How to Consume Cannabis Safely?


More and more people across the country are able to consume cannabis legally. At the same time, we must understand the associated risk factors. Education and responsible consumption are necessary to protect public health and safety.


Scientific evidence supports the use of medical cannabis for a range of therapeutic indications. For recreational users, the estimated chances of becoming dependent on cannabis after any lifetime exposure is 8.9%, which is considerably lower than for cocaine (20.9%), alcohol (22.7%) or tobacco (67.5%) (Lopez-Quintero et al., 2011).



THC

THC is a cannabinoid with psychoactive properties. THC is a Schedule 1 drug under the United Nations Convention on Psychotropic Substances because it has the capacity to produce a state of dependence (United Nations, 1971).


CBD

CBD is a cannabinoid with no psychoactive properties and has no abuse potential. (WHO, 2018).


Recommendations for Safe Cannabis Use


1. Initiate cannabis use after age 21. Do not consume cannabis at an early age specifically before age 16. Many states and companies currently limit use to over 18 or 21. Frequent cannabis use can affect the developing brain. There are elevated risks of developing mental health problems, including depressive symptoms and psychotic symptoms with early-use. Early-use cannabis users are 4 times more likely to develop cannabis dependence. Studies also suggest poorer educational outcomes occur due to early initiation of cannabis.



2. Refrain from consuming products containing high amounts of THC. Cannabis properties and potency have drastically changed over the years as production techniques continue to evolve. Understanding the composition, potency and dosage are vital parts of cannabis use and safety.


High amounts of THC are associated with acute and chronic mental and behavioral outcomes. For example, frequent use of high-potency cannabis (“skunk”) has been associated with marked effects on memory, increased paranoia, and greater dependence severity in (especially younger) users .


The use of high-potency “wax dabs” has been linked to cannabis-induced psychosis among individuals with no psychiatric history. Cannabidiol (CBD) may help to reduce the adverse effects of THC, such as the intoxicating, sedating, and cardiovascular effects.



3. Do not use synthetic cannabis, such as Spice and K2. Synthetic cannabis is known to cause acute cognitive impairment, psychosis, anxiety, strokes, seizures, myocardial infraction, tachycardia, nausea, and death.





4. Consume cannabis orally rather than regularly smoking to reduce respiratory health risks. Smoking practices such as holding your breath or inhaling deeply can increase the intake of hazardous byproducts such carcinogens, tar, toxins and carbon monoxide. Vaporizers have been shown to reduce respiratory problems but there is no significant research on long term vaporizer use.


Because of the delayed response in the body for oral cannabis consumption, there is a risk of unintended high amounts of THC. Thus sometimes leading to poisoning and hospitalization. To prevent this, purchase from a trusted source, adhere to product instructions and follow dosing guidelines.



5. Daily cannabis use is associated with higher risks of adverse health and social outcomes. In frequent use is recommended to avoid dependence, unless used for medical purposes. For daily medical use potency and dosing are important factors to consider to limit negative outcomes.



6. Do not drive or operate machinery while impaired from cannabis. Driving increases the incidents of motor vehicle accidents. It is recommended to wait at least 6 hrs. before

operating a motor vehicle. Times may vary depending on user and potency.








7. Populations that should avoid cannabis use include, individuals with predisposition for, or a first-degree family history of, psychosis and substance use disorders, as well as pregnant women (primarily to avoid adverse effects on the fetus or newborn).


Discussion


Cannabis can be very beneficial when used appropriately. There is conclusive evidence that oral cannabinoids are effective in preventing and treating chemotherapy-induced nausea and vomiting. Moderate evidence shows improved symptoms of fibromyalgia, improved short term sleep disturbances associated with obstructive sleep apnea syndrome, reduction in symptoms of chronic pain and improved short term symptoms of adults with multiple sclerosis–related muscle spasms.


As you, your family members, and friends become more interested in cannabis use, please follow the cannabis recommendations and dosing guidelines for a safe and effective experience.


 

References


1. Caspi A, Moffitt TE, Cannon M, et al. Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene × environment interaction. Biol Psychiatry. 2005;57(10):1117–1127. Crossref, Medline, Google Scholar


2. Rey JM, Sawyer MG, Raphael B, Patton GC, Lynskey MT. Mental health of teenagers who use cannabis: results of an Australian survey. Br J Psychiatry. 2002;180:216–221. Crossref, Medline, Google Scholar

3. Fischer, B., Russell, C., Sabioni, P., van den Brink, W., Le Foll, B., Hall, W., Rehm, J. & Room, R. (2017). Lower-Risk Cannabis Use Guidelines (LRCUG): An evidence-based update. American Journal of Public Health, 107(8). DOI: 10.2105/AJPH.2017.303818


4. Freeman TP, Winstock AR. Examining the profile of high-potency cannabis and its association with severity of cannabis dependence. Psychol Med. 2015;45(15):3181–3189. Crossref, Medline, Google Scholar


5. Harris CR, Brown A. Synthetic cannabinoid intoxication: a case series and review. J Emerg Med. 2013;44(2):360–366. Crossref, Medline, Google Scholar 93. Seely KA, Lapoint J, Moran JH, Fattore L. Spice drugs are more than harmless herbal blends: a review of the pharmacology and toxicology of synthetic cannabinoids


6. National Academies of Sciences, Engineering, and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. National Academies Press; 2017. Doi: 10.17226/24625


7. Pierre JM, Gandal M, Son M. Cannabis-induced psychosis associated with high potency “wax dabs.”

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