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The CBD-Infused Cocktail

Are they as safe as you think?

Key points

  • Consumers need to understand the realities of cannabinoids and their potential impact on the body.
  • Cannabis can be relatively harmless compared to some pharmaceuticals, but that does not mean that cannabis is always safe.
  • CBD is sold over the counter and online, so it must be safe, right? Unfortunately, that is not necessarily true.
Polina Kovaleva/Pexels
cannabis cocktail
Source: Polina Kovaleva/Pexels

Recently, Page Six reported that CBD cocktails were featured at an exclusive party in The Hamptons. For many people who don’t drink alcohol, the idea of CBD-infused cocktails seems like the safer choice. However, despite the excitement of adult-use cannabis becoming legal in New York and many other states, consumers need to understand the realities of cannabinoids and their potential impact on the body.

Changing cannabis prohibition is a vital step in reducing significant social problems like incarceration, which has negatively impacted communities of color disproportionately; and, cannabis, unlike what past propaganda portrayed, can be relatively harmless compared to some pharmaceuticals in the public domain. However, that does not mean that cannabis is always a safe product to consume.

While it’s true that cannabinoids, concerning many mood-altering substances, pose less of a threat than some commonly prescribed medications, cannabinoids (including CBD) do have an impact on the body. Consumers need to be aware of the realities and potential implications of using CBD in their beverages or as a supplement in general.

CBD is a cannabinoid that is produced in both hemp and THC-heavy cannabis plants. It is legal and currently not regulated in the US and is widely used by many people struggling with anxiety symptoms. It impacts the CB2 receptor and reduces cortisol, therefore easing the symptoms of anxiety. It can be found over the counter, online, and has become so mainstream that it must be safe, right? Unfortunately, that is not necessarily true.

A study in JAMA found that most CBD products tested contained ingredients that differed from what was found on the label. Another study found adulterants in CBD products (i.e., contaminants found in K2/Spice and cough syrups) that could exacerbate anxiety and other health conditions. As a rule, I educate my clients that the safest cannabis or hemp-derived products are found in legal dispensaries where product testing is required. When it comes to CBD, it’s essential to know the source of the product and if it is from a reputable company that maintains strict product testing protocols.

Is the only problem that CBD can present related to purity? No way. Even when using safe CBD products, it’s important to understand potential side effects that can create significant issues. Sadly, within legalization efforts, there is rarely any discussion about the possible adverse effects of cannabis.

If you mention adverse side effects in the cannabis space, many people assume that you are anti-cannabis. This is not my perspective; however, transparency and risk assessments are vital to understanding any pharmacological intervention. CBD and CBD-THC products have helped many of my clients for specific reasons, but there is always a risk that must be understood.

Physiologically, CBD can create problems for consumers even if they are using safety-tested CBD products. In addition to using safety-tested products, dosage is an essential factor in using CBD safely. Research indicates that high doses of CBD can harm the liver. Still, when examining the results, it’s important to note that this animal study that found liver toxicity used an equivalent dose in humans of 1800mg/day. Most people, however, consume use CBD 10-80mg/day, and a more recent study found that typical dosing has minimal impact on the liver. However, another issue to consider when consuming any CBD product is the role of drug-drug interactions.

Taking CBD and other medications may increase the risk of side effects such as drowsiness, nausea, diarrhea, and liver damage. Unfortunately, commonly prescribed medications used to treat mental health symptoms such as depression, bipolar disorder, ADHD, and anxiety can raise the risk for adverse side effects of CBD to consumers. For example, in my practice, it is not uncommon for patients to be prescribed psychiatric medications like Lamictal, Adderall, Clozaril, Ativan, and/or Xanax, to name a few. Cannabis-based medicines can impact the efficacy and side effects of these medications.

Researchers have identified over 130 medicines that can present drug-drug interactions for patients consuming cannabis-based medications like CBD. In addition to some psychiatric medications, other commonly prescribed medications like warfarin (a common blood thinner), levothyroxine (a thyroid medication), and amiodarone (a heart rhythm medication) have demonstrated a negative drug-drug interaction.

CBD is often well-tolerated, but the idea that it is a medication that is safe for all to use is simplistic and inaccurate at best. It is a pharmaceutical that can benefit many people and pose potential risks if consumers are not adequately educated and aware.


Kocis P, T, Vrana K, E: Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions.
Med Cannabis Cannabinoids 2020. doi: 10.1159/000507998