I have recently received questions from readers about cannabidiol, or CBD, mostly curious of three things: how effective is CBD in its isolated form opposed to whole plant form; what do the ratios on the dispensary packages mean; and which ratio should I choose?

For the sake of clearing up any confusion, when I mention CBD, I am referring to the real cannabis-derived compound, not the hemp-derived snake oil now found in every smoke shop and most gas stations housing a glass case full of scales and glass pipes.

There seems to be this misconception that CBD is the sole medicinal compound found in the cannabis plant, and tetrahydrocannabinol (THC) is only responsible for getting you high. But this misconception was birthed from a complicated and necessary dilemma for cannabis supporters -- finding a way to present cannabis in a different light by focusing on the other most beneficial compound, CBD. By simply swapping out three different upper case letters, opponents became more apt to hear what we had to say.

Unfortunately, I feel by putting all the attention on CBD, THC is being further demonized and discredited as the unnecessary part of the plant which is only beneficial in making music and movies more interesting.

Several studies conducted over the last decade have shown that when THC is isolated, it has the ability to kill cancer cells in the human body without harming the body’s good cells. It is also an effective pain reliever with anti-inflammatory effects 20 times that of aspirin, and twice the power of hydrocortisone -- with no threat of addiction. This also highlights THC’s potential for thwarting the use of opiates for pain.

According the Cannabis Health Index, “THC may protect the heart from damage and may mitigate damage from heart attack. Recent discoveries have isolated several mechanisms by which THC demonstrates heart-protective abilities. While these latest insights are still in their beginning stages, it is likely that the way we will treat acute and chronic heart disease in the future will change as a result. The pre-clinical trials done by the FDA recently suggested that THC reduces neuropathy onset in patients that suffer from this condition. Neuropathy refers to nerve pain or nerves degeneration."

So, while CBD and THC both have a myriad of benefits when isolated and used singularly, they are most effective when working together -- and create what is referred to as the “entourage effect.”

According to “CBD: A Patients Guide to Medicinal Cannabis,” “It is precisely because of the ‘entourage’ effect of cannabis that makes it so effectively therapeutic. There are conditions that will respond to pure CBD, but, remembering that our own endocannabinoid system is complex, it makes sense that the highly compatible phytocannabinoid system exploits the complexities of our built-in processes. Contrary to the original idea that CBD was an inactive component of cannabis, it has many effects in common with THC and many unique effects as well. Even when there are similar effects, such as the anti-inflammatory properties of both THC and CBD, each accomplishes them in a different way, resulting in a more varied and robust response as a result of the two working together.”

The challenge is in finding the right CBD/THC ratio to suit your needs. This ratio is different for everyone, as it varies depending on our individual physiology, specific condition and tolerance to cannabis. This is where the trial-and-error approach comes into play.

CBD and THC at an equal 1:1 ratio is ideal for activating the entourage effect, and is most often used for pain relief, anxiety, spasticity, fibromyalgia, insomnia, nausea and appetite stimulation. A 1:1 is considered the best starting point due to the multitude of conditions it may treat with minimal impairment.

Higher CBD options, such as 2:1 or 3:1, are often used in fighting autoimmune disorders, gastrointestinal issues, arthritis and psoriasis with little to no psychoactivity.

In 2017, a widely-publicized CBD study appeared in the New England Journal of Medicine. The double-blind, placebo-controlled CBD treatment trial for children and young adults with the often-drug-resistant seizure disorder Dravet syndrome yielded profound results. CBD-dominant ratios of 25:1 resulted in the average frequency of convulsive seizures per month decreasing from 12.4 to 5.9, compared to an average decrease from 14.9 to 14.1 with the placebo.

If you are considering the use of a CBD/THC combination, my advice is to just start low. It has also been suggested that letting your body get used to CBD alone before introducing THC can eliminate any uncomfortable psychoactive effects -- especially in those who have never used cannabis before.
