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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 Overdose

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.  

Edible Overdose

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.

Smoking Marijuana

Medical researchers are constantly learning more about cannabis as it becomes more readily available for study. Even as arguably the most commonly used illegal drug, the effects of smoking marijuana are not well known.

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When Did People Start Smoking Marijuana?

It’s unclear how long humans have used cannabis as a drug, but archaeologists have discovered tools used to burn psychoactive marijuana dating back 2,500 years in China. The Chinese Emperor Shen Nung created the first written record of cannabis use in the year 2727 B.C., almost 5,000 years ago. Because of the speed of its growth and its use as hemp for ropes and cloths, cannabis saw use throughout many ancient societies lasting through to the present day. Even though we’ve been smoking marijuana for thousands of years, its effects on our bodies are still being discovered. As it becomes more legal and more available, knowing those effects has become more important.

Effects of Smoking Marijuana on the Lungs

When smoked, marijuana spends most of its time in the lungs. Because they are both most-commonly smoked, marijuana and tobacco are often compared. Cigarettes are thought to cause more bodily harm and than smoking marijuana, but that isn’t the case. While cigarettes cause many more deaths each year, smoking marijuana is actually more damaging.

Smoking marijuana deposits 4 times as much tar in the lungs as cigarettes, due in part to the inhalation technique. The common method of smoking marijuana includes holding the smoke in the lungs for a much longer duration than other smoked substances. This continued exposure allows more of the molecules in the smoke to settle in the respiratory system, but does it create long term issues for the lungs?

Ultimately, lungs are most comfortable when inhaling air. When you burn anything and inhale the smoke, it creates an inflammatory response in the airways and lungs. Smoking marijuana can cause coughing, wheezing, and chest tightness. People who self-identify as heavy users report more frequent symptoms of bronchitis and commonly show increased airway resistance. The Guardian reported that smoking a single marijuana joint “may cause as much damage to the lungs as five change-smoked cigarettes.”

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Risk of Lung Cancer

One of the most pressing questions revolves around potential lung cancer associated with smoking marijuana. Marijuana smoke contains carcinogens (cancer-causing chemicals) but, as of yet, no positive link can be established between smoking marijuana and a significant increase in lung cancer occurrence. Other research demonstrates that THC and CBD, the two main active ingredients in marijuana, may both possess anti-tumor effects. Scientists theorize that this ability could be a reason behind the relative lack of lung cancer incidence in even heavy smokers.

Research into marijuana’s effect on the lungs proves challenging for a number of reasons. In the US, marijuana is still classified as a Schedule I drug by the federal government, which places barriers between researchers and conducting research. Once research is green-lit, several factors can cloud results, especially in regard to the lungs. Many people who report significant long-term use of marijuana also report use of cigarettes, which have been proven to cause cancer. These kinds of factors can distort the results of a study to the point where researchers cannot comfortably draw conclusions.

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Effects of Smoking Marijuana on the Mouth

Research on the effects cannabis causes in oral health often runs into the same issues as lung research. Identifying one substance and its sole effects on the mouth has proven to be a difficult task. Evidence tentatively shows a link between smoking marijuana and poor dental health, but many people who smoke marijuana also smoke nicotine products, drink alcohol, or take poor care of their teeth in general.

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Risk of Testicular Cancer

The data may be unclear when it comes to lung cancer, but new research is starting to reveal a possible link between heavy cannabis use and testicular cancer. A study including over 40,000 Swedish men has found that in the 50 years since its started, those men who report heavy use of marijuana were also more likely to report incidences of testicular cancer.

Scientists are unsure as to what would cause this reaction in the body. They hypothesize that the way THC and CBD bind to certain cells in the testes can trick your body into processes that lead to the growth of tumor cells. More research needs to be done in order to discover if this link exists or not, but they suggest moderation when it comes to using marijuana.

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Smoking Marijuana During Pregnancy

More research needs to be done to fully explore the relationship between marijuana and pregnancy, but the information available generally points in one direction. Most information suggests that use of marijuana during pregnancy can have negative effects on the baby at birth and perhaps lasting through childhood.

If an expectant mother regularly uses marijuana when pregnant there is a higher risk of low weight and length for the newborn.

Research also shows that drug or alcohol use during pregnancy can double or close to triple the risk of stillbirth. As a child ages, less research exists to demonstrate any links between marijuana and possible complications. What little research we do have highlights an increased rates of poor memory and poor attention skills in children who were exposed to marijuana in the womb.

Smoking marijuana is one of the oldest drug habits in human history, but do we know what it does to our body? Legalization has led to more research.