Short answer
High-CBD medical cannabis carries more cannabidiol (CBD) than tetrahydrocannabinol (THC). Human trials of CBD for inflammation are small and brief. No cannabis product holds FDA approval to treat inflammation. Epidiolex, a purified CBD oral solution, is approved for two epilepsy syndromes and tuberous sclerosis complex. Patients in state medical programs use high-CBD products for joint pain, muscle spasm, and sleep. Convenience shapes that choice: tinctures, capsules, and gummies hold a large share of sales in several state markets.
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What the label says
US medical products list CBD and THC in milligrams per unit or per milliliter.
- A 20:1 ratio means 20 parts CBD to 1 part THC. One mL may hold 20 mg CBD and 1 mg THC.
- A 1:1 ratio means equal parts. It causes intoxication in most users.
- Broad-spectrum means THC is removed. Full-spectrum means trace THC remains, up to 0.3% by dry weight under federal hemp rules.
A high-CBD claim with no mg number tells you nothing. Ask for the certificate of analysis (COA) for the batch. The COA lists cannabinoid content and test results for pesticides, heavy metals, and mold.
What the evidence shows
CBD lowers cytokine release and reduces swelling in mouse and rat models of arthritis. Human data lag.
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- Most human studies test CBD for epilepsy, anxiety, or chronic pain, not inflammation itself.
- Trials use doses of 2.5 to 20 mg per kg per day. A 70 kg adult at 10 mg/kg takes 700 mg per day.
- Store doses of 10 to 50 mg per day sit far below trial doses.
- Topical CBD trials for knee and hand arthritis report small pain reductions over 2 to 4 weeks. Sample sizes run 20 to 100 people.
No study shows CBD reverses joint damage or lowers C-reactive protein in humans. Clinicians who recommend it treat symptoms, not disease.
Product forms, onset, and duration
- Inhalation: onset 5 to 10 minutes. Duration 2 to 3 hours.
- Tincture under the tongue: onset 15 to 60 minutes. Duration 4 to 6 hours.
- Capsule or gummy: onset 60 to 120 minutes. Duration 6 to 8 hours.
- Topical cream or patch: onset 20 to 30 minutes at the site. Blood THC stays low.
Food slows absorption. A gummy eaten after a heavy meal may take 3 hours to work.
Dose steps
- Start at 5 to 10 mg CBD per day for week one.
- Add 5 to 10 mg each week until symptoms change or side effects appear.
- Split the dose: one in the morning, one at night.
- Log dose, time, and effect for 4 weeks. Take the log to your clinician.
Interactions and side effects
CBD inhibits the CYP3A4 and CYP2C19 liver enzymes. It raises blood levels of clobazam, valproate, warfarin, and some statins. Common side effects: sleepiness, diarrhea, appetite loss, and dry mouth. High doses raise liver enzymes. In trials, 5 to 20 mg per kg per day caused ALT or AST elevations in a share of patients. Liver function tests every 3 months are common practice at these doses. People with liver disease need medical supervision before use.
Convenience and product choice
State programs let patients buy measured, packaged products with no smoking and no equipment. That format matches daily dosing. Market trackers report that ingestible and topical categories grow faster than flower in several states. The pattern points to convenience as a prime driver: fixed mg per dose, a known onset, and no smell. Data on exact category shares varies by state and by reporting firm, so treat any single figure with caution.
Legal status
Medical cannabis programs operate in 38 states and the District of Columbia. Rules differ on possession limits, purchase limits, and qualifying conditions. A state medical card does not cross state lines. Federal law lists cannabis as a Schedule I drug, and no high-CBD product except Epidiolex has FDA approval.
Questions for a pharmacist
- What is the CBD mg per dose on this label?
- Can I see the batch COA?
- How does this interact with my blood thinner?
- What is the THC content, and will it show on a drug test?