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Cbd oil for pain vs thc

CBD vs. THC: What’s The Difference?

Lenore Cangeloso is a board-certified acupuncturist and herbal medicine practitioner based in Oregon.

Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Table of Contents

  • What Is CBD?
  • What Is THC?
  • CBD vs THC: Key Differences
  • How Are CBD and THC Similar?

Neither cannabidiol (CBD) nor delta-9-tetrahydrocannabinol (THC) are new discoveries—they were first isolated from cannabis plants by scientists in the early 1940s. However, our understanding of the two plant compounds is still evolving today as scientists continue to study them, learning more about their characteristics and medical benefits.

Improved education about the cannabis plant and its two main compounds not only boosted their popularity, but also brought them into the mainstream in recent years. Below, learn more about the similarities and differences of CBD and THC, how they can benefit the body, their potential side effects and how they’re treated by the U.S. legal system.

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What Is CBD?

Cannabidiol, or CBD, is one of the main cannabinoids (chemical compounds unique to cannabis) found in cannabis sativa plants.

A cannabis sativa plant can be classified according to its CBD and THC production potentials:

  • Type I cannabis sativa contains more than 0.3% THC and less than 0.5% CBD.
  • Type II cannabis sativa contains more than 0.3% THC and 0.5% CBD.
  • Type III cannabis sativa contains less than 0.3% THC and more than 0.5% CBD.

Type I and type II cannabis sativa are considered marijuana while type III is classified as hemp.

CBD can be derived from any type of cannabis sativa plant, but it’s legal throughout the U.S. only when it comes from hemp specifically—an important distinction explained in greater detail below.

What Is THC?

Delta-9-tetrahydrocannabinol, or THC, is another main cannabinoid found in cannabis sativa plants. THC is the compound that produces the intoxicating, psychoactive “high” often associated with cannabis.

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CBD vs THC: Key Differences

CBD and THC may come from the same plant, but their unique chemical structures affect how they interact with the body. Because of these inherent differences, they are also treated differently in the U.S. legal system.

Chemical Structure

“From a chemistry standpoint, THC and CBD are isomers, meaning they share the same chemical formula (C21H30O2) with different chemical structures,” say Nick Jackowetz and Soheil Hajirahimkhan, chief scientific officer and head of research and development at Cirona Labs, a cannabinoid product developer. “While the structure of CBD consists of two 6-membered rings, THC has an additional 6-membered ring that is formed via the attachment of a carbon and an oxygen atom (called an ether bond).”

Therefore, CBD and THC bind differently with the receptors in the body’s endocannabinoid system, which helps modulate the central nervous system, synaptic plasticity (how neurons communicate with each other) and the body’s response to external stressors.

The two main receptors in the endocannabinoid system are CB1, which is largely found in the brain and central nervous system, and CB2, which is mostly found in the immune system (and in much lower levels in the central nervous system). THC tends to bind with both receptors while CBD has little affinity for either.

Psychoactive Properties

THC is the compound most commonly associated with psychoactive effects while CBD is not. However, this understanding is “a huge misconception,” says Monique McHenry, Ph.D., director of the Medical Cannabis Center for Research and Education at the University of Vermont Medical School.

Lauren Rudick, partner of the cannabis practice at Hiller, PC, a law firm in New York, agrees with McHenry. “It’s an important distinction,” she says. CBD is still psychoactive, meaning it affects the mind—it’s just not intoxicating and doesn’t impair function.

The “high” from THC comes from its binding with CB1 receptors. Since CBD doesn’t attach to CB1 or CB2 receptors like THC does, it doesn’t produce the same intoxicating effect.

However, when CBD and THC are consumed together, CBD binds to the receptors and blocks THC from binding with them, thus mitigating some of the effects felt from the THC.

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Should You Take CBD for Pain?

People looking for a safer pain reliever are turning to cannabis-derived CBD. Michigan Medicine experts weigh in on what’s currently known about the trendy supplement.

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Want to learn more on this topic? Listen to this podcast from the Rogel Cancer Center on Medical Marijuana for Cancer Patients.

CBD, short for cannabidiol, is undergoing a surge in popularity as the hot new supplement, with a promise to treat a variety of conditions including pain, anxiety, and insomnia, just to name a few. It’s also available in all manner of forms, from lotions and oils to CBD-infused food and drink. But does it work?

CBD is one of the compounds in the cannabis plant, better known as marijuana. Unlike the famous cannabinoid tetrahydrocannabinol (THC), CBD doesn’t cause the psychological effects typical of being “high”. Both CBD and THC act on the body’s natural endocannabinoid system, which plays a role in many processes including appetite, pain and memory.

The scientific evidence around CBD use is thin, a fact that is mainly due to politics. “Cannabis has been a Schedule 1 drug for a long time, which has limited the type of research needed to figure out how best to use it therapeutically,” says Kevin Boehnke, Ph.D., research investigator in the department of anesthesiology and the Michigan Medicine Chronic Pain and Fatigue Research Center. Under the U.S. Federal Controlled Substances Act, Schedule 1 drugs are defined as having no currently accepted medical use and a high potential for abuse.

Yet marijuana has been used as a medicinal plant for thousands of years, he notes. In fact, one of the first recorded uses of cannabis was for rheumatism, also known as arthritis. Cannabis products were widely used as medicines in the 19th and early 20th centuries, and were listed in the U.S. Pharmacopoeia before the onset of Federal restriction in 1937 under the Marijuana Tax Act.

Much of the research literature around CBD in particular supports its use as a treatment for childhood epilepsy. Indeed, in 2018 the FDA approved the CBD-based drug Epidiolex as a drug for childhood epileptic conditions. In a substantial policy shift, Epidiolex was designated as Schedule V, which is the least restrictive drug schedule and indicates little potential for abuse.

While there aren’t any published clinical trials on CBD in pain, Boehnke notes that ongoing preclinical studies in animals have demonstrated that CBD reduces pain and inflammation, and studies of CBD in humans show that it is well-tolerated and has few negative side effects. “There are also observational studies that ask why people use CBD and if it’s effective, and results tend to be quite positive. People report using CBD for anxiety, pain, sleep — all things that go hand-in-hand with chronic pain,” he says. The passage of the 2018 Farm Bill removed hemp-derived CBD (

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So many people are turning to CBD as an alternative pain reliever, especially in light of the opioid crisis, that in a commentary published in Annals of Internal Medicine, Boehnke and Daniel Clauw, M.D., director of the Chronic Pain and Fatigue Research Center, provided advice for clinicians on how to counsel their patients about CBD and cannabis use.

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They also provided guidance for the Arthritis Foundation, who recently surveyed 2,600 people with arthritis and found that 29% currently use CBD to treat arthritis symptoms.

Boehnke and Clauw recommend that people with chronic pain talk to their doctor about adding CBD to their treatment plan, and continue to use their prescribed medication. They offer the following advice for people wanting to try CBD:

Don’t smoke or vape. Bottom line is smoking anything harms the lungs. Vaping has been associated with a recent epidemic of lung disease, according to the Centers for Disease Control & Prevention.

Purchase from reputable sources. Like vitamins and other supplements, CBD products aren’t regulated or FDA approved to treat disease, so buyer beware. Look for products that have been tested by an independent third party lab “so you don’t end up with a product that has THC in it or a product contaminated with heavy metals or pesticides,” says Boehnke.

Route of administration matters. CBD is best taken in pill or capsule form for slow extended release or as an oral tincture (infused oil that contains CBD) for faster effect onset.

Start low, go slow. Take a small amount and slowly increase your dosage until you start to get symptom relief over a matter of weeks. Track your symptoms to get a sense of whether or not CBD is a helpful part of your treatment plan.

Check your state laws. While medical marijuana is legal in many states, it’s still illegal at the Federal level, putting CBD in a legal gray zone in many areas.