There are safer ways to explore cannabis use
With legalization around the corner, those curious to try marijuana for the first time, or after a long time, should know some key facts
Curious about cannabis?
With the legalization of recreational use fast approaching, many middle aged or older people are considering taking a trip down marijuana lane — perhaps trying the drug for the first time in decades.
As an addiction medicine physician and researcher, I don’t encourage anyone to try cannabis before understand- ing the risks. If you plan on doing it, there are ways to be safer, especially since today’s pot is a far cry from the relatively low strength weed of the 1960s.
First, it’s worth asking yourself what you’re expecting to get out of the experience. If you’re hoping to improve insomnia, pain, anxiety or depression, that’s not recreational use. These are medical conditions, and all of them can be addressed with evidence-based med- ical/behavioural treatments.
If you feel that cannabis is more “natural” than an antidepressant pill, I would point to treatments like mindfulnessbased meditation, which are backed by good evidence and are the most natural, holistic treatment of all.
There is nothing natural about inhaling smoke into one’s lungs to get a drug!
Some of my clients tell me they’re lonely, and smoke to pass the time. For them, cannabis is a solitary experience.
I would not call this recreational use either — I try to help these clients address the real problems in their lives, rather than papering them over with pot.
But many people are just curious to try it again, and wish to do it safely. To reduce the risks, it’s recommended you start very slowly. Vaping exposes you to a lot fewer chemicals per puff than smoking — be it in a joint, spliff or pipe — but look for a strain with the lowest percentage of THC, the chemical in cannabis that can make you high.
On the streets, the average strain contains 30 per cent THC, which is several times higher than what you may have smoked 30 years ago.
Aim for a much lower dose. And try to buy from a licensed producer rather than off the street.
When first starting out, make sure you’re with a trusted friend for the entire experience — which might be much longer than you’re expecting. Start with a low amount and see what happens but don’t just keep increasing the dose if you don’t get an effect. If you haven’t taken cannabis in many years, you might not get high the first time back, or you might experience a delayed reaction especially if you take it orally such as in the form of a cookie.
It’s especially important not to mix pot with alcohol. The high is different when both substances are at play. And if you have a bad experience you’ll never know how much of a role alcohol played. Both can make you sleepy and that is a dangerous combination. People who try pot after many years may have a bad experience because they were drinking at the time. With your inhibitions and judg- ment impaired, it’s easy to take too much and become very sick.
Even the rituals around smoking pot are different than they were in the 60s, and could spell trouble for the uninitiated. For example, in our era of plenty, people may not pass a joint around; it’s considered unhygienic and you don’t want to be doing this if you are an aging baby boomer at risk for flu, for example. With a whole joint, pipe or cookie to yourself, it’s that much easier to overdo it.
If you take too much cannabis, the greatest danger is from accidents, like falling. Paranoia, too, is a real risk. (There’s even a study suggesting cannabis can trigger a psychotic episode in people with certain genes, although we need more research on this. But please: if you’ve ever experienced psychosis, don’t use cannabis.)
Bottom line: If you start feeling uncontrollably paranoid or unwell in any way go to the nearest emergency room. Don’t just sleep it off, especially if you have been drinking alcohol or used oth- er substances. The latter can be contaminated with potent drugs that stop your breathing or heart. At the ER, they’ll make sure you’re OK. Don’t try to tough it out like when you were young. Remember, as people get older their bodies and brains aren’t the same, and don’t bounce back as quickly or easily.
Finally, talk to your doctor about any medical or psychological conditions in your health history or any medications you’re taking that might be a concern with cannabis. Unfortunately, we don’t know much yet about the prescription drugs that might be dangerous when combined with, so don’t be surprised if he or she has trouble answering your questions. For more information about the risks and benefits of cannabis, and how doctors are struggling to help patients despite limited information, check out the current issue of UofT Med, the Faculty of Medicine’s magazine.
Dr. Peter Selby is a professor in the departments of Family and Community Medicine and Psychiatry at U of T. He is also a Clinician Scientist in the Addictions Division and the Director of Medical Education at CAMH.