CBD vs THC: What’s the difference?


 | Last revised

Sep, 2021

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CBD and THC’s medicinal properties are a topic of growing fascination. Scientists are discovering that Cannabidiol (CBD) and tetrahydrocannabinol (THC) are capable of doing incredible things.

Here I will tell you how much we already know they can do, how we think they do it, and what the differences between them are.

Check out our guide to accessing CBD Australia.

But first, what are CBD and THC?

There are around 80-100 cannabinoids found in the cannabis plant. CBD and THC are the two we know most about. Both are molecules that boast a range of therapeutic benefits. CBD is recognised to possess anti-inflammatory, antioxidant, neuroprotective, painkilling and anxiety-inhibiting qualities. THC holds its own therapeutic attributes which are often overshadowed by its ability to induce a psychoactive ‘high’ in its users.


They have identical molecular structures (30 hydrogen atoms, 21 carbon atoms and 2 oxygen atoms, for the science nerds out there) and both interact with your body’s cannabinoid receptors to affect the release of neurotransmitters in your brain [1]. So why are their effects so different?

Well, this comes down to a slight variance in the arrangement of their atoms and the way they interact with the wonder that is your endocannabinoid system (ECS).

The Endocannabinoid System

The ECS is a neuromodulatory system in our bodies that helps to regulate functions such as sleep, pain perception, metabolism, cognitive function, motor control, mood and immunity. It pervades almost every major organ system, so keeping a balanced ECS is crucial to maintaining good health [2].

Put simply, this network is comprised of three parts: endocannabinoids, cannabinoid receptors and enzymes which break cannabinoids down. Endocannabinoids are neurotransmitters that induce different physiological reactions depending on their location and the receptor that’s targeted. And different endocannabinoids react with different cannabinoid receptors located throughout the body.

We spoke with Dr Ben from CDA Health about the endocannabinoid system. We like the simple explanation – the ECS is there to help your cells deal with local stresses. It’s all about bringing the body back into balance.

This is why cannabis has such an impact on us. In addition to endocannabinoids produced within our bodies, cannabinoid receptors also interact with phytocannabinoids – the cannabinoids such as CBD and THC which come from the cannabis plant [3].

CBD, THC and The ECS (Endocannabinoid System)

Study of the ECS and the impact of various cannabinoids upon it is still in its infancy, though our understanding of this system is growing.

THC has a binding affinity for the cannabinoid receptors CB1 and CB2, with a particularly strong attraction to the CB1 receptors. Located throughout the body, CB2 receptors are associated with the immune system, while CB1 receptors are densely located in the central nervous system. It is through its activation of CB1 that THC produces the sensation of being ‘high’.

CBD, on the other hand, reacts very weakly to this receptor (if at all) and can even interfere with the binding of THC, dampening the latter’s mind-altering potential. Thus consuming CBD alone will never get you ‘high’.

While it is known that CBD interacts with different molecular pathways to THC, there is still a lack of consensus on just how it produces the reactions it does [4]. Most experts believe it works by preventing endocannabinoids produced within the body from being broken down, allowing them to have a greater impact. Others think that it binds to a receptor that is yet to be discovered.

Regardless, while we continue to learn of how CBD and THC interact with the ECS we are also discovering the huge array of benefits these interactions produce. An increasing number of scientific studies are identifying the therapeutic characteristics of both CBD and THC, placing emphasis on their success in relieving pain, aiding mental health and alleviating the symptoms of illness.

To summarise their relationship with the endocannabinoid system, THC binds to specific cannabinoid receptors in our body to produce a reaction whereas CBD works differently. Most experts believe CBD prevents other cannabinoids from breaking down. The additional interactions between these cannabinoids and our cannabinoid receptors produce the effects we attribute to CBD. But remember, the alternative theory that CBD binds to a receptor we don’t yet know about cannot be discounted.

Phytocannabinoids Fighting Disease

Early studies into how CBD and THC can mitigate the symptoms of an array of conditions have yielded promising results.

Alone, and in combination with THC, CBD has demonstrated neuroprotective qualities which have led to its use in treating malignant brain tumours, Multiple Sclerosis, Parkinson’s disease, neuropathic pain, Alzheimer’s disease and pediatric seizure disorders [5]. On its own, CBD has benefitted patients with schizophrenia [6], enabling them to improve cognitive performance and overall functioning, and helped reduce the occurrence of self-injury, rage attacks and hyperactivity in children with autism [7].

Studies have also shown it to reduce the onset of certain cancerous cells, help to lessen the impact of other cancers and make alternative cancer treatments more effective [8].

As our knowledge of these cannabinoids increases and they make their way into mainstream treatment, we could regularly see CBD and THC enhancing (and even saving) lives.

CBD vs. THC For Pain Relief

One of the main ways CBD relieves pain is by helping the body to conserve anandamide, a cannabinoid we naturally produce, also known as the “bliss molecule”. Anandamides help to reduce our inflammation and pain levels and control our appetite, memory and mood. But they also break down quickly, resulting in deficiencies that can cause ailments such as chronic pain, depression and anxiety. When CBD enters the ECS it binds to the proteins that break down anandamide, preserving it in our system for longer.

CBD also modulates and regulates endorphins, chemicals produced in the body which alleviate pain and stress [9]. This makes it a suitable alternative to opioid painkillers, which replicate the effects of endorphins while also suppressing their natural production, reducing the body’s ability to combat pain independently. Though CBD is not as potent as opioid-based alternatives, it helps to naturally increase the body’s internal endorphins and thus comes without the same risk of long-term dependence to its users.

THC’s effectiveness in treating pain comes once again from its interactions with the CB1 and CB2 cannabinoid receptors [10], the two main receptors in the ECS which also happen to assist in processing pain.

The variety of pain it combats is similar but distinct to that of CBD. For instance, both are proven to alleviate migraines and inflammation, while THC is considered unique in its ability to treat muscle spasticity and the symptoms of glaucoma [1]. A recent study based on 27 measured symptom categories, including ten different types of pain, found THC to generate “measurable improvements in symptom relief” and even significantly outperform CBD [11].

More research is required though. Historically, THC’s psychoactive effects have discouraged studies on its medical efficacy and, like CBD, there is still much to learn about the range and extent of its capabilities as a painkiller.


CBD, THC and Mental Health

The relationship between these cannabinoids and mental health is a complex one. It’s true that misuse of either can yield negative results, but I’ll start by talking about how CBD and THC both have the potential to improve your mental well being.

CBD VS. THC For Sleep

And what better place to begin than with sleep? Sleep deprivation can cause or aggravate a range of psychological disorders and afflicts over half of Australians [12]. Fifty-three per cent of adults suffer from a medical condition that impacts their sleep and Aussies are amongst the most likely to use prescription sleep medication [13].

Here, both CBD and THC can help. THC is a potent sleep-inducer, and research has shown it to be a practical short-term cure for insomnia – though it comes with its drawbacks. Chronic administration can cause users to grow accustomed to its sleep-enhancing qualities [14], meaning they subsequently struggle to snooze without it. THC use can also cause you to develop a less pronounced circadian rhythm (your body’s 24-hour internal clock, controlled by the hypothalamus) and result in daytime sleepiness [15].

CBD is less effective at knocking you out but can help to create stable sleep patterns and provide long-term relief from sleeplessness [8]. Preliminary studies also show its promise in alleviating conditions such as REM sleep behaviour disorder and excessive daytime sleepiness [16].

So THC is better at setting you down for that great night’s kip but CBD is more suitable for developing healthy, long-term sleep patterns. In this case, the optimum cannabinoid depends on your particular ailment and how you wish to pacify it. Both are viable alternatives to pharmaceutical options.

CBD VS. THC For Anxiety

This case is more black and white. While CBD is an effective anxiolytic, the majority of research into how THC affects anxiety is less encouraging. A number of negative psychological reactions are included in THC’s list of potential side effects [17], with some studies showing it to induce anxiety and a sense of panic rather than impede it [18].

Again, lack of research diminishes this verdict. Competing studies have suggested that TCH’s biphasic nature (meaning it has two phases) causes different dose sizes to have completely different impacts on anxiety, with “lower doses generally being anxiolytic and higher doses being anxiogenic” [19]. Still, the majority of research underlines its anxiogenic qualities.

With CBD it’s more straightforward. An increasing number of studies recognise it as an anxiolytic agent [20], while others have noted its ability to inhibit stress and alleviate the symptoms of depression. Furthermore, it is often tolerated with fewer negative reactions than routine psychiatric medications [21].

It can even counteract some of the undesirable effects associated with THC [22]. Just as its interactions with the ECS can mitigate the sensation of being ‘high’ that THC produces, CBD’s interference with the CB1 receptors can reverse THC’s unwanted anxiogenic effects. So prospective THC users who wish to experience its therapeutic benefits but are perturbed by its potential side effects can ease their fear of suffering a negative reaction by taking it alongside CBD.

Which begs the question…

CBD and THC: Better Together or Apart?

It depends on what you’re looking for. CBD’s list of potential side effects might be less daunting than that of THC, but its products can also be less potent. A recent study concluded that THC can produce more significant therapeutic effects than CBD [17], but laws regarding access to THC are more strict. It’s also worth noting that most workplace drug tests look for THC but not CBD, making the latter more suitable for people who face screening as part of their job.

But if it doesn’t have to be an “either/or” decision, there’s much to be said for combining the two. In some instances of using CBD for medicinal purposes, the supplementary consumption of THC is required for patients to consciously experience its effects [11]. Not only does THC have its own medicinal qualities lacking in CBD, but it can amplify CBD’s therapeutic benefits when used alongside it.

Scientists are also exploring the “entourage effect” obtained by using whole extractions of the cannabis plant instead of its individual components. Early research suggests the synergistic relationship between cannabinoids and terpenoids (the aromatic molecules found in cannabis) can achieve a much higher degree of medical efficacy than any isolated compound [23], supporting the idea that all elements of the cannabis plant work better as a whole, rather than as individual parts.

If you’re interested in learning how to make cannabis oil, our step-by-step guide covers everything you need to know.

The Legal Stuff

Unfortunately, your biggest obstacle to accessing the entourage effect will be legality. While there are many options in places like America & Canada, obtaining CBD- and THC-based products in Australia is a much harder task.

In Canada cannabis is 100% legal, while nine states in America (plus the District of Columbia) allow recreational marijuana use and access to the products derived from it.

Here, we may be edging towards a more liberal stance on cannabis, but most Australians must still undergo the labyrinthine process of gaining medical approval if they are to obtain cannabis products legally. And the rules vary from state to state.

To learn more about the legalities of CBD oil in Australia, check out our article is CBD legal in Victoria.

The Side Effects

Having written much on the benefits of using CBD and THC, I’d be remiss not to mention their side effects.

The adverse reactions to THC can include anxiety, paranoia, delusions, hallucinations, difficulty concentrating, impaired perception and reduced motor skills. Though you cannot fatally overdose on it, you can consume more than your ECS can handle, eliciting the aforementioned symptoms, each with their own potential consequences.

When it comes to CBD, users should be more concerned with the reliability of what they consume; an increasing number of synthetic CBD products are being wrongly labelled as CBD [24]. In the US, a 2017 report found that 70% of CBD products were labelled incorrectly and 26% contained less CBD than indicated [25].

Provided you have a trustworthy source, the most commonly reported side effects from CBD use – diarrhea, tiredness, appetite fluctuations and weight change – are relatively minor, and pale in comparison to those from more conventional therapies used to treat the same disorders [26]. A World Health Organisation report went so far as to suggest that any side effects occurring with CBD use are likely the result of drug-to-drug interactions between CBD and other medications, adding that it “does not produce the [adverse] effects that are typically seen with cannabinoids such as THC” [27].

Bearing that in mind, it’s worth considering the side-effect profiles of the pharmaceutical drugs which are commonly used instead. The Alcohol and Drug Foundation acknowledges that relaxant-type medications such as benzodiazepines, prescribed for stress, anxiety or insomnia, can cause dependence. Its website mentions “increasing concern among medical professionals about the risks of using these drugs, particularly when they are used for a long time” above a huge list of side effects suffered both when using these drugs and when experiencing withdrawal from them [28].

Prescription pain medication is worse. Australian death rates from opioids have doubled in little more than a decade [29], prompting medical professionals to declare the nation’s soaring use of prescribed opioids a “national emergency”. Strong painkillers such as codeine, oxycodone and fentanyl “can be effective for short periods of time, but have been proven to lose effectiveness quickly and can cause dependence” [30].

At the other end of the spectrum, evidence suggests that “CBD’s anxiolytic and low addictive-behaviour reinforcing properties make it a possible treatment for drug addiction’ [8].

So, when considered alongside the negative impact of the drugs they could supplement and even replace, it’s clear the world needs increased research into, and deregulation of access to, CBD- and THC-based products. They are not cure-alls. They are distinct from one another, with their own merits and drawbacks. But used correctly, they can do a lot of good.

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