Marijuana (Cannabis)
Cannabis, also called marijuana or weed, refers to any item (plant/flower, oil, hash, edibles etc) that contains THC (delta-9 tetrahydrocannabinol), the psychoactive compound found in the marijuana indica and marijuana sativa plant. The psychoactive effect is what is commonly called a “high.” In 2023, Maryland legalized the sale use and possession of recreational cannabis for people 21+, but cannabis is still illegal at the federal level. Since Hopkins receives federal money, the university abides by federal law and prohibits the use and possession of cannabis in university buildings, on university property, and at university events by anyone regardless of age.
The Effects of THC
THC is one of over 100 compounds in the marijuana plant that is further processed in other methods of consumption. People may take cannabis for certain effects from a certain strain, but in general THC causes altered senses, distorted sense of time, change in mood, impaired body movement, and difficulty thinking and problem solving. Some motivators to use THC are to help cope with stress, anxiety, and depression, to reduce insomnia, and to inspire creativity.
THC vs CBD
CBD (cannabidiol) is one of the 113 identified compounds in the marijuana plant. Both THC and CBD have some therapeutic effects for anxiety and depression, nausea from cancer treatments, and insomnia. The difference is that CBD has no psychoactive effect and has been used primarily in addressing medical and mental health conditions just like THC and additionally for seizures, chronic pain, and inflammation. Because THC causes the psychoactive effect, people seek out strains or products with higher and higher levels. These are often represented in a percentage of THC, a milligram of THC per dose or a ratio of THC to CBD.
However, more may not be better. The strength of THC has increased through cross-breeding different plants and additionally through other products like oils and waxes that can have up to 90% THC. This increased strength has also been linked to more harms.
The most immediate harms are “green outs,” where a person can experience paranoia, anxiety, nausea, vomiting, rapid heart rate, panic attacks, and psychosis.
Medium-term harms can include poor quality of sleep (people may fall asleep faster but they may have shallower and less restful sleep) and worsening mental health symptoms, particularly anxiety.
Long term harms are dependency, addiction, psychosis, extreme cases-schizophrenia, and cannabis hyperemesis, where a long-term/habitual user can experience random bouts of vomiting, belly pain, changes in diet, and dehydration. As THC tolerance builds, people take more to have the same effect, and while the high might be diminished, the adverse effects from smoking more do not.
Some studies have suggested that CBD can help moderate the effects of a green out; other studies have suggested that it can make it worse. It is easier to study cannabis now than it was in the past, but there is still much we don’t know about cannabis, CBD, THC, and the effect of other cannabinoids on each other or on our bodies.
If you choose to use cannabis, below are some harm-reduction tips.
1. Understand the difference between ingesting and inhaling. Consuming edibles or smoking cannabis flower are two typical ways to use cannabis. If you chose to use cannabis, be mindful of the different ways that each method can affect the body.
2. Go low and slow. Whether you are new to or familiar with cannabis edibles, or if you are a seasoned smoker of cannabis, using edibles is a difference experience.
If you choose to smoke cannabis, choose a strain on the lower end of the spectrum. Especially in new environments, tolerance can decrease. If you come to Hopkins from another state and choose to continue to use cannabis, consider going low and slow before using the regular amount you would use. Wait 30-90 minutes after your first dose to see how you do before taking another one.
3. Talk to your budtender. Budtenders are sales associates/workers at a dispensary. They are knowledgeable about cannabis and its effects. Be honest about your previous experience with cannabis or lack thereof, ask about what you are looking for out of the experience, and what to do to reduce the risks. There is always a risk of harm when using cannabis but being honest may help decrease the risk with more information to make an informed decision.
4. Use cannabis in a safe place around safe people. The environment can have an impact on your experience, especially in the case of a green out. If you are a new user, consider using cannabis in a safe, familiar place and around people who are experienced or sober who can help you should anything go wrong. Avoid taking cannabis from others as you aren’t sure about dose or strength. You cannot die from a cannabis overdose but it can be an uncomfortable and stressful situation. If something goes wrong, and a person can’t be comforted or calmed, the amnesty policy may also apply.
5. Consider a T-break. A T-break or tolerance break is an intentional pause in using cannabis. It can be done for many reasons, like a busier schedule, wanting to save money, increasingly negative experiences, or cannabis taking a bigger role in someone’s life than they intended. When you take a T-break, it has to be intentional and done carefully. Stopping cannabis after constant use can bring on withdrawal systems and sudden changes that may be uncomfortable, but they are your body’s way of adjusting. They go away after some time, but you can be prepared for the physical and mental symptoms you may experience.
6. Be careful of what you eat before during and after you take an edible. If you choose to use cannabis and take an edible be mindful of what you eat. Some studies indicate that taking an edible on an empty stomach can increase how fast it takes effect.
Resources
If you would like to learn more about your cannabis use, you can use eCHECKUP TO GO Cannabis. This is a free and anonymous online module to receive personalized feedback.
If you have taken too much cannabis and are having negative reactions, call or have someone call the Maryland Poison Center at 800-222-1222.