The Difference Between CBD and THC

The Difference Between CBD and THC

Cannabis: CBD versus THC 

There is often confusion between CBD (cannabidiol) and marijuana which contains THC (delta-9-tetrahydrocannabinol). When I first heard about CBD, I  thought it was just a different delivery system for THC, for getting high. No judgment there, but I didn’t really understand the distinction, the chemistry and the health benefits of CBD until I investigated further. Then I discovered that CBD is not the same as THC. While they are the two most abundant cannabinoids found in the cannabis plant, THC is the one that has the psychoactive or euphoric effect, while CBD does not get you high, no matter how much you take...

Both affect our endocannabinoid system, and are derived from the cannabis or hemp plant which is bred along two different lines. What we call hemp has strong, tall, and narrow stalks for making rope, paper, and cloth, CBD, and a trace of THC. In contrast, the marijuana/THC plant, an offshoot of hemp, is short with bushy leaves and THC containing flowers. Those that are bred for recreational marijuana have a far more THC than CBD. Hemp-derived CBD, by definition has a THC content of 0.3% or less. It’s far from enough to get you high. It still helps you to feel good. It relieves anxiety and enhances mood due to its actions on your chemical messengers, or neurotransmitters. 

While THC and CBD share similarities, and both have medicinal effects, there are some key differences between the two compounds. 

Hemp Oil Extract 

You’ll see CBD referred to as Hemp Oil Extract, because it’s not only CBD: it contains many other cannabinoids, and a variety of healing compounds including terpenes, such as beta caryophyllene, that have medicinal value in their own right. This  produces the full entourage or synergistic effect of all the ingredients where the total effect is greater than its parts. . 

Clinical Use:

CBD has been a great boon to my psychiatric practice, where I have often prescribed supplements that contain the precursors to the various neurotransmitters or brain messengers. Through the endocannabinoid system, CBD enhances and helps to balance them as needed, thereby enhancing mood. 

Besides its effects on mind and mood, CBD has many other health benefits as described here.

THC Issues:

In times past, when people smoked cannabis, the THC was balanced by the higher CBD content, so we didn’t see many of the problems that we’re having today. These days, it’s not uncommon for some individuals, often new to the plant,  to get quite irritable, anxious, and maybe even paranoid, psychotic,  and out of control. They’re getting too high, too fast, and it’s not a good feeling. This is because the THC has helped release a flood  of the activating neurotransmitter, dopamine. There is not enough CBD in the plant that they’re smoking, or ingesting, to neutralize the powerful activating effect.

CBD to Treat THC Response:

We can actually bring them down fairly quickly with CBD. I far prefer this remedy to their going to the emergency room and being injected with strong psychiatric medication, with its attendant side effects, although sometimes this is what is needed in the immediate situation. It will subdue them, but it’s not addressing the problem at the root cause. Moreover, these individuals are often prescribed psychotropic medication going forward, with all their pitfalls: many side effects, brain changes, and difficulty getting off them. 

Longer-term, the individual will still need CBD to help rebalance their brain chemistry, the duration depending on the person’s endocannabinoid level, and other metabolic factors. 

The problem is, these individuals are often prescribed psychotropic medication going forward, with all its pitfalls: side effects, brain changes, and difficulty getting off them. And they do nothing to raise the low endocannabinoid levels. Often there is a downward spiral with the individual never recovering, since ongoing use of medication causes dependency on it as well as brain changes. Often these mostly younger people may end up dropping out of school and having their entire lives go south, simply because of a single bad experience with THC. 

In functional medicine, we look for the root cause—restoring balance, and not just treating symptoms. So treating these individuals with CBD, supplements, and psychotherapy can generally bring them around, and they can go on to lead fulfilling lives. 

Cannabis Use Disorder

By the same token, CBD is also useful in treating cannabis use disorder, as I have seen in my own clinical practice, and here is a case in point. At her wit’s end, Brad’s mother had  brought her 18 year old son to see me. He’d been smoking weed excessively, was highly anxious and had problems sleeping – but insisted he needed it to help his anxiety and sleep issues! He was not happy to be in my office, to say the least, wouldn’t make eye contact and barely answered my questions. I asked if he knew about CBD. He said he didn’t, waving his hand dismissively.

I asked if he’d be willing to try some to help his anxiety and after some hesitation, he agreed to it. I gave him a dropperful of 50 mg of CBD, and then continued my conversation with his mother. After 10 minutes or so I looked over at Brad and asked how he was feeling. He sat up, looked directly at me, and exclaimed, “I feel really good, more relaxed, better than I have in a long time!” He clearly was more present and was connecting with me, the start of a needed therapeutic alliance. 

So the first step, a biochemical intervention opened the door. This is why I say that any treatment for mental health or addiction issues should start with balancing the underlying chemistry. With an excess of the activating dopamine released by his THC intake, it’s no wonder Brad couldn’t relax. The CBD actually neutralized the THC by unhooking it from the active CB1 receptor, accomplishing what no talk therapy or medication is able to do. Then, with a few ups and downs over the next few weeks,  Brad had a positive response to treatment: the CBD reduced his anxiety, improved his sleep, enabled him to think more clearly and make better decisions. This allowed us to go on to do some family therapy, for the benefit of all concerned.. 

This result was corroborated by  a 4-week placebo-controlled clinical trial that included 82 people (average age 26) with cannabis use disorder who showed reduced use after  taking 200 mg of CBD twice daily. The reduction in cannabis use was confirmed by a decrease of a breakdown product of THC in their urine. (Freeman, Lancet Psychiatry 2020).


CBD and THC are the major constituent cannabinoids of the cannabis plant. You can get excellent medicinal results from CBD, without the THC, although THC also has some specific medical uses. The problems arise when there is too great a disproportion of THC and CBD, especially if the individual already has a low endocannabinoid system. They would then  be more sensitive to the THC and thus more susceptible to having an adverse reaction. The good news is, balance can be restored with CBD.

If using these compounds medicinally, you should be assessed individually before deciding on which is best for your needs. For THC use, ask a knowledgeable professional about the type, dose and delivery system of the product. It can be obtained legally only at a licensed dispensary while CBD is readily available  from many retail sources. Check out my blogs for more information. 

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