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It has become an all too familiar story for medical providers in Colorado – a patient presents with palpitations, paranoia, nausea, and anxiety following marijuana ingestion.   Often times they state, “I didn’t know how much to eat!” or “Nothing was happening so I ate more.”  With legal marijuana becoming more accessible, new users may not be as familiar with the substance, commonly leading to unpleasant effects and unwanted overdosing.  This is especially true in its edible form.

In contrast to smoking, edible marijuana differs in time of onset, duration, and dosing.  Effects can be felt 20-90 seconds after smoking cannabis, whereas the oral form can take anywhere from 20-120 minutes or longer when consumed on a full stomach. The duration also differs significantly, lasting anywhere from 3-9 hours in the oral form with after effects reaching up to 12-24 hours, in contrast to the more familiar 2-4 hour high provided by smoking. The effects of oral cannabis are often more intense than smoking, which is usually attributed to differences in dosing.

Cannabis is orally active in the range of a few milligrams, with 6-8 mg as a typical dose in a non-daily user.  This assumes the product contains approximately 10-15% tetra-hydrocannabinol (THC), the active ingredient in marijuana plants, which varies depending on the strain.  Dosing is easier to establish if purchased from a distributor where the milligrams are clearly marked on the package, but often the serving sizes are not made clear.

For example, a large cookie could be sold with a serving of 10mg per serving, but with 6 servings in one cookie for a total of 60 mg – quite a bit more than the 6-10mg recommended dose!  For this reason, Colorado lawmakers have passed new regulations requiring single serving packaging.  Most products on the recreational market will be individually wrapped in approximately 10mg doses so users know exactly how much they’re taking with each serving, and exactly how much one serving is.  These packaging rules do not account for products in liquid form or the brownies made by a friend or neighbor so the general rules may not apply – be knowledgeable about what you are taking!

When using recreational edibles, start with ¼ to ½ of a full dose in a product with unknown potency.  Following ingestion, wait at least 2 hours until re-dosing; make note of the amount taken along with its effects to adjust dosing for the next use.

If you or someone you know makes the mistake of ingesting too much cannabis, do not panic!  While it may feel horrible, there have been no adult deaths attributed to ingested marijuana alone, even with large amounts. If someone is having a negative reaction, try to make a comfortable environment where time can pass and the drug can be metabolized.

If there are health or safety concerns, seek medical attention, but the majority of the time, patients with marijuana overdose need little diagnostic or therapeutic interventions.  This is NOT the case when marijuana is used in conjunction with alcohol or other drugs.

Low, one-time dosing of edibles without other substances is the best way for the novel user to approach ingestion and to prevent unwanted and long-lasting negative effects.

1. Edible pot is different than smoking – READ THE LABELS!
2. Start with 6-8mg and wait a FULL TWO HOURS to see effects
3. Effects will take longer to start and will last longer than smoking marijuana!
4. Packaging should state mg/serving and serving size; homemade edibles have no such reliability so beware!

“Cannabis and Marinol Dosage.” Erowid.  Accessed 1 February 2015.

Marx J, Hockberger R, Walls R.  Rosen’s Emergency Medicine, 8th ed.  2013; 2020-2021.
“The LESS method: A Measured Approach to Oral Cannabis.”  Erowid  Accessed 31 January 2015.

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