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Medical cannabis and overdose
Cannabis (also known as marijuana) has been legally available for prescription in the UK since 1st November 2018 and increasing numbers of people have been prescribed medical cannabis to help them manage a variety of conditions such as chronic pain and anxiety.
If you are a medical cannabis patient, it is important to follow your doctor's guidance around dosing. Exceeding this could put you at risk of an overdose.
The good news is that overdose symptoms are usually temporary and manageable. Read on to find out about the causes of cannabis overdose, the signs and side-effects of overdose and how to minimise your risk of experiencing an overdose.
How much cannabis (marijuana) causes overdose?
The amount of cannabis needed to cause signs of overdose will vary from person to person. More experienced users of cannabis will develop a degree of tolerance and will also get to know their own threshold. Newer users of cannabis may not be aware of the levels they can tolerate and it can be easy to take too much by mistake if you are not introducing your medication slowly and starting with a low dose. “Start low and go slow” is a useful mantra to follow if you are new to medical cannabis particularly as the different forms of medical cannabis vary in the time they need to take effect.
The amount of cannabis you need to consume to develop symptoms of overdose is dependent on not only how sensitive a person is to cannabis but also the way that it is administered. Some people may react differently to various forms or preparations of cannabis.
For example, when you inhale cannabis, the cannabis enters your lungs and chemicals are released into your bloodstream and brain. This process happens quickly so that you start to feel the effects after a few seconds or minutes with the peak effect occurring within approximately 30 minutes.
On the other hand, if you take your medication as an edible, the cannabis enters the stomach, is processed by the liver before releasing the chemicals into your bloodstream and finally the brain. This process takes longer so that you start to feel effects between 30 minutes to one hour after eating your edible. The peak effect will be experienced after about 4 hours.
This is putting it quite simply too, there are many different types of inhalable and edible cannabis, creating many more factors around strength and form that should be considered. Again, it is always best to start low and go slow!
It is also important to remember to pace yourself. Your doctor may advise you to dose when required or when symptoms return. However, you should always wait to see how the first dose will affect you before taking another.
Cannabis overdose can cause both physical and psychological symptoms
Taking too much cannabis can cause both physical and psychological symptoms which can make you feel unwell and be frightening, especially if it is the first time you’ve experienced them.
The physical symptoms can include a “whitey” or “white out” when your face becomes pale and you feel dizzy or sick. You may also vomit and, in rare cases, temporarily become unconscious or ‘faint’.
Other physical symptoms include shakes or tremors. Your mouth may also feel dry as saliva production can be reduced. (This is also a fairly common side effect of cannabis use, and should not be a cause for concern without any of the accompanying aforementioned symptoms.)
Your heart rate can increase and your blood pressure may also go up. These symptoms may also present a risk to people who have an underlying or undiagnosed heart condition.
Psychological symptoms include feeling anxious and disorientated so that you cannot think clearly. You may experience symptoms that are similar to a panic or anxiety attack. Some people may experience paranoia or psychotic symptoms such as hallucinations or delusions. Studies have shown that those who have a history of anxiety or depression are more at risk of developing paranoia, however, this risk can be mitigated when cannabis is prescribed by a doctor and dosage is monitored.
What should you do if you experience symptoms of overdose?
Usually, the symptoms of overdose are temporary and may last anything from half an hour to a couple of hours and you can manage them yourself effectively.
If you do experience symptoms of overdose, try to remain calm and move somewhere that you can be comfortable and safe. Make sure that you are well hydrated by having a glass of water. If possible, ask someone you trust to stay with you in case you need help or support.
Some people feel that sleep can relieve many of the overdose symptoms, so it may be worth considering resting if you are in an appropriate position to do so.
If you are worried, your symptoms become worse, you are struggling to breathe or you have chest pains then seek urgent medical attention.
How can you reduce the risk of overdose?
The “low and slow” method of introducing your medical cannabis is important to manage any side-effects and to reduce the risk of overdose. It means that you can get to know your own body and your individual response to your treatment. This allows you to fine tune the dose so that you can experience maximum symptom relief while minimising risk of overdose.
If you have any concerns about side-effects or symptoms of overdose you can discuss these with your specialist doctor so that your treatment can be adjusted as necessary.
Can you die from a cannabis overdose?
Cannabis has been described as a relatively safe drug which has not been associated with fatal overdose. It has been suggested that a lethal dose would be more than 15,000 mg of THC or about 750 times that of a dose which would cause intoxication.
In addition, cannabis does not appear to affect the part of the brain associated with breathing. This means that, unlike opioid overdose, cannabis does not appear to cause respiratory depression (ineffective breathing) which may be fatal.
Summary
All medications have side-effects and individuals react in different ways to different therapies.
When starting to take medical cannabis or changing to a different form or strain a “start low and go slow” approach is recommended. Always monitor how you feel and raise any concerns with your Alternaleaf specialist doctor so that you can work together to adjust your treatment to suit you and minimise any side-effects.