THC can enter the fetal brain and may increase the risk of low birth weight or premature birth [1.9.2]. While research on CBD is limited, animal studies show high doses caused reproductive problems in male fetuses [1.9.2]. It is expected that CBD transfers to babies through breast milk, and products may be contaminated with THC, pesticides, or heavy metals, posing additional risks [1.9.2, 1.9.4].
4. Don't Consume with Alcohol
Mixing CBD and alcohol is not recommended [1.8.2, 1.8.3]. Both substances can cause drowsiness, sedation, and impaired motor skills, and combining them can amplify these effects, increasing the risk of accidents [1.2.1, 1.8.1]. While some animal studies suggest CBD might protect against alcohol-induced liver and brain damage, the interaction in humans is not well understood [1.8.5]. Both substances can also stress the liver, potentially increasing the risk of liver damage [1.2.3].
5. Don't Buy Untested and Unregulated Products
The CBD market is largely unregulated, leading to widespread issues with product quality and safety [1.6.3]. A 2017 study found that over two-thirds of CBD products sold online were mislabeled [1.5.4].
- Don't trust the label alone: Always look for a Certificate of Analysis (COA) from a third-party lab [1.3.2]. This report verifies the product's CBD and THC content and confirms it is free from contaminants like heavy metals, pesticides, and bacteria [1.3.2, 1.5.4]. Reputable companies make their COAs easily accessible [1.3.2].
- Don't buy the cheapest option: Inexpensive products may be made from low-quality hemp that has absorbed toxins from the soil [1.3.3]. Your health is worth the investment in a reputable, tested product [1.3.3].
- Don't misunderstand the label: Familiarize yourself with terms like "Full-Spectrum" (contains all cannabinoids including trace THC), "Broad-Spectrum" (all cannabinoids except THC), and "Isolate" (pure CBD) [1.3.2].
| Safe CBD Practice | Risky Behavior to Avoid |
|---|---|
| Consult a Healthcare Provider [1.3.3] | Self-prescribing without medical advice [1.6.4] |
| Buy Products with a COA [1.3.2] | Purchasing the cheapest, untested products [1.3.3] |
| Start with a Low Dose [1.3.3] | Taking a high dosage immediately [1.3.3] |
| Check for Medication Interactions [1.2.1] | Mixing with blood thinners, sedatives, or alcohol [1.2.3, 1.4.4] |
| Avoid Use if Pregnant/Breastfeeding [1.9.2] | Using CBD to manage pregnancy symptoms [1.9.4] |
| Be Patient and Consistent [1.3.3] | Expecting immediate results and giving up quickly [1.3.3] |
Conclusion: Prioritize Safety and Education
While CBD holds promise for various wellness applications, the potential risks are significant and should not be overlooked. The most critical rule is to prioritize safety. This means not using CBD without consulting a doctor, especially if you take other medications or have health conditions. It means not trusting an unregulated market and doing your homework to find high-quality, third-party tested products. By avoiding these common pitfalls—not mixing with contraindicated substances, not using during pregnancy, and not starting with a high dose—you can make a more informed and safer decision about whether and how to incorporate CBD into your life. For more information on product safety, you can consult resources from the U.S. Food and Drug Administration.
Link: FDA - What You Need to Know About Products Containing Cannabis or Cannabis-derived Compounds
