Can You Build Tolerance to CBD? Understanding Long-term Use and Effects
Author: Pavel Čermák
Many people, especially those new to CBD, wonder, "Can I use CBD for a long time? And can my body develop tolerance to it?" These are important questions to address. Frequent use of marijuana can lead to tolerance, where the user needs increasingly higher doses to achieve the same effects. Since CBD and THC are closely related, it’s natural to assume that tolerance could also develop for CBD. So, how does it really work?
Explanation of CBD and Tolerance
CBD is still not fully explored, but in general, we can say "no" to the question of whether it leads to tolerance. The use of CBD does not lead to tolerance. In fact, the opposite is true. The use of CBD often leads to reverse tolerance.
Reverse tolerance means that over time, users can reduce their dose and still achieve the same results. This happens because CBD increases natural endocannabinoids in the body. This is different from THC, which reduces cannabinoid receptors over time, requiring users to increase their dosage.
This is very noteworthy regarding CBD’s medical aspect (and cost), as patients can reduce their dose and maintain effectiveness without needing to increase it.
What to Do If You Feel You've Built Tolerance
Let’s say you have been using CBD for several months and you feel that you are no longer achieving the desired results. What should you do?
The first thought might be to increase the dose, which might work, but we recommend a different approach.
Since the estimated time CBD stays in the human body is between 18-32 hours, try skipping CBD use for at least two days. Then, resume using it and try a slightly lower dose.
For more information on how to properly dose CBD, check out our article: CBD – Less is Sometimes More.
Conclusion
Further research is needed to confirm the "reverse tolerance" hypothesis, but evidence suggests that CBD users may not need to worry about tolerance. This is especially significant given the wide range of CBD's healing effects. Many of the issues currently treated with heavy medications, which themselves can lead to tolerance, could potentially be managed with CBD without the same risk. The lack of CBD tolerance is another compelling point in favor of this remarkable cannabinoid.
Studies Highlighting CBD Tolerance and Use
NEWS FROM AES 2018
A study presented in New Orleans revealed that a cannabis oil extract with a cannabidiol (CBD) to tetrahydrocannabinol (THC) ratio of 20:1 can reduce seizures in children and adults with treatment-resistant epilepsy. However, about a quarter of the patients developed tolerance.
"CBD is a good choice for children and adults with certain types of epilepsy," said Shimrit Uliel-Sibony, MD, lead author of the study and leader of pediatric epilepsy services at Dana-Dwek Children's Hospital in Tel Aviv Sourasky Medical Center.
Previous studies have found that cannabinoid efficacy can be reduced when used to treat pain. Efficacy also decreases in animals with seizures.
To assess cannabinoid tolerance in treating children and adults with epilepsy, researchers in Israel conducted a prospective review of 92 patients with treatment-resistant epilepsy. Patients ranged from 1 to 37 years old, with an average age of 11.8 years. They were treated with hemp oil extract from March 2014 to December 2017. Researchers defined tolerance as needing to increase the dose by at least 30% after a reduction in efficacy or a more than 30% reduction in treatment response.
Patients had various forms of epilepsy and had been using hemp oil extract for an average of 19.8 months. Of the 84 patients included in the tolerance analysis, 21 patients (25%) developed tolerance after an average of 7.3 months at an average dose of 12.6 mg/kg daily. After the patients with tolerance received an increased dose, 4 patients returned to their earlier response levels, and 10 patients had a response that was "satisfactory but below the [previous] level of response."
Approximately one-third of patients discontinued treatment due to side effects or lack of efficacy. Side effects included drowsiness, nausea, decreased appetite, and vomiting. Two patients experienced worsened seizures, and one patient had signs of psychosis; treatment was immediately discontinued in these cases.
The researchers received no funding for this study.
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By understanding CBD tolerance and its effects, users can make informed decisions about their long-term use of CBD products and manage their dosages effectively.