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The Evidence on the Safety of Cannabinoids

Are CBD and THC safe to use regularly? Are there any THC or CBD side effects to be aware of? Can these cannabinoids be addictive?

These are just a few of the many questions regarding cannabis safety that many people have.

Unfortunately, there is a lot of misinformation out there, so it’s important to look to published research and evidence to better understand the safety of cannabinoids

The International Journal of General Medicine published an article titled Safety Considerations in Cannabinoid-Based Medicine that delves into just about everything you need to know about cannabinoid safety. Keep reading to learn all about what this article says on cannabinoid safety.

Are cannabinoids safe?

Cannabinoids are chemical compounds that have gained a lot of popularity recently. Although cannabis has been used for its alleged healing properties for thousands of years, THC and CBD have become better-known lately thanks to more research on the individual cannabinoids.

CBD and THC are two of the most popular cannabinoids - both with many interesting benefits. Although the benefits of cannabinoids have been studied a lot lately, there is not as much being reported on safety. The team of researchers who published the article mentioned above wanted to discuss and clarify the safety evidence of cannabinoids to provide better insight on the matter.

In their studies, they concluded that cannabinoid-based medications are generally very safe, especially when compared to other treatments and medications.

The article by Gottschling et al 2020 stated that “Patients receiving cannabinoid-based medicines generally do not increase their dose over time, once the therapeutic dose has been achieved. This is in contrast to opioid use, where dose escalation and addiction are not uncommon.” (1)

Cannabinoids are not known to be very addictive, and they pose few side effects. This is a completely different situation from most opioids and other medications as many have a high abuse potential and many side effects. Although risks are possible with any medication, many find the risks very low with cannabinoid-based medications and treatments.

The researchers mention that more research is needed to establish a safety profile for each cannabinoid. Because most studies on cannabinoids use different dosing, formulation, administration, and more, the disparities can cause confusion. With more research, we will gain a clearer picture of the safety of cannabinoid-based medications.

Contraindications of CBD and other cannabinoids

Cannabis-based medications that have been approved and licensed for specific health issues by national regulatory bodies like Epidiolex®, Sativex®, Marinol®, Syndros®, and Cesamet® have clear contraindications.

A contraindication is a situation where a medication should not be used because it may be harmful to that patient based on their situation.

Cannabinoid-based medications, just like other medications, have contraindications that physicians must be aware of. A few examples of contraindications and relative contraindications (which are not absolute) include being less than age 25, having a psychiatric illness, having cardiovascular disease, and more.

The researchers state that, “The currently known contraindications do not seem excessive or severely restrictive in the context of other treatments for similar indications.” (1)

It is very important for physicians to assess these contraindications to ensure that their patients are not prescribed medications that could potentially harm them. These contraindications are designed to keep patients healthy. However, it’s important to note that we don’t necessarily know what specific cannabinoid is contraindicated. Also, the researchers state that in some cases, the benefits of prescribing a cannabinoid-based medication may outweigh the risks.

What is cannabis-use disorder and cannabis-withdrawal


The article also discusses both cannabis-use disorder and cannabis-withdrawal syndrome. If you’re like most people, you’ve probably never heard of either.

Cannabis-use disorder is a substance use disorder defined by a problematic pattern of cannabis (marijuana) use that leads to clinically significant distress or impairment. It includes the possibility that individuals can be negatively impacted by cannabis use without being addicted


Cannabis-withdrawal syndrome refers to unpleasant withdrawal symptoms in individuals who regularly use cannabis (marijuana) and then discontinue use.

The researchers acknowledge that cannabis-use disorder can arise, though it’s much more likely with recreational use. Also, it’s important to understand that cannabis withdrawal symptoms, although possible, do not typically cause significant psychiatric or medical problems like opioids and alcohol do. “Additionally, recreational cannabis use does not appear to be associated with increased mortality compared with the general population,” the article states. (1)

Ultimately, the researchers point out that, “available tools to detect substance-use disorder designed for recreational drug use may not be suitable for assessing problematic medication use in patients.” (1) The information we have on cannabis-use disorder and cannabis withdrawal syndrome are primarily based on recreational use; we need more research to better assess issues that may arise in cannabis-medication use.

Cannabinoids vs. Opioids

As we’ve mentioned multiple times, research and clinical studies have pointed to the fact that cannabinoids are typically safer than opioids in treating many conditions.

The researchers also state that, “In real-world studies, 97% of patients with chronic pain reported that they were able to decrease their opiate dose and 92% found the side effects more tolerable with cannabinoids compared with opiates.” (1)

Ultimately, although there are risks to using CBD or THC as a treatment option, those risks and side effects are typically less severe and problematic as compared to the risks and side effects from opioid use.


(1) Gottschling S, Ayonrinde O, Bhaskar A, Blockman M, D'Agnone O, Schecter D, Suárez

Rodríguez LD, Yafai S, Cyr C. Safety Considerations in Cannabinoid-Based Medicine.

Int J Gen Med. 2020 Dec 1;13:1317-1333. doi: 10.2147/IJGM.S275049. PMID:

33299341; PMCID: PMC7720894.

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