Risks & Harm Reduction

While cannabis (marihuana or marijuana) is an effective medicine for many ailments, it is not a panacea and should be used with care.

Cannabis affects everyone differently just like the foods we eat and the medicines we take.  One of the greatest challenges of cannabis becoming accepted and utilized as a medicine in its “crude” format is the large number of medically active ingredients that occur in varying levels – even in the same varietal.  This makes it difficult for the medical community to “prescribe” within a “standardized” way.  For many in the medical community they have a problem with the patient being able to titrate their own dosing.

Many people in the medical community find it difficult to believe that it can be safe to smoke a medicine.  When in fact, it is a fairly reliable way to deliver medicine quickly into the lungs and then into the blood and the brain.  Inhalation is especially effective and quick acting when the patient inhales using a vaporizer which delivers the active ingredients without the irritants of the smoke.  Doctors who do prescribe cannabis say that the immediate relief provided by inhaled cannabis and the patient’s ability to safely titrate their own dose are benefits of cannabis.

Marijuana Risks

The following are a list of the most common risks (but not all) associated with cannabis consumption.

Most Common Marijuana Risks	Harm Reduction Option
Chronic Bronchitis or lung irritation	Regular smokers sometimes have a nagging cough. Vaporizers, edibles or a tincture will help mitigate the harm smoke may cause. Draw the vapor into the body for a 5 count and release at the end of the breath.  Holding smoke in the lungs for a long time (10-20 seconds) may contribute to trapping tar in the lungs and creating irritation. This also gives the smoker a false sense of being high due to the lightheadedness caused by holding the breath.  This is bad for the body and the brain as it is restricting oxygen flow.
Tachacardia – increased heart rate	Interviews with smokers and science indicates that the higher the THC level the higher likelihood one may experience heart palpitations. If you are in a state where you have access to chemical analysis at the site of purchase – buy cannabis that has more moderate THC level or balance of THC and CBD. Know that the heart palpitations will stop, most likely within the hour.
Adverse Mood Reactions – panic, depression, dysphoria, depersonalization, delusions, illusions, and hallucinations	17 % of regular users report having experienced some type of adverse mood reaction, typically early in their smoking experience (Janet E. Joy, 1999).  Such reactions are more common in beginner smokers. Consider waiting 5-10 minutes before taking another drag until you know how the herb is going to effect you. Please note that sometimes there are delayed reactions commonly referred to as a creeping high.
Sedation	Many people report feeling very tired or sleepy after consuming cannabis.  If sedation is not what you want or need, make sure you are using a Cannabis sativa.  Cannabis indica varieties generally result in sedation.
Irritated throat or lungs from heat	Traditionally non-smokers may find that smoking cannabis through anything other than a vaporizer will irritate their lungs or leave their throat feeling burned.  Vaporizers reduce irritation and prevent carbon monoxide from entering the lungs.  If you are using a pipe, pack it tightly.  Compacting the herb in the bowl of the pipe reduces irritation for some.
Risk of Addiction	The risk of cannabis addiction is small if at all.  In fact the majority of the most respected cannabis scientists will argue that cannabis addiction does not exist and that addiction is often confused with habituation. A widely reported 1999 Institute of Medicine report states the probability of becoming dependent on various abuseable substances is as follows: cannabis 9%, alcohol 15%, cocaine 17%, opiates 23%, nicotine 32%. In a 2002 review by Anthony (C.J), cannabis ranked eleventh in dependence potential after heroin, cocaine, tobacco, methadone, barbiturates, alcohol, benzodiazepines, amphetamines, buprenorphine, and ketamine (Holland, 2010, p. 138).”  After a deeper review of these numbers, we find that the 9% cannabis addiction rate figure is contrived by old data supplied by the National Institute on Drug Abuse.  Read Dr. Sunil Aggarwal’s explanation about why the figure is overblown and based on bad science. For those who do find cannabis habit forming, any withdrawal-like symptoms are mild (restlessness, poor sleep, irritability) and subside within a couple of days.  However, this is VERY rare.

Contraindications – Who Should NOT Use Cannabis

• Healthy Teens – Research in this area is conflicting.  While cannabis consumption is far safer than many things teens will experiment with, we encourage parents to talk to their children about cannabis use explaining both risks and benefits and to talk about the difference between use and abuse.  There is some evidence that teens who consume cannabis before the age of 16 are susceptible to changes in the brain.  There is an equal amount of data that refutes that or that says those effects are not long term.  More research is needed. Our objection to teen use largely boils down to maturity and their ability to use it wisely, as most who do so are using cannabis as a recreational drug.  There are however, many students who will argue that cannabis helps them manage their attention deficit disorder and helps them be more creative.  In the case of sick children and teens, cannabis can provide incredible symptomatic relief and in some cases can alter the disease process.  Promising areas for treating sick children and teens with cannabis include treatment of Epilepsy, cancer and autism.

• Anyone wishing to conceive a child.  While there is little scientific evidence on this subject, it probably is wise to err on the side of caution with this one.  Preliminary research raises the concern that due to the high anti-angiogenic (prevents growth of new blood vessels) properties of cannabis, it could prevent the egg’s adhesion to the uterine wall or lead to a miscarriage.

• Patients with infection that requires a strong Th1 immune response such as Legionella should be very careful with cannabis

• Cannabinoids should also be used cautiously (especially in teens) if there is a family history of psychosis or if there user is at a high risk of developing psychosis

• Elderly people should be mindful that cannabis may cause dizziness in some or could affect their balance.  For this reason they should take the necessary precautions to ensure their safety when using cannabis.

Disclaimer: This information is compiled from a large body of international medical research papers.  While we have taken every effort to include as many risks as possible, we do NOT represent that this list is complete and bear no responsibility for how this information is used or interpreted.  Please do additional reading that is specific to your own health concerns.  Every person is different therefore reacting differently to all inputs.  Seek the advice and counsel of your physician first and foremost.

The possession of Cannabis is a violation of Federal and some State laws.  Visit the NORML.org site for State specific information or 420dude.com for other legal information.