Skip to content

Is it safe to have CBD every night? A Pharmacological Review

5 min read

A 2018 World Health Organization (WHO) report concluded that CBD is “generally well-tolerated, with a good safety profile”. But for those wondering, is it safe to have CBD every night?, it is important to consider the nuances of long-term use, potential risks, and product quality.

Quick Summary

Nightly CBD use is generally well-tolerated by many, but can pose risks including drug interactions, liver enzyme elevation, and potential side effects. The lack of regulation for non-prescription products also presents concerns regarding quality.

Key Points

  • Drug Interactions Are a Major Concern: Nightly CBD can inhibit liver enzymes (CYP450), potentially increasing the concentration of other medications in the bloodstream.

  • Liver Enzyme Elevation Risk: Recent FDA-led trials show that daily use can cause transient, asymptomatic liver enzyme increases in a small percentage of healthy adults.

  • Lack of Regulation Creates Risks: Non-prescription CBD products are not FDA-regulated, leading to potential mislabeling of potency and contamination with heavy metals, pesticides, or THC.

  • Start Low and Monitor Effects: It is safest to begin with a low amount and gradually increase while monitoring for side effects like drowsiness or digestive issues.

  • Medical Consultation is Crucial: Always consult a healthcare provider before starting a nightly CBD regimen, especially if taking other medications or having pre-existing conditions like liver disease.

  • Withdrawal Symptoms Are Possible: While not physically addictive, long-term, heavy users may experience mild, psychological withdrawal-like symptoms such as irritability or sleep disturbances upon cessation.

In This Article

The General Safety Profile of CBD

Cannabidiol (CBD), a non-intoxicating compound derived from the cannabis plant, has gained widespread popularity for its potential therapeutic effects. It's often used to help with sleep issues, anxiety, and chronic pain. The World Health Organization (WHO) has noted that pure CBD does not appear to have abuse potential and exhibits a good overall safety profile. However, the key distinction is between the pure, FDA-approved pharmaceutical grade CBD, Epidiolex, and the unregulated supplements widely available to consumers.

While short-term use is generally considered safe, the safety of taking CBD every night, especially long-term, requires a closer look at several important factors, including potential side effects, drug interactions, and the inconsistencies of an unregulated market.

Why Do People Take CBD at Night?

Many individuals incorporate nightly CBD into their wellness routine for its potential to aid sleep and relaxation. Research suggests CBD may help address underlying issues that disrupt sleep, such as anxiety and chronic pain. By calming the nervous system, it can help promote better sleep quality for some users. This non-sedating approach is often contrasted with traditional sleep aids that can cause morning grogginess or dependency.

Potential Risks and Side Effects of Nightly CBD Use

Risk of Elevated Liver Enzymes

A recent FDA-led clinical trial demonstrated that daily CBD use can lead to elevated liver enzymes in a small but notable percentage of healthy adults. This effect was transient and reversed after stopping CBD use. The risk is higher for those taking higher amounts or with pre-existing liver conditions. This underscores the importance of medical supervision, especially for long-term nightly use. Without monitoring, these asymptomatic enzyme elevations can go unnoticed.

Significant Drug Interactions

One of the most significant risks of nightly CBD use is its potential for drug interactions. CBD is metabolized by the same liver enzymes (cytochrome P450 or CYP450) that break down a large number of prescription drugs. When CBD inhibits these enzymes, it can cause other medications to build up to potentially dangerous levels in the bloodstream. This is a serious concern that necessitates medical consultation before starting a nightly CBD regimen.

Commonly Interacting Medications:

  • Blood Thinners: Drugs like warfarin are particularly susceptible, with CBD potentially increasing the risk of bleeding.
  • Antidepressants and Sedatives: CBD can increase the sedative effects of benzodiazepines (like Xanax) and certain antidepressants (like SSRIs), leading to excessive drowsiness and impaired motor skills.
  • Other Medications: Interactions have also been reported with certain anti-seizure drugs, immunosuppressants, and even common painkillers like acetaminophen.

Other Common Side Effects

Even with safe, high-quality products, nightly CBD use can lead to some side effects that are typically mild and temporary. These may include:

  • Drowsiness or fatigue
  • Dry mouth
  • Diarrhea
  • Changes in appetite or weight
  • Mood changes, such as irritability
  • Lightheadedness

The Problem with Unregulated Products

Because the non-prescription CBD market is not regulated by the FDA, there is a significant risk of quality control issues. Studies have repeatedly shown major discrepancies between a product's labeled content and its actual content. This means a consumer may be getting more or less CBD than they intended, making the amount unpredictable.

Furthermore, contamination is a serious concern. Independent lab tests have found that some CBD products contain contaminants like heavy metals, pesticides, and residual solvents. Some products also contain more THC than the legal limit, which can cause unwanted psychoactive effects and lead to failed drug tests, particularly with full-spectrum products. To mitigate this risk, consumers should seek out products with a Certificate of Analysis (CoA) from an independent, third-party lab.

Comparison: Nightly vs. Occasional CBD Use

Feature Nightly CBD Use Occasional CBD Use
Drug Interaction Risk Significantly higher risk due to consistent daily intake affecting liver enzymes. Much lower risk, but caution is still needed, especially when combined with other substances.
Liver Impact Small but documented risk of transient liver enzyme elevations, particularly with higher amounts. Negligible risk, as the liver is not exposed to a consistent, daily amount.
Tolerance/Withdrawal Potential for psychological dependence or a perceived need for the substance after long-term use. Minimal to no risk of tolerance or withdrawal symptoms.
Side Effect Consistency Regular use increases the potential for consistent or cumulative side effects like fatigue or digestive issues. Side effects are typically isolated to the day of use and are less frequent.
Consistency of Effect Can build up in the system, potentially leading to a more consistent effect over time. Effects are more acute and may require more trial and error to find the right amount.

Safe Practices for Nightly CBD Use

For those considering nightly CBD, informed use is essential. Following these guidelines can help minimize risks and promote a safer experience:

  1. Consult a healthcare provider: This is the most crucial step, especially if you take other medications or have pre-existing health conditions, particularly liver disease. A doctor can help determine if CBD is appropriate for you and advise on potential drug interactions.
  2. Choose high-quality products: Always buy from reputable brands that provide a Certificate of Analysis (CoA) from an independent lab. This document verifies the CBD content and screens for contaminants like heavy metals, pesticides, and excessive THC.
  3. Start with a low amount: Begin with a small amount and increase slowly based on your response. Keeping a journal to track your amount, effects, and any side effects can help you find your optimal level.
  4. Monitor your body's response: Pay attention to how you feel, especially when starting a new product or increasing the amount. If you experience adverse side effects, consider reducing the amount or stopping use. For those with liver concerns, regular monitoring of liver enzyme levels may be prudent under a doctor's guidance.
  5. Be aware of potential withdrawal: While pure CBD is not physically addictive, abruptly stopping long-term, high-dose use may lead to a recurrence of the symptoms it was treating. Tapering off gradually can minimize any psychological or mild physical effects.

Conclusion

Ultimately, the question of whether it is safe to have CBD every night depends heavily on individual circumstances, health status, and product choice. For many healthy individuals taking no other medications, nightly use of a high-quality, lab-tested product is likely safe and well-tolerated. However, potential risks such as drug interactions, especially for those on specific medications, and the documented risk of liver enzyme elevation cannot be ignored. The unregulated nature of the supplement market also requires careful selection to avoid mislabeled or contaminated products. The safest approach is always to consult with a healthcare provider before beginning a nightly CBD regimen to ensure it is the right and safest choice for your health needs.

NIH PMC5569602

Frequently Asked Questions

The most common side effects include fatigue, drowsiness, dry mouth, and diarrhea. Some people may also experience changes in appetite or mood.

You should not take CBD with prescription medications without first consulting your doctor. CBD can interfere with how your liver processes many drugs, including blood thinners, antidepressants, and sedatives, leading to potentially harmful interactions.

To ensure a product's safety, choose reputable brands that provide a Certificate of Analysis (CoA) from an independent, third-party lab. This verifies the product's CBD potency and confirms it is free of harmful contaminants like heavy metals and pesticides.

Pure CBD is not considered physically addictive and does not have the potential for abuse. However, some long-term users may develop a psychological dependence on its therapeutic effects, and may experience mild withdrawal-like symptoms if they stop abruptly.

Recent studies have shown that daily use of CBD can cause transient and asymptomatic elevations of liver enzymes in some healthy adults. This risk is higher with higher amounts and in individuals with pre-existing liver conditions.

It is best to start with a very low amount an hour or so before bed. Monitor your body's response over several nights before considering a gradual increase. Always consult a healthcare provider beforehand.

Yes, it is possible, particularly with full-spectrum products, which can contain trace amounts of THC. Regular use can lead to a buildup that may trigger a positive drug test. Using broad-spectrum or CBD isolate products can minimize this risk.

References

  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
  6. 6
  7. 7
  8. 8
  9. 9
  10. 10

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.