..."In general, people think, 'Oh, I don't have to worry about marijuana. It's a safe drug,' " says Nora Volkow, director of the National Institute on Drug Abuse. "The notion that it is completely safe drug is incorrect when you start to address the consequences of this very high content of 9THC."
Pot's paradoxical effects
THC can have opposite effects on our bodies at high and low doses, Volkow says. Take anxiety levels, for example.
"When someone takes marijuana at a low [THC] content to relax and to stone out, actually, it decreases your anxiety," she says. But high concentrations can cause panic attacks, and if someone consumes high-enough levels of THC, "you become full-blown psychotic and paranoid."
Weed can have a similar paradoxical effect on the vascular system. Volkow says: "If you take low-content THC it will increase your blood flow, but high content [THC] can produce massive vasoconstriction, it decreases the flow through the vessels."
And at low concentrations, THC can be used to treat nausea in cancer patients undergoing chemotherapy. But Volkow says that "patients that consume high content THC chronically came to the emergency department with a syndrome where they couldn't stop vomiting and with intense abdominal pain."
It's a condition called cannabinoid hyperemesis syndrome.
"The typical patient uses [inhales] about 10 times per day ... and they come in with really difficult to treat nausea and vomiting," says Andrew Monte, an associate professor of emergency medicine and medical toxicology at the University of Colorado's school of medicine. "Some people have died from this ... syndrome, so that is concerning."
Scientists don't know exactly how high levels of THC can trigger the syndrome, but the only known treatment is stopping cannabis use.
...Most people show up at his emergency department because of "intoxication" from too much pot, either straight or mixed with other drugs, Monte says. The bulk of these cases are due to inhaled cannabis, though edibles are associated with more psychiatric visits.
"We're seeing an increase in psychosis and hallucinations, as well as anxiety and even depression and suicidality," Monte says.
He thinks the increased potency of marijuana plays a role in all these cases. "Whenever you have a higher dose of one of these types of drugs, the patient is at a higher risk of having an adverse drug event. If the concentration is so much higher ... it's much easier to overshoot the low-level high that they're looking for."
...Adolescent and young adults who use recreationally are especially susceptible because their brains are still developing and are sensitive to drugs in general, says Gruber of the MIND program. In a recent review of existing studies, she found that marijuana use among adolescents affects cognition — especially memory and executive functions, which determine mental flexibility and ability to change our behavior.
Medical marijuana users can face unexpected and unwelcome effects from potent weed. "It's very important for people to understand that they may not get the response they anticipated," Gruber notes.
Studies done on the medical benefits of pot usually involve very low doses of THC, says Monte, who adds that those doses "are far lower than what people are getting in a dispensary right now."
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