What Does a Cannabis Overdose Feel Like?

One of the reasons why some patients prefer to use medical cannabis to manage their symptoms is that it can be a safer alternative.  For conditions like chronic pain, patients have often been prescribed opioids or NSAID drugs.  Both of these can cause complications when used over the long term. 

When you have a health condition where the symptoms are not going to go away, you need something that can help.  Because the option to live with symptoms that are not resolved is no option at all.  It means living with debilitating discomfort or mental health struggles that can greatly impact your life. 

While cannabis is viewed to be safer than most prescription pain medications, that doesn’t mean there are no contraindications. One of the greatest myths among cannabis users (recreational or medical card holders) is that you cannot overdose on marijuana. And you may be surprised to learn that you can. 

There are many different ways that a patient can experience an overdose situation when using cannabis.  This is why there are limits to how much cannabis a registered patient can purchase within a set period of time.  And while those limits can feel frustrating (particularly if you have severe symptoms), they are in place to protect your health and safety.

Who is Most at Risk for a Cannabis Overdose?

Patients with a medical card who have years of experience using medical marijuana are the least likely to overdose on cannabis.  That is because they learn what strains and potencies are most effective over time.  

But what if you are new to using cannabis?  Adventures in college aside, for some patients, it may have been decades since they tried cannabis.  And if you are living with painful symptoms that you haven’t been able to moderate with other therapeutics, you may be tempted to start with high-potency strains.  Or cannabis concentrates available at your local dispensary.

This is a mistake some people make. When your body is not familiar with cannabis, you can be more susceptible to its effects. Simply because you haven’t built a tolerance for it.  And proceeding to use too much or potent THC products can subject you to a very uncomfortable situation.  When you have taken more cannabis than your body can metabolize without producing side effects that can be worse than the symptoms you were trying to address.

Every year, thousands of Americans are hospitalized for cannabis toxicity events.  Some of the patients require emergency medical care.  And tragically, minors are most at risk for accidental ingestion by accessing cannabis products stored at home.  Children can mistake edibles, for example, as candy, leading to a health emergency.

Cannabis Potency Has Increased Substantially 

If your parents (or grandparents) were at Woodstock, they probably have a story about smoking a blunt.  But did you know that in the history of cannabis use in the United States, cannabis has never been more potent than it is today?

Back in the 1960s, for example, the average potency for marijuana was around 5% THC content. It was rare for anyone to find cannabis that had a higher THC level. It was also common for people to smoke cannabis leaves, stems, and seeds along with their bud.  Different parts of the cannabis plant have higher levels of CBD, which can counteract some of the effects of THC.

Cannabis was also difficult to get, as it was not legalized in any state.  That meant that illegally purchased cannabis was stored for longer periods of time, allowing THC levels to degrade.  It was nothing compared to the potency of the cannabis that is available from dispensaries today.

The average potency of cannabis sold in American dispensaries in 2021 was 20%.  While some strains have lower content (starting from 10% THC), they can be harder to find. And with the legalization of concentrates, higher-potency cannabis products are now legally available in most states. This increases the risk of cannabis toxicity if patients are not using medical marijuana responsibly as part of a doctor-supervised treatment plan.

Cannabis Concentrates Provide the Highest Risk of Overdose

When you have chronic pain, convulsions, or a debilitating mental health condition, you want and need relief.  Because those symptoms can disrupt every aspect of your life.  From your ability to take care of yourself, ease of mobility,  your relationships, and even employment opportunities. 

In most states where medical marijuana is legalized, concentrates are available at dispensaries.  But they are only recommended for people who are seasoned cannabis users.  And in cases where lower potency strains are not providing pain relief.  Often, cannabis concentrates are also used for compassionate care or end-of-life comfort for patients with terminal health diagnoses.

There are several types of cannabis concentrate products for patients.  Most concentrated products are smokable or inhalable, but there are other types of products that patients can try, including:

• THC oil (tinctures administered through sublingual uptake)
• Budder (or wax)
• Crumble
• Shatter
• Crystalline (Isolates)

Cannabis concentrates are highly potent.  While cannabis flower and other products may average anywhere from 10% to 25% THC, concentrates average between 54% to 69% tetrahydrocannabinol (THC) content for solvent-based products.   Products prepared with non-solvent-based extraction methods average between 39% and 60% THC. 

The psychoactive and physiological impact of cannabis concentrates is strong. And with few exceptions, they are not recommended for most patients.  Typically they are reserved for patients who have moderate to severe symptoms, where average THC levels are not providing symptom relief.

Is a Cannabis Overdose Life Threatening?

Despite strong controls regarding opioid prescriptions and dispensing, the number of Americans who died from opioid-related overdose has increased.  The Centers for Disease Control and Prevention estimated that 100,306 overdose deaths occurred from April 2020 to April 2021. And that was an increase of 28.5% from the previous year.

To date, there are no recorded fatalities where cannabis was the sole cause of toxicity. However, that does not mean that cannabis-related deaths do not occur in conjunction with other prescribed or illicit drugs. 

A cannabis overdose is not life-threatening. But it can cause other health problems. And create a situation where your body will not tolerate any amount of cannabis after an extreme and adverse event. 

Cannabinoid Hyperemesis Syndrome (CHS)

You can get too much of a good thing.  Even though cannabis may be effective at helping you manage health symptoms, there is a risk of overdosing.  No, you may not end up in a hospital, but you could end up at home in a very uncomfortable state. 

Cannabinoid Hyperemesis syndrome (CHS) happens when you have exceeded your body’s tolerance and ability to metabolize cannabis.  And the side effects are very similar to consuming too much alcohol. But the difference is CHS can actually cause your body to reject any cannabis in the future.  Making it impossible to consume medical marijuana to help with your symptoms in the future. 

Scromiting is another term, and it paints an unpleasant visual.  One of the main symptoms of cannabis toxicity is uncontrolled vomiting. When your body recognizes the THC levels to be excessive and tries to purge it from your system.   The vomiting is so violent and persistent that some people may “scream” or cry.  Hence the term “scromiting” or ‘scream vomiting.’  

The symptoms of CHS can last for days or longer and sometimes result in the need for emergency care. The uncontrolled vomiting can cause long-term digestive problems and injure vital organs. 

It can be frightening to experience, but it can be caused by excessive use of highly concentrated cannabis.  However, persistent use of cannabis concentrates is the cause of Cannabinoid Hyperemesis Syndrome.  Which means it develops from using too much potent cannabis on a daily basis over a period of time. 

More Bad News About Cannabinoid Hyperemesis Syndrome 

After you have been diagnosed with CHS (one incident is enough to cause the condition), using medical cannabis may no longer be an option. Because the body registers cannabis as a threatening toxic substance.

Attempting to use cannabis after a cannabis overdose incident or CHS can retrigger the uncontrolled vomiting. Whether you abstain for a few weeks or a few months.  It varies by individual, but some people have never been able to use cannabis again after their overdose.

Cannabis Limits Put Patient Safety First 

Responsible use of medical marijuana means following the dose recommendations and quantity limitations provided by your doctor. When a physician provides a recommendation, it is based on your current health conditions, prescription medications, health history, and symptom management needs. 

Over time, patients can develop a tolerance to cannabis products (like any other controlled substance).  And that can result in wanting to try higher potency products or increasing the volume of cannabis used on a daily basis. 

It is important to remember that medical cannabis is one piece of your symptom management plan.  There are other therapeutics, including cold and heat therapy and the use of cannabidiol (CBD) in conjunction with medical marijuana for safe and effective relief. 

Patients should regularly research different types of cannabis strains that can help them with symptom management.  Remember that terpene content and different cannabinoid profiles (CBG, CBN, THCA) can provide results.  They work together (entourage effect), and some strains may be more effective than others in providing the results you are looking for.  Without the need to increase potency levels beyond the safe thresholds for your body.