Full-Spectrum CBD May Trigger Positive THC Result Use of so-called “full-spectrum” formulations of cannabidiol (CBD) products can cause users to test positive for THC, the component of marijuana Read on to learn more about how drug tests for cannabis work and what research says about CBD use potentially leading to a positive result. Find out the benefits of CBD, what it is, and the associated risks.
Full-Spectrum CBD May Trigger Positive THC Result
Use of so-called “full-spectrum” formulations of cannabidiol (CBD) products can cause users to test positive for THC, the component of marijuana that causes euphoria, according to an open-label study published in JAMA Psychiatry.
Full-spectrum CBD products contain THC, but at levels too low (≤0.30% by weight) to meet federal guidelines for Schedule 1 classification. To determine whether use of such a product might cause a positive urine drug test for THC, the authors enrolled 15 individuals being treated for anxiety to receive a full-spectrum, high-CBD extract containing 9.97 mg/mL of CBD (1.04%) and 0.23 mg/mL of Δ9-THC (0.02%), 1 mL sublingually 3 times per day for 4 weeks. Presence of THC was assessed using a presumptive test panel, followed by gas chromatograph-mass spectrometry performed by Quest Diagnostics.
Seven patients tested positive for THC, and 7 tested negative (1 patient dropped out).
“Despite limitations in sample size and diversity, these findings have important public health implications,” the authors concluded. “It is often assumed individuals using hemp-derived products will test negative for THC. Current results indicate this may not be true,” and the results may have “potential for adverse consequences, including loss of employment and legal or treatment ramifications, despite the legality of hemp-derived products.”
Dahlgren MK, Sagar KA, Lambros AM, et al. Urinary tetrahydrocannabinol after 4 weeks of a full-spectrum, high-cannabidiol treatment in an open-label clinical trial. JAMA Psychiatry. ePub ahead of print. November 4, 2020. doi: 10.1001/jamapsychiatry.2020.3567
Does CBD Show Up On A Drug Test?
Dr. Jessica Cho practiced medicine with a single mission: Help patients attain wellness and create a life full of joy, vitality and balance.
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Table of Contents
- How Drug Tests for Cannabis Work
- Can CBD Use Lead to a Positive Result on a Drug Test?
- How to Make Sure a CBD Product Doesn’t Contain THC
Despite the widespread popularity of cannabidiol (CBD), a lot of confusion about the plant compound remains, including whether it shows up on a drug test.
CBD and delta-9 tetrahydrocannabinol (THC) are both cannabinoids, or active constituents, of the cannabis sativa plant. However, while the intoxicatingly psychoactive properties of THC lead to a “high,” CBD doesn’t produce the same intoxicating effects.
Since the two cannabinoids are sourced from the same plant, it’s fair to wonder whether both THC and CBD would show up on a drug test. Read on to learn more about how drug tests for cannabis work and what research says about CBD use potentially leading to a positive result.
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How Drug Tests for Cannabis Work
Drug tests for cannabis aim to detect THC, not CBD. According to Kelly Johnson-Arbor, M.D., a triple-board certified medical toxicologist and co-medical director of National Capital Poison Center in Washington, D.C., there are a few types of drug tests that can detect the presence of cannabis in the human body.
One of the most common tests is the immunoassay. “In this test, a sample of a patient’s urine (or other bodily fluid like blood) is analyzed to look for chemicals that resemble the active metabolite, or breakdown product, of THC,” explains Dr. Johnson-Arbor. “The immunoassay does not test for the presence of THC itself, and the test does not provide information about the degree of impairment or amount of THC to which an individual was exposed.”
Immunoassays are inexpensive and accessible, and they provide fast results. However, because false positives and false negatives can occur, they’re considered presumptive screening tests. Dr. Johnson-Arbor says many organizations use confirmation drug testing as a next step.
“Confirmatory testing using mass spectrometry is often used for forensic or workplace drug testing and is considered the ‘gold standard’ for drug testing because it’s the most accurate way to detect the presence of a drug in a person’s urine or blood,” says Dr. Johnson-Arbor. Mass spectrometry is an advanced method of testing that detects compounds based on their unique chemical structures and, for confirmatory testing, is typically combined with other advanced testing methods. Mass spectrometry, however, is more expensive and time consuming than immunoassays, it requires highly trained staff, and results may not be available for days or even weeks.
Drug tests can detect THC for three days after a single use and more than 30 days after heavy use. “THC is fat soluble and can be stored in body fat for a long time,” says Dr. Johnson-Arbor. “Chronic THC use can lead to accumulation of THC in fatty tissues, and the THC can then slowly release into the bloodstream over time.”
What Level of THC Leads to a Positive Result on a Drug Test?
There’s no standard level of THC evaluated across all drug tests. “Different laboratory test manufacturers may have different cutoff levels for positive THC test results,” says Dr. Johnson-Arbor.
With that said, the cutoff level for THC on an initial immunoassay test is 50 nanograms per milliliter of urine. “This amount represents the concentration of THC metabolites in the urine but doesn’t reflect the actual amount of THC used by the patient being tested,” says Dr. Johnson-Arbor.
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Health Benefits of CBD
CBD is an abbreviation for cannabinoid. Cannabinoid is a natural substance found in cannabis, also known as marijuana, and also in hemp plants. Today, you can find CBD oil in capsules, oil bases for vaporizers, tinctures, food items, and beauty products such as bath bombs or lotions.
Unlike its cousin THC, CBD is not intoxicating or psychoactive. Proponents of CBD oil and other CBD products claim that it can be used to treat conditions such as chronic pain, inflammation, migraines, epilepsy, autoimmune diseases, depression, and anxiety.
Research into some of these claims is ongoing, and there is still a lot about CBD that we don’t know but researchers are trying to find out.
Researchers are looking for answers when it comes to the full potential of CBD. What have they discovered in the meantime? So far, we know that CBD is a proven treatment when it comes to certain types of epilepsy, and early research is showing promise in regards to various anxiety disorders.
Approved to Treat Epilepsy
In 2018, the first FDA-approved drug, cannabidiol (Epidiolex), containing CBD was released on the market to treat two different kinds of epilepsy — Dravet syndrome and Lennox-Gastaut syndrome.
The FDA approved the treatment for patients as young as two years old. Studies showed it was effective in comparison to a placebo in reducing the frequency of seizures.
Though we need more research, a 2015 medical journal review article looked at CBD and its effect on multiple anxiety disorders, including generalized anxiety disorder, seasonal affective disorder, panic disorder, and post-traumatic stress disorder.
The results showed that there was “strong preclinical evidence” to support the treatment of anxiety disorders with CBD, though more research is needed on long-term dosing.
Research surrounding CBD is ongoing, and there are many questions that researchers do not have the answers to yet, such as whether or not the means of taking CBD impacts the risks or efficacy. Some common means of taking CBD include inhaling through a vaporizer, ingesting through food, or taking orally as a pill.
Here is a list of a few potential risks and side effects that come with CBD. Some of these risks are controllable if taking CBD under the guidance of your doctor.
During drug trials for Epidiolex, the FDA determined liver injury to be a side effect of CBD. Signs of liver injury showed up on blood work used to detect early problems with the liver. You can manage this risk by only taking CBD under the supervision of your doctor.
Interaction with Other Medications
If you are taking other medications, CBD can impact their efficacy, and the dose you are taking may need to be re-evaluated by your doctor. CBD can potentially interact with other medications to cause side effects.
Because there is limited research on how CBD interacts with prescription drugs and with standard over-the-counter supplements, it is best to talk to your doctor before taking CBD if you are taking other medications.
Though not much research has looked specifically at CBD, it seems that there is a negative relationship between cannabis use and sperm count, as well as other measures of male fertility, including sperm viability and motility.
Most of these studies have focused on animal participants, and further research is needed. Experts recommend awareness around these potential side effects when prescribing cannabis to patients who are of reproductive age.
Amounts and Dosage
Because the FDA currently does not regulate CBD, there are no specific recommended doses. Doses in most clinical trials have ranged from 100 to 800 milligrams a day.
Before using any CBD product, you should speak to your doctor to come up with a safe dosage plan that works for you. This plan should also take into account your symptoms and any other medications or supplements that you may be taking.
Neurotherapeutics: “Cannabidiol as a Potential Treatment for Anxiety Disorders.”
The Journal of Urology: “Cannabis and Male Fertility: A Systematic Review.“
U.S. Food and Drug Administration: “FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy.”
U.S. Food and Drug Administration: “What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD.”