Is CBD safe to use with other drugs?

On its own, CBD is a safe drug. CBD is increasingly legal, and more and more doctors are recommending it for many health conditions. It often replaces more expensive or much more dangerous drugs that treat the same conditions. Because of the opiate crisis, many people are looking for safer medicines that treat chronic pain conditions, and CBD is for many people a safe and effective alternative.

However, a drug that is safe on its own can be harmful in combination with other medications. Two harmless drugs can hurt someone if they take both of them at once. A drug that is safe on its own can also increase the risk of severe side effects for a more dangerous drug.

Given the potential dangers of drug combinations, how sure can we be that CBD is safe? Doctors know enough about how the drug interacts with other medications that they do not consider CBD dangerous. However, you have to be careful with CBD as it is not entirely harmless. The possible risk of CBD is that it can change or intensify the effect of other medicines. Your doctor should even know about what vitamins and over the counter supplements you use if you want to be as safe as possible.

Mixing CBD with other drugs is usually safe

A lot of the time, it is safe to combine CBD with other medications. Doctors are not firmly against combining CBD with other drugs. They may tell you that CBD could not in any known way interact with another medicine, and it is safe to take both of them at the usual doses.

They may also tell you that while CBD could interact with the other medication and strengthen its effect, you can still take both with no risk of severe side effects. They may also tell you to pay attention to whether or not you experience new or increased side effects from your other medicine. Combining CBD with other medications is something to be careful with, and not something doctors will tell you to avoid entirely.

How your body breaks down drugs and how drug interactions work

Just as your body has to break down food, it also has to break down medicines. Your digestive system and your liver help you metabolize and get rid of medicines. If you take two drugs at once, one drug may change how the body metabolizes the other drug.

A group of enzymes that is vital to your body's ability to metabolize drugs is known as CYP450. These enzymes convert drugs into other substances so that your body can get rid of them.

Some medicines can increase, decrease, or change the effect of CYP450. This can sometimes be dangerous. Two drugs can work synergistically, or in other words, intensify each other's effects. This synergy can turn a safe dose into a dose that causes dangerous side effects. A drug can also make another drug ineffective by changing the speed of drug metabolism.

Why CBD can be risky to take in combination with other medications

CBD can make your body break down some drugs too slowly. Some medicines make some of the body's enzymes less effective. One of the many CYP450 enzymes is known as CYP3A4. CYP3A4 helps break down many different drugs. Researchers estimate that more than half of all prescription drugs are broken down by CYP3A4 [1].

CDP can be risky because it reduces the effect of some of the body's systems. Since CBD inhibits some CYP450 enzymes, including the very important CYP3A4, it can cause some medications to remain in the body for too long. If you cannot get prescription drugs out of your system fast enough, they may build up until safe doses become dangerous.

CBD is not the only medication that inhibits CYP3A4, and doctors do not consider any medicine that inhibits this enzyme to be inherently dangerous. However, you do have to be careful with CBD. Talk to your doctor first. Even if your common sense suggests that a particular medicine would not be harmful in combination with CBD, get a doctor's opinion on the issue.

How to safely take CBD in combination with other medicines

A doctor will not necessarily tell you not to take CBD with another medication. If you can benefit from both medicines, there is a good chance you will be able to take both of them. You might have to control the dose of CBD, your other drug, or both, and the doctor may require other precautions.

If you are combining CBD with a drug of questionable safety, the doctor may ask for blood samples. With a blood sample, the doctor can tell whether or not the drug is building up in your system. Often, the CBD will not have a huge effect, and your doctor will allow you to keep taking both substances.

Another way of potentially using CBD safely with other medicines is to use CBD topical creams rather than tinctures or capsules. When you use a topical cream, the CBD affects you even though not much of the medicine enters the bloodstream with most creams. If the CBD does not end up in the blood, it may not inhibit any enzymes that break down other drugs. Talk to your doctor about whether or not creams might be a safer idea.

If you should not eat grapefruit while taking a drug, it may not be safe to take CBD with it

Eating grapefruit or drinking grapefruit juice can prevent your body from breaking down drugs. Grapefruit can affect your body's enzymes in a way similar to CBD. Many medicines, therefore, advise against eating any grapefruit when using them. Don't take CBD with any medication that has one of these warnings unless your doctor tells you that it is ok.

How dangerous are interactions between CBD and other medications?

Researchers do not yet have a detailed list of how safe each drug is to combine with CBD. The side effects of various medications and combinations of medicines vary from person to person, so experts will have to do a lot of new research to discover how safe CBD is with each drug. If you combine any medicine with CBD, a doctor may simply ask you to watch for side effects. A doctor does not have specific information about how safe each drug combination is.

Some scattered research suggests that combining CBD with most other drugs is safe, but some drugs may be exceptions to this rule. A study of combining CBD with epilepsy medication discovered that while levels of epilepsy medication did increase in blood samples, this was not enough of an increase to make the combination unhealthy [2]. A different study suggests that some epilepsy drugs can increase beyond normal levels if they are combined with CBD [3]. Doctors recommend caution when using CBD in combination with other drugs but do not advise avoiding CBD.

It is also possible for some medicines to prevent CBD from working. Some other drugs block an enzyme that helps your body use CBD, which makes CBD do little or nothing. Many doctors nowadays take CBD seriously. If you are unsure of what dosage of CBD to take or whether or not CBD will treat your condition, a doctor may be able to answer your questions.

Is CBD legal in many places?

In the United States, CBD products are legal even in states where THC products are not. Within certain limitations, CBD has been legal everywhere in the United States since 2019. Just because your state still has laws against marijuana does not mean that CBD is illegal. Check your local laws if you are not sure about what conditions make CBD legal, but it is more or less legal everywhere.

In Canada, cannabis products of all kinds are legal for recreational use, so there will be no problems getting CBD, though you might have to order it in the mail if there are not yet any stores selling cannabis products in your area. Outside of Canada and the United States, the laws vary. Many countries in Europe and elsewhere still have strict laws against cannabis products, which may still include CBD. Laws against marijuana do not always mean laws against CBD. CBD may be treated more leniently because it cannot get you high.

What drugs may be risky to combine with CBD?

Doctors do not know much about precisely how dangerous CBD is to take in combination with other drugs. However, there is a limited amount of medical research, plus what people commonly report. One can also speculate about how safe CBD is to take with another drug based on how CBD affects the body's ability to break down substances.

CBD and Alcohol: Does CBD make alcohol more or less harmful?

Whether or not CBD is safe to take with alcohol depends on how much you are drinking. If you drink moderately or lightly, CYP450 enzymes do not have anything to do with getting the substance out of your system. With lighter drinking, other enzymes break down the alcohol [4].

However, with heavy drinking, the body does use CYP450 enzymes to help break down the large quantities of alcohol. This means that it is presumably a very bad idea to use CBD if you are getting drunk or if you are a regular drinker.

However, people often combine alcohol with marijuana and do not hurt themselves, so it must not be blatantly dangerous to combine the two. How unsafe it is to combine the two is not known, but you should not risk combining a lot of alcohol with CBD.

Could CBD prevent harm from drinking alcohol?

There is some evidence to suggest that CBD may protect drinkers from harm. It may prevent rather than cause liver damage. Since CBD is a powerful antioxidant, it might protect the liver from alcohol-related damage. Studies show less harm to the liver for heavy drinkers that use CBD [5]. This does not necessarily prove that binge drinking while using CBD is safe. Binge drinking while using CBD could still be harmful even if CBD may prevent gradual liver damage.

The benefits of CBD for people quitting alcohol

If you are trying to quit alcohol, CBD may prevent cravings. Many people report that CBD helps them overcome many addictions, including an alcohol addition. Studies on animals, although not yet on humans, show that CBD reduces the motivation to drink alcohol [6].

CBD may benefit alcohol users. However, it is not yet known whether or not binge drinking is more dangerous when combined with CBD. Possibly, drinking a lot of alcohol, and taking a lot of CBD together could be harmful if it would prevent the body from breaking down the alcohol quickly enough. CBD may have the potential to do either harm or good for alcohol drinkers.

Are caffeine and CBD a good combination?

CBD does increase the effectiveness of caffeine - but in a good way. Since caffeine is a relatively harmless or healthy (if somewhat addictive) drug, you can use CBD to make caffeine more potent. CBD prevents adenosine, a chemical responsible for tiredness, from affecting the brain, allowing you to stay alert. When combined with caffeine, this can keep you alert for a long time. High doses of CBD can make you sleepy, so combine caffeine with a relatively low dose of CBD. Talk to your doctor about whatever drugs you use, but they are not likely to object to combining CBD with caffeine.

Is there any possibility of getting addicted to CBD?

Probably not. It is not chemically addictive in the way that alcohol is or opiates are. Even caffeine is a somewhat physically addictive substance; this is not the case for CBD. However, people describe themselves as addicted to all sorts of substances and activities that are not chemically addictive. So, perhaps nothing is truly never addictive. Any enjoyable habit might be difficult to stop.

However, people do not complain about being addicted to CBD. It is not considered even slightly addictive. Instead, CBD has potential as a treatment for addictions. Research shows CBD to have the potential to help people overcome many different addictions [7]. Research is still in its early stages, but CBD already has a reputation as a potent drug for treating withdrawal symptoms. CBD is a mostly but not extremely safe substance. It can be safe and even positive to combine CBD with all sorts of other substances, but be one the safe side and talk to your doctor first.