Can You Overdose on Marijuana?
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Barbara Peacock / The Image Bank / Getty Images
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 doesn’t come with a clear definition of overdose. In fact, doctors aren’t entirely sure how much tetrahydrocannabinol (THC) it takes to overdose. THC is the active ingredient in marijuana most likely to induce the high users are seeking.
Risk of Death
Some wonder if marijuana overdose can cause death. There have been a few isolated case reports where marijuana has been implicated in people’s death. However, a clear causal relationship has not been established.
What medical professionals aren’t clear about, is whether those cases had other contributing factors (like pre-existing cardiac conditions).
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. 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. 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.
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. 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.
Increased THC Concentration
Just like how modern farmers are able to get much bigger yields from crops like corn and beans, weed farmers today are much more successful than they were in the past. The levels of THC in marijuana are well above what it was before the current farmers were born.
The concentrations of THC increased from 3.4% in 1993 to 8.8% in 2008. Some folks say that just means you don’t have to roll the blunts as fat as you used to, but let’s face it: When you’re chasing the high, the bar just keeps getting higher.
A Word From Verywell
Marijuana overdose is still a debated topic and there isn’t really a clear answer on how much pot is too much. Until there is, it’s important to be diligent if you choose to use and to keep yourself informed. Don’t accept the mantra that weed is natural and therefore, safe. What makes anything safe is an informed consumer and a critical mind.Learn about the risks of using too much marijuana, and find out whether it's possible to overdose from it and die.
You Might Not Overdose on Cannabis, But You Can Still Overdo It
Can you overdose on cannabis? This question is controversial, even among people who frequently use cannabis. Some people believe cannabis is as dangerous as opioids or stimulants, while others believe it’s completely harmless and has no side effects.
You can’t overdose on cannabis in the way that you can overdose on, say, opioids. To date, there have not been any reported deaths resulting solely from cannabis use, according to the Centers for Disease Control and Prevention (CDC) .
But that doesn’t mean you can’t overdo it or have a bad reaction to cannabis.
There isn’t a straightforward answer here because everybody’s different. Some people seem to tolerate cannabis well, while others don’t tolerate it well at all. Cannabis products also vary greatly in their potency.
Edibles, however, seem to be more likely to cause a negative reaction. This is partly because they take a long time to kick in.
After eating an edible, it can be anywhere from 20 minutes to 2 hours before you start to feel the effects. In the meantime, many people end up eating more because they mistakenly believe the edibles are weak.
Mixing cannabis with alcohol can also cause a negative reaction for some people.
Cannabis products containing high levels of tetrahydrocannabinol (THC), the chemical that makes you feel “high” or impaired, can also cause a bad reaction in some people, especially those who don’t use cannabis often.
Cannabis can have quite a few less-than-desirable side effects, including:
- thirstiness or a dry mouth (aka “cotton mouth”)
- concentration problems
- slower reaction times
- dry eyes
- fatigue or lethargy
- increased heart rate
- anxiety and other changes in mood
In rarer cases, it can also cause:
- paranoia and panic attacks
- nausea and vomiting
These side effects can last anywhere from 20 minutes to a full day. In general, cannabis that’s higher in THC is associated with more severe, long-lasting effects. And yes, it’s possible to wake up with a “weed hangover” the following day.
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.
Chew or sniff black peppercorns
Anecdotally, many people swear that black peppercorns can soothe the side effects of overindulging in cannabis, especially anxiety and paranoia.
According to research , black peppercorns contain caryophyllene, which might weaken the uncomfortable effects of THC. But this remedy hasn’t been rigorously studied, and there is no evidence in humans to support it.
Call a friend
It may be helpful to call a friend who has experience with cannabis. They may be able to talk you through the unpleasant experience and calm you down.
Having a bad reaction to cannabis usually isn’t a medical emergency.
However, if someone is experiencing hallucinations or signs of psychosis, it’s important to get emergency help.
Looking to avoid a bad reaction in the future?
Keep the following in mind:
- Start with low doses. If it’s your first time using cannabis, it’s a good idea start low and slow. Consume a small amount and give it plenty of time to kick in before using more.
- Be careful with edibles. Edibles take anywhere from 20 minutes up to 2 hours to kick in because they need to be digested first. If you’re trying edibles for the first time, or if you’re not sure of the strength, have a very small amount and wait at least 2 hours before having more.
- Try a low-THC cannabis product. Most dispensaries and cannabis shops list the amount of THC in their products. If you’re new to cannabis, or if you’re sensitive to the side effects, try a low-THC product or one with a high CBD:THC ratio.
- Avoid overwhelming situations. If cannabis sometimes makes you anxious or confused, it might be best to use it in a safe, calm environment.
While nobody has died from overdosing on cannabis alone, it’s possible to consume too much and have a bad reaction. This tends to happen more with edibles and high-THC products.
If you’re new to cannabis, pay careful attention to how much cannabis you’re consuming at a time and give yourself plenty of time to feel the effects before using more.
Sian Ferguson is a freelance writer and editor based in Cape Town, South Africa. Her writing covers issues relating to social justice, cannabis, and health. You can reach out to her on Twitter.Some people insist it's impossible to overdose on marijuana, while others swear that they have. As with most debates like this, the truth lies somewhere in the middle. ]]>