For the many who reside in states without legal recreational cannabis, the only type of cannabinoid-based therapy we’re able to get our hands on comes in the form of hemp-based CBD products. This makes our cannabis decision-making process pretty simple; all we really have to worry about is what brand to buy and what dose to take.
But if you qualify for medical cannabis or live in a state that has recreational cannabis, you’ll have way more options.
And I mean way more options.
Visit a dispensary and you’ll be confronted with countless combinations of strains, dosages, delivery methods, and CBD-to-THC ratios. That last one can be a real doozy — especially when you realize these ratios can range anywhere from 30:1 to more than 1:10 CBD-to-THC.
But what does the CBD-to-THC ratio really tell us? You may have read that a 1:1 ratio is the “golden ratio” for cannabis, but is that really true?
If you’re wondering why the CBD-to-THC ratio is important in the first place, it tells people what type of cannabis they’re using and what effect it will likely have. THC is the main intoxicating compound in cannabis — aka, the one that makes you high — and CBD is not intoxicating. In other words, CBD will not get you high.
A high CBD-to-THC ratio means that the product will be less intoxicating (or even non-intoxicating entirely). A “high” ratio of CBD to THC includes products like those listed as:
Once you get down to ratios like 4:1, 2:1, and 1:1, you may experience some of the classic symptoms of THC — including euphoria, hunger, dry mouth, and fatigue — and possibly even the uncomfortable side effects like panic, paranoia, and even delusions if you take too much (luckily, avoiding them is pretty easy).
After reading the paragraph above, it’s easy to assume that CBD is just THC without the “high.” But actually, it’s much more complicated than that.
CBD and THC are distinct compounds with very different activities on the body and brain. THC can stoke anxiety and temporary psychosis, while CBD is known for its anti-anxiety and anti-psychotic effects. According to the authors of a 2012 study, CBD can even “prevent psychotic-like symptoms induced by high doses of THC,” by acting on the body’s CB1 receptors as an allosteric modulator.
(English translation: CBD changes the receptors’ configuration so THC cannot bind to them as efficiently and thus freak you out.)
This symbiotic relationship is known as the “entourage effect.” Coined in 1998, the term tells us that cannabinoids work better together than in isolation. Studies have shown that combining CBD and THC leads to fewer side effects and superior therapeutic qualities. In just one example, a 2010 study that tested different cannabis preparations for patients with pain not responsive to other treatments showed that THC-only treatment was no better than the placebo while the THC-CBD combination treatment showed significant beneficial effects. In another study — published in the journal Biochemical Pharmacology—that tested the effects of cannabis on breast cancer cells, the results showed that a full-cannabis extract treatment worked better than isolated THC.
After reading about the entourage effect and how CBD and THC work together, it seems intuitive that a 1:1 ratio would the the best since it contains equal amounts of both cannabinoids. You wouldn’t be alone in thinking that. Such a mix is often described as the “golden ratio.” Leafly described it as the ratio that “tames the euphoria of THC while calming anxiety.”
But according to Sarah DeFrancesco, ND, a naturopathic doctor and cannabis expert practicing in Portland, OR: “It’s oversimplifying it to say 1:1 is the best ratio.”
“It depends on the desired results,” DeFrancesco says. In reality, the so-called best ratio of CBD to THC depends on the reason you’re using cannabis in the first place.
“For example, lower THC may prevent increased anxiety and higher THC may be desirable for those seeking pain relief,” says DeFrancesco.
So if 1:1 isn’t the universally optimal ratio, how do you find the best ratio for you? Unfortunately, a 2017 survey showed that most doctors don’t feel qualified to instruct their patients on different CBD:THC ratios and other aspects of taking cannabis, such as dosage and delivery methods (perhaps unsurprisingly, studies show most medical cannabis patients don’t understand dosage, either).
Finding the best CBD:THC ratio for you is best approached through good old-fashioned trial and error. To start, ask yourself questions like:
If you fall into that second category, you might opt for a higher THC ratio. To give you an idea, the description of Care by Design’s 1:1 oil (which is, somewhat curiously, marketed as “CBD Drops”) says it’s best taken at night because it “may be psychoactive” and cause sleepiness.
If you’re looking for something to provide relief as you go about your day, a higher ratio of CBD might be the way to go since it won’t leave you as impaired (or possibly at all). Case in point: Care by Design’s oil also comes in a 8:1 variety, which is recommended for daytime use for “people looking to minimize mood altering effects.”
Regardless of the product you choose, cannabis experts always recommend following the rule “start low and go slow.” That’s because at this point, there’s no scientifically sound way to predict how you might respond to varying ratios of CBD to THC. As Dr. Perry Soloon, a board-certified anesthesiologist and cannabis expert, told cannabisMD: “It has nothing to do with sex, age, weight, height, or any of the other parameters you might expert.”
Instead, more elusive factors like endocannabinoid tone — which refers to the overall health of your endocannabinoid system — appear to play an important role. And since scientists don’t have a reliable way to measure that yet, your only real option is to (cautiously) find the right balance on your own.
There is one last point to make, and that’s that the effect we get from cannabis is not solely based on the interplay of the two compounds discussed above.
“It’s not all about the CBD:THC ratio,” says Dr. DeFrancesco. According to her, other cannabinoids (like CBG or CBN) and terpenes (like limonene or myrcene) also play an important role in the benefits you experience, which is why you always want to opt for a full spectrum extract if you do use cannabis — regardless of the CBD-to-THC ratio.
As DeFrancesco explains it, “The planet designed itself with all of its constituents over thousands of years for a reason.”