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Safe Use of Cannabis

by Tod H. Mikuriya, M.D.

Cannabis, ingested safely, is one of the most useful of medicines for a variety of conditions. These include: pain, spasticity, anxiety, depression, headache, nausea, anorexia, epilepsy, asthma, dysmenorrhea, premenstrual tension, withdrawal from other drugs, and glaucoma.

Ignorantly or imprudently used, cannabis can be harmful.

Physical effects.

Irritation of the throat and lungs is one of the most obvious adverse effects to the marijuana smoker as is the inevitable cough upon inhaling.

The cough is the body's reaction to the irritation of the numerous constituents of the smoke. Prolonged and repeated exposure to these irritants can lower resistance to and aggravate infections from viruses, bacteria, or fungi.

The lesser the coughing, the safer the smoke. The fewer puffs the better.

For these reasons, and to reduce harm to the user; better a water pipe of the more potent flower tops of cannabis than a joint of leaves.

Even better: Vaporization.

Delta 1,9 tetrahydrocannabinol (THC), psychoactive ingredient of cannabis, is a resin that vaporizes at 155 to 157 degrees centigrade (311-318 degrees Fahrenheit) which is lower than the combustion point of cellulose: Fahrenheit 451. Any way to decrease exposure of the throat and lungs to products of burning reduces harm to the cannabis user.

Dosage and Route of Administration

Starting with a small amount and gradually increasing the dose is the key to avoiding unwanted mental side effects. This is called titration- self-titration if adjusted by the user.

Mental Effects

Impatience and overdosing with oral cannabis is the most frequent mention of the drug in medical literature of the 1800's. Oral cannabis overdoseage is much more intense and longer lasting than from the inhaled route. Because of the two to three hours before onset of effects, a common mistake of the inexperienced is to repeat the oral dose with the consequence of overdosing.


Should you take too much cannabis you may expect the mental effects of time distortion, racing thoughts, disorientation, speeding heart rate, dry mouth, and reddened eyes. The greater the dose, the greater intensity and longer these stimulant effects will last before sinking into a deep sleep. No lasting harm will result but the experience will not be forgotten.

Other Adverse Effects

Other adverse mental effects are a prolonged dullness after use or paranoia and a fear of loss of control. Cannabis, an effective relaxant, can cause an alienation or detachment. The price of relief of tension may be a dulling or suppression of feelings. Insensitivity to feelings of others or situations may result.

Set and Setting

The result of the drug is a combination of set (expectations), setting, personality, and the drug.

Best case: Enjoying a puff or two sitting at home with a friend at the end of the day.

Worst case: Taking a puff driving down the freeway, then looking sideways into the eyes of a cop.

Personality and Individual Difference

Individuals with personalities that are prone to substance abuse, allergy, sensitivity, or adverse reactions to other medicines should exert greater caution and try the drug only if absolutely necessary.

Dependence & Withdrawal

Because cannabis is such an effective medicine for the relief of many uncomfortable conditions, using the drug on a continuing basis is not uncommon. One must decide issues of personal risks/benefits of continuing using cannabis.

Withdrawal from chronic cannabis use produces several nights of more intense dreaming and possibly some slightly increased nervousness during the day. Some increase in exercise, if possible, and/or small amounts of other sedatives will ease the transition from cannabis dependence.

Cannabis- a Tool

Cannabis is a tool like other drugs; useful for many people if informed of its effects. with realistic expectations, responsibility and common sense. There is a range of appropriate use: from total avoidance to using cannabis several times a day.

Because of current uncertainty of supply from it's illicit status there can be great variability in strength.

Draft 5 11/24/93


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