Does CBD Make You Paranoid? No Need To Get Anxious About It

Anxiety, panic attacks, and paranoia are the most common acute side effects of marijuana use. Most casual weed users never experience them, but they’re well-known risks of cannabis intoxication. So it’s not surprising that some people interested in trying CBD would wonder if it could also make them paranoid or anxious.

There’s no reason to panic. CBD (the abbreviation of cannabidiol) doesn’t trigger any of marijuana’s sometimes-problematic effects.

The reason is easy to explain.

Weed is harvested from cannabis plants. They’re rich in THC (tetrahydrocannabinol), the psychoactive compound that interacts with receptors in the brain to make users high. That interaction can also lead to troublesome mental health effects like paranoia, panic, and anxiety in people who may already be susceptible to those issues.

By contrast, the cannabidiol in CBD products is extracted from hemp plants. Hemp is very similar to cannabis, but with a key difference: there’s very little THC in hemp.

That means CBD products contain so little THC that they won’t make you paranoid or cause the other serious symptoms sometimes associated with weed use. And once consumed, extracted CBD interacts primarily with different receptors in the body, not the ones in the brain that can intoxicate users or cause troubling effects.

Research has established that CBD has very few side effects, most of which are only experienced by people new to CBD products or those regularly using extremely high amounts of cannabidiol. None of those effects are serious, and none affects mental health.

This should also help ease users’ minds: one of CBD’s most important apparent medical benefits is the calming of anxiety and stress, not the creation of it.

In fact, some studies appear to confirm “stoner knowledge” that taking CBD may ease the anxiety and psychiatric symptoms sometimes caused by cannabis intoxication. However, other research has reported contradictory results, with some studies even claiming that cannabidiol could make those symptoms worse. The jury’s still out.

The bottom line, though, is simple. CBD doesn’t make you paranoid or anxious. If you’re still worried, though, here’s a more complete look at the details.

Meet THC and CBD

THC and CBD are plant compounds known as cannabinoids. They’re the two most important cannabinoids found in cannabis and hemp plants, and they’re each believed to provide significant health and wellness benefits. More than 100 other cannabinoids are also found in the plants, some appearing to provide lesser benefits.

As discussed in the introduction, cannabis contains lots of psychoactive THC and very little CBD.Hemp plants — the sources of the CBD used to create CBD products — contain bountiful amounts of cannabidiol and very little THC.

That partially explains why CBD products don’t make users high.

The other reason? Governments that have approved the sale and use of CBD products have set strict limits on the amount of THC that can be contained in those products. In the UK it’s 0.2% and in the US it’s 0.3%, for example — and that’s far below the level of THC that would impair users. The limits ensure that CBD products don’t deliver THC’s trademark effects.

How do THC and CBD do their work? Read on.

Cannabinoids and the ECS

Smoking marijuana or using another cannabis product puts THC into your body. Ingesting a CBD product, of course, puts CBD into your body. (You can also smoke hemp to take CBD into your lungs, but most people don’t — and it’s illegal in some countries like Britain.)

What happens from there?

Once the THC or CBD has undergone digestion (not necessary if smoking, vaping, or dropping oil under the tongue, because those methods bypass digestion), the cannabinoid is metabolised in the liver. Its active metabolites are then sent into the bloodstream to find and engage with an important system in the body. They don’t take quite the same path, though.

The system is called the endocannabinoid system (ECS), and it governs a large number of crucial bodily functions. The ECS regulates — and this is just a sample — thinking and memory, pain control and sleep, appetite and body temperature, immunity and inflammation.

ECS receptors, located throughout the body, send and receive control messages to organs, systems, and each other. The messages are carried by neurotransmitters produced internally and known as endocannabinoids. And as their name suggests, endocannabinoids are very similar in chemical structure to cannabinoids like THC and CBD.

That similarity is the secret to THC’s and CBD’s effectiveness. It allows them to interact with the body’s ECS receptors to send and receive their own control messages, or block ones already being sent.

Not all ECS receptors are created equal, though. There are two sets of receptors.

CB1 receptors are located mostly in the brain and nervous system, and they control functions like thought, pain, and sleep. CB2 receptors are primarily found throughout the rest of the body, and they’re responsible for governing responses like inflammation and immunity.

Remember that we said that THC and CBD take different paths? THC finds and binds to CB1 receptors in the brain to deliver its effects; that’s how it’s able to alter users’ thoughts, moods, and perceptions. CBD mostly interacts with CB2 receptors in other parts of the body, allowing it to provide its apparent medical benefits without getting users high.

That might have been a longer explanation than you wanted, but it was important for the rest of this discussion. It explains why the THC in marijuana can make some people paranoid, panicked, or anxious; THC may overstimulate CB1 receptors in the amygdala, the part of the brain that controls fear and related emotions like paranoia.

CBD, however, does its work elsewhere, where it appears to ease anxiety and stress — not trigger them.

Here’s some of the research.

THC, CBD, and Paranoia

Science has been aware of THC’s psychoactive effects for decades and its apparent medicinal properties for almost as long. CBD’s potential medical benefits were discovered much more recently, and since it was a non-intoxicating cannabinoid, researchers essentially ignored it for quite some time.

That’s why many more studies have investigated THC’s effects and side effects, including the troublesome anxiety and paranoia that users may experience.

What’s Known About THC and Paranoia

The best-known study on the subject was conducted at Oxford in 2014, with more than 120 people who had used marijuana in the past and had no known mental health issues. Two-thirds of them were injected with the amount of THC they’d get from smoking a strong joint, and the rest were injected with a placebo.

Half of those receiving THC told researchers that they had at least some paranoid thoughts, compared with about a third of those who received the placebo. Those receiving a dose of THC also reported increased worry and anxiety, negative self-perceptions, worse moods, and altered perceptions. All of those issues faded as the THC wore off.

The research team concluded that cannabis can (but doesn’t always) trigger short-term paranoia, possibly as a response to anxiety, negative thoughts, and changes in perceptions.

Other research has reported similar results.

One survey of adolescent weed users found that one-third of respondents had experienced anxiety or paranoia, with heavier smokers and those considered to have cannabis use disorder much more likely to report paranoia. A similar observational survey found that for every year a teen used marijuana, their odds of experiencing paranoia more than doubled.

Several factors appear to play a major role in whether a user will temporarily feel paranoid while consuming THC.

• Genetics: Some users appear to be genetically predisposed to anxiety and paranoia. One study theorized that those more likely to become paranoid were born with more opioid receptors toward the back of the brain, making them more sensitive to THC. People with more of those receptors toward the front of the brain could be more likely to feel relaxed instead.
• Potency: In one study, cannabis with a higher concentration of THC generated more negative feelings in users than weed with half the amount of the cannabinoid. Negative feelings appeared to be the first indicator that paranoia could develop.
• Tolerance: Some people are genetically able to handle higher doses or more frequent use than others, potentially reducing their susceptibility to marijuana’s possible negative effects.
• Sex: Research indicates that women might be more likely than men to experience symptoms like anxiety and paranoia while smoking. One study showed that higher estrogen levels made users as much as 30 percent more sensitive to weed’s effects.

What’s Known About CBD and Paranoia

Numerous studies have shown that CBD exhibits no potential to cause paranoia in users. One large 2018 research review summarized existing research by concluding that CBD has antianxiety, antipsychotic, and neuroprotective properties that make it a potential weapon against many serious mental health disorders, and not the cause of them.

With that in mind, scientists have focused more on the question of whether cannabidiol has the potential to mitigate the anxiety, paranoia, and similar troubling effects that can be triggered by THC.

A comprehensive 2019 review of research found that the ECS appears to play a major role in patients developing psychosis, and that patients with the disorder showed greater activity of CB1 receptors in the amygdala. CBD, however, appears to lower that activity in the amygdala and other areas of the brain, and (not coincidentally) lower anxiety symptoms as well.

Several studies have demonstrated CBD’s apparent ability to ameliorate THC-induced negative effects in real life.

• Ten reported interventional uses of cannabidiol in patients with paranoia, schizophrenia, or psychosis (between one and 88 patients participated in each study) showed significant improvements in symptoms. In more than half of the interventions, improvements were significant.
• In a more rigorous study, administering CBD before intravenous administration of THC significantly reduced incidents of paranoia and memory impairment, compared to participants who received a placebo before THC was administered.

Researchers say that cannabidiol’s apparent ability to ease psychiatric symptoms in THC users could be explained in several ways.

1. While CBD doesn’t bind to CB1 receptors, it appears to interfere with THC’s effects on those receptors and possibly lessen THC’s ability to trigger paranoia and other mental health issues.
2. CBD appears to prevent the breakdown of anandamide, an endocannabinoid known as the “bliss molecule” that increases mental outlooks and happiness. Higher levels of anandamide seemed to counter psychotic symptoms in one study that’s been conducted.CBD may also slow the production of dopamine, another neurotransmitter that’s been linked to paranoia.

It’s important to note that CBD did not provide universal improvement or reversal of serious mental health symptoms in the studies we’ve cited. Researchers theorize that the triggers of, or the predisposition to, paranoia, psychosis, and other conditions in individual patients or users could be one explanation.

It’s also important to note that some studies have not shown the same positive results. One reported that regular smokers reported no difference in effect between high-CBD and low-CBD cannabis, and another found that people experienced a more powerful high with THC edibles than with ones containing both THC and CBD.

The explanation for that last study may be what’s called the “entourage effect.” It’s been shown that THC is more effective when it’s consumed along with the other plant compounds found in cannabis — so THC’s ability to cause paranoia and other mental health problems could depend on how much CBD is used to counteract THC’s effects.

Recent research appears to support that theory. A 2024 study published in the journal Cannabis and Cannabinoid Research details a project in which 300 anxiety patients were given one of three types of marijuana: THC-dominant (24% THC/1% CBD), balanced (12% THC/12% CBD), or CBD-dominant (1% THC, 24% CBD). They smoked an average of three times per week.

All of the groups were found to be less anxious after the project was over. However, those who used the CBD-dominant weed showed the greatest improvement in their symptoms, and they were significantly less likely to become paranoid while they were smoking or shortly afterward.

In short, CBD does not make users paranoid, and it may help counter the anxiety, paranoia, and panic that some people experience after cannabis use. The latter possibility is still to be proven, though, and the CBD dosage appears to be a critical element in the equation.

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