I wanted to echo
@newboots's caution that there are few well-designed studies of the effects of CBD. There is only one CBD-based medication, Epidiolex, that has been sufficiently studied to be deemed worthy of approval by the US FDA, but for only one specific form of seizures.
So, until more is known, all information is anecdotal, and specific to the individuals using them. Indeed, even if there are lots of studies, we need to remember that “individual results vary”. With cannabis, this is far more so than with other herbal medications, for reasons discussed below.
In the mean time, here are some guidelines I share with my clients (as a counselor without prescribing authority) for any medication for anxiety or pain. Most of these do not apply to the situation discussed in the OP, since they relate to long-term use, but I feel compelled to post some cautions for those who want to try something new for their symptoms.
(The advice here does not apply to medications like anti-inflammatories, anti-depressants, immunosupressants, etc., that work very differently, and kick in slowly.)
1) If you find that your anxiety/pain medication kicks in quickly and/or wears off suddenly, be sure to use it sparingly. Any substance that is quick-acting carries the risk of addiction, because the brain quickly learns what brings the relief, and tries to feel more and more of the relief by exaggerating/exacerbating the “bad” symptoms. Try to find a variety or method of delivery (other than repetition) that brings slower relief and/or makes it last longer. Or use it infrequently, for temporary relief or with long breaks, rather than for continuous relief.
2) Any medication that brings quick-ish relief from anxiety or pain carries the long-term risk of exacerbating the anxiety or pain. The reason is that anxiety/fear and pain are necessary for survival; if the brain goes through a prolonged period without anxiety or pain, it realizes something is off, and will ratchet up the sensitivity in order to feel something, anything, that is happening. In some cases, the brain will instead/also opt to simply become less sensitive to the medication itself; the medication will eventually become useless. Because of this, it is necessary to let yourself feel some anxiety and pain; my rule of thumb is to a) aim for about 50-70% relief, rather than 100% relief, at any time, and b) allow the symptoms to return quite a bit before taking the next dose. NEVER use extra medications for temporary “breakthrough” pain or anxiety; if they are indeed temporary, the more you ride those out, the better. Panic attacks may be an exception; however, if you are having one or more panic attacks a day despite taking “rescue” medications, you may in fact be experiencing a rebound from the medication. In case of rebounds, consider (and discuss with your prescriber, if any) taking lower doses.
3) Almost all anxiety and pain medications carry the warning: “do not operate heavy machinery.” And “heavy machinery” includes cars and, unfortunately, skis. The reason is obvious: anxiety and pain medications work essentially by dulling the nerves, and this slows down ALL nerves, not just the pain receptors you want to target. Slower nerves mean more accidents. The warning applies to topical application as well, unless the medication only affects the applied area: when topically applied, capsaicin, benzocaine, and lidocaine, for instance, tend to stay in place, but CBD, menthol (Tiger Balm, Bengay), and salicylic acid (Aspercreme, Bengay) do not.
4) There are more reasons why being on medication for anxiety and pain will make you more prone to injury. Anxiety and pain are supposed to give us warnings when we are overdoing things. Without this warning, we are more likely to overdo things. You may also overstrain one part of the body to protect another part of the body; without pain signals to warn you, you won’t realize you are doing this until it’s too late. Different muscles’ nerves respond differently to medications, too, creating an imbalance in muscle strength, which creates strain in ligaments and joints.
5) And one specific to cannabis. Worse so than with other herbal preparations, cannabis-derived products are rarely standardized. Each strain of cannabis—not just “sativa” vs. “indica” vs. “hemp”, but every named variety—has a very unique combination of constituents with wildly varying effects and side effects. Even if you stick to the same named variety, you will find huge differences from batch to batch, sometimes even plant to plant, because of uncontrolled genetics, growing conditions, processing conditions, etc., even if you control your dosage strictly. Test every new batch you get with a low dose.
6) Beware that some people will react to a medication in a manner completely opposite of the common response. This is especially true with people with history of traumatic brain injury, chronic PTSD, ADHD, and autism.
I am not disputing CBD’s effectiveness. In fact, most of these cautions apply if and only if CBD is effective for you. The same warnings apply to other “natural” pain and anxiety medications like kratom, kava kava, and valerian root, not to mention synthetics like opioids (hydrocodone, oxycodone, fentanyl, etc.) and benzodiazepines (clonazepam, alprazolam, diazepam, lorazepam, etc.).
One additional word of caution for cannabis-infused food: with each batch, wait at least an hour after ingestion to get a sense of how much it affects you. It kicks in very slowly, which is good in view of my warnings above, but people often mistake this to mean there is no effect, and ingest too much. If it is your first time ever using a cannabis product, do not do it alone.
Effects of cannabis on animals are even less known, but there is some suggestion that cats are very sensitive to THC. Dogs are generally not as sensitive, but some may eat vast quantities of the stuff. All species may exhibit aggressive behavior and/or be prone to injury. It should presumed that there is a great deal of variation in sensitivity from breed to breed. And remember: cats and dogs are very small, compared to us. All in all, use great caution; even with a veterinarian’s guidance, always start with the smallest dose recommended.
