Key takeaways:
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CBD (cannabidiol) is one of many cannabinoids extracted from the hemp plant and has an indirect effect on the endocannabinoid system (ECS)
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CBD is non-addictive and won’t get you high
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THC (tetrahydrocannabinol) is found in cannabis, has a direct effect on the receptors of the ECS, has a psychoactive effect and is addictive
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Studies show that CBD tolerance isn’t an issue for most people, unlike long-term cannabis users, who can build up a tolerance to THC
What does tolerance mean?
Tolerance refers to the body’s ability to adapt to a specific substance. It underpins the theory that if we take or use something, such as a medicinal drug, caffeine, or alcohol, over a long period, we’ll become accustomed to it, and it’ll no longer have the same effect. As a result, we’ll have to take or use more to achieve the same benefit.
Some people are concerned that they’ll build up a tolerance to CBD, or cannabidiol, but to date, studies appear to suggest that humans are unlikely to build a tolerance to CBD oil and other CBD products, and this is down to how CBD works in the body.
How CBD interacts with the endocannabinoid system
The endocannabinoid system, or ECS, is a complex network of cells and neurotransmitters that runs from the brain throughout the body. Only relatively recently identified, in the 1990s, it’s not yet fully understood but is thought to send signals throughout the body via neurotransmitters to help regulate various bodily functions, including mood, sleep, pain perception, appetite and immune function.
Endocannabinoids are naturally occurring chemicals produced by the body that bind to receptors of the ECS, signalling that action needs to be taken, such as releasing endorphins to boost mood or relieve pain.
CBD is a type of cannabinoid found in the hemp plant that interacts with the ECS, and studies suggest that CBD works by preventing naturally occurring endocannabinoids from breaking down. It’s hypothesised that due to this action, CBD may help relieve symptoms of anxiety and chronic pain and help promote better quality sleep.
It’s thought that THC, or tetrahydrocannabidiol, works differently from CBD, and instead of preventing endocannabinoids from breaking down, it binds to receptors of the ECS called CB1 and CB2. THC is another cannabinoid, found in the cannabis plant, and is responsible for the high and psychoactive and addictive effects of cannabis. CBD isn’t addictive and won’t cause a high.
Although CBD and THC are both cannabinoids, it’s possible to build a tolerance to THC, but not to CBD oil and other CBD products.
How tolerance works in the body
Tolerance tends to develop with drugs and medicines that bind to the receptors of the ECS, such as the THC found in cannabis products. It’s thought to develop in response to the brain adapting to continued use of a drug and therefore requiring a higher dose to achieve the same effects.
Studies show that THC tolerance and tolerance to other drugs can take place as follows:
First exposure
When we first take or use a substance, such as cannabis, alcohol or caffeine, the substance binds to a specific receptor in the brain. In the example of cannabis, THC binds to cannabinoid receptors. This triggers an action, and in the case of THC, this results in a high or a feeling of relaxation.
Adaptation over time
If we continue to use cannabis, causing the cannabinoid receptors in the brain to be regularly triggered, it’s thought that the brain adapts, and the effects are no longer the same and might feel weaker.
Fewer receptors
Over time, the brain reduces the number of cannabinoid receptors available for THC to react with.
Less sensitive receptors
At the same time, the receptors that are available become less sensitive, and THC cannot react as well with them.
Balancing mechanisms
The brain may even undergo processes that involve checks and balances, causing it to compensate for overexposure to a substance by increasing levels of another substance that counteracts the effects of the drug.
Experiencing reduced effects
The combined effect of fewer receptors, desensitisation and compensating is a reduced effect, requiring more of a substance to achieve the same effects as before.
Recovery and reset
Having a break from taking a substance such as cannabis can give the brain time to reset and restore the number of receptors available and their sensitivity, meaning that the usual dose goes back to having the same effect without the need to take more.
Does CBD cause receptor downregulation?
To date, studies suggest that CBD doesn’t cause downregulation (a reduced number) of receptors of the ECS, as THC does.
Can you build a tolerance to CBD products?
Due to the fact that CBD doesn’t cause downregulation of the receptors of the ECS, it’s thought that CBD tolerance isn’t possible in the same way as tolerance to THC is. This is thought to be because CBD prevents endocannabinoids from breaking down, rather than directly interacting with the receptors of the endocannabinoid system.
However, there’s evidence to suggest that patients using CBD to control epileptic seizures (some people are eligible for a CBD medicine called Epidyolex, licensed for prescription-only use for some types of epilepsy) may notice a reduced effect and studies continue into why this might be.
Research and studies
CBD and its benefits are the subject of much research. Specifically, research into CBD tolerance is sketchy, but so far, the results seem to indicate that tolerance to CBD is unusual.
An animal study in 2017 concluded that while more studies were needed, “CBD does not appear to produce the kind of tolerance typically seen in compounds that act directly on receptors like THC”.
The World Health Organisation has also reported that CBD is generally well tolerated, isn’s addicitive and is unlikely to cause tolerance.
CBD vs THC tolerance
THC is a cannabinoid that interacts with the C1 and C2 receptors of the endocannabinoid system. This direct interaction means that, due to the reasons outlined above, THC tolerance is possible.
CBD, on the other hand, is thought to impact the ECS by preventing the breakdown of the endocannabinoids produced by the body. This indirect action means that CBD tolerance isn’t a problem.
In fact, research suggests that CBD may actually cause a reverse tolerance.
Reverse tolerance: why CBD can feel less effective over time
Reverse tolerance is the opposite of tolerance and describes the idea that long-term use of CBD could result in requiring less CBD to achieve the same effects.
Studies into the potential for reverse tolerance, or sensitisation, of CBD aren’t readily available. But anecdotal evidence suggests that because CBD is thought to work by increasing the availability of natural endocannabinoids (by preventing their breakdown), it thereby supports the better functioning of ECS receptors.
In turn, it’s hypothesised that this could cause the ECS to become more efficient and self-reliant, therefore requiring less CBD to achieve the same effects.
Does increasing the dose restore effects?
CBD dosing can be tricky to get right initially. But with the right CBD dosing guidance, finding your optimal dose is easier. You may find that decreasing your dose helps you achieve the same effects over time, due to reverse tolerance. If you then find that you need to increase again, this should then restore the effects.
Common misconceptions about CBD tolerance
Since CBD and THC are both cannabinoids, it’s common for them to be thought of as having the same effects on tolerance. But as we’ve discussed here, a CBD tolerance is unlikely, and a THC tolerance is likely with long-term cannabis use.
This is because CBD has an indirect effect on the receptors of the ECS, helping to prevent the breakdown of the naturally occurring endocannabinoids.
THC directly impacts the ECS by binding with its receptors, which can cause downregulation and the need for more THC to have the same effects.
How to keep CBD working well
Research shows that CBD has many beneficial effects, and can help manage symptoms of anxiety, poor sleep and chronic pain.
To keep it working well for you, the following may be helpful:
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Consistency is key, and taking CBD every day will help it build up in your system for long-term benefits
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Start on a low dose of around 20 to 25 mg per day and increase slowly by 5 mg per day each week until you reach the desired effects
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Take CBD with or after a meal that contains healthy fats to help the body absorb it
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Take CBD at night as part of a bedtime wind-down routine if you’re using it to promote better sleep
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Take CBD during the day if you’re using it to support anxiety
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Use CBD as part of a healthy diet and lifestyle that supports good overall health
Tips if CBD doesn't work for you
If you’ve been taking CBD regularly for a number of weeks but you feel like you’re not seeing any benefit, try increasing your daily dose by 5mg per day for a week. Continue to slowly increase your intake until you see a benefit. Always choose CBD from a reputable brand.
More information and research
Cannabidiol-Enriched Oil and Tolerance in Epilepsy
Clinical research examining long-term CBD use in treatment-resistant epilepsy, noting that some patients experienced reduced effects over time.
https://pubmed.ncbi.nlm.nih.gov/32713661/
World Health Organization (WHO) Report on CBD
WHO review concluding that CBD is generally well-tolerated, non-addictive, and unlikely to cause dependence or tolerance.
https://www.openaccessgovernment.org/who-perspective-on-cannabidiol/80838/
(PDF source cited)
https://farmacbd.es/wp-content/uploads/2022/12/oms-cbd.pdf
Preclinical Evidence on CBD and Tolerance
Animal and pharmacological data suggesting that CBD does not produce tolerance in the same way as substances that directly activate CB1 receptors (e.g. THC).
https://farmacbd.es/wp-content/uploads/2022/12/oms-cbd.pdf
Review: Safety and Side Effects of Cannabidiol
Comprehensive review of human and animal studies assessing CBD’s safety, tolerability and long-term effects, including lack of typical tolerance.
https://drugprevent.org.uk/ppp/2018/07/an-update-on-safety-and-side-effects-of-cannabidiol-a-review-of-clinical-data-and-relevant-animal-studies/
Summary Article Referencing Clinical Evidence
Industry-facing overview summarising current research and clinical observations around CBD tolerance.
https://cbdclinicals.com/can-one-build-a-tolerance-to-cbd/
FAQs
Can you become addicted to CBD?
No, studies show that, unlike cannabis and THC products, CBD doesn’t have an addictive or habit-forming effect.
Can you have withdrawal from CBD?
No, CBD isn’t addictive and doesn’t lead to tolerance and therefore won’t cause withdrawal symptoms if you stop taking it.
References
Batalla, A., Bos, J., Postma, A., & Bossong, M. G. (2021). The Impact of cannabidiol on human brain function: a systematic review. Frontiers in Pharmacology, 11, 618184. https://doi.org/10.3389/fphar.2020.618184
Gorelick, D. A., Goodwin, R. S., Schwilke, E., Schwope, D. M., Darwin, W. D., Kelly, D. L., McMahon, R. P., Liu, F., Ortemann-Renon, C., Bonnet, D., & Huestis, M. A. (2012). Tolerance to effects of High-Dose oral Δ9-Tetrahydrocannabinol and plasma cannabinoid concentrations in male daily cannabis smokers. Journal of Analytical Toxicology, 37(1), 11–16. https://doi.org/10.1093/jat/bks081
MSEd, K. C. (2023, December 12). Is cannabidiol (CBD) addictive? Verywell Mind. https://www.verywellmind.com/cbd-addiction-can-you-get-addicted-to-cbd-5211798
Ms, M. G. R. (2019, November 21). Understanding drug tolerance. Healthline. https://www.healthline.com/health/drug-tolerance
This article is for informational purposes only and does not constitute medical advice. Please consult your healthcare provider before starting any new supplement, especially if you are pregnant, breastfeeding or taking other medications.
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