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Smoke or edible? New research suggests best way to consume cannabis

Pink lemonade flavoured hard candy edible made with THC from the marijuana plant for medicinal use Photo by Shannon Laura/Shutterstock

Do you prefer to smoke cannabis or eat it? The debate rages on as to which one gives you the better high, but when you’re deciding which way to consume cannabis, it’s also worth considering the latest research on emergency room visits. When scientists analyzed nearly 10,000 visits to UCHealth University of Colorado Hospital following legalization in the state, they found cannabis edibles were responsible for more emergency room visits and more severe complications than inhaled cannabis.

“When controlled for product availability via product sales data, edible cannabis products lead to approximately 30 times more ED visits per milligram of tetrahydrocannabinol than inhaled cannabis,” says study author Andrew A. Monte.

Of the 9,973 emergency room visits between 2012 and 2016, Monte’s analysis found 25.7 per cent were at least partially related to cannabis. Of the 2,567 marijuana-linked visits, nine per cent, or 238 cases, involved edibles, even though ingestible products made up only 0.3 per cent of total cannabis sales by weight.

The mismatched ratio is not a surprise to emergency doctors in Canada.

The human body processes THC in the stomach all at once,” says Dr. Joseph Finkler, an ER doctor in Vancouver. “You go from nothing to everything. Newbies, especially, are often not used to feeling so weird so quickly.”

In the study, nearly half of emergency room patients who had consumed edibles complained of intoxication, while less than a third of smokers said the same. Feeling too high can trigger a fight or flight response. The heart beat speeds up, breathing gets rapid, and the mouth goes dry.

“A lot of people think they’re having a heart attack,” Finkler says. “It’s basically a drug-induced panic attack.”

The study found 18 per cent of edible users complained of short-term psychiatric conditions like anxiety and psychosis, compared to just 11 per cent of smokers. Another eight per cent of edible users complained of heart conditions like irregular heartbeat and even heart attack, compared to three per cent of smokers.

Smoking has its own issues, however. According to the report, inhaling cannabis is twice as likely to lead to gastrointestinal issues: 32 per cent of smokers reported vomiting compared to 15 per cent of edible consumers.

Monte is unsure why reactions differ across the varying ways of using cannabis. It’s important to note that the study only shows correlation, not that either smokable or edible products actually caused these reactions. Finkler says the take-home advice is to always go low and slow: start with a small dose and wait at least an hour before taking more.

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