Ask ten people in a supermarket queue why they bought a bottle of CBD drops and you will hear the same three words again and again: anxiety, pain, sleep. What you will not hear is much about clinical evidence, because for most of those uses there is very little. A new international survey has now put numbers on that gap, and the numbers are large enough to matter for regulators, doctors and anyone who has ever wondered whether the CBD on the pharmacy shelf is a medicine, a food or something in between.
The study, published in the International Journal of Drug Policy by Elle Wadsworth of the University of Bath and colleagues from Australia, New Zealand, the United States, Germany and Canada, draws on the 2024 wave of the International Cannabis Policy Study. It surveyed 79,644 people aged 16 to 65 across six countries with very different rules for CBD: Canada, the United States, Australia, New Zealand, the United Kingdom and Germany. The researchers asked who uses CBD-only products, what kind, where they buy them, and, most importantly, why.
Key Takeaways
Across all six countries, anxiety, depression and pain were the reasons people most often gave for using CBD-only products, with anxiety cited by 30 to 47 percent of past-year users and pain by 32 to 49 percent depending on the country. Roughly three quarters of people who used CBD for a mental health reason said it was their main reason for using it at all, and more than three quarters said the same about physical health. Lifetime use ranged from 16.2 percent in New Zealand to 46.4 percent in the United States. Oils and drops dominated in Europe and Oceania while edibles led in North America, and where people bought CBD closely mirrored what each country’s law allows. In the UK, Australia and New Zealand, close to a third of people who had ever used CBD said they did so because they could not legally get medical cannabis. The authors stress that for the conditions people most often name, robust clinical evidence for CBD is limited or absent, and that retail products contain doses far below those tested in trials.
Anxiety, depression and pain: the reasons that dominate everywhere
The question at the heart of the study was simple. People who had used a CBD-only product were shown a list of mental and physical health conditions and asked whether they had ever used CBD to improve or manage any of them.
The mental health answers were remarkably consistent. Anxiety came first in every country: 41.8 percent of past-year users in Canada, 46.5 percent in the United States, 42.3 percent in Australia, 39.6 percent in New Zealand, 44.5 percent in the United Kingdom and 30.4 percent in Germany. Depression came second, named by between 24.2 percent (UK) and 31.1 percent (Australia and New Zealand). Post-traumatic stress disorder was third, ranging from 12.0 percent in the UK to 20.2 percent in Australia.
The physical health list looked much the same from country to country. Pain led in all six: 46.7 percent in Canada, 46.2 percent in the United States, 39.8 percent in Australia, 49.3 percent in New Zealand, 32.3 percent in the UK and 32.6 percent in Germany. Sleep problems followed, from 20.7 percent in the UK to 34.5 percent in New Zealand. Headaches and migraines were third, and here Germany stood out with 35.1 percent, the highest of any country.
What makes these figures more than a wish list is a follow-up question. People who said they used CBD for a mental health condition were asked whether that was one of the main reasons they used it. Around three quarters said yes, from 70.2 percent in Canada to 79.0 percent in the UK. For physical health the share was even higher, between 74.2 percent in Germany and 85.3 percent in New Zealand. In other words, most CBD use in these six countries is not casual wellness dabbling. It is people trying to treat something.
One detail from Germany deserves a closer look. Only 6.9 percent of German past-year users said they had never used CBD for any of the listed mental health conditions, compared with 20 to 31 percent elsewhere. The German sample is smaller and the question wording was translated, so the difference should be read with care, but it suggests that German users are more likely than others to frame their CBD use in explicitly therapeutic terms.
How many people actually use CBD
The survey asked everyone, not just cannabis consumers, whether they had ever used a CBD-only product. The answers varied enormously by country and lined up with how easy CBD is to get.
The United States led on every measure: 46.4 percent had used CBD at some point, 19.3 percent in the past 12 months and 7.7 percent in the past month. Canada followed with 38.3 percent lifetime use, 15.4 percent in the past year and 6.2 percent in the past month. The UK sat in the middle at 28.0, 14.3 and 5.3 percent, and Germany slightly lower at 24.0, 8.6 and 3.2 percent. Australia and New Zealand, where CBD is available only on prescription, had the lowest figures: 20.8 percent lifetime use in Australia and 16.2 percent in New Zealand, falling to 8.5 and 5.5 percent for the past year and 2.5 and 2.1 percent for the past month.
These numbers fit a broader pattern. A 2026 meta-analysis of CBD use in North America and Europe, cited by the authors, found lifetime prevalence of 28.9 percent in North America and 12.8 percent in Europe. The new survey’s figures sit inside those ranges, which is reassuring for a study that relied on online panels rather than random population samples.
Which products people reach for
Within the past-year users, product choice split the six countries into two camps. In Canada and the United States, edibles were the most common format, used by 31.6 and 34.2 percent respectively. In Australia, New Zealand, the UK and Germany, oils or liquid drops came first, at 42.3, 46.8, 34.0 and 46.4 percent.
The UK had one distinctive habit: CBD drinks. More than a quarter of British past-year users, 27.3 percent, had used them, compared with 11 to 19 percent elsewhere. The authors link this directly to availability. CBD-infused soft drinks are sold in British supermarkets next to ordinary fizzy drinks, so people buy them the way they would buy any other beverage. Vaping liquids were also popular in the UK at 21.4 percent, while topical creams and ointments were most common in the United States at 28.7 percent.
The authors note that oils, drops and edibles are the formats people tend to see as more medicinal, which fits the reasons for use described above. The British drinks market is the exception that shows how much the surrounding retail landscape shapes behaviour.
Where people buy CBD, and why it tracks the law
Between 51.5 percent (New Zealand) and 72.1 percent (UK) of past-year users had paid for a CBD product in the previous 12 months. Asked where they made their most recent purchase, respondents in each country pointed to whatever their national rules allow, even though the survey never asked whether a source was legal.
In Canada, where CBD is regulated exactly like THC cannabis under the Cannabis Act, the top answers were “another type of store”, which the open-text responses revealed to mean licensed cannabis shops, at 34.9 percent, and online at 22.1 percent. In the United States, where the 2018 Farm Bill opened the door to hemp-derived CBD in ordinary retail, the leading sources were online (24.0 percent) and grocery stores, gas stations or malls (20.8 percent). The FDA’s own guidance makes clear that only one CBD product, Epidiolex, is approved as a medicine, yet the retail market operates largely outside that framework.
Australia and New Zealand told a different story. There, CBD is treated as an unregistered medicine available only on prescription, and the survey reflected that: pharmacies or clinics were the top source for 38.5 percent of Australian buyers and 42.3 percent of New Zealanders. The second most common source in New Zealand, however, was a dealer in person at 13.7 percent, which the authors suggest may point to the informal “green fairy” network that has long supplied medical cannabis outside official channels. Australia’s Therapeutic Goods Administration has had a pathway for over-the-counter low-dose CBD since 2020, but no product has yet been approved through it, so the provision sits unused.
In the UK, where CBD is regulated as a novel food under the Food Standards Agency, pharmacies or clinics led at 27.8 percent, closely followed by grocery stores, gas stations or malls at 23.4 percent. Germany’s top source was online at 29.6 percent, followed by pharmacies or clinics at 19.3 percent, matching a market where specialist CBD web shops are the norm.
The lesson the authors draw is that consumers overwhelmingly use legal channels when legal channels exist, and turn to friends, family or dealers mainly where access is tight. This is one of the clearest findings in the paper and one of the least surprising.
CBD as a stand-in for medical cannabis
The most policy-relevant part of the study concerns three countries without legal recreational cannabis: the UK, Australia and New Zealand. Respondents there who had ever used CBD were asked whether they had done so because they could not legally access medical cannabis.
The answer was yes for 28.4 percent of British users and 39.6 percent of Australians and New Zealanders. That is a substantial minority using CBD as a substitute rather than a first choice. Before adjusting for other factors, British respondents were less likely than Australians and New Zealanders to report this (a risk ratio of 0.72), but once age, sex, education, income and cannabis use status were taken into account the difference stopped being statistically significant (adjusted risk ratio 0.82, with a confidence interval running from 0.68 to 1.00).
The authors’ explanation is about how people picture CBD. In Britain, CBD sits in supermarkets next to vitamins and soft drinks and is easy to see as something separate from medical cannabis. In Australia and New Zealand, CBD is only available through the medical cannabis system, so the two are hard to separate in the consumer’s mind. That context matters when reading the rapid growth of private UK medical cannabis prescriptions, which is happening alongside a large and separate over-the-counter CBD market.
The strength of the link between CBD and prescribed cannabis varied accordingly. In Canada, Australia and New Zealand, people who used cannabis for medical reasons were five to fourteen times more likely to have used CBD in the past year than non-consumers. In the UK and the United States the effect was smaller, a two- to threefold increase. Among past-year CBD users, the share who held a medical cannabis prescription ranged from 37.3 percent in Canada and 33.0 percent in the United States down to 12.5 percent in Germany and just 7.3 percent in the UK. The overlap between CBD use and any cannabis use was greatest in Canada, at 71.8 percent, and smallest in the UK, at 17.5 percent, where most CBD users do not use cannabis at all.
Who uses CBD
The demographic picture was broadly familiar. In all six countries, people who had used cannabis in the past year, and above all those with a prescription, were far more likely to have used CBD. Younger adults, particularly those aged 25 to 36, and people with higher education were also more likely to use it in most countries. Only in Canada were people assigned female at birth more likely to use CBD than men, which is a departure from earlier studies that consistently found higher CBD use among women. In the United States, respondents who said it was easy to make ends meet were more likely to use CBD, and so were those living in states without medical cannabis laws, which fits the idea that CBD fills a gap where prescribed cannabis is unavailable. Readers interested in how Americans explain their cannabis use more broadly can compare these findings with the reasons for cannabis use in a large US survey.
What the evidence says about the reasons people give
Here the paper turns from description to warning. Anxiety, depression and pain are the conditions people most often name, yet the evidence that CBD helps with them is thin.
For anxiety the picture is the least discouraging. A 2024 systematic review and meta-analysis pooled eight trials with a combined 316 participants and found a meaningful reduction in anxiety, but the authors of that review themselves urged caution because the sample was so small. For pain the verdict is harsher. A 2024 review in the Journal of Pain examined 16 randomised trials of pharmaceutical-grade CBD and found that 15 showed no benefit over placebo. For depression there is essentially no trial evidence at all. The only condition with solid clinical proof, severe childhood epilepsy, was named by just 3.4 to 6.0 percent of users.
There is also a dose problem. CBD-only products sold as foods or wellness products in Europe typically contain around 20 to 25 milligrams per dose. Clinical trials that found effects used 300 to 1,500 milligrams. A person taking supermarket CBD for anxiety is taking a small fraction of any dose that has been tested. Separate laboratory work has shown that the label often does not even match what is in the bottle, as a European study of 186 CBD oils found when roughly half failed accuracy checks. For a broader grounding in what CBD is and what the science currently supports, The Cannex maintains a complete science-based guide to CBD.
The authors’ conclusion is direct: therapeutic use of CBD is happening on a large scale, mostly without medical supervision, for conditions where the evidence is limited or absent. They call for clearer labelling, better consumer guidance and, above all, better trials.
Limits of the study
This is a survey, not a clinical study, and it cannot say whether CBD works. It can only say what people believe and do. The samples were drawn from online panels rather than random population sampling, and although the data were weighted to match national statistics on age, sex, region, education and cannabis use, the authors note that the US sample had fewer people with low education and fewer Hispanic respondents than the general population, and that the New Zealand sample was skewed on education too.
Sample sizes also differed sharply. The United States contributed 9,412 past-year CBD users, the UK 1,668, Canada 2,957 and Germany 738, but Australia only 266 and New Zealand only 203. Estimates for those two countries carry wide confidence intervals and comparisons involving them should be treated with caution. The German figures come from a translated survey and a sample where cannabis consumers were deliberately oversampled and then weighted back down, which is standard practice but adds a layer of modelling between the raw answers and the published percentages. Germany’s own cannabis use patterns after partial legalisation are shifting quickly, which is another reason to treat 2024 figures as a snapshot rather than a settled picture.
Finally, the survey changed the wording that introduces CBD questions between 2023 and 2024, and half the sample saw each version. The authors report that this made a noticeable difference only in the UK and that it did not change the overall conclusions.
FAQ
The three most common reasons in every country were anxiety, pain and depression, followed by sleep problems and headaches. Around three quarters of people who used CBD for a mental health condition, and more than three quarters who used it for a physical one, said that condition was their main reason for using CBD.
It depends heavily on where you live. In the 2024 survey, 46.4 percent of Americans had ever used a CBD-only product, compared with 38.3 percent of Canadians, 28.0 percent of Britons, 24.0 percent of Germans, 20.8 percent of Australians and 16.2 percent of New Zealanders. Past-month use was far lower everywhere, from 2.1 percent in New Zealand to 7.7 percent in the United States.
Only weakly. Small trials suggest CBD may reduce anxiety, but the total number of participants studied is a few hundred. For pain, a recent review found that 15 of 16 randomised trials showed no benefit over placebo. Retail products also contain far lower doses than those used in trials. The only condition with strong clinical evidence is severe childhood epilepsy.
At federal level, hemp-derived CBD with less than 0.3 percent THC was removed from the definition of marijuana by the 2018 Farm Bill, which is why it appears in grocery stores and gas stations. However, the FDA has approved only one CBD product, Epidiolex, as a medicine, and has not authorised CBD as a food additive or dietary supplement. State rules vary and hemp-derived product regulations are changing, so the legal status of a given product depends on where and how it is sold.
Legal disclaimer
This article summarises published research for general information purposes only. It is not medical, legal or regulatory advice and does not recommend the use of any cannabis or cannabidiol product. The laws governing CBD differ substantially between and within the countries discussed, including the United States, Canada, the United Kingdom, Germany, Australia and New Zealand, and are subject to change. Anyone considering CBD for a health condition should consult a qualified healthcare professional, and anyone with questions about the legality of a product in their jurisdiction should consult the relevant regulator or a legal professional. The Cannex accepts no liability for decisions taken on the basis of this content.
