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Why edibles are the best way to consume cannabis right now, according to a medical marijuana doctor

Legal cannabis sales have spiked during the coronavirus pandemic.

Since COVID-19 is a respiratory illness that affects the lungs, experts are concerned that people who inhale cannabis through a vape, joint, pipe, or bong could be at a heightened risk for severe symptoms like pneumonia, as Insider previously reported.

But for those who can’t part with their cannabis habit because of its ability to relieve anxiety, insomnia, or chronic pain, consuming edible products rather inhaling the substance is the safest way to use cannabis right now, Dr. Rachna Patel, a medical marijuana physician, told Insider.

“It can be assumed to be safe to consume cannabis products in the form of edibles, in the form of tinctures, in the form topicals, given the risk and exposure that we have currently to COVID-19,” Patel said, because there is no evidence that suggests cannabis itself messes with a person’s immune or respiratory system.

Rather, it’s combustible and aerosolized cannabis people should worry about, because those two methods introduce carcinogens to the lungs.

Data suggests that people with underlying lung conditions, such as smokers, have a higher risk of COVID-19

Although research specific to cannabis use and COVID-19 risk is non-existent, lung health experts say they don’t need coronavirus-specific data to warn people that marijuana vapes, e-cigarettes, and other forms of smoking aren’t a good idea right now.

“From China and Italy, we see people who developed COVID-19 and had underlying lung disease, [they] have more complications and die more often,” Dr. Barry J. Make, a pulmonologist at National Jewish Health, previously told Insider. “So this is the perfect time to stop smoking.”

Preliminary CDC data has found that chronic lung diseases including asthma, chronic obstructive pulmonary disease (COPD), and emphysema, are common underlying conditions in patients hospitalized with COVID-19 in the US.

These types of lung-related pre-existing conditions are common among longtime smokers, Make said.

But food and drinks that are infused with cannabis, and tinctures, which are concentrated liquid extracts you dispense on your tongue, don’t produce smoke or aerosols and therefore remove the risk of lung disease.

If you want anxiety relief, look for a CBD-rich edible or tincture

If a person decides to replace their smoking or vaping with edible cannabis, Patel said that different concentrations of THC and CBD, the two main compounds in marijuana, have different benefits.

She said that strains with high concentrations of CBD, which doesn’t cause psychoactive effects, and low in psychoactive THC, offer relief from anxiety.

“You want to use a high-CBD product as opposed to a high-THC product because high amounts of THC can induce anxiety to the point where someone can feel paranoid,” Patel said.

For anxiety relief, Patel said choosing hemp-derived products, which come from hemp plants that are naturally higher in CBD than THC, are a better option than marijuana-derived tinctures and edibles that tend to have more THC than CBD.

Edibles higher in THC than CBD are best for people who have loss of appetite, nausea, or severe nerve pain, Patel said.

Edibles are better than tinctures for insomnia

For people who struggle with insomnia, the form of cannabis used is an important factor.

“For those who have trouble staying asleep, edibles are preferred over the sublingual use of tinctures because when you ingest some form of cannabis . it lasts longer in your system, like six to eight hours,” Patel said.

Tinctures, on the other hand, wear off after four to six hours.

When deciding your dosage, start small

Edible cannabis products come in a variety of forms and concentrations, and people react to dosages differently, so finding the right amount can be difficult.

According to Patel, edible novices should start with about 4.25 milligrams of CBD if they have mild levels of anxiety, and use even less if they need an edible high in THC.

“You want to be even more careful [with THC] because now you’re running the risk of the psychoactive effects and other side effects, physiological side effects, which are far more uncomfortable than the side effects of CBD,” Patel said.

Those side effects include anxiety, paranoia, heart palpitations, dizziness, hallucinations, nausea, and vomiting.

Patel said the proper dose depends on a person’s medical history, their reason for using cannabis, and their previous experience with the substance. People who have had gastric bypass surgery, for example, need to use a sublingual form of cannabis like a tincture because they won’t feel the effects of other edibles.

Since dosing is so individualized, starting with a small amount, seeing how it makes you feel, and adjusting from there is the best way to gauge what you need.

Patel said if you wake up feeling groggy or lethargic, feeling fatigued, or have diarrhea or headaches after using a cannabis edible, it means you should decrease your dose.

Combustible and aerosolized cannabis methods like vapes, joints, and pipes can harm the lungs, so eating the substance is a safer option.

What’s the Safest Way to Consume Cannabis Right Now?

Even in the face of the new coronavirus, people need their weed. In fact, cannabis dispensaries are considered an “essential” business in several states and are still selling cannabis, often prioritizing medical cannabis patients.

But, considering that both inhaling cannabis and the new coronavirus can take a toll on your lungs, you might be wondering whether it’s safe to smoke weed right now. The truth is that everyone is different and, with so little research, it’s hard to know what might be right or wrong in any individual case. So SELF spoke to a few experts to learn as much as we could.

Smoking anything—including cannabis—should not be your first choice right now.

The first thing to know is that “we don’t have a lot of data,” Kathryn Melamed, M.D., pulmonary and critical care physician at Ronald Reagan UCLA Medical Center, tells SELF. “This is all very new and we’re learning as we go.”

So we don’t have any research specifically on how the new coronavirus might affect those who regularly smoke cannabis. But we can get some clues from early research on those who developed COVID-19 and smoked cigarettes, Jordan Tishler, M.D., medical cannabis expert at InhaleMD in Boston, tells SELF.

For instance, in a meta-analysis published last month in the Archives of Academic Emergency Medicine, researchers pooled data from previous studies that contained information on nearly 77,000 patients. They found that smoking cigarettes was one of a few underlying health conditions found frequently in coronavirus patients along with high blood pressure, heart disease, chronic obstructive pulmonary disorder, diabetes, and kidney disease. And both the CDC and WHO list smokers as being high-risk for severe symptoms from a COVID-19 infection.

That’s not totally surprising because the effects of smoking on the lungs are well-established. We know that smoking does damage to the elastic tissues of the lungs, which affects their ability to actually ventilate and allow you to breathe, Dr. Melamed explains. It also causes damage to the cilia, the little hairlike projections that line and help clean the lungs, which makes it harder for them to get rid of particles you breathe in normally that can cause further issues.

In the long-term, that kind of damage leads to COPD and related issues, like emphysema and chronic bronchitis, and also predisposes you to developing infections like pneumonia, Dr. Melamed says.

And even in the short-term, “you could imagine that if smoking cigarettes or marijuana was leading to any sort of lung damage or predisposing you to lung injury, that would put you at some increased risk of poor outcomes if infected with coronavirus,” Dr. Melamed says. But, again, our understanding of how this might affect your risk for severe COVID-19 symptoms is still developing.

So how does smoking cigarettes compare with smoking cannabis? “Generally speaking, we do not see the same pattern of lung disease in patients who only smoke cannabis compared to tobacco,” Dr. Melamed says. Part of that may be due to the difference in the amount of smoking that occurs in those two groups, as well as the amount of carcinogenic compounds found in cigarettes. Overall, there isn’t a lot of data, but the evidence we have so far suggests that smoking cannabis poses much less of a risk to your health, SELF explained previously.

But if you have the option to consume cannabis without smoking it, you should probably take it, Dr. Tishler says. Even if there’s minimal risk to your long-term health associated with smoking cannabis, just the simple act of smoking can cause lung irritation, wheezing, and coughing. And if you have asthma or any chronic lung disease, you might find that smoking weed aggravates or triggers your symptoms.

Those are unpleasant effects at any point, but especially now that we are in the middle of the new coronavirus pandemic. Considering that COVID-19 infection comes with respiratory symptoms, including a cough, you might want to avoid doing anything that can similarly contribute to respiratory issues—even if only to avoid the anxiety that would come with experiencing those symptoms.

Ultimately, even though we know smoking cigarettes and smoking cannabis are different in some important ways, Dr. Tishler says that if you can avoid smoking anything—including cannabis—you probably should.

What should you do if you don’t want to smoke?

Smoking cannabis shouldn’t be your first choice, experts say. But some people rely on cannabis to help manage medical conditions. Is smoking okay in those situations? “It’s all about risk and benefit here,” Dr. Melamed says, adding that effectively managing any chronic medical conditions you have is also key in preventing severe infection from the coronavirus, which may include using cannabis. She recommends limiting your consumption to only the amount that’s actually necessary and that, ultimately, the decision to smoke or not should be made with the help of the medical professional who is recommending your cannabis use.

If you have the option to do something other than smoke your cannabis, here are some alternatives that would be less likely to irritate your lungs:

Vaping (but not from cartridges): Using a vaporizer is probably the closest thing to smoking that you can do without actually smoking. Vaporizers heat the weed enough to release the compounds you want (like THC and CBD) but not enough to actually burn it and produce those pyrolytic compounds. So this is generally considered to be a safer way to inhale cannabis than smoking. Vaping is ideal for patients who need fast relief from their symptoms, Dr. Tishler says, because its effects are felt within 10 to 15 minutes and don’t last as long as those felt with edibles.

But, as SELF explained previously, experts recommend sticking to vaporizers that use dry herb (actual cannabis plant material) rather than vapes that heat concentrated cartridges of oil. Vape cartridges were recently linked to an outbreak of serious lung illnesses, and we don’t know very much about how even legal vape pens like these affect the lungs, Dr. Melamed says, noting that she has “a lot of concerns about the long-term health risks of vaping” these products. She recommended that people avoid using vape pens like these and cautioned that any new device that isn’t FDA-approved—including dry herbs vapes—may have long-term risks we aren’t aware of yet.

Edibles: These are products designed to be eaten, and they come in a variety of forms. You’ll see them as the classic gummies, brownies, and cookies as well as drinks, pills, capsules, and tinctures, which are cannabis-infused liquids made from oil or alcohol that can be taken alone or mixed into food or drinks. Edibles may be better for people who are managing more chronic health issues (like chronic pain) because, although they don’t begin to work as quickly as inhaled cannabis, the effects last longer, Dr. Tishler explains.

However, there are some drawbacks to this method, including the fact that the cannabis you’re eating has to go through your digestive system before getting to your bloodstream. That means it will take longer—anywhere between 30 minutes and two hours—before you’ll experience the effects. And the effects you experience may feel different or stronger compared with those you had after smoking or vaping due to a different THC conversion process.

There are a bunch of other possible methods of administration, but Dr. Tishler says these are the ones we know the most about and, therefore, the ones he trusts and most regularly recommends to patients.

Whatever you decide to do, remember the golden rule: Start low and go slow, meaning that you should choose a low dose to start with and increase your dose very slowly. Only take more after you’ve given your first dose enough time to work. And remember that even medical cannabis products in a dispensary don’t go through the same rigorous FDA approval process that prescription medications do, Dr. Tishler says. So your experience with these products may be hard to predict.

And, of course, regardless of smoking, the most effective ways to avoid an infection are still maintaining social distancing, washing your hands, and wearing a mask, Dr. Melamed says. Above all, if you’re not sure what you should be doing right now, it’s important to check in with a medical professional who can take your unique personal circumstances into account.

Considering that the new coronavirus can cause serious respiratory symptoms, is it safe to smoke weed right now? ]]>