- How Does it Work?
Our brains have their own set of cannabinoids. These natural chemicals play a role in normal brain development and function. The endocannabinoid system is responsible for things like appetite, sleep, emotions and movement. THC and CBD interact with these specific receptors throughout the nervous and immune systems when marijuana is used.
When a person smokes marijuana, the THC and CBD quickly pass from the lungs to the bloodstream and then throughout the body. When a person eats marijuana, the body absorbs THC and CBD more slowly.
- Lower Risk Guidelines
The following information is adapted from a review of 233 peer reviewed articles and systematic reviews (Fischer et al, 2017).
1. The most effective way to avoid risks is to abstain from marijuana use. If you do use, the risks will vary in likelihood and severity depending on quantities, product quality, user characteristics, etc. so you can never expect the experience of one person to be the same the experience of another.
2. Prolong initiation if possible. The earlier you start, the more risks.
3. Be aware that high THC-content products carry greater risks for mental and behavioral outcomes. Make sure you know the nature and composition of products you use. Consider keeping CBD capsules on hand. CBD modulates THC so it can lessen paranoia and panicky feelings.
4. Use a vaporizer or another alternative to regular inhalation of combusted marijuana to decrease health impacts to your respiratory health.
5. Stick to using once a week or on weekends only at most. Daily use is strongly associated with risks of experiencing negative outcomes, both averse physically and emotionally.
6. Stay home and relax, do not drive if you are using marijuana.
7. Individuals with a predisposition or family history of psychosis and/or substance use disorder should refrain from using marijuana.
- Brain Development
The developing brain responds differently to marijuana than the adult brain.
Marijuana can change your brain if you use it before your brain is fully developed. This is part of the reason you must be age 21 or older to consume.
- Your brain fully develops at age 25-26, so there are still risks to using if you are younger than 26.
- Marijuana use can reduce memory and learning functions if you use before brain development is complete.
- Marijuana can affect how the brain builds connections, so using marijuana early on will result in alterations to perception, mood and other functions.
- For example, someone may use marijuana to cope with feeling down or cope with feelings of anxiety; in doing so, they risk compromising the natural brain processes that would otherwise help that individual develop natural coping mechanisms during brain development.
The frequency, THC concentration, duration of use and age of initiation all impact the magnitude of brain change.
- Mental Health
Anyone using marijuana should be aware of the mental health implications if they (1) begin to use it as a coping mechanism, (2) have a predisposition/family history of mental health problems, or (3) are a heavy user. See Medicinal Use below; marijuana should not be used to self treat mental health issues.
From the National Academy of Science, 2017
- The higher the level of use, the greater the risk of developing schizophrenia and other psychoses.
- Regular use is likely to increase the risk for developing social anxiety disorder
- Heavy users are more likely to report thoughts of suicide than non-users
Substantial research also indicates that individuals with a predisposition for of family history of psychosis and/or substance use disorder should refrain from using marijuana.
Nine percent of people who try marijuana become addicted. If you use before age 18 the rate of dependence is about 17% or 1 in 6.
A common misconception is that marijuana helps:
- Sleep difficulties
- Lack of appetite
- Depressed mood
When withdrawal symptoms include:
- Nervousness or anxiety
- Sleep difficulties
- Decreased appetite
- Depressed mood
Individuals are led to believe that marijuana is helping these symptoms, but in some cases, they are experiencing withdrawal symptoms of marijuana. Withdrawal symptoms can occur within 8 hours of abstinence but can be delayed up to 72 hours. The symptoms usually peak in severity on day 10 and can last 45 days or longer.
For more information see the DSM (Diagnostic and Statistical Manual of Mental Disorders) criteria for Marijuana Use Disorder.
- Physical Health and Negative Reactions
Negative Reactions or a "Bad High"
- Higher levels of THC increase the chance of a negative reaction.
- A negative reaction may include panic, delusions, severe paranoia, extreme confusion, increased heart rate and nausea/vomiting.
- In 2010, marijuana was involved in more emergency room visits than alcohol, cocaine, heroin or amphetamines. Rates continue to increase. If you decide to use, be aware of dosage and potency. Edibles cause a more intense and prolonged high.
- If you or a friend experiences a negative reaction, remember the feeling is temporary. Try to lay or sit down, shut your eyes and do your best to relax. If you or someone else has mixed marijuana with other substances, or you notice signs of a medical emergency, call 911.
- Cannabinoid Hyperemesis is a new clinical condition characterized by vomiting, pain and the desire to take a hot shower.
- It usually occurs in chronic users.
- Talk to your provider if you are concerned about cannabinoid hypermesis
- Smoking marijuana can negatively impact respiratory health and long-term health outcomes.
- Secondhand marijuana smoke impairs arteries longer than secondhand tobacco smoke, and research is still being conducted to better understand the impacts of secondhand smoke.
- Special Concerns for College Students
- Studies have shown that college students who use marijuana experience negative academic outcomes including a lower GPA and a longer time to graduation.
Students who choose to use marijuana should be familiar with casual use vs. high risk use to best avoid negative outcomes.
- Infrequent use (less than weekly)
- Experimental use - generally in social settings
- Minimal Consequences with use - does not impact social life or academics
High Risk Use
- Frequent use (more than once a week)
- Use negatively impacts academics
- Use for anxiety or emotional struggles
- Use outside of a social setting (alone)
- Use to help sleep (restlessness or inability to sleep usually caused by use)
If you believe you or a friend can use support, see the Get Support tab below.
- Medicinal Use
- There are very few randomized control trials on medicinal marijuana use, but we do know it is effective for four conditions:
- End of life pain/cancer pain
- Chemotherapy induced nausea and vomiting
- Multiple Sclerosis
If you do not have one of the conditions listed above, you should not use marijuana to self-medicate. See the dependence tab above for more information.
There is not enough conclusive research to date, but some sources suggest marijuana might be effective for Alzeimer's disease, Lou Gehrig's Disease, Crohn's disease, Hepatitus C, and HIV.
The FDA has approved two medications that have controlled dosages, are purchased and picked up at a pharmacy like other prescriptions, are quality controlled and have prescribing information based on research.
"The FDA requires carefully conducted clinical trials in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication. To date, researchers have not conducted a sufficient number of large-scale clinical trials to show that the benefits of the marijuana plant (as opposed ot its cannabinoid ingredients) outweigh its risks in patients it is meant to treat." -US Department of Justice
- Get Support
- If you would like to talk to someone about your marijuana use, or you are concerned about a friend, call (530) 752-6334 or go to Health-e-messaging and log in to schedule an appointment with the Alcohol, Tobacco and Other Drug Intervention Services Coordinator. There is no charge for the confidential appointment.