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Can you overindulge in cannabis enough to overdose?

Can you overindulge in cannabis enough to overdose?

Smoking or vaping may be the best way for those wanting to control their cannabis experience

It’s sometimes referred to as a green out, cannabis poisoning or even just a really bad time—but it’s not what most people think of as an overdose.

“When we talk about overdoses in cannabis, it’s not an overdose in the strictest sense,” explains Alex Samuelsson, a cannabis scientist and educator better known as Alex the Chemist, and founder of DevCat Consulting. “When we talk about a cannabis overdose, we generally mean overconsumption.”

That is not to say, however, that consuming too much cannabis does not result in negative psychological and physical side effects. Symptoms of cannabis overconsumption can include anxiety or panic attacks, nausea, dizziness, a sense of impending doom, heart palpitations, short-term memory loss, paranoia and drowsiness.

In rare, worst-case scenarios, overconsumption can lead to cannabinoid hyperemesis syndrome (CHS)—an attack of severe, uncontrollable vomiting fits that can last hours or even days. Sometimes, an article in LiveScience notes, sufferers feed the need to take hot baths or showers to relieve symptoms.

The side effects of CHS should dissipate a short time after cannabis consumption stops, but could re-occur if the person starts using cannabis again. Although the syndrome can occur in any user, it is more commonly associated with chronic, long-term use of potent cultivars than occasional, recreational consumption. There is no treatment for the syndrome; only management of symptoms and side effects such as dehydration.

Though rare, a study published last year indicates the syndrome is increasingin prevalence. Despite the plethora of unpleasant side effects, however, there are no reported cases of cannabis “overdose” alone directly causing a fatality. But is it possible?

What’s the likelihood of a cannabis overdose?

It’s highly unlikely, says Samuelsson. “From a tactical stance, I don’t think it’s possible for most people to overdose in a fatal way, especially if you’re using regular consumption means—smoking, vaping and/or, say, eating 10-mg, standard dose capsules [of psychoactive cannabinoid THC],” he says.

“It’s technically possible,” Samuelsson continues, “but in as much as it’s technically possible to overdose from drinking too much water, through which you can ruin the whole electrolyte balance within your blood and body. In that technical sense, it is the same thing with cannabis—yes, you can ingest so much that it starts to interfere with your body function.” For example, he notes it could trigger issues like heart palpitations and cyclic vomiting that can lead to medical emergencies such as heart attacks and seizures.

What health conditions could contribute to a negative effect?

Although he won’t rule it out entirely, Samuelsson is sceptical of the drug’s ability to lead to a fatality in an otherwise healthy person. Most people who suffer fatalities in which cannabis was deemed to be a contributing factor were already suffering from illnesses or medical issues, particularly heart disease and respiratory ailments like asthma (for smokers), prior to their deaths.

“People are very unlikely to suffer a cannabis-related fatality without pre-existing medical conditions,” Samuelsson emphasizes. He cites a recent case in which a 70-year-old man with a heart condition consumed a 90-mg cannabis lollipop and suffered a heart attack as a result of paranoia and hallucinations. In that instance, the man survived.

“There is a cause for concern if there is a pre-existing condition,” Samuelsson acknowledges. That said, it’s still hard to pinpoint a set amount of THC that would constitute an overdose.

When cannabis is consumed, “the THC gets converted to a different molecule, so it will react at the receptor in a different manner than THC will, so it’s very hard to pin down,” he explains.

“I’ve seen some contrived numbers, like, ‘you’d have to smoke the equivalent of 2,525 pounds,’” he says, but adds he has yet to see a method of calculation to which he’d give credence.

“Maybe, if you just literally drank litres of pure distillate, then, maybe, we could accurately calculate that number,” Samuelsson says.

Best way to avoid potential harm: Just don’t do it

The best way to deal with cannabis overconsumption is prevention. Potencycan certainly contribute to overconsumption—one is more likely to experience negative side effects if smoking a concentrate versus flower, for example—but the method of consumption is also one of the biggest factors.

“When smoking cannabis, there are limits to how much you can ingest at any given time, although dabs and other concentrates can complicate that because you can have much higher doses of THC with those methods,” Samuelsson explains. “Smoking or vaping is the better way to go if you’re wanting to control your experience.”

If users are seeking control—novices especially—Samuelsson advises them to “start low and go slow,” especially when it comes to edibles, through which it is easier to overconsume.

“By far, what would take the cake—pun intended—is edibles, because you can really consume much higher quantities, and because the THC will be transformed in the liver into a much more potent molecule,” he says. “Smoking is kind of self-limiting; you just get so high that you can’t smoke anymore, whereas when eating cannabis, you can ingest much more at once. You can eat anything from a couple of mg to thousands of mg [of THC]. You can put that amount in a small brownie that you can eat in two minutes, and you’ve just had way more than what you could have smoked in hours or even days.”

What to do when you know you’ve overconsumed

If someone realizes that they have ingested too much cannabis, there’s not a whole lot they can do to mitigate the effects. Still, there are a few things to try.

“There’s no tried-and-true or standard way, but some of the things that are anecdotally reported to help are consuming CBD [cannabidiol, a cannabinoid], and [the terpene] linalool, which is also reported to have calming effects,” Samuelsson notes. “These might help modulate the THC high and help bring down the intensity for a lot of people if they’re experiencing THC intoxication due to overconsumption.”

Some early studies have indicated that taking non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) can help counteract a cannabis high.

In rare, serious cases, CHS can cause an electrolyte imbalance that may result in seizures or brain swelling. There have been a very few reported fatalitiesattributed to CHS, although those patients had a history of uncontrollable, cyclic vomiting that may have contributed to their deaths.

If a user is vomiting uncontrollably, complaining of chest pain or having difficulty breathing, it’s a good idea to seek the guidance of a trusted healthcare professional. “If you have pre-existing medical conditions and you are going to try cannabis, start very low and go very slow and evaluate over time because, hey, the cannabis isn’t going away,” Samuelsson advises. “There will always be more cannabis. Play it smart and if you do overdose, know it’s not going to be the end of the world. You will recover from it.”

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