How to Manage a “Bad High” from Cannabis Edibles

How to Manage a "Bad High" from Cannabis Edibles

It finally happened to me..I went on a bad trip. Actually bad is an understatement- it was absolutely horrible. As a non-smoker (yep, that's right- I don't smoke weed) edibles, tinctures and drinks are my preferred methods of consumption. Last night, I took an edible (5mg THC) to go to sleep and everything went sideways. To be honest, I’m still a little disturbed by it because of how horrible it felt. 

For sleep I have my preferred edibles that work for me, but on this night I was out and asked my girlfriend to share one of hers. I don't always use THC for sleep, I go back and forth between CBD and THC for sleep depending on my mood. I wanted to disconnect from my thoughts before I went to bed, so I opted for THC. Unfortunately for your doctor, the absolute opposite happened 😣

Cannabis edibles are an increasingly popular way to enjoy the benefits of cannabis. However, their delayed onset and potent effects can sometimes lead to an overwhelming experience, commonly referred to as a "bad high" or "bad trip." These experiences can leave people with very unpleasant memories that can lead to a lifelong aversion or fear of consuming cannabis. For others it can even lead to hospitalization secondary to physical and/or mental health crises. Being that I know a little something about cannabis, let’s explore the science behind these experiences, including how cannabinoid receptors influence neurotransmitter release, who may be more susceptible, the health concerns associated with bad highs, their manifestations, and effective ways to manage them. Better strap in cuz we’re going for a ride 🙃

The Science Behind a "Bad High" from Edibles

Cannabis edibles take longer to produce effects because they are metabolized through the liver. This process converts THC (tetrahydrocannabinol) into 11-hydroxy-THC, a more potent metabolite that can intensify and prolong the psychoactive effects.

The Role of Cannabinoid Receptors

Cannabis affects the brain by interacting with cannabinoid receptors (CB1 and CB2) in the endocannabinoid system.

• CB1 receptors, primarily located in the brain, modulate the release of key neurotransmitters, including dopamine, serotonin, and glutamate.

• Excessive activation of CB1 receptors by high doses of THC can disrupt normal neurotransmitter balance, leading to:

  • Dopamine surges, which may initially feel euphoric but can quickly turn to anxiety or paranoia at high levels.

  • Reduced GABA release, contributing to feelings of panic and overstimulation.

  • Glutamate dysregulation, which can cause sensory distortions and confusion.

Pearls:

• THC interacts with CB1 receptors to alter neurotransmitter release, which contributes to the symptoms of a bad high.

• Imbalances in dopamine, serotonin, and glutamate can cause anxiety, paranoia, and sensory distortions.

Who is Most Susceptible to a Bad High?

Certain populations are more likely to experience adverse effects:

• Cannabis-Naive Users: Those unfamiliar with THC’s effects are less tolerant to its psychoactive properties.

• Individuals with Anxiety Disorders: THC can intensify underlying anxiety, especially at high doses.

• Low Body Weight or Sensitivity: Lighter individuals may experience stronger effects due to lower THC thresholds.

• Adolescents and Older Adults: These groups are more vulnerable to heightened sensitivity due to brain development or slower metabolism.

Demographic Insights

• Studies are suggesting that younger cannabis users (aged 18–24) have greater risk of  experiencing a bad high from consuming cannabis, compared to those over 55.

• Women may be more prone to bad highs due to hormonal fluctuations affecting THC metabolism.

Pearls:

• Younger users and those new to cannabis are more likely to experience bad highs due to low tolerance.

• Women and individuals with anxiety are particularly susceptible due to physiological and psychological factors.

Recognizing the Symptoms of a Bad High

A bad high can present with a range of physical and psychological symptoms:

• Physical Symptoms: Increased heart rate, sweating, dizziness, dry mouth, nausea, or vomiting.

• Psychological Symptoms: Intense anxiety, paranoia, sensory distortions, feelings of doom, or confusion.

• Cognitive Effects: Overstimulation or an inability to focus.

These symptoms stem from the overstimulation of CB1 receptors, which dysregulates normal brain signaling.

• Serotonin Overload: This can exacerbate feelings of unease or nausea.

• Dopamine Spikes and Crashes: Sudden mood swings, from euphoria to paranoia, are common.

Serious Health Concerns

Although a bad high is rarely life-threatening, it can pose risks for:

• Heart Conditions: Elevated heart rate and blood pressure may endanger individuals with cardiovascular issues.

• Psychiatric Disorders: THC can exacerbate symptoms in people with schizophrenia or bipolar disorder.

Pearls:

• Symptoms of a bad high are often tied to disruptions in neurotransmitter levels caused by THC.

• Pre-existing health conditions, like heart disease, can make bad highs more dangerous.

How to Manage a Bad High

If you or someone else experiences a bad high, these strategies can help:

1. Stay Calm and Ground Yourself

• Mindfulness Techniques: Focus on breathing slowly and deeply to reduce anxiety.

• Comfortable Environment: Move to a quiet, familiar place to minimize external stressors.

2. Hydrate and Snack

• Water: Staying hydrated can alleviate dry mouth and dizziness.

• Snacks: Foods rich in fats may help slow THC absorption and reduce its effects.

3. Use CBD

• CBD’s Role: Research shows CBD interacts with cannabinoid receptors differently than THC, potentially reducing anxiety and paranoia caused by THC overdoses.

• A 2019 study noted that CBD can counteract THC’s psychoactive effects, providing relief during a bad high.

4. Black Pepper and Lavender

• Black Pepper: Anecdotal evidence suggests smelling or chewing black peppercorns can calm anxiety.

• Lavender: Linalool, a terpene in lavender and lilac, is thought to have soothing properties.

5. Rest or Sleep

• Allowing the body time to metabolize THC naturally is often the best solution.

6. Medical Attention

• For severe symptoms like hallucinations, chest pain, or psychosis, seek professional medical help immediately.

Pearls:

• CBD has a scientifically supported role in alleviating the psychoactive effects of THC.

• Anecdotal remedies like black pepper and lemon may provide additional relief, though they lack robust scientific backing.

Wrapping It All Up

I’ve had a lot of patients tell me about their experiences with a bad high and their fear of edibles since. I’ve always given them advice like you’ve read in this post: hydrate, rest, take CBD etc, so you'd think I would've known what to do when it was my turn to start tripping. Nope. After that experience, I formulated a game plan with my girlfriend because I vocalized to her some of what I was experiencing: palpitations, anxiety, racing thoughts, uncontrolled emotions, etc.. The plan moving forward is that if I ever express those sentiments after taking an edible-  get me some CBD and some water STAT, then find a place for me to lay my tripping behind down 😅. And…never ever take that brand of edible again lol. 

As I mentioned, cannabis edibles can be an enjoyable and therapeutic way to consume marijuana, but their potent effects can sometimes lead to an overwhelming experience. Understanding how THC interacts with CB1 receptors and neurotransmitter systems highlights the science behind a bad high and provides valuable insights into how to manage it effectively. By starting with low doses, recognizing symptoms early, and employing strategies like using CBD or practicing mindfulness, you’ll have a better chance of navigating the challenges of a bad high.

Pearls:

• CB1 receptor activation and neurotransmitter imbalance underlie the symptoms of a bad high.

• Combining scientific and anecdotal remedies, such as CBD and grounding techniques, can alleviate symptoms effectively.

PS: For a safe and enjoyable cannabis experience, always remember to "start low and go slow." You can always take more, but you can never take less! If in doubt, consult a healthcare provider to ensure your safety.