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“CBD inhibits the cytochrome P450 enzymes that break down important psychiatric drugs,” says Blessing. CBD isn’t the only substance that messes with the body’s ability to metabolize these drugs — both St. John’s wort and the humble grapefruit are unfriendly — but CBD is comparatively poorly studied. The way CBD inhibits those enzymes could dramatically raise the levels of SSRIs or opioids in the system, potentially leading to an overdose.
In late June, the US Food and Drug Administration could approve the Epidiolex, a pharmaceuticalized form of CBD for several severe pediatric seizure disorders. According to data recently published in the New England Journal of Medicine, the drug can reduce seizures by more than 40%. If Epidiolex wins approval it would be the first time the agency approves a drug derived from the marijuana plant. (The FDA has approved synthetic THC to treat chemotherapy-related nausea.)
CBD is derived by growing cannabis, drying it out, pulverizing it, and then, often, using a rotary evaporator filled with an ethanol solvent to extract the CBD. (There are some other methods, but the ethanol one is common.) It’s a pretty old and fairly low-tech technique, but it’s effective. What you end up with is, hopefully, about 99 percent pure CBD in the form of white powder, which is called CBD isolate. (Some CBD is billed as “full spectrum,” which means it contains other things from the cannabis plant, like a bunch of other cannabinoids, but there’s no formal definition for full spectrum.)