Many more have become violently ill or wracked with disturbing mental or psychological trauma after using synthetic cannabis, with more than 64 percent of 7,600 documented exposures over that time frame requiring medical attention, the study found. (These figures don’t capture the full scope of the problem; synthetic cannabinoids are difficult to detect and use is often only detected after the user is in the hospital or the morgue.)
A broad term used generally to describe a range of potent chemicals, intended to mimic natural plant-based cannabinoids and to bind to many of the same receptors—but in some cases, up to 100 times more powerful; the difference in impact comparable “to the difference between a hose hooked up to a fire hydrant versus a faucet with a slow drip,” in the words of Dr. Patricia Frye, a Maryland-based physician and cannabis expert. “Synthetic cannabis” is banned under federal and most state law. (Plant-derived cannabis products created via chemical synthesis, including Delta-8 THC and Delta-10 THC, aren’t in this product category.)
Though not a priority for law enforcement, who still arrested hundreds of thousands of Americans for marijuana possession in 2020, synthetic cannabis is notorious stuff. Most often appearing in large cities, fake weed was the ultimate culprit behind a so-called “zombie outbreak” in 2016 in New York City, after several dozen people exhibited the same troubling dis-associative symptoms after smoking a particularly nasty “incense” product called “AK-47” Karat Gold.
Why would anyone use such dangerous and toxic stuff? And how can policymakers discourage such self-harm and solve what researchers described to Cannabis Now as a “serious health threat”?
The obvious answer will not shock you.
Nobody Really Likes Synthetic Weed, But…
Initially created in labs to understand how cannabinoid receptors work, synthetic cannabis was never intended for use in humans. And perhaps owing to the nasty side effects, synthetic cannabis use isn’t widespread.
Natural cannabis is far more popular. Even the estimated 0.2 to 0.4 percent of the population who do admit to using synthetic weed say they’d prefer natural cannabis.
However, there’s some societal “encouragement” for synthetic cannabis use: synthetic weed prohibition turns out to be difficult to enforce. Synthetic cannabis doesn’t contain THC. Users won’t show THC metabolites on a urine screening, and so drug tests can’t detect synthetic cannabis, the study noted. Thus, anyone in a position to want a buzz and avoid punishment for weed, including US service members, may decide that fake cannabis is worth the risk.
Users profiled in another recent study, from researchers based in Spain, confirm this ready common-sense explanation: Because drug tests don’t search for synthetic cannabinoids, meaning people worried about losing employment, housing, or other opportunities for a positive drug test are willing to risk serious consequences to achieve something like a weed-like buzz.
In other words, drug laws encourage drug users to risk great bodily and mental harm they wouldn’t otherwise risk. They say so themselves.
Synthetic cannabinoids “exist as a by-product of prohibition,” said Dr. Ethan Russo, a physician, neurologist and prominent researcher and author.
“Following the law of unintended consequences, the continued pervasiveness of urine drug screening for employment has stimulated the popular appeal of synthetic cannabinoids, which are not detectable on routine laboratory tests,” Russo told Cannabis Now. “The result is considerable attendant morbidity and mortality.”
In some places, this situation is getting worse. According to the researchers’ findings, published in the journal Frontiers in Psychiatry, “synthetic cannabinoids are increasingly gaining popularity and replacing traditional cannabis.”
However, that’s not the case in the US, where a simple and popular policy intervention leads to a decline in synthetic cannabinoid exposure (and related deaths and hospitalizations) of more than 37%. Only 5.5% of the synthetic cannabinoid poisonings tracked in the study occurred in states with legalization laws.
This magic public-health solution is allowing people to use cannabis safely and legally.
With Synthetic Cannabis, Legalization Saves Lives
As the Washington state researchers noted, synthetic cannabinoid exposures declined in the US starting in 2016—the same year that four states (California, Maine, Massachusetts and Nevada) legalized adult-use cannabis for adults 18 and over.
Of the exposures that were recorded, most–-56%–-occurred in states “with restrictive cannabis policies at the time of the exposure,” the researchers wrote. When a state passed a law with a more “permissive cannabis policy,” synthetic cannabinoid exposures reduced by 37%, they added.
This amounted to an “association” between “liberal policies (legalization) for natural cannabis and declines in reported synthetic cannabinoid poisonings,” they concluded. “This finding suggests a potential effect of policy change on substance use behaviors that may have long-term public health implications.”
Tracy Klein, the lead researcher and a professor in Washington State University’s College of Nursing, didn’t respond to a request for comment. But other experts, including Frye and Russo and Peter Grinspoon, a Boston-based physician and lecturer at Harvard Medical School, accepted the findings as a strong endorsement for cannabis legalization as a public-health intervention.
Synthetic cannabis harms people, but people don’t want to use it when natural cannabis is available. When natural cannabis is available, people don’t use it. Legalization saves lives. Could there be a simpler proposition?
“The rules of society have created this problem,” Russo said, “one that should no longer exist once a legal and regulated market for cannabis is established.”
“Legalizing cannabis, in the adult-use market, would certainly eliminate the need for experimenting with these potentially deadly chemicals,” Frye said.
Cannabis preparations are likely effective at preventing and treating migraines, according to a recently published review of available research. The study, “Medical Cannabis for the Treatment of Migraine in Adults: A Review of the Evidence,” was published in May by the peer-reviewed journal Frontiers in Neurology.
To complete the study, researchers affiliated with the University of Arizona analyzed previously published scientific studies on the effects that cannabinoids have on migraine patients. The objective of the review was to assess the effectiveness and safety of medicinal marijuana in the treatment of migraine in adults.
The researchers identified 12 studies that had been published in Italy and the US involving a total of 1,980 migraine patients. The review revealed that plant cannabinoids have the ability to reduce the number of migraine days and to abort the onset of migraine headaches. The use of cannabis preparations was also associated with significant reductions of pain, vomiting and nausea caused by migraine.
Reducing Migraine Symptoms
Migraine is one of the world’s most common neurological diseases, according to information from the Migraine Research Foundation, affecting approximately 39 million people in the US and about one billion globally. Symptoms, which are often debilitating, can include severe headache, dizziness, nausea, visual disturbances and extreme sensitivity to light or sound. Migraine disease is commonly treated with strong pharmaceutical drugs, although results of treatment vary widely from patient to patient.
Researchers conducting the review of scientific literature determined that after 30 days of use, medical marijuana significantly reduced the number of days patients experienced migraines and the frequency of migraine attacks per month. After six months of use, cannabis significantly reduced the nausea and vomiting associated with migraine.
Medical marijuana was 51% more effective in reducing migraines compared to products that didn’t contain cannabis. Compared to amitriptyline, medical marijuana aborted migraine headaches in 11.6% of patients and reduced migraine frequency. The researchers concluded that there is substantial evidence to support claims that medical cannabis (MC) can be effective at reducing the frequency of migraine and aborting migraine attacks when they occur. The authors of the study also called for more rigorous studies of the effect that cannabis can have on migraine and associated symptoms.
“There is promising evidence that MC may have a beneficial effect on the onset and duration of migraine headaches in adults,” the authors wrote in their conclusion of the study. “However, well-designed experimental studies that assess MC’s effectiveness and safety for treating migraine in adults are needed to support this hypothesis.”
Findings Supported by Previous Research
The new study is consistent with previous research that has shown cannabis can have a beneficial effect for migraine patients. A 2018 study found that cannabidiol (CBD) has several pharmacological properties including acting as an anti-inflammatory, while numerous anecdotal accounts of CBD oil successfully being used for migraine have been reported. Last year, data from a clinically validated survey showed that 86% of respondents reported a decrease in headache impact after using a cannabidiol (CBD) formulation for a 30-day trial period.
The survey was taken by customers using a CBD oil product designed by Axon Relief, a company that creates supplements specifically for migraine sufferers. Known as the Headache Impact Test (Hit-6), the clinically validated survey measures the impact that headaches have on a respondent’s daily life and ability to function.
Participants completed the Hit-6 survey both before and after using the CBD oil. During the 30-day trial period, respondents experienced an average of 3.8 fewer headache days than before using Axon’s CBD oil, a reduction of 23%. Chronic migraine sufferers, defined as people who experience 15 to 29 headache days over a 30-day period, saw a 33% reduction in their headache days.
A participant in the informal Axon study identified only as Glen reported that since “the ’90s I’ve been on constant high doses of carbamazepine and gabapentin. The periodic pain breakthroughs were only controlled by hydrocodone, which always made me feel…uncomfortable,” Glen wrote in a statement from Axon. “What a change CBD oil has made: no more carbamazepine or hydrocodone, and only half the gabapentin—and far better pain control. Pain breakthroughs still happen, but another squirt of Axon CBD, and the pain is gone within 15 minutes. I have no side effects.”
Of the 105 people who participated in the trial for Axon, 15 reported that they were experiencing daily headaches at the beginning of the study. By the end of the 30-day trial period, the number had dropped to 10, a reduction of 33%.
Another review of available research published by the journal Cureuslastyear also found that medical cannabis could be an effective treatment for migraine. The authors of that study found “encouraging data on medicinal cannabis’ therapeutic effects on alleviating migraines in all of the studies reviewed.”
In 1976, a glaucoma patient named Robert Randall became the first person in the US to be granted legal status as a medical marijuana patient. As a teenager, Randall had been diagnosed with glaucoma and was told by doctors he would likely lose his eyesight before his 30th birthday. After learning of research that indicated THC could be an effective treatment for the disease, he began smoking marijuana. He was subsequently arrested for marijuana cultivation in Washington, D.C., but wasn’t convicted of the charges based on a defense of medical necessity. Thus, the cannabis and glaucoma debate began.
Randall then petitioned the Food and Drug Administration to provide marijuana to treat his disease. In 1976 the FDA approved the petition, later launching the Compassionate Investigational New Drug (IND) program to provide unapproved but promising drugs including cannabis to Randall and patients like him. After receiving shipments of joints from the federal government for 25 years to treat the disease, Randal died at the age of 53 in 2001. During that time, he never lost his eyesight.
What is Glaucoma?
Glaucoma is a group of related diseases of the eyes characterized by a buildup of fluid in the eye resulting in an increase in interocular pressure (IOP). The condition causes pressure on the optic nerve leading from the eye to the brain, leading to a slow loss of vision that can culminate in blindness. Traditional treatments for glaucoma include eye drops, oral medications and surgery. Glaucoma is the leading cause of blindness among people older than 60, according to the Mayo Clinic.
Some research has shown that THC, the cannabinoid largely associated with the classic marijuana “high,” can temporarily reduce IOP, thereby reducing the pressure on the optic nerve. A review of research into cannabis and glaucoma published in 2019 found that five randomized clinical trials found evidence that cannabis could lower interocular pressure. However, the researchers noted that the studies reviewed had design flaws including a small sample size and inadequate controls. But the glaucoma and marijuana studies also failed to compare the effects of cannabis on glaucoma to traditional treatments. The study concluded that randomized clinical trials (RCTs) showing the efficacy of cannabis as a treatment for the disease were necessary before its use could be recommended.
“The studies that were reviewed were highly variable in their methods and patient population selected, and therefore no current evidence supports the use of any form of cannabis to replace existing,” the authors of the review wrote in their conclusion. “Until further research in the form of RCTs with more evidence to support the use of cannabis for lowering IOP, it should not be recommended at this time.”
Noting that the effect that THC has on IOP is short-lived, the authors also added that if patients decide to use cannabis to treat the disease, “they would require frequent dosing, which has the potential to reduce patient adherence and increase side effects of the medication.”
Other research that supports cannabis as a treatment for glaucoma include animal studies that suggested cannabis might improve blood flow to the eyes and promote healing. Animal research also suggests that cannabis may have neuroprotective effects that might prevent damage to the optic nerve.
What About CBD?
However, not all forms of cannabis and glaucoma are effective and shouldn’t be used as a treatment for the disease. A study published in 2006 found that while THC reduced interocular pressure, CBD actually increased IOP. The educational website Glaucoma Today notes that cannabis varietals “with higher THC content can be expected to lower IOP, whereas strains with higher CBD content can be expected to increase IOP. It is therefore important that eye care providers caution patients who are interested in treating their glaucoma with medical cannabis that products with a high CBD content may have a detrimental effect on their disease process.” Patients who choose to treat their glaucoma with cannabis should choose products with negligible amounts of CBD.
Proponents of medical cannabis as a treatment for glaucoma argue that it’s a natural medication with few side effects. Advocates for the glaucoma and marijuana marriage also believe that cannabis can help the pain often associated with glaucoma and reduce the need for surgery. However, the American Academy of Ophthalmology (AAO) maintains that cannabis is not a practical treatment for glaucoma, primarily because of the temporary nature of its effect. The AAO notes that to effectively reduce IOP, patients would have to ingest 18 mg to 20 mg of THC six to eight times daily. The AAO also cites evidence that cannabis might have the opposite effect than intended, increasing IOP and causing additional damage to optic nerve. As a result, the professional group does not recommend the use of cannabis to treat glaucoma.
“Several current, effective treatments for glaucoma are more reliable and safer than marijuana,” the AAO wrote in 2021.
“One of the difficulties with post-traumatic stress disorder is that the readiness or need for treatment may emerge years after the trauma. Therefore, veterans and their families need long-term treatment options and long-term access to treatment, even if symptoms are not present at their time of discharge.” -William H. Braun, from Veteran’s for Medical Marijuana
Post Traumatic Stress Disorder (PTSD) wreaks misery on soldiers and families. Military training, combat experience and traumatic events like sexual abuse often radically change cognitive functioning. Unable to process peacetime situations without infusing combat conditioned responses, PTSD sufferers live chaotic, often isolated lives. Approximately 6500 veterans and 349 active service members committed suicide in 2012. The United States Veterans’ Administration (VA) is tasked with providing medical care for all honorably discharged veterans. This includes some psychological care.
A veteran with PTSD faces life and career altering choices. The VA does not dissuade this notion, advising on their website. “You may think that avoiding your PTSD is critical to keeping your job. But if your PTSD symptoms are getting in the way of doing your duties, it is better to deal with them before they hurt your military career. Getting help for PTSD is problem solving.”
The VA outlines several treatments, “cognitive processing, prolonged exposure treatment, mindfulness practice” to name a few, but provides more extensive information for psychiatrists prescribing Selective Serotonin Reuptake Inhibitors (SSRIs), antidepressants and other prescription drugs. “The only two FDA approved medications for the treatment of PTSD are sertraline (Zoloft) and paroxetine (Paxil). All other medication uses are off label, though there are differing levels of evidence supporting their use…” In a series of videos linked to the site, Psychiatrist Matthew J. Friedman of the VA National Center for PTSD explains that his patients “usually use these medications indefinitely.”
“David” is a former Army Corporal 1st Cavalry who served two terms in Iraq as a chaplain’s assistant in a 900 troop infantry unit. He started suffering from night terrors during basic training after performing sleep deprivation exercises. “I’m dead asleep, having a nightmare. They call me back. I try to explain to them that my time is done. Then I’m in Iraq and it’s hitting the fan and I can’t find my weapon! I don’t remember the rest, but if someone comes into my room or makes the slightest noise, I jump up in the fighting position, screaming, cursing, telling them that I am going to rip them in half. I’ve punched people, thrown stuff. My brother has kicked my ass my entire life, whenever it happens he’s terrified.”
Before enlisting, David was a teetotaling Protestant and devout believer in “George Bush, the War in Iraq, all of it.” Responsible for protecting unarmed rabbis, priests, imams and monks as they performed their duties, he screened soldiers seeking spiritual advice to make sure they weren’t a threat. “They told me all the stories, so I know how every one of their buddies died in detail. Then I would prepare their memorial services.” With the clergy’s help, David implemented a system to make sure those close to a fallen comrade didn’t sleep where they could see their friend’s empty bunk, a common trigger for night terrors. Many soldiers were simply “too far gone,” and referred to psychiatrists.
“More often than not, that’s the route that ends up happening. These people cannot handle it. They were not right for the situation. They thought they wanted to kill people without having any idea what that means. And then the reality bomb hit them so hard that they just couldn’t recover from it.”
For David, healing from the trauma of seeing friends grotesquely killed, sexual harassment from a senior officer, a broken engagement during his first tour, and the shock that George Bush was “just a spokesman for the oil industry” was found primarily through frequent sessions “talking for hours with a Rabbinical scholar while smoking joints.” After a few months processing the theological, political and personal ramifications of the war this way, he realized his night terrors were becoming less frequent. “I wasn’t smoking every night, so I didn’t see a correlation that it was stopping the night terrors.”
Four years back in the US and still waking violently to the slightest sound, David “just couldn’t take it anymore” and sought help from the VA. He told a physician’s assistant that he suspected marijuana might be helping, but worried about side effects. “All the research I had done said it was safe. The guy was very casual, but he recommended that I stop using it because they had stuff that would do the trick.”
The assistant prescribed diphenhydramine (Benadryl), an allergy and sleep aid, and “some blood pressure pills to make my heart slow down and stop the nightmares.” The treatment didn’t stop the problem and left him groggy and dysfunctional in the morning. “Benadryl hazes you, whereas weed, especially Sativa, makes me think clearer.”
David worries that he might “start liking marijuana too much and abuse it,” but prefers to take that risk over a lifetime experimenting with prescription medications. “I don’t subscribe to that way of thinking. I am completely 100 percent sure that marijuana cured my night terrors. My brain operates at a higher level than normal about my surroundings and I think about things in a much more peaceful way. My roommates can walk into my room now when I’m asleep and I’m like, “Hey, Dude.”
Years of persistent lobbying by the advocacy group Veterans for Medical Marijuana goaded the US Veteran’s Administration to clarify its stance in a January 2011 memo. “VHA policy does not administratively prohibit Veterans who participate in state marijuana programs from also participating in clinical programs where the use of marijuana may be considered inconsistent with treatment goals. Patients participating in state marijuana programs must not be denied VHA services. If a patient reports participation in a state marijuana program to a member of the clinical staff, that information is entered into the ‘non-VA medication section’ of the patient’s electronic medical record.”
Currently, the medical establishment waits to see if specific molecules can be isolated from cannabis and used to treat specific symptoms. With new strains bred daily across a multi-billion dollar global industry, testing with scientific certainty is an elusive goal. Several small studies are currently being funded and undertaken by federal and private researchers. For veterans and those close to them experiencing PTSD, research into treatment opportunities is crucial to finding a path to recovery.
Experimenting with treatment for mental disorders is extremely dangerous. Cannabis Now does not advocate or repudiate any particular course of treatment, but all available studies have shown that talking to friends, loved ones and professionals about PTSD triggers is vital to recovery. Veterans for Medical Marijuana urges those seeking treatment to, “Be assertive, every veteran deserves any, and all, medical and/or psychological help.”
Fewer and fewer places in the US remain where it’s still a criminal act for adults 21 and older to use cannabis. Even fewer places deny sick Americans (with the right sickness to qualify them as medical marijuana patients) some accommodation to use cannabis lawfully. But even these 14 cannabis legalization holdouts agree that it’s OK to give marijuana extracts to kids, as long as those kids have been diagnosed with an autism spectrum disorder. And with good reason. Miraculous stories are all over the internet, such as children speaking their first words after using cannabis oil, or autistic adults with severe anxiety and near-total social isolation rejoining society after smoking cannabis. So, this begs the question, “Can cannabis ‘treat’ autism?”
A definitive final answer is elusive. However, as a review authored by researchers led by Mariana Babayeva, a professor at the Touro College of Pharmacy in New York and recently published in the scientific journal Frontiers in Bioscience found, a growing number of “clinical studies have shown promising results of cannabis treatment in” autism spectrum disorder (ASD).
How Cannabis Helps Autism
This makes practical and scientific sense. CBD and THC activate the network of receptors called the endocannabinoid system. “Due to its vital role in regulating emotion and social behaviors, the endocannabinoid system represents a potential target for the development of a novel autism therapy,” the study states.
Cannabis does help autism, as this latest review, prior studies and loads of compelling, convincing anecdotal stories say. But what cannabis treatment would work best for each individual case of autism, and how much cannabis should be given in those instances?
“It’s too early for anyone to recommend cannabis as a validated, well-studied type of a substance,” said Dr. Nathan Call, director of clinical operations at the Marcus Autism Center in North Druid Hills, Georgia, in a recent interview.
That’s the final word on cannabis and autism that’s yet to be spelled out. In the meantime, autism and cannabis suffer from the same knowledge gaps plaguing the rest of cannabis-based medicine.
Defined by the Centers for Disease Control and Prevention as “a developmental disability caused by differences in the brain,” autism has several known risk factors, but lacks a clearly identifiable cause. Treatments generally involve the off-label use of pharmaceutical drugs as a last and final desperate intervention to prevent behavior dangerous to the person or to others, as well as careful education—and plenty of coping skills.
However, as the authors of the Frontiers in Bioscience review noted, “several studies have suggested that dysfunctions in the components of the endocannabinoid system may contribute to the behavioral deficits and neuroinflammation observed in autism.”
Other studies have associated autism with problems with the body’s immune system. And there are endocannabinoid receptors found in immune cells that could “control the movement of inflammatory cells,” meaning if the receptors can be given the right amount of cannabis to generate the right response, that, too, might soothe the symptoms sufficiently to allow the sufferer to enjoy something closer to a “normal” life.
Given the knowledge gaps, studies investigating cannabis’ potential in treating autism have, by necessity, taken a shotgun approach, trying concoctions with low THC, no THC, high THC or ratios of CBD to THC including 20:1.
The 20:1 concoction, hit on by researchers in Israel, seemed to consistently present good results for most participants, with self-injury and rage improving in 67.6% of children in one 53-person study—but worsening in 8.8% of participants. And using cannabis in children is, of course, particularly delicate work.
What We Know, What We Don’t
But despite knowing this much, we still don’t know enough. As Babayeva and her co-authors stated, “there are very limited clinical data on the impact of cannabis on autism”—which, like cannabis, has many different phenotypes. And what works for someone with behavioral outbursts might not work for someone with severe anxiety.
“While cannabis might be beneficial in persons with one phenotype, it may have no effect or severe adverse outcomes in persons with other phenotypes,” the researchers wrote in their review.
Simply put, there isn’t enough data yet on specific cannabis concoctions for specific phenotypes of autism, leading parents and practitioners to grope around in the dark, hoping to stumble onto the winning formula.
“More clinical investigations are needed to discover the efficacy, safety and dosing of the therapy,” the report states. “This would be a significant advance in the treatment of autism and could lead to improved functioning and quality of life for the patients and their families.”
Cannabis and Autism: The Final Word, For Now
Dale Jackson lives in Georgia, one of the states where adults can’t use cannabis without risking arrest, but where children with autism—like Jackson’s nine-year-old son Colin—are supposed to be able to access the drug. Without cannabis oil, Colin engages in the kind of self-harm associated with an autism spectrum disorder. Jackson wakes up at night hearing a thumping sound from his child’s room: the sound of Colin knocking his own head against the bedroom wall.
Cannabis has helped, but the problem, as Jackson said recently, is that Georgia’s nice-sounding law is unworkable. There’s “nowhere to buy it in Georgia,” Jackson recently told WALB, which means Jackson must resort to illicit means: underground medicine-makers in Georgia, or legally obtaining cannabis oil in other states and then illegally transporting it across state lines.
These are reasonable acts for a desperate parent with a child in distress, but both are unlawful.
“When you’re a caregiver of a child who’s hurting you every day or hurting themselves every day, you’re willing to try a lot of things to try to make your life a little bit better,” Dr. Call told TheAtlanta Jewish Times.
At the present time, seven studies investigating cannabis in autism are in various stages of completion at universities across the US and Israel. Once the new data is presented, more, larger and longer-term studies will be required to present a definitive answer on how much CBD or THC is needed for the exact autism spectrum disorder. Until then, the final word on cannabis and autism is that it seems to help—it may even be a miracle cure. But finding the right mix is a shot in the dark.
It’s Friday afternoon and you’re leaving work early. You’re ready to ease into the weekend slowly and steadily, opting for mindful relaxation over nihilistic raging. Instead of heading over to a happy hour, you decide to unwind with some cannabis.
You want enough for the whole weekend. Knowing from experience, at least one other person (who never seems to have any of their own) will ask you to share. So, while your housemate or partner heads into the shop for a bottle of wine or a six-pack, you dip into the dispensary or text your plug and ask for something with “between three and five units of cannabis.” Your perfectly reasonable request is greeted with confusion and derision, because—duh!—no such thing exists.
Misunderstood or vilified when it’s not prohibited, marijuana has long suffered from a lack of concrete knowledge. One metric that experts agree is holding cannabis back is an agreed-upon “standardized marijuana unit.” Most everything else humans put in their bodies that governments regulate and tax can be easily measured, categorized and divided: a “thousand-calorie burger,” a tropical cocktail with the total alcohol equivalent of “two drinks,” movie-theater popcorn with “two servings” of butter.
But cannabis isn’t this. A host of factors, including personal tolerance and method of ingestion, as well as complications such as terpenes and secondary cannabinoids, complicate the effects of cannabis and defy easy standardization.
If a five-milligram edible hits two people differently, and five milligrams of THC inhaled hits an entirely different way from the edible, what’s the purpose of printing “five milligrams” on the label in the first place? You could be forgiven for declaring the whole exercise futile, except that’s not how science or regulators work.
But rather than propose one, Brown and his colleagues poured cold water on the concept.
“However, it is unlikely that a “one size fits all” definition will capture both nonmedical and medical use of cannabis and may be insufficient for constructing comparisons between administration routes,” the article stated.
Rule of Fives
So far, the “best available” standardized cannabis unit seems to be 5 milligrams of THC, or about half of the 10-milligram dose that regulators in adult-use states including California and Colorado have hit upon. Adult-use edibles in those states are limited to no more than 100 milligrams per packaged product, and regulations require the 100-milligrams to be broken up into discreet units, with the idea that such careful division will reduce instances of over-intoxication.
Five milligrams of THC per “marijuana unit” is the standard first proposed in 2020 by researchers Tom Freeman and Valentina Lorenzetti, who published their reasoning in the journal Addiction, arguing that such a value reflects “the quantity of primary active pharmacological constituents.”
With concentrates that isolate THC from other constituent compounds such as secondary cannabinoids and terpenes—edibles or pharmaceutical-grade cannabis products including FDA-approved Sativex—the “rule of 5” is probably workable, cannabis industry insiders say, but with exceptions that quickly saddle the “standard” with so many qualifications that it’s no longer standard.
“The problem with five milligrams is, how do you get five milligrams in your lungs versus your stomach?” said Mark Lewis who holds a doctorate degree in biochemistry and is the president of Napro Research, a California-based analytics firm. Five milligrams inhaled will hit more quickly than five milligrams ingested, which both hits more slowly and is metabolized differently by the liver. Any “standard unit” must address questions of bioavailability, the amount of cannabis a person can metabolize over a period of time.
For all these reasons, “five milligrams isn’t five milligrams, isn’t five milligrams,” he said.
Lewis highlighted some of the most basic impediments to a five-milligram standard: Beyond method of ingestion, there’s secondary cannabinoids including CBD as well as THC-V and terpenes, all of which can help “10 milligrams” hit more quickly or more intensely than 20—a phenomenon he experienced firsthand when trying out a new hemp-derived, Delta-9 THC-based gummy.
The gummy had five milligrams of THC advertised—a small dose, a microdose for Lewis. However, the gummy also had 2-3% essential oils. “I took one in the morning, and—oof! It snuck up on me,” he said. “I was driving, and thought, ‘Wow, that coffee was strong—I’m talking about conspiracy theories and some weird stuff.’ Then I remembered I ate that gummy. And I was pretty dang buzzed for the next couple of hours.”
Other product-makers question whether a standard unit is more necessary than accurate labeling, whatever the unit may be.
“I think the accuracy of the label is more important than the standard,” said Ian Monat, the co-founder and CEO of rhythm, which makes hemp-based CBD beverages. Monat said that CBD products in particular are beset with wildly inaccurate labels. And even a precise figure can become inaccurate over time as cannabinoids degrade, processes that are accelerated in the presence of compounds including aluminum—like a beverage can.
Brown and his co-authors agree. In their article, they call for standardized units to somehow accommodate questions of ingestion as well as CBD ratios and essential oils, and state that patients need to be clearly informed that their product’s concentration and the “delivered dose” may be different—and, like Lewis said, that five milligrams isn’t always five milligrams.
Or, in another analysis, outside of THC-only pharmaceutical grade cannabis or strictly-THC-only extracts or edibles, dosage is too complicated and too personal a question to be answerable in universal figures.
Psychedelics have been in the spotlight of late, with study after study into different compounds showing that there are different, more efficient, and physically healthier ways to treat issues like depression, other psychological issues, and pain. So is it that surprising that psychedelics have also shown promise as a treatment for neurodegenerative diseases?
As psychedelics gain prominence for help with psychological issues, they are also being looked at as an answer for neurodegenerative diseases. As there is currently no real answer to these problems, compounds like LSD, and psilocybin provide answers not currently seen in Western medicine. We’re here to cover everything interesting in this new and emerging medical field, and you can follow along by signing up for The Psychedelics Weekly Newsletter. Get the latest on what’s going on, and when new deals on psychedelic products and paraphernalia become active, be the first to have access.
What are neurodegenerative diseases?
Think of that grandparent, or great uncle, who seemed to forget your name over the years. The one (or maybe several) that started to lose their keys, started mixing new events with old memories, or started telling stories like they were living 50 years ago. These are some of the most noticeable symptoms of neurodegenerative diseases like dementia, which we often see as Alzheimer’s disease.
Neurodegenerative diseases are the accumulation of neurodegeneration, a process in which “nerve cells in the brain or peripheral nervous system lose function over time and ultimately die.” Though symptoms of these problems can be treated, “there is currently no way to slow disease progression and no known cures.” The instance of these diseases rises greatly in the elderly, with a 2021 report by the Alzheimer’s Disease Association estimating that approximately 6.2 million Americans have the affliction, while another 1.2 million will have Parkinson’s by 2030.
Alzheimer’s and Parkinson’s are the two most prevalent neurodegenerative disorders, but the class of diseases also includes several other well-known entries, as well as some lesser-known issues. Huntington’s Disease is on the list, which is generally inherited by way of a mutation in the huntingtin gene, and which results in the gradual worsening of physical abilities and coordinated movement, including the ability to speak. Multiple sclerosis, a demyelinating disease where the covers of nerve cells in the brain and spinal cord are damaged, results in physical, mental, and psychiatric issues.
Multiple system atrophy, a product of degeneration of neurons in different parts of the brain, results in slower movement, tremors, rigid muscles, autonomic dysfunction, ataxia, and a general feeling of unsteadiness. Amyotrophic lateral sclerosis (aka Lou Gehrig’s disease), causes the loss of voluntary muscle control due to the loss of motor neurons. And brain issues caused by prions are included too, which involve misfolded proteins that act like cancer in the brain, spreading their dysfunction. Prion diseases are not well understood, and stand out as a variance to the general understanding of viruses, bacteria, fungi, and parasites.
It is expected that somewhere in the neighborhood of 50 million people in the world currently live with some neurodegenerative disease. This number is estimated to rise to about 152 million by 2050. This makes sense as life expectancy rises, leading to more and more people in the general age range to get dementia, with those in poorer countries where there are fewer medical and nutritional options, showing the highest numbers. Global costs of these diseases run about US$1 trillion per year. As these diseases can’t be cured, and while there are things that can decrease likelihood of getting one, (like drinking less alcohol, or not having diabetes), there is nothing in the currently accepted repertoire of Western medicine to keep them from happening.
Psychedelics are drugs that fit under the heading of hallucinogens, which are themselves part of the grouping of psychoactive substances. They are primarily known for their ability to induce hallucinations, which are sensory experiences that though experienced, don’t actually exist. Beyond this, they are known for causing users to feel euphoric, spiritual, connected to others and the universe, mystical, and to promote life-changing experiences. Recently, they have repeatedly shown to help with psychological disorders and pain issues.
The idea that they can help change a person’s affect, makes it unsurprising that psychedelics have also been eyed for their ability to help with neurodegenerative diseases. And one such study pointing this way comes out of Yale, called Psilocybin induces rapid and persistent growth of dendritic spines in frontal cortex in vivo, which was published in July 2021, in Neuron. In this study, the scientists used imaging of mice brains to show that psilocybin allowed for increases in spinal size and density, changes which were still in effect a month after administration. The study also showed that psilocybin helped improve behaviors related to stress, and helped deal with increased neurotransmissions due to excitation. Overall, the study showedhow psilocybin can help to rewire the cortex of the brain with long-term results.
This is backed up by a September 2021 clinical review entitled: From psychiatry to neurology: Psychedelics as prospective therapeutics for neurodegenerative disorders, which investigated research into how “psychedelics may act therapeutically on cells within the central nervous system (CNS) during brain injuries and neurodegenerative diseases.” The final assessment of the review? That “Psychedelics stimulate neuro- and gliogenesis, reduce inflammation, and ameliorate oxidative stress. Therefore, they are promising candidates for future therapeutics for psychiatric, neurodegenerative, and movement disorders.”
The review seeks to “discuss the current state of the art of how psychedelics influence neural tissue homeostasis and activity.” The study authors further clarify, that this is not just about dealing with symptoms either, but that psychedelics may be “disease-modifying therapeutics, and not simply just providing symptomatic relief”, with clinical trials that have “demonstrated both safety and efficacy for their therapeutic use in controlled clinical settings.” They sum it up with, “Therefore, the use of psychedelics as therapeutics is very promising and should be further developed, paying special attention in the future to prospect applications in neurodegenerative diseases.”
Another review from 2020 came to similar conclusions, but stated the need for much more research. Psychedelics as a Treatment for Alzheimer’s Disease Dementiapoints out that “Animal models testing the neurobiological effects of psychedelic compounds have demonstrated hippocampal neurogenesis at lower doses and suppression at higher doses and potent neuroprotective properties.” It further states that neuroplasticity changes suggest “a potential role for both sub-perceptual “micro”- and psychedelic-doses as a strategy for neuroprotection and cognitive enhancement in prodromal AD (Alzheimer’s disease).”
Going back to 2019, and there’s further reason to look at psychedelics for the treatment of neurodegenetative diseases like Alzheimer’s. That year, New York-based biotech company Eleusis Therapeutics finished phase I of trials into how LSD can be used for the disorder, completing the phase with 48 healthy volunteers, with an average age of 63. “The trial compared three ‘microdoses’ of LSD – 5, 10 and 20 micrograms – to placebo and found no significant differences between the groups on cardiovascular measures like ECG reading and blood pressure as well as other clinical measures, other than a slight increase in headache.”
These amounts were not enough to induce a psychedelic response in participants. As of June 2021, the company was working on Phase II, with the examination of microdosing LSD on Alzheimer’s patients.
According to Eleusis CEO and founder Shlomi Raz in an interview with Forbes magazine in 2020, “LSD in particular seemed like an attractive candidate for such a therapeutic approach, as it is capable of potent and prolonged activation of the serotonin and dopamine neurotransmission receptors implicated in Alzheimer’s disease, and specifically the serotonin 2A receptor.”
It’s important to remember that psychedelics were illegalized in the late 60’s and early 70’s, because this means that research into their capabilities was greatly stymied. Why exactly they were illegalized is a highly debatable subject, though the idea of danger which was so tightly tied to them during these times, seems to have been greatly proved wrong. Especially in consideration of the much more dangerous drug options, like opioids, which have been made widely available, despite psychedelic drugs providing the same benefits, with no real death count attached.
One of the biggest hits to the government line happened in 1994, when former Assistant to the President for Domestic Affairs, John Ehrlichman, who worked under President Nixon, made this statement about anti-drug measures taken during that administration:
“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
Psychedelics were very much tied to the anti-war movement, and their criminalization started in 1968 with the Staggers-Dodd Bill which made LSD and psilocybin illegal. This was followed by the 1970 Comprehensive Drug Abuse Prevention and Control Act, which enforced stricter measures on pharmaceutical companies and their reporting. Though this doesn’t sound like a bad thing, it worked to rule many drugs out. This was followed up in the US by the 1984 Comprehensive Crime Control Act under President Reagan, which served to allow the emergency banning of a drug by the government, which in turn was used the following year to outlaw MDMA.
On a wider scale, the UN enacted the Convention on Psychotropic Substances treaty in 1971, which placed psychedelic compounds in Schedule I, thereby making a statement that they are dangerous compounds, with no medical value.
In the recent past, however, things have changed, as more comes out about the beneficial properties of psychedelics. This subject was initially investigated in the mid-1900’s before being outlawed; with new researching popping up to supplement it now. Along with this research, a safety profile has developed for psychedelics which includes no real death count. Many locations in the US have subsequently decriminalized psychedelic use, or legalized them for medical use (Oregon), with three states currently working for statewide recreational legalizations: Washington, California, and Michigan.
No one wants to die, and this is probably why this particular topic gets so much attention. End of life diseases come with only one end, and the efforts to find cures for things like dementia attest to how much we don’t want to give up our lives. There are certainly realities related to many of these disorders that undermine the idea of trying to fix them, however, in cases where fixing a problem is applicable, possible, and within reason for someone to live their life, psychedelics could certainly provide a key measure.
Regardless of whether it’s for a child with a genetic condition, or an old person with Alzheimer’s, the growing body of research into psychedelics for neurodegenerative diseases, proposes an option not seen before in Western medicine.
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Disclaimer: Hi, I’m a researcher and writer. I’m not a doctor, lawyer, or businessperson. All information in my articles is sourced and referenced, and all opinions stated are mine. I am not giving anyone advice, and though I am more than happy to discuss topics, should someone have a further question or concern, they should seek guidance from a relevant professional.
Everyone wants their weed these days, with all different ways to consume the plant. Some want to smoke it, some want to eat it in edibles, some only want to vape it, some take their bong hits, some rub it on their skin, some put oil under their tongue, and some swallow down tinctures or pills. And if we really want to get down to it, some use suppositories, or nasal sprays, or skin patches as well. At one time in life, things were simpler. And one of the most basic uses of cannabis, was as a tea. Today, you can still enjoy cannabis as a nice hot cup of tea, by brewing it yourself at home.
A good old-fashioned weed tea is one of the best ways to enjoy cannabis, whether for medical or recreational purposes. Read on for a great general recipe on how to make it. We’re all about everything that goes on in the cannabis industry, and you can keep on top of the news by subscribing to the THC Weekly Newsletter. Once signed up, you’ll get first access to offers on cannabis products like vapes, edibles, and lots of other paraphernalia! We also provide deals on cannabinoid compounds like HHC-O, Delta 8, Delta 9 THC, Delta-10 THC, THCO, THCV, THCP & HHC, which are in our “Best-of” lists. Please keep in mind… *If you do not feel comfortable with these products, we don’t advise you use them, and instead advise that you only purchase and use products that you feel comfortable with.
The history of cannabis tea
Cannabis has shown up in different time periods, often used in similar ways for treating different things. There are records going back as far as 2737 B.C. in China, when Emperor Shen Neng prescribed the tea to treat gout, rheumatism, malaria, and for poor memory.Around that time, use of cannabis as a medicine spread throughout Asia and the Mid East, into Africa, and India as well. Back then, cannabis could be used for tons of purposes, like during childbirth, ear infections, pain relief and for stress.
There are references in in ancient Tai religious texts suggesting that if cannabis is steeped and consumed it can lead to spiritual enlightenment, which speaks to both use with psychological issues, as well as recreational use. Another interesting story to come out of that general region, is of Chinese surgeon Hua Tuo, who gained recognition well beyond China, and who was the first (as far as we know) medical doctor to combine cannabis tea with other things like sedatives or alcohol, for the purpose of surgery, from around 208 AD.
In Ancient Greece, both cannabis tea and paste were used to treat animals and people. For example, rags were soaked in cannabis tea and then wrapped around open wounds on legs of horses, marking one of the earliest uses of cannabis as a veterinary medicine.
India also has a tradition with cannabis tea, though its version is a little milkier, and called bhang. Bhang was used for religious and medical purposes, seen as a treatment for headaches, insomnia, sunstroke, lack of appetite, gastro disorders, and pain, including for childbirth. The spiced, milky cannabis drink is not only still drank today, but was the basis for the wording in the Single Convention on Narcotic Drugs from 1961, which keeps the drink in a legal loophole status.
In Ancient Egypt, an ancient text called the Ebers Papyrus from 1550 BC describes a prepertation in which cannabis is made into a tea that’s used for medical purposes. There even seemed to be some kind of understanding of a conversion that had to happen from THCA to THC in order for different benefits to be gained. And this without having any understnidng of how cannabinoids work. In Egypt, cannabis tea was even used in suppositories for the treatment of severe pain and inflammation from hemorrhoids.
When Columbus landed in South America in 1492, he brought with him hemp rope, which introduced it to the natives at the time. It became so important in America, that by 1619, the Jamestown Virginia colony had enacted a grow law to ensure that all farmers produced hemp. It was adopted directly into Western medicine in the late 1930’s by William O’Shaughnessy, who incorporated what he learned from being a part of the British East India Company, into his medical practice, even releasing the publication Bengal Dispensatory and Pharmacopoeia in 1842.
Benefits of cannabis tea
One of the main benefits of cannabis tea, is that as an edible, it goes through the digestive tract rather than being absorbed into the lungs, and this means the converting of THC to 11-hydroxy-THC which lasts significantly longer (4-6+ hours) than standard smoking (1-2 hours). It’s also thought that the water solubility of 11-hydroxy-THC allows it to pass through the blood brain barrier more easily. Plus, as a tea, it can be slowly ingested to get dosing correct, or as a way to microdose over time.
As an edible in general, it comes with the benefit of not being smoked, and not coming with all the issues that smoking comes with. Though this can be horribly misunderstood, it’s not about smoking tobacco which causes the smoking-related health problems, it’s the lighting something on fire and breathing it in. We know this as smoke inhalation, and it gets tied to smoking cigarettes so frequently, as smoking cigarettes is essentially forcing a body to go through constant smoke inhalation. Drinking a tea bypasses this danger entirely.
One detraction, is that, much like other edibles, cannabis tea can take time to set in, since it must make it through the digestive tract. However, as a liquid, it can sometimes start a bit sooner, with some saying as quick as 30 minutes after ingestion. This would make it one of the faster working edibles.
Brew your own cannabis tea
We know a few things about cannabis. We know its fat soluble and not water soluble which is important to know when making a cannabis tea, as simply boiling the cannabis in water won’t give the cannabinoids anything to attach to, making it difficult to make a good tea. Even simply boiling it will not be enough to decarboxylate the plant if that’s the desire (though it doesn’t have to be).
The decarboxylation process converts THCA to THC, which allows for more psychoactive effects. But THCA also has plenty of health value, so whether the cannabis is decarbed or not, is your personal preference. Tea can be made by simply boiling the cannabis, by boiling the cannabis with an oil, or to make an infused tea with already made cannabis oil or tincture.
General recipe – This recipe is basic and calls for the following. It can easily be modified based on what the user is specifically going for. For example, cannabis can be decarbed first, or not. An infused oil can be added, or not. And additional ingredients like honey and lemon can vary, as well as whether those products – like honey – are also infused.
1 gram – ground cannabis
1 tablespoon – unsalted butter or coconut oil (whichever you prefer)
1 teabag (any kind)
4 cups of water
Any ingredients desired for flavor – honey, milk, sugar, cinnamon, etc.
Cheesecloth or a fine strainer
And the steps for use are the following:
1 – Take four cups of water and boil, and once boiling, add tablespoon of butter or coconut oil and let it melt completely, this will allow the cannabinoids to bind to something in the liquid.
2 – Once dissolved, add in ground cannabis into the boiling liquid, and then lower the temperature to a simmer.
3 – Simmer the mixture for 15 minutes. This time period can be lengthened at lower simmering temperatures, in order to preserve more compounds of the plant which can be hurt by high heat.
4 – When simmering is done, strain out the cannabis matter. You can use cheesecloth, by securing it around the top of the bowl being used with a rubber-band or string. Pour the mixture through the cheesecloth so the weed matter stays on the cloth and the liquid ends up in the bowl/jar/teapot. A metal strainer can be used, but use one with fine straining, as bigger holes will let more particles through.
5 – Add in your teabag for flavor, and any other extra ingredients like mint, lemon, or honey. Not everyone will love the taste of cannabis tea straight, so adding in flavoring might be a good idea for a more enjoyable experience. Steep for a few minutes. This method involves a minor decarb in letting the cannabis simmer with the oil for a period of time, but not at the higher temperatures an oven would use. Conversely, decarbing the cannabis first would create a stronger THC tea, rather than a THCA tea. Or, to use a butter or oil already infused with decarbed cannabis.
There are plenty of great products to be bought in life, but sometimes if you really want something done to your own specifications, it means doing it yourself. Cannabis tea is easy enough to make, and can be made by anyone looking to get just medical properties, or for a drink to make them feel really good. The best part of DIY processes? You control the outcome. Enjoy!
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Disclaimer: Hi, I’m a researcher and writer. I’m not a doctor, lawyer, or businessperson. All information in my articles is sourced and referenced, and all opinions stated are mine. I am not giving anyone advice, and though I am more than happy to discuss topics, should someone have a further question or concern, they should seek guidance from a relevant professional.
About a year ago, a new cannabis product, Canna Bumps, appeared on the California market, encouraging people to snort their cannabis. The product managed a remarkable feat: uniting the otherwise splintered and fractious legalization movement and the marijuana industry like never before. Cannabumps refers to a crystalized, high-potency THC resembling a fine white powder that California company THC Living cheekily packaged in a small clear vial along with a little spoon, meant to be snorted. Everybody hated it.
“We didn’t legalize marijuana for this,” was one common line of critique. “Products like Canna Bumps don’t merely offend the good taste of consumers and colleagues in the cannabis industry. They do real harm,” wrote Leafly’s Bruce Barcott last May. “They help keep cannabis illegal for hundreds of millions of Americans…They hurt medical marijuana patients and cannabis consumers across the nation.
For anyone living in an artificial “good drugs, bad drugs” binary trying to push mainstream acceptance of cannabis, this was (so to speak) over the line.
However, despite the product’s controversial nature, a recently published study reveals that Canna Bumps might have been ahead of its time. Turns out, snorting cannabis is even more scientifically sound than most cannabis available on the adult-use market, perhaps in spite of its marketing. And since it’s more efficient than smoking or eating, as more of the drug is absorbed in a shorter period of time, it’s arguably far more “medicinal.”
The Science of Snorting Cannabis
It’s long been accepted that smoking or vaporizing cannabis, while extremely popular, is also sloppy and inefficient, as well as unhealthy. Cannabinoids are burned away and lost in the smoke; tar and unhealthy carcinogens are inhaled into the lungs.
Eating cannabis is certainly healthier, but since the effects take much longer to be felt, edibles aren’t ideal for quick relief. For a while, cannabis suppositories were offered up as the healthiest and “most medicinal” method of consuming cannabis, particularly for patients with extreme nausea and/or breathing issues, for whom eating or smoking presented barriers. But this was also the least practical method.
That leaves nasal inhalation as a possible and likely vector. And as a study of a “nanoparticle cannabinoid spray for oromucosal delivery” published in the journal Medical Cannabis and Cannabinoids in January found, nasal inhalation—or “snorting,” or the same way allergy sufferers (well hello, spring and pollen) consume their glucocorticoids–-is fast-acting and efficient, while presenting no issues for people with lung or stomach problems.
One metric for drug-delivery efficiency is a value called “area under the curve,” or AUC. An AUC value represents “total drug exposure across time,” or how much of a drug the body can absorb within a certain period. AUC is one method of determining bioavailability. And “despite administration of a lower dose,” “higher AUC values” were detected in 12 healthy subjects who tried the oromucosal cannabinoid spray.
What’s more, the sprays resulted in “no serious adverse effects” and “only minor psychotropic effects” at the dosage given (12 sprays, 3.96 mg of THC, according to the study).
That low level might not satisfy Canna Bumps customers, who are presumably trying to get really ripped, really fast—something anyone promoting, or at least tolerating dabbing, can’t in any good faith condemn. But the takeaway is clear: Snorting cannabis works. Snorting is even good.
Snort Em if You Got ‘Em
Cannabis flower still rules both the medicinal and adult-use markets. But after two years of the COVID-19 pandemic—which came on the heels of the vaporizer-lung crisis—“people also care about their lungs more than ever,” observed Bob Langlais, the head curator at Massachusetts-based Lucida Club, a self-described “cannabis platform” geared towards beginners.
Many Lucida Club patrons complain about breathing issues—and Langlais himself cops to being beset by chronic bronchitis after smoking, despite thoroughly enjoying the immediate delights of a hash rosin hit. Further, he’s noticed a need for high-potency, non-combustible products that aren’t cookies or chocolate bars, for people with diabetes or with nausea for whom eating a bunch of chocolate just isn’t feasible. In this context, nasal sprays are “extremely exciting,” he said.
“I think the applications for medical cannabis are huge,” Langlais said, adding that Cannabumps’ downfall was their marketing strategy. “I think they were onto something. I just wish they’d rebranded something more marketable.”
Ross Anderson, the chief operating officer of Austin, Texas-based CBD company Elevated Wellness, learned that consumers may try snorting a product even if it isn’t marketed that way.
Elevated Wellness has a line of powdered drink mixes using nano-encapsulation technology, the same fast-acting method used in most cannabis drinks. “We had a guy from New York come in and get some—and he snorted it all,” Anderson recounted. When Anderson and his stunned team asked the New York guy how it went, the answer was swift and unequivocal. “Fantastic,” the man said.
“I just think [snorting] is something not a lot of people think about… but it makes all the sense in the world,” Anderson said. “It’s so much more immediate of relief, you get considerably higher bioavailability, so you can in theory take lower doses. We do it with all these other drugs—why not with cannabis?”
Ketamine is the new medical trend, though its been popular on the recreational market since the 80’s, and enjoys use as a legal schedule III anesthetic. For those who use it, the term ‘k-hole’ should be familiar, and for those who want to get into it, it’s a good thing to know about.
Ketamine proposes a great alternative for pain management and the treatment of psychological disorders, but users should be aware of what can happen when too much is taken. A k-hole isn’t life threatening, but can send a user to an out-of-control place. We cover everything important in the emerging industry of psychedelics, which you can read about in The Psychedelics Weekly Newsletter. Keep up with everything going on, and be the first to get access to new deals for psychedelic products as they come in.
What is ketamine?
The drug ketamine is a dissociative anesthetic with this chemical formula: C13H16ClNO. Though it enjoys a large recreational following, the drug was approved in 1970 by the FDA as an anesthetic, having been found for that purpose by Parke-David Pharmaceutical company in 1962. It’s called a ‘dissociative anesthetic’, because that sounded better at the time to researchers than the word ‘psychedelic’, however, it does have the ability to make parts of the brain feel like they are dissociating from each other.
Ketamine was only cleared for use as an anesthetic, even though it was found in original testing that it was a good drug for pain, as well as having the ability to promote beneficial psychological effects. Whether this was purposefully ignored, or just not flushed out fully at the time, is hard to say, but a close relative of ketamine, called esketamine, was approved by the FDA in 2019 for use with depression, and subsequently, suicidal ideation.
While ketamine was not given this approval, there is a loophole that allows easy – and legal – access to the masses, should they have the money to pay for it. As a legal drug, ketamine can be prescribed by any doctor off-label. This FDA-approved process means that even though ketamine is not meant for things like pain management and depression according to the FDA, it can be used for these things if a doctor feels it would benefit a patient.
This has led to a massive gray-market ketamine industry full of clinics where patients can receive both a prescription for use, and the drug treatment itself. This is generally done via IV, though those who opt for the esketamine treatment, will receive it via nasal spray. Esketamine treatment requires the use of a monoamine antidepressant at the same time, making it less desirable for many patients, especially if they’re seeking ketamine treatment to avoid standard antidepressants.
Ketamine used in a recreational way generally comes as a white powder which is snorted. It creates a high that sort of feels like floating, and the dissociation in the brain can be felt, like different sides pulling away from each other. It can distort the senses, cause minor hallucinations, and promote overall feelings of well-being in a user. For me it distorted sound, made things move slower, and made my body feel heavy, but in a good, sort of relaxed way.
What’s a k-hole?
First off, it’s good to remember that ketamine is an anesthetic. When used as an anesthetic, the entire point is to essentially incapacitate a person, meaning its meant to be strong enough to knock a person out, or if not knock them out, get them close to it. A k-hole is like a person accidentally anesthetizing themselves.
When a person gets into a k-hole, they lose control of certain abilities. Think of a person under anesthesia, they’re usually not following a conversation, or walking around, or responding to anything. Such is the same with a k-hole. The body is inundated to the point that functionality is lost. While some local anesthetics do allow a patient to remain awake and alert, (something that’s important for certain procedures), ketamine is a general anesthetic, and when the body has too much of it, it kind of shuts down certain functions.
This can be seen as a form of overdose, but when it’s used as an anesthetic, this is the desired effect. A person will essentially feel so dissociated up top, that they can’t control their body or reactions anymore. This doesn’t mean a loss of bladder control, or for the lungs to stop, but it does serve an important purpose, in keeping a person from taking more. It’s important to understand that unlike overdosing on a drug like heroin, where basic autonomic functions (like breathing and heart rate) can be interrupted to the point of death, ketamine doesn’t do this, though it can certainly cause alterations in heart rate and blood pressure.
When you think about it, its like a pre-overdose. The body shuts down in certain ways, but this acts as a safety mechanism, as a person in this state can’t consume more. In this way, its actually difficult to overdose on ketamine, as the body will enter this phase before the point of overdose, making it difficult for a user to use enough to actually kill them. It’s almost like a built-in safety mechanism to stop real overdosing from happening. When used as an anesthesia, there is always a doctor to monitor levels, so this isn’t a problem. When used for recreational purposes, a k-hole acts as a barrier to further use.
Why does a k-hole happen?
In terms of what causes this response, it’s not well understood, but one study into sheep did shed some light on it. In a 2020 study entitled Characteristic patterns of EEG oscillations in sheep (Ovis aries) induced by ketamine may explain the psychotropic effects seen in humans, the cortical electroencephalography (EEG) response was examined in 12 sheep given ketamine.
It was found that there were immediate and wide-ranging changes in EEG patterns, which affected all parts of the EEG spectrum. As the ketamine wore off, the lower frequencies, which had been more prevalent, led to alternating EEG frequencies going back in forth in short periods from low to high and back again. It’s thought that this oscillation highlights the dissociative aspect of ketamine, as this phase of oscillation is when things like hallucinations occur.
However, when a very high dose was administered of 24 mg/kg, there was a complete stop to activity related to cortical EEG, which lasted for a few minutes before regular function resumed. While it can’t be said for sure, and much more research must be done, this study provides the first indication of what could be causing the k-hole state in both animals and humans at high doses of ketamine. As of yet, this state has not shown to produce damage in the user, but again, much more research needs to be done. Another important question to it all, is what would happen if more ketamine was administered during this extreme phase, and whether at that point, there would be more chance of death.
What does a k-hole feel like?
At one point I did a bit of ketamine with an ex-boyfriend. It wasn’t really my thing in the end, and I never did large amounts. In fact, I was always mindful of this k-hole idea. I remember watching a friend tear through lines, and thinking that I’d for sure get the chance to see a k-hole in action. As it turns out, a lot (and I mean A LOT) of ketamine can be used before this happens, and even my over-the-top friends never fell into a hole, at least not when I was there.
When in a k-hole a person isn’t asleep, and therefore at least somewhat aware. I know from my time on ketamine that awareness is definitely limited, even pre-k-hole, so a person in this state would be somewhat aware, but not completely, and in a state of general and mass confusion. While the person experiencing a k-hole is still technically able to hear, see, and feel things, these inputs are wildly confused by the brain, making an understanding of them difficult, or impossible, for the user. In most cases, things like speaking, or even moving, are out of the question. Depending on how much a person likes to be out-of-control, this can either be a scary feeling, or a relaxing feeling.
For many people its akin to an out-of-body experience, although I found my non-k-hole experience to be like that as well. I imagine it would be a more intense version of this. As ketamine causes confusion and disorientation to begin with, this would be emphasized during a k-hole, when the brain is struggling to make sense of things it can’t put together. For those like me who don’t like being out-of-control, this can create anxiety. Think of being on a rollercoaster, or simply being carried somewhere, and having no ability to stop it.
Now think of being confused as a child in a crowded place. Or looking into a distorted mirror. Or hearing sounds through water. These feelings or sensations could all be part of both a standard ketamine trip, and a k-hole experience. The main difference is that with standard use, a person usually maintains physical functionality, while someone in a k-hole does not.
How long does it last?
One of the positives of ketamine is that its short-acting. Most highs are over in about 30-45 minutes, so if you’re unhappy with your experience, you don’t have to experience it for long. This is beneficial for those who fall into a k-hole, in that it won’t last for a very long time. It can, however, take a few minutes to come on after ingestion, so users should be aware to pace themselves.
While it could seem like it goes on forever for a person in that state, the actual amount of time is relatively short. In contrast, if a person takes too much LSD and ends up in a bad trip, that bad trip might be experienced for many hours. In either case, death is not generally much of a fear, but extreme discomfort and confusion, are.
A k-hole is probably a good indication that a user needs to slow down. If you continuously put yourself in a position where you lose functionality, it might be worth thinking about how use you the substance. On the other hand, for those who like to force such loss in functionality, a k-hole could be seen as a bit of a brain vacation. As with anything that incapacitates a person, its best to know your surroundings and who you are with, as a loss of functionality could pose a threat under many circumstances. Think date rape, robberies, or simply ending up somewhere and having no idea where you are.
Can you die of a k-hole?
Your body will always try to stop you from going too far with something bad for you. When eating too much food, or drinking too much alcohol, for example, the body eventually shuts down, putting you to sleep. When you drink too much alcohol, or take too much of a something your body sees as a bad substance, you might throw up to get it out of your system. These are fail-safes your body uses to maintain control.
While alcohol can make a person tired, and is used by some to bring on sleep, the idea of passing out from drinking is different, and indicates the body needing to shut down to keep the drinker from consuming more. The body, of course, isn’t thinking of it like that, it’s a reactive measure of the way alcohol depresses the central nervous system, but by depressing it enough, it also keeps a person from consuming more, which can override it. Having said all this, passing out can also be an indication of alcohol poisoning itself, and if a person remains unresponsive for too long, they should receive emergency help.
Of course, we already know that a person can still drink themselves to death, eat themselves to death, or take too much of something poisonous. Much like anything else, a large enough dose of ketamine could be fatal, but this is written about so infrequently, that it seems the k-hole generally works at slowing down use. After all, if you can’t move or think right, you also can’t do another line. In fact, I’ve had a difficult time finding general amounts that can cause death, and ketamine deaths are extremely rare.
How much does it take? I did find one study that put it at 11.3 mg/kg via IV, or 678 mg if a person is about 154 pounds (70kg). That would be like doing over half a gram of cocaine at once. I mention cocaine because its more well-known as a recreational drug, and the idea of a line is understood, even if it’s not specifically consistent between people or occurrences. Both are short acting drugs where that amount can certainly be done over a period of time, but very few people will take an entire half gram of cocaine or more in one line, and the same is true of ketamine.
In terms of ketamine deaths in general, here is an indication of why we hear so little about it. One of the only statistics I could find comes from England, and establishes from coroner reports that between the years of 1997-2005 there were less than five deaths where ketamine was implicated. This is as per a National Programme on Substance Abuse Deaths database investigation from January 31st, 2020. It’s kind of hard to so much as call the drug dangerous, when the death statistics are so monumentally low, and only implicate the use of ketamine by the person who died, but not that it was the only substance used.
That ketamine is as safe as it is, might actually have to do with the k-hole effect, though this is just supposition on my part at the moment. A k-hole might be a point of intense confusion for the brain, but the inability to keep going, might also be beneficial. Not every drug affords us this, and with approximately 70,000 dying a year in the US from opioids, it makes the idea of a k-hole seem like a walk in the park.
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Disclaimer: Hi, I’m a researcher and writer. I’m not a doctor, lawyer, or businessperson. All information in my articles is sourced and referenced, and all opinions stated are mine. I am not giving anyone advice, and though I am more than happy to discuss topics, should someone have a further question or concern, they should seek guidance from a relevant professional.