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Care by Design 18:1 Sublingual Spray Review

Care by Design 18:1 Sublingual Spray Review

If you’ve ever taken more than the recommended dose of acetaminophen or ibuprofen, it’s often because more is needed. Maybe you’re suffering from the flu and need to break a fever, or have an especially bad headache. Most painkillers, prescription or over-the-counter, work in this way: more medicine means more relief.

One of the largest learning curves when it comes to cannabidiol is that it’s biphasic: more CBD does not necessarily mean more relief. It means different relief. The science of cannabinoids is still developing and there’s a lot of trial-and-error for patients and caregivers. The ratio of CBD to THC is also important rather than a straight dose of CBD. Researchers are unclear as to why small amounts of THC bring out the benefits of CBD, but they do. I’ve noticed a pattern that suggests the higher the ratio of CBD to THC, the better it works for medical conditions that are difficult to treat.

Multiple sclerosis, fibromyalgia and Dravet syndrome are diseases CBD can potentially treat when conventional methods have failed. MS an\d fibromyalgia occur often enough in the population that pharmaceutical companies have devoted resources towards developing new treatments, but Dravet syndrome is more rare. It presents in children less than a year old and is devastating to their quality of life. Treatments for epilepsy in general requires heavy doses of tranquilizing drugs, and this can cause long term harm to a growing child. CBD’s potential to treat Dravet syndrome is significant enough that pharmaceutical companies have taken notice and are studying CBD in full scale clinical trials.

I was curious if an 18:1 ratio could work for my seasonal affective disorder. Luckily, southern California has very few cloudy days, but those days can stop me in my tracks. Care by Design’s collection of CBD sprays has been great for my pain and IBS symptoms in lower ratios, but I didn’t notice any antidepressant qualities. During a rainy week, I tried their 18:1 sublingual spray.

Having used Care by Design’s sprays before, I knew 3-4 sprays works well for me. For reference, I’m 5’11” and height and weight should be considered when determining a proper dose. The company suggests 1-2 sprays and that is an excellent place to start for a full grown adult. While I’ve heard patients sometimes mix the spray into a drink or food, I would not recommend this when you’re relying on this medicine for acute conditions. I find the taste of the sprays to be very mild, but “chasing” the spray with water will all but eliminate the cannabis flavor after you’ve used the spray.

On a typical cloudy day, normal tasks require a lot of motivation for me. I have to force myself to get up, make coffee, read my email and so on. Each step feels like my mind and body are saying “NOPE.” After three sprays in the morning, it felt like a totally normal day. Compared to typical antidepressants, I noticed a change rather quickly. I also noticed when it tapered off in the afternoon, so I took 3 more sprays around 4pm. With a week’s worth of El Niño weather, I was able to see what daily use was like. It was a nice feeling to know that the spray works as needed and doesn’t linger in my system. I’m not opposed to long-term therapies at all, but I am opposed to taking something when it’s not necessary. As soon as the sun came back, I wanted to go back to my normal routine. Even when I was using the spray, it felt like my normal routine. I didn’t feel “high” or even a reduced amount of anxiety (there are other ratios and other cannabis products I would use for that effect). I simply was able to function normally without the heaviness that depression brings to the mind and body.

One of the great aspects of CBD, and cannabis in general, is that I experience no withdrawal. While there is anecdotal evidence that suggests marijuana withdrawal exists, I personally have not had that experience, nor have I with any CBD product (in contrast, my caffeine withdrawal symptoms might be the worst withdrawal I’ve ever experienced!). That can’t be said for prescription antidepressants, some of which can lead to seizures and comas when stopped abruptly. Because of this, antidepressants in general require a significant time commitment to see if they work, and more time to taper off should they be ineffective or produce unwanted side effects. For those who experience temporary depressions, this could be an option in dealing with those situations. Depression is a complicated illness with many causes and even more treatment options, and this product is unique among those options.

In choosing a CBD treatment, dosage is critical. Care by Design thoroughly tests their products, and I’m confident that I’m getting what I pay for when I choose their products. CBD products are an investment and Care by Design has taken steps to establish trust with patients by being transparent about their manufacturing process and their testing. I will continue to search for their products when looking for a reliable CBD medication.


Photo credit: Care By Design

Care by Design 1:1 Sublingual Spray Review

Care by Design 1:1 Sublingual Spray Review

I’ve had the unfortunate experience of witnessing what long-term use of conventional painkillers can do to the body. Seeing people suffer from liver disease, kidney infections and permanent damage to the digestive system due to long-term use of over-the-counter medication is a reality. This doesn’t even include prescription medications, of which we are currently experiencing an epidemic of abuse in this country.

These medications are often used to treat common conditions. Almost everyone has used ibuprofen or acetaminophen to treat a headache or muscle pain after a workout. Some people need them regularly to treat arthritis or chronic pain conditions. As a dancer, I’ve had a long history of using ibuprofen to treat pain consistent with physical overexertion. The fact is, its effectiveness leaves a lot to be desired. You still need to treat swelling and stiffness due to inflammation, and ibuprofen only goes so far.

Care By Design, a medical cannabis company in California with a reputation for giving back to the community and producing consistently dosed, high-quality products has disrupted the medical industry with their CBD Rich Sublingual Sprays. They currently offer five of these concentrated cannabis tinctures, designed to be sprayed under the tongue, with different ratios of CBD (cannabidiol) to THC (tetrahydrocannabinol) — 1:1, 2:1, 4:1, 8:1 and 18:1. Each ratio is formulated to treat different symptoms and conditions.

What I’ve found with using Care by Design’s 1:1 CBD (cannabidiol) Rich Sublingual Spray is that it can treat all of the symptoms I commonly suffer from (pain, inflammation, stiffness, soreness) more effectively than any other medication available to me and with no side effects. While it may seem extreme to use a cannabis product in place of an OTC treatment, I’ve discovered it treats a wider variety of discomforts, some of which I’d given up on trying to treat and instead have been forced to cope with.

care by design spray review

A balanced ratio of two cannabinoids, CBD and THC, working together synergistically in a process known as the entourage effect has the best of both worlds for my physical discomfort. With CBD’s ability to reduce inflammation and THC’s ability to reduce the sensation of pain, it covers the spectrum in treating the various causes of pain. Combined with rehydration, balanced electrolytes and the right diet, my recovery time after a rough workout is hours, not days.

A dose of two sprays every 4-6 hours is enough to keep me relaxed. If I need to be more focused, I can switch to a 2:1 ratio that will keep me comfortable and alert.* If I’m particularly dehydrated or have an empty stomach, I like to use this spray in combination with food and water. It results in time-released relief rather than a shorter burst. As with other sublingual sprays, I hold them under my tongue and swish it around my mouth before swallowing. The veins and thin skin under the tongue allow the active ingredients in the Care By Design CBD Rich Sublingual Sprays to be absorbed into the bloodstream faster.

care by design 1:1 sublingual spray review

I’ve previously mentioned how lower CBD to THC ratios have treated some of my other ailments, and that’s what I like about lower ratios: they treat a wide variety of common conditions. A 1:1, 2:1 and 4:1 will all treat my irritable bowel syndrome (IBS) symptoms and calm my nerves without the strong high I get from my favorite cannabis strain. However, I still reach for the 1:1 more often when pain is involved. When pain is acute, I think the THC calms some of the reactions my body has to pain, like increased blood pressure and anxiety. If IBS is my main concern, I can switch to a 2:1 or 4:1 and leave the high for a later time (and keep my THC tolerances low).

There’s a lot to think about before using any cannabis product on a regular basis. More data is surfacing on how cannabis can treat chronic pain, which backs up my experiences in using Care By Design’s CBD Rich Sublingual Sprays. Someday, I hope someone makes a “sampler pack” of CBD ratios since there can be trial-and-error in finding the right ratio. And as CBD is biphasic, different ratios treat different conditions, so you may find a couple of different ratios have a place in your medicine cabinet. Because of this, consistency and quality are the main priorities in choosing a CBD product, and Care by Design has established a dedication to both.

*Please investigate how cannabis-based substances affect you before performing any activity.

care by design sublingual spray review

the LA lady (2)

Care By Design High CBD Sprays Review

Care By Design High CBD Sprays Review

The face of the average cannabis consumer is changing. With states putting both medical and recreational marijuana laws on the books, the average user can be anyone: young, old, parents, co-workers, students, retirees and so on. Legal cannabis businesses are keeping up, marketing their products to veteran cannabis consumers as well as first time customers.

In the new market, the average medical cannabis patient is often left to read between the lines of marketing strategies, sometimes buying expensive products only to discover they’re not strong enough or not designed to fit their needs.

In reality, many patients would prefer their medical marijuana be packaged and labeled no differently than the ibuprofen from the pharmacy. For many, knowing the cannabinoid profile, including THC to CBD ratios, is just as important as dosage and potency information. A lack of product information and knowledge can leave some patients playing a guessing game.

For example, California cannabis producers aren’t required to provide testing information or “proof of potency.” As a result, the quality and potency of many products vary from batch to batch. While the Golden State has yet to establish a system for this, certain manufacturers are taking it upon themselves to self-regulate.

Care By Design, one such exemplary cannabis product producer, has undertaken the challenge of creating medical cannabis products with the patient in mind. Sublingual sprays from Care By Design, a form of cannabis concentrates called tinctures, come in a variety of CBD to THC ratios. No matter the specific ratio, each contains more CBD than most raw cannabis flowers.

care by design sublingual spray review

Care By Design provides basic guidelines for finding the right ratio for your needs. As a general rule, smaller ratios tend to treat physical ailments, including pain (even neuropathy). Larger ratios treat mood disorders like anxiety and depression. The relationship between THC and CBD is biphasic; one ratio might alleviate symptoms while another might exacerbate them. Clearly, more research is needed to guide doctors and patients. In the meantime, you may have to try more than one ratio to see what works best for your needs. Thankfully, this company labels each of their sprays with not only the ratio, but the amount of THC and CBD in each spray and a manufacturing date. This will help patients who are familiar with consuming edibles to determine dosages by the milligram.

None of Care By Design’s cannabis sprays seem to be designed for recreational use. Even the 1:1 spray containing the highest amount of THC produced no noticeable high in me. Based on Care By Design’s suggestions, I decided to stick to the lower ratios since my symptoms tend to involve pain (migraines, headaches and sciatic pain).

Best Ratios for Me

For tension headaches, the 2:1 and 1:1 ratios worked well. I tried keeping it to two sprays but when a migraine kicked in, 3-4 sprays of the 1:1 worked much better for me. Muscle aches and sciatic pain also responded to 4:1, 2:1 and 1:1.

care by design sublingual spray bottle

In terms of dosing, this is a very discreet way of medicating. The onset of relief is not quite as rapid as vaporizing or smoking, but it was quicker than eating an edible. What’s more, I have a fairly accurate idea of how much medication I’ve consumed, whereas I often lose track of how many hits I’ve taken from a vape cartridge. The taste is typical of cannabis tinctures, but without any added flavors.

I like to keep the spray under my tongue for as long as is comfortable so that the medication can absorb into the bloodstream a bit faster, which I think is the main benefit of a sublingual application (method of consumption). After the initial 1-3 sprays, it took about 30 minutes to really feel the pain relief and the effect lasted no more than 5 hours. I didn’t experience any of the typical cannabis side effects: no increase in appetite, dry-eyes, dizziness or altered thought patterns. The 1:1 certainly has a muscle-relaxing quality and an overall feeling of wellness, so I’d recommend keeping physical activity to a minimum.

For anyone who suffers from chronic conditions like pain, feeling “normal” is a gift. While I respect the recreational effects cannabis can offer, having medication that can simply make me feel like myself again is the ultimate goal. These High CBD Cannabis Sprays from Care By Design will fill a void in my medicine cabinet. I’m ecstatic that a company has taken the time to consider the needs of the medical patient and I hope they inspire other companies to follow suit.

Meanwhile, I’m grateful to feel normal.

Care By Design and Grow For Vets Partner to Help Veterans

Care By Design and Grow For Vets Partner to Help Veterans

The number of United States veterans suffering from Post Traumatic Stress Disorder (PTSD) is at its highest rate in history. Two organizations have announced a partnership with one goal in mind — to help those veterans suffering from PTSD.

Care By Design, a California-based medical marijuana company and Grow For Vets, a national non-profit that provides veterans with medical marijuana, have begun a study researching the therapeutic effects of cannabis for treating PTSD. Their study will compare symptom reduction of PTSD in relation to cannabis dosage, as well as the cannabinoid profile, which is the ratio of CBD to THC. Ultimately, the study would serve as a guide for PTSD treatment using medical cannabis.

PTSD is said to affect over one million veterans. Michael Hayes, Director of CBD Guild, explained to Whaxy:

“PTSD is a heartbreaking disorder that’s believed to be a major contributor to the staggering number of veteran deaths each year from prescription drug overdoses and suicides.”

Healthcare for veterans is often limited, and treatments for PTSD are underwhelming. The 2014 American Legion survey revealed that 59 percent of veterans who seek treatment for PTSD experienced no improvement or have even worse symptoms after treatment.

“A growing body of research suggests that cannabis therapy can help those suffering with PTSD,” says Hayes. Cannabis therapy can help mitigate the hallmark symptoms of PTSD including impaired fear extinction, poor memory consolidation and chronic anxiety. Continues Hayes,

“We’re working with veterans and others with PTSD to learn if that’s the case, and to help them use cannabis in a medically appropriate way.”

Recognizing the potential researching cannabis for PTSD treatment, Roger Martin of Grow For Vets says,

“We partnered with Care By Design on this important project because they are at the forefront of the movement to make quality cannabis medicine available to patients in need.”

Care By Design and Grow For Vets are commencing recruitment for a 6-month research study immediately. Visit for more information on enrollment.

grow for vets ptsd study

The Trouble with CBD-Only State Laws

The Trouble with CBD-Only State Laws

With medical laws sweeping the nation, more and more patients are eligible for legal and safe access to cannabis — or at least the right to legally possess and consume it. As of June 2015, 14 states had passed “CBD-only” laws, programs designed to provide safe access to low-THC, high CBD (cannabidiol) cannabis oil for a limited set of diseases. In many states, including Iowa, Missouri, and Oklahoma, the only qualifying condition is epilepsy or debilitating seizures.

CBD-Only Laws Relatively Ineffective

Such laws are primarily motivated by childhood epilepsy and intended to curb the occurrence of seizures. Unfortunately, most are relatively ineffective and more a political stunt to gain reelection than an effort to truly help sick adults and children. Many of these patients gain no benefit from conventional pharmaceutical treatments. Many CBD-only states, however, are providing no safe access to an organic medicine that can easily be extracted into a concentrated form and given to children twice a day.

Often, such limited medical cannabis laws are given the name of a child patient who helped inspire them them or was cited as a reason to support the legislation, such as the Harper Grace Durval bill (Mississippi), the Haleigh’s Hope Act (Georgia), and the Alexis Carey bill (Idaho). Unfortunately, such laws serve a minority of childhood epilepsy sufferers. Current research and anecdotal evidence has revealed that CBD-only oils significantly reduce seizure activity in less than one-third of patients. Thus, seven out of 10 children with severe epileptic conditions like Dravet syndrome and Lennox-Gastaut syndrome do not gain effective improvement to their condition and a significant decrease in seizures from CBD only.


CBD-only states that limit the herbal extract to only epilepsy also discount the most common condition for which CBD oil is administered: Cancer. By allowing only patients suffering seizures or childhood epileptics to use CBD oil, politicians most intent on re-election discount a sizeable portion of their citizens and millions of sick people when they so tightly limit the scope of their state’s CBD law.

No Access to Medicine

Some experts have observed that a network of dispensaries that provide trained budtenders and sage advice to desperate patients is typically not available in most states that have implemented CBD-only medical cannabis laws. Laws that merely legalize and remove penalties from the possession or consumption of something like CBD oil, but that do nothing to provide safe access to medicine and consulting for patients are of little real help.

Some have opined that current CBD legislation in many states is merely a political ploy to satisfy medical cannabis and patient advocates and put up a roadblock to future legislation that is more comprehensive and less restrictive. In other words, the governors and legislatures of many conservative states have beaten cannabis activists and legalization groups like NORML and MPP (Marijuana Policy Project) to the punch with their own highly diluted, mostly ineffective laws.

medical marijuana dispensary washington

Also, programs that cater to a single disease like epilepsy reach a very small portion of the overall patient population. According to the MPP:

“…only two percent of the registered patients in both Rhode Island and Colorado report seizures as their qualifying conditions.”

This reveals that CBD-only laws sometimes provide safe access to very few patients. Unfortunately, MPP reported that “The vast majority of [all medical cannabis] patients have symptoms that benefit from strains of marijuana that include more than trace amounts of THC.”

Critics and Lip Service

Vocal critics of CBD-only legislation include Paul Armentano, the Deputy Director of NORML. Armentano has called such laws “largely unworkable” and believes that this is due to the tight restrictions they place on doctors and patients. For example, Tennessee, Utah, and Florida provide access to CBD oil not via dispensaries and retail outlets like those in Portland, Seattle, Denver, and Los Angeles, but instead limit qualified patients to those participating in a special FDA clinical trial.

This obviously greatly limits participation and access, delivering help to very few actual patients after the hype of national press releases and photo opps has passed. In addition, patients in such states are shown no respect in terms of their desire or right to choose their own variety and brand of cannabis medicine from the retail outlet of their choice. Such limited access results in programs that are more lip service than actual help for millions of patients, their caregivers, and their families. In essence, many such programs are a monumental societal-level taunt, inviting very sick patients and desperate parents to participate in programs with very little actual effectiveness.

The Studies

Patients are increasingly seeking high-CBD varieties of cannabis for treatment of many diseases and conditions, most notably cancer, epilepsy, multiple sclerosis, pain, and anxiety. There is also evidence that adult seizure patients, especially females, have a greater need for THC than other sufferers. Even if most states were actually providing safe, reliable access to high-quality, laboratory tested CBD oil containing no THC, the latest research indicates that such a limited approach that disregards the benefits of whole plant therapy helps few children — and actually increased seizure activity for some.

One study published in 2014 and conducted by Dr. Kevin Chapman involved 58 children, with an average age of seven, with “catastrophic forms of epilepsy.” It found that less than 30 percent of children treated with CBD-only oil containing very little or no THC experienced a reduction in seizures of 50 percent or greater. When THC is added to the mix, the majority of patients begin to experience a reduction in seizure activity. It is also estimated that many patients who gain marginal or even good efficacy from CBD-only oil would experience even greater therapeutic benefits if their medicine also contained some THC, even in small amounts or maybe at a 1:1 ratio with CBD.


A 2015 CBD Patient Survey conducted by Care by Design surveyed 2,495 patients between March and August of 2015. One of the survey’s key findings was the fact that CBD oils lacking THC are not as therapeutic or effective as those containing between 20 and 35 percent THC. Concluded the survey:

“THC matters. A higher ratio of CBD to THC does not result in better therapeutic outcomes. Patients using the 4:1 CBD-to-THC were the most likely to report a reduction in pain or discomfort….”

The survey goes on to note that patients who use an oil featuring a 2:1 CBD-to-THC ratio reported “the greatest improvement in overall wellbeing.” This confirms other research that has discovered that CBD and THC interact synergistically to enhance the therapeutic effect of the other, an example of the entourage effect.

Anecdotal Patient Testimonies

Many desperate parents of children with epilepsy have experimented with CBD oil. Unfortunately — as research has indicated — for the majority of them, oils high in CBD, but low in THC, do not work best for their children. Jason David has been treating his seven-year-old son, Jayden, an epilepsy sufferer with Dravet syndrome, with medical cannabis in one form or another since 2011. Dravet is one of the worst manifestations of epilepsy and does not respond to conventional treatments. Said David:

“I wish Charlotte’s Web [a CBD-only oil from Colorado] worked for all epileptic kids, but it doesn’t. The worst seizures Jayden ever had on medical cannabis was while we were using Charlotte’s Web.”

Brian Wilson, a former East Coast resident, moved to Colorado in 2014 because of its medical cannabis law. He is another parent of a child suffering from Dravet syndrome. In an interview with Ladybud in 2014, Wilson said:

“CBD is a very important part of the mix, but only part. We saw minor seizure control and developmental progress with CBD alone, but we didn’t see real seizure control until we added measurable levels of THC to the mix.”

Wilson also noted that the acidic precursor to THC, THC-A, provides significant therapeutic value to some patients. “This is highly individualized medicine. There is no magic bullet,” he added.


Some medical cannabis advocates believe that vague CBD-only bills “betray the science behind cannabis medicine.” Patients are finding that CBD, without any THC, is simply not effective or is marginally effect, when clearly superior solutions exist. In fact, several cases like that of Jason David and his son Jayden have been reported in which CBD only increased seizure disorders, often during times of illness, stress, or hormonal change.

More Research Necessary

Unfortunately, until cannabis is removed from Schedule I of the Controlled Substances Act of the federal government — which considers it as dangerous and addictive as heroin and bath salts — human trials and detailed research will fail to occur in the United States. Even cocaine and methamphetamine, truly addictive and dangerous drugs, are categorized as Schedule II and can be prescribed by a doctor.

Until Congress commits to comprehensive research into the medical efficacy of cannabis for a wide variety of diseases and ailments, tens of millions of patients throughout the country will needlessly suffer. More must be understood about the delicate and nuanced interplay of cannabinoids and terpenes and how they benefit patients with a variety of conditions. Until this happens, a naturally occurring herb that could be helping a sizable portion of the patient population will continue to be outlawed, denying the sick safe access to a 10,000-year-old organic medicine.

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