Marijuana (cannabis) has a reputation for being a totally benign drug. To read the claims from the proponents of weed, it would seem that cannabis only has beneficial effects. Ask any stoner from the 60s about their bad experiences and it becomes clear that marijuana isn’t always rainbows and unicorns.
There is plenty of evidence that, as drugs go, marijuana is significantly less dangerous than many other oft-abused substances, including alcohol. But less dangerous is a far cry from saying it’s completely safe.
Marijuana is one of the most widely used drugs in the U.S., according to the National Institute on Drug Abuse. There are no reports of fatal marijuana overdoses, but it is possible to overdose on cannabis. Symptoms range from mild to severe.
Marijuana Overdose Symptoms
Can you overdose on marijuana? Yes, but unlike overdoses of other illicit drugs, a marijuana overdose won’t likely be fatal.
Here are are the symptoms you may experience if you overdose on weed:
- High levels of anxiety
- Panic attack
- Rapid heart rate
- Difficulty conversing
- Poor coordination
- High or low blood pressure
- Nausea and vomiting
- Extreme confusion and memory problems
Milder overdoses are typically characterized by nausea, anxiety, lethargy, dizziness, and paranoia, says Dr. Weiner. This set of symptoms is sometimes termed “greening out.” He adds that THC overdose signs include cannabinoid hyperemesis syndrome (CHS) and marijuana-induced psychosis (MIP). The former involves bouts of severe vomiting and abdominal pain—usually lasting for less than 24 hours.
Courtney Allen-Gentry, an Advanced Holistic Public Health Nurse, says that marijuana overdose is unlikely with smoking or vaping. You are a lot more likely to overdose on weed edibles because it’s difficult to determine the exact dosing.
What You Should Do
When you or a loved one overdoses on marijuana, Dr. Weiner recommends a visit to urgent care. If your loved one is experiencing a psychotic break due to a weed overdose, keeping them safe is vital, urges Dr. Weiner.
In the meantime or for milder cases, RN Allen-Gentry suggests hydrating with lemon juice in water, which helps neutralize terpenes and counteracts the dehydrating effects of THC. She adds that “chewing black peppercorns will shift discomfort due to terpenes.”
Other Adverse Effects
Marijuana is a strange drug in that it contains a lot of active ingredients. Although scientists cite different numbers, in addition to THC, there are thought to be over 100 other cannabinoids in cannabis. Not all of these act the same way.
Get too much THC and you may have a psychoactive reaction that is not unlike that of a stimulant. Cannabidiol (CBD) is associated more with sedative effects.
The effects of marijuana use are all over the map. There have been cases of heart arrhythmias and sudden cardiac arrest while smoking weed. There are reports of both seizures and the reduction of seizures, which seems to be based on which type of cannabinoid and at what amounts are used.
Here are some examples of THC toxicity that have been published:
- Heart arrhythmias: Some doctors believe that heart disturbances are under-reported in marijuana use.1 Since smoking weed and taking other drugs often go together, it’s really hard to isolate the cause when the heart starts doing crazy things. Even drinking alcohol intensifies the effects, which means you can’t say for sure whether it was the pot or the booze that caused a problem.
- Psychosis or paranoia: Users report severe psychotic episodes with hallucinations and negative associations.2 In some cases, the psychosis can last significantly longer than the amount of time it should take to metabolize the THC.
- Uncontrollable vomiting: Although THC often has anti-nausea properties, it can rarely be associated with a syndrome of persistent vomiting. More often associated with chronic cannabis use, uncontrollable vomiting is sometimes relieved with a hot shower.2
Even the method of consumption makes a difference. For example, a user may consume too much THC in edible form because it takes longer to see an effect. If one brownie doesn’t work, they take another…and maybe just one more. Suddenly, they have a serious reaction.
THC that is consumed in edible form is metabolized differently than when it’s inhaled.3 It takes longer to absorb THC in edibles, which can lead to the user thinking they didn’t get enough.
Edibles are also much more prone to accidental overdoses. Smoking marijuana doesn’t usually happen accidentally. Even second-hand smoke from your neighbor’s party isn’t really going to do anything but stink up your apartment.
However, leaving laced cookies lying around pretty much begs for someone to try a bite. Kids are especially likely to munch on marijuana goodies. When grandma is trying a little medical marijuana for the first time and accidentally leaves it out for the grandkids to explore, you have a recipe for overdose.
Children presenting to the emergency department with accidental ingestion of marijuana becomes increasingly common in every state that legalizes marijuana for recreational use. Once it’s legal and tolerated, it’s a lot easier to accidentally leave your marijuana out on the coffee table for the kids to find.
Increased Concerns About Overdose
There are several reasons that medical and health experts have become concerned about the potential for marijuana overdose and adverse effects.
Increased Marijuana Use
Marijuana has been available for medicinal use since 1996 when California legalized it. Now, California, Alaska, Colorado, Maine, Massachusetts, Michigan, Nevada, Vermont, Washington, and Washington D.C. allow recreational use. In Oregon, the number of dispensaries doubled after recreational weed was legalized.
As the momentum of recreational pot burns across the country, people you probably didn’t expect to see getting high are trying weed for the first time in years. While they might have smoked a little pot in college, this isn’t the same thing.
Many in the medical world report being a bit surprised by the marked increase in marijuana use in states where it has been legalized. Many paramedics, EMTs, and emergency department healthcare providers figured that those who cared about getting high had their medical marijuana prescriptions and could get it when they wanted.
As it turned out, there were plenty of people interested in trying the recently illicit substance. All that new consumption has led to significant increases in marijuana-induced emergency department visits.
How to handle it
If you or a friend has overindulged, there are a few things you can do to reduce the unpleasant side effects.
If you’re feeling anxious, it’s good to self-soothe by telling yourself that you’ll be OK. Remind yourself that nobody has ever died from a cannabis overdose.
It might not feel like it right now, but these symptoms will pass.
If you’re feeling nauseated or shaky, try to have a snack. This might be the last thing you want to do, especially if you also have dry mouth, but it makes a big difference for some people.
Speaking of dry mouth, make sure you drink plenty of liquids. This is especially important if you’re vomiting, which can dehydrate you.
If you’re panicking, try slowly sipping water to help ground yourself.
Sleep it off
Sometimes, the best thing to do is wait for the effects to subside. Sleeping or resting is a good way to pass time while you wait for the cannabis to work its way out of your system.
If too much is happening around you, it can make you anxious and even paranoid.
Switch off the music or TV, leave the crowd, and try to relax in a calm environment, like an empty bedroom or bathroom.