Exploring the Side Effects and Risks of Cannabinoids: A Comprehensive Guide


The advent of cannabinoids like THC and CBD in medical therapy has sparked interest not only for their promising benefits but also for their potential side effects and risks. These compounds interact with the body’s endocannabinoid system, exerting varying degrees of effects that depend on the dosage, individual biochemistry, and concurrent medical conditions or medications. This guide aims to provide an exhaustive overview of these risks and side effects and draws comparisons with commonly used over-the-counter (OTC) medications.

Detailed Risks and Side Effects of Cannabinoids

THC (Tetrahydrocannabinol)

  1. Dry Mouth: Almost universal across dosages, THC interacts with salivary glands, reducing saliva production, which can cause discomfort and potential dental health issues over long-term use (Huestis, M. A., et al., 2019).
  2. Impaired Motor Skills: As THC dosage increases, so does impairment in motor coordination. This is particularly problematic for activities like driving, operating machinery, and even simple tasks requiring dexterity (Bonn-Miller, M. O., et al., 2017).
  3. Potential for Dependency: Higher doses increase the risk of dependency and the potential for withdrawal symptoms like irritability, insomnia, and loss of appetite (MacCallum, C. A., & Russo, E. B., 2018).
  4. Contraindications: Patients with underlying conditions such as anxiety, depression, or schizophrenia may find that THC exacerbates their symptoms. It is also known to interact with medications like blood thinners (White, C. M., 2019).

CBD (Cannabidiol)

  1. Dry Mouth: Unlike THC, dry mouth is less commonly reported with CBD use (Iffland, K., & Grotenhermen, F., 2017).
  2. Lowered Blood Pressure: High doses of CBD can result in a significant drop in blood pressure, which could be risky for people with existing low blood pressure conditions (MacCallum, C. A., & Russo, E. B., 2018).
  3. Potential for Liver Damage: Primarily observed at very high doses, CBD can elevate liver enzymes, signifying potential liver damage (White, C. M., 2019).
  4. Contraindications: CBD has shown interactions with medications like antiepileptics and blood thinners. It is not recommended for patients with liver diseases or those who are already on blood-thinning medications (Iffland, K., & Grotenhermen, F., 2017).

Comparative Risks of OTC Medications

  1. Tylenol (Acetaminophen): At high doses, it may lead to severe liver damage and, in extreme cases, acute liver failure (Hodgman, M. J., & Garrard, A. R., 2012).
  2. Benadryl (Diphenhydramine): It commonly causes drowsiness, dry mouth, and in some instances, can cause urinary retention (Simons, F. E., & Simons, K. J., 2011).
  3. Ibuprofen: Regular high-dose use can lead to gastrointestinal issues like ulcers, and even kidney damage (Rainsford, K. D., 2009).
  4. Herbal Remedies: Varying widely, some may interact with anticoagulants, antihypertensives, and diabetes medications (Posadzki, P., Watson, L., & Ernst, E., 2013).

Extensive Comparison Table

This table outlines the potential side effects at varying doses of cannabinoids and OTC medications.

Risk/Side EffectVery Low DoseLow DoseModerate DoseHigh DoseVery High DoseTylenolBenadrylIbuprofenCBDTHC
Dry MouthRare (CBD)Common (THC)Common (THC)Common (THC)Common (THC)NoYesNoRareCommon
Motor ImpairmentNoMild (THC)Moderate (THC)Severe (THC)Extreme (THC)NoYesNoNoYes
Dependency RiskNoLow (THC)Moderate (THC)High (THC)Very High (THC)LowModerateLowLowHigh


  1. Iffland, K., & Grotenhermen, F. (2017)
  2. MacCallum, C. A., & Russo, E. B. (2018)
  3. Bonn-Miller, M. O., et al. (2017)
  4. Huestis, M. A., et al. (2019)
  5. White, C. M. (2019)

Medical Illnesses and Diagnoses for Caution

Patients with liver disease, cardiovascular issues, or mental health disorders such as schizophrenia and severe depression should exercise extreme caution. For specialized, evidence-based advice, consult Dr. Caplan at CED Clinic.

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