Ground zero for drug overdoses in downtown Vancouver is St. Paul’s Hospital. So when Dr. Joseph Finkler, one of the ER doctors, says not to worry if you’ve gotten too high on cannabis, he’s speaking from experience.
“I’ve done a lot of research on the subject,” he says. “It helps to keep in mind that there’s a fair body of research showing that no one has ever fatally overdosed from cannabis.”
The fact probably won’t be helpful when you’re in the middle of a green out, Finkler acknowledges. Most of the people who show up at his ER from cannabis are new and less experienced users consuming edibles. Experienced users typically know what they’re getting into. And when inhaling cannabis, THC, the psychoactive component, hits the blood stream immediately. With edibles it can take up to two hours. Often newer users get impatient and take another dose, thinking the first didn’t work or wasn’t strong enough. Then when the body does process the THC it all enters the blood stream at the same time, Finkler says.
“Newbies tend to underestimate the time it takes for the drug to work and the effect it’s going to have on them,” he says. “They’re not used to feeling so weird, so quickly.”
The funny feeling triggers the body’s fight or flight response. Often the heart beat quickens, breathing gets rapid, and the mouth goes dry. “It’s basically a drug induced panic attack,” he says. “Some people have a sense of doom or feel think they’re having a heart attack. It can feel really unbearable.”
At that point, Finkler’s advice is to ask for help and find a quiet, safe feeling space. Try taking long, slow breaths in and out. “It’s always better to ride it out with a good friend,” he says. “But if you can’t slow your breathing or calm yourself down, it’s time to come in and get some help.”
At the hospital they’ll probably sit the patient down in a quiet corner and administer a mild sedative, like Ativan, which helps take the edge off. And then they wait for the high to wear off. That typically takes four to six hours.
“The good news is I’ve never seen any serious complications from this drug,” Finkler says.
Regardless, it’s obviously better to avoid greening out or getting too high in the first place. The best way to do that is to follow the golden rule of cannabis consumption: go low, go slow. Start with the smallest recommended dose, or a half dose for brand new users, and then wait at least two hours before taking more. Finkler suggest being especially cautious of home made cannabis treats. It’s hard to know the THC concentration and there are interactions with other plant oils that can compound the effect of THC on the body
“It’s always best to just be cautious,” Finkler says. “I’ve never had someone in my ER complaining about not being high enough.”