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CBD vs THC, Which is Right for Me?

by in Written by Dr. Daniel January 1, 2020

With the explosion of cannabis products into the mainstream, this topic couldn’t be hotter. Although cannabis has hundreds of identified cannabinoid compounds, Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are present in the highest concentrations. They account for the bulk of beneficial physiologic properties attributed to cannabis plants.

These two compounds have significant differences for users, so having the correct information about CBD with THC and what they do is crucial to becoming a more informed patient and making healthier decisions.

THC vs CBD: Psychoactive effects

The most striking difference between these two is the psychoactive effects. THC administration results in an unmistakable euphoric “high,” whereas CBD does not have overt psychoactive properties. For this reason, some users might seek out one or the other at a particular time or setting. Sometimes users may seek out the combination of effects that CBD with THC can provide.

thc compound

CBD has a much more marked effect on peripheral nerves and produces a more substantial body relaxation due to its soothing anti-inflammatory properties. For example, long-haul truck drivers might not want to risk using THC for legal and safety reasons but still might desire the beneficial effects of cannabinoids. In this case, CBD would be a more logical choice. 

Research has shown the highest yield medicinal cannabis strains contain a balanced of both THC and CBD. The decision on which to use primarily depends on the patient’s comfort level with feeling the euphoric “high” associated with THC administration.

What are Cannabinoids?

Cannabinoid Guide

Simply put, cannabinoids are compounds that interact with the endocannabinoid system. The cannabinoids synthesized by the body are called endocannabinoids. The two best examples of endocannabinoids are Anandamide and 2-Acylglycerol, or 2-AG for short. These compounds are made in the body and have similar structures to cannabinoids made in plants. The cannabinoids in plants are called phytocannabinoids. These phytocannabinoids bind to the same receptors in the body as our endocannabinoids and are affected by the same enzymes. These phytocannabinoids are common sources of CBD with THC used in treatments.

These plant-based cannabinoids open up another vast topic of the endocannabinoid system which we will delve into as a recurring theme on future blogs. In short, this system is present in humans and other mammals. It has evolved over thousands of years to restore homeostasis, or natural balance, to our physiologic systems when we encounter stimuli that perturb our natural balance. The endocannabinoid system is a collective of hormones, receptors, and enzymes with active sites all over the body. Some sites include the brain, digestive system, immune cells, reproductive systems, sensory pain nerves, emotional centers, sleep and wakefulness sites, and memory. With such far-reaching functions, it is clear why people are so interested in cannabis products making a resurgence as medicine. Given that these chemicals can be separated, some users may seek out CBD with THC specifically. Often, this is in the form of CBD with THC tinctures.

Cannabinoids are fat-soluble substances that interact with the receptors of the cannabinoid system. It is only after binding to their specific receptor that cannabinoid compounds exert their effects. Once attached to their cannabinoid receptors, the CB1 and CB2 receptors, a cascade of reactions follow within the target cell. The result? The release of neurotransmitters or hormones that further medicate and amplify the effects of cannabinoids.

THC vs CBD: A closer look at the chemistry

Cannabinoid Guide

On first look, Tetrahydrocannabinol and Cannabidiol (THC and CBD) seem almost identical. They share a familiar chemical formula and have an equivalent molecular weight. Looking at their chemical structure, they look practically identical to the untrained non-chemist. But upon closer look at the THC compound, you can notice a cyclic structure with an Oxygen atom sandwiched in between two carbon atoms in what is called an Ether bond. This bond enables THC to sit comfortably in its receptor, like a lock and key, and exert its effects.

On the other hand, when it comes to CBD with THC, Cannabidiol has opened up that ring structure. Look closely, and you notice a hydroxyl group (-OH) at the end where the oxygen was formerly bound on each side by carbon atoms. Now the structure has two -OH groups and is therefore called a -Diol. Because it is a “diol,” this structure cannot sit comfortably in the same receptor as THC because of its nonpermissive shape. When CBD comes into contact with the CB1 receptor, it restricts the binding of THC to the active site of its receptor. This modulation of THC’s activity by CBD receptor binding is called Allosteric inhibition.

THC vs. CBD: Legal status

At the time of this writing, products containing higher than 0.3% THC are still considered illegal on a federal level in the United States as a Schedule I drug. CBD-based products with less than 0.3% THC are not psychoactive and are entirely legal for consumption in all US States, and do not require a Medical Marijuana Card to get CBD from a retailer. An example of one of these products may be a CBD tincture with THC in it. These CBD with THC products are legal due to the minimal level of THC within them. On the other hand, in states that have a medical marijuana program, patients can still obtain medical marijuana with appropriate physician certification and licensure by that state despite marijuana’s status as a federally illegal drug. If patients abide by the rules of their respective state’s medical marijuana program, they will not be subject to criminal prosecution by local and state authorities. The Rohrabacher-Farr Amendment of 2014 prohibits the Justice Department from spending funds to interfere with the implementation of state medical cannabis laws.

THC vs. CBD: Will I pass a drug test?

Patients taking THC-containing products should be advised that use will likely result in a positive test on most employment-based drug screens. Most drug tests will not show positive for most CBD-based products below the 0.3% threshold. However, certain high sensitivity tests might show positive. This can be the case with CBD with THC tinctures.

Pure CBD isolates contain no THC, but CBD products labeled as “Full Spectrum” include the complete entourage of cannabinoids. As a result, it is possible to show positive for THC despite not having psychoactive effects. For the most part, however, users can rest assured that most products marketed as CBD that are below 0.3% THC will not test positive for THC.

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