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What Are the Side-Effects of Cannabis & Medical Marijuana?

Cannabis has a huge variety of effects, meaning that what could be useful for one person could be completely different for another person. One person’s positive is another’s negative. This makes finding what works challenging, but also rewarding as well. It also makes determining what constitutes a positive and negative side-effect a little confusing as well. Here’s some advice from Leafwell on what the side-effects of cannabis are, and what could be considered negative or positive.

What’s the Difference Between an Effect and Side-Effect?

In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended. Usually, the term “side-effect” is used for negative effects, and the positive effects are grouped under the “main effect”, but this is not always the case.

Essentially, the main way to determine the positive and negative side-effects of medical cannabis is to ask yourself, “What do I intend to use cannabis for? What do I hope to get out of it, and what effect am I seeking?”

Cannabis is a Pharmacy in a Plant, Meaning it Can Have Multiple Effects – One Person’s Treasure is Another’s Poison

It is best not to think of cannabis as one simple thing. It is a living organism that expresses multiple characteristics, including variations in cannabinoids, terpenes and flavonoids. This means that different types of cannabis can have different effects. You can use different ratios of various cannabinoids, terpenes and flavonoids for different effects, and these can all have their positives and negatives.

Just as with any other medicine, you would use particular cannabinoid-terpene-flavonoid ratios for different conditions. Which particular one is suitable for you depends on both the condition you are suffering from and your own individual body type. No medication is truly a one size fits all, and cannabis is no different in this regard.

The Positive Side-Effects of Cannabis

There are usually a few simple things that suggest a person is generally living healthily. These include:

  • Eating well
  • Sleeping well
  • The ability to maintain some level of physical activity
  • Being able to live throughout the day without too much physical, mental, emotional or spiritual pain
  • Being able to use a medicine without too many negative side-effects

Medical cannabis, when used properly, can return balance to the body and help achieve all of these without the need for multiple different pills.

The ideal dose is basically one at which you are able to achieve all of the above, without too many horrible side-effects and being able to keep functional throughout the day. Finding the ideal ratio may take a bit of trial and error, but you can take a look at our guide on dosing for more information on this, as well as our cannabinoid-terpene table.

Dosette / daily pill / set dose box for Monday to Sunday. Containing nugs of cannabis rather than pills.
Daily pill organizer (dosette box). Credit: NIAID. From https://www.flickr.com/photos/niaid/24888074919. CC BY 2.0

 

Negative Side-Effects of Cannabis

If dosed appropriately, cannabis shouldn’t have too many negative side-effects (although some of them can have their positives as well – it’s not a black-and-white thing. This can include:

  • Dry/cotton mouth – not great for your teeth or gums, but those who are prone to drooling may find it beneficial to some extent.
  • Overeating or undereating – THC can prompt hunger, low doses of THCV can suppress hunger. Both of these effects can be positive or negative, depending on your condition and needs.
  • Fatigue and sleepiness – again, this can be a benefit, but not always so. Fortunately, cannabis contains a range of non-intoxicating compounds that can be therapeutically useful.
  • Vomiting and nausea – even though cannabis can treat nausea and vomiting, using too much THC can have the opposite effect on occasion.
  • Anxiety and paranoia – as with nausea and vomiting, too much THC can prompt anxiety and paranoia. Low doses of THC can beat anxiety, and CBD can help balance out and reduce paranoia to some extent.
  • Short-term memory loss – again, associated with high doses of THC, and something that is particularly of concern for younger cannabis users under 25 who have developing brains. Can be mitigated by the use of CBD and pinene.
  • Tolerance – this can be both a positive and negative. Having to use increasing amounts of THC and other cannabinoids can prove to be unhelpful and occasionally expensive. On the other hand, developing tolerance can be useful for those who need to use high doses of THC therapeutically without so many negative side-effects. Some people change the cannabinoids and terpenes they use when they get too tolerant to one particular strain or product.
  • Cravings, addiction and withdrawal – cannabis is not necessarily highly addictive for most people, but this doesn’t mean that some people can abuse it to some extent. If medical cannabis is being used compulsively and is producing more negative effects than positive effects, then you may need to stop using cannabis or change which cannabinoids you are using.
  • Irritability and mood changes – many people get chilled out and relaxed on cannabis, and their troubles can seem less serious or easier to overcome. Some people, however, can get irritable or suffer from a negative emotional state if they use high amounts of THC too regularly or if they use the wrong cannabinoid profile.
  • Cannabinoid hyperemesis syndrome (CHS) – this is a rare condition where regular, long-term consumption of high THC cannabis can build up and cause nausea and vomiting after ingesting cannabis, which is the opposite of its usual effects. CHS looks similar to the symptoms of cyclical vomiting syndrome (CVS), which cannabis can be used to treat in some cases!

The Effects of Some Cannabinoids and Terpenes

Here’s some basic information on which cannabinoids and terpenes could be useful for different conditions:

  • Tetrahydrocannabinol (THC) – the main psychoactive component of cannabis. Can be used for its sedative and analgesic effects. Useful for treating insomnia, nausea, lack of appetite, asthma and chronic pain.
  • Tetrahydrocannabivarin (THCV) –  anti-psychoactive in low doses, blocking THC and suppressing hunger. Psychoactive in higher doses, but producing a cleaner, more energetic, “up” effect compared to THC. Useful for nerve pain, diabetes and weight control.
  • Cannabidiol (CBD) – non-intoxicating, and can produce both relaxed and uplifting effects, depending on dosage and personal physiology, as well as which other terpenes and cannabinoids it is combined with. CBD can help dampen the psychoactive effects of THC. CBD does not directly bind to cannabinoid receptors, but influences their behavior.
    CBD is useful for mood and anxiety disorders, its anti-inflammatory effects, and the treatment of seizures associated with epilepsy. CBD could be useful for autism as well. Combined with even small amounts of THC, CBD is useful for chronic pain as well.
  • Cannabigerol (CBG) – CBG can bind to CB1 receptors, but does not do so in the same way as THC. This means that CBG does not have the same psychoactive effects as THC, having at most a mild psychoactive effect (usually none) for most people. CBG could therefore be useful for its anti-inflammatory and antiemetic (nausea and vomiting prevention) effects. CBG also has antibacterial effects, and could be useful for the treatment of superbugs. Some people have reported nausea with high amounts of CBG ingestion, however.
  • Cannabichromene (CBC) – CBC is not as common as CBD, but could be a far more potent antidepressant and anxiolytic (anxiety-beating) compound compared to it.
  • Cannabinol (CBN) – mildly psychoactive, and useful for insomnia. Has sedative properties, and could be an excellent alternative to benzodiazepines, barbiturates and other sedatives.
  • Beta-caryophyllene – associated with the peppery smell of cannabis. Beta-caryophyllene is a selective CB2 receptor agonist, meaning it can be useful for controlling inflammatory responses and preventing over-inflammation. Beta-caryophyllene also has analgesic effects. Could be very useful for chronic pain, nerve pain and autoimmune disorders.
  • Pinene – associated with the piney smell of cannabis. Has both relaxing and refreshing effects. Can also be used to diminish some of the negative effects of THC, such as short-term memory loss. Also has antibacterial effects, and could comn=bine with CBG for the treatment of superbugs like MRSA.
  • Limonene – the lemony terpene. Combined with pinene and beta-caryophyllene, can be awakening. As with pinene, when used on its own, can be both refreshing and relaxing. Can be useful for beating stress, anxiety and depression,
  • Linalool – the lavender terpene. Has relaxing effects, and could be very useful for insomnia, anxiety and chronic pain.
  • Myrcene – the musky mango/grape terpene. Has relaxing, sedative properties, and is also useful for insomnia.
  • Humulene – the hoppy, beer-like terpene. As with myrcene, humulene has sedative properties. Linalool, myrcene and humulene could be said to be the trifecta of relaxing terpenes, whereas a combination of beta-caryophyllene, limonene and pinene make up the energetic terpenes.
  • Cannaflavin A, B and C – the main flavonoids that give cannabis its distinctive flavor. The flavor of cannabis also has anti-inflammatory and anti-anxiety effects.

The above is by no means a comprehensive list of all the cannabinoids and terpenes in cannabis. There are up to 150 cannabinoids, 220 terpenes and 20 flavonoids in cannabis, all of which combine to produce different ranges of effects at different dosages, all affecting different receptors in the body in different ways. This is known as the entourage effect, and is part of the reason why cannabis is a pharmacy in a plant.

It must also be made clear that different cannabinoids and terpenes have different effects at different dosages and combinations, called the biphasic effects of cannabis (i.e. two different and even opposing effects at different dosages).

Ways to Counteract the Negative Side-Effects of Cannabis

You can read more on how to reduce the negative side-effects of cannabis here, but here’s some simple advice:

  1. Ensuring proper rest, food and fluid intake can reduce the chances of a negative experience.
  2. Keeping calm and a cup of herbal or green tea can be effective if you’re feeling anxious or panicky.
  3. Black peppercorns could help “awaken” you from an overly anxious or sedative experience.
  4. Fresh air and the smell of grass and trees – the smell of pinene and seeing nature can be a pleasant, relaxing experience.
  5. Using CBD can help buffer THC’s psychoactivity.
  6. Eating some fruit – the terpenes and natural sugars in fruit can be helpful in those who are feeling they are “whiteying” or “going green” (slang for the faint, nauseous feeling associated with consuming too much THC).
  7. Hot showers and capsaicin cream – can help stop any nausea or stomach cramps that can sometimes result from THC consumption.

Overall: You Can Use Different Cannabinoids and Terpenes in Different Amounts to Reduce Negative Side-Effects

Essentially, by using a broad range of terpenes and cannabinoids, and then maybe taking a note of a particular few that are particularly helpful for you, may be the best way to get the effect you’re seeking from cannabis whilst at the same time reducing the chances of a negative side-effect.

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Written by
Dipak Hemraj
Dipak Hemraj - Chief Research Officer

Dipak Hemraj is a published author, grower, product maker, and Leafwell’s resident cannabis expert. From botany & horticulture to culture & economics, he wishes to help educate the public on why cannabis is medicine (or a “pharmacy in a plant”) and how it can be used to treat a plethora of health problems. Dipak wants to unlock the power of the plant, and see if there are specific cannabinoid-terpene-flavonoid profiles suitable for different conditions.

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