With recreational marijuana legal in Illinois as of January 1, people have been lining up — in some instances, down the block — at state-licensed dispensaries, which have been selling out of product. The doors are now wide open to the health benefits of cannabis, although it’s no risk-free wonder drug.
While taking marijuana recreationally can be a fun way to unwind for some — similar to how some people enjoy a beer or a glass of wine — cannabis poses its own unique health risks. And, just as with alcohol, individuals should know how to use it safely.
On the bright side: Plant positives
Research shows that cannabis has medical benefits, such as helping to ease chronic pain, improve sleep and relieve nausea associated with chemotherapy. Because of these benefits, 33 states and Washington, D.C., have legalized medical marijuana.
Prior to the legalization of recreational marijuana, Illinois residents needed a medical marijuana card to buy cannabis. The state issued cards for more than 50 qualifying conditions, such as post-traumatic stress disorder (PTSD), severe fibromyalgia, spinal cord disease and cancer.
A 2017 review from the National Academies of Sciences, Engineering, and Medicine looked at 20 years of studies and found substantial evidence that cannabis or cannabinoids improved chronic pain, multiple sclerosis spasticity symptoms and nausea and vomiting due to chemotherapy. However, it found limited, insufficient or no evidence of its value for PTSD, anxiety, cancer, epilepsy and irritable bowel syndrome.
People most commonly use medical marijuana to treat chronic pain, according to a 2019 report in the journal Health Affairs. It offers a safer alternative to highly addictive opioids for pain management.
Marijuana interacts with the brain’s cannabinoid receptors, leading to changes in the levels of neurotransmitters. Rather than reducing the intensity of the actual pain, THC can make the experience of pain more bearable, according to a small-scale 2012 study in the journal Pain.
Marijuana’s benefits and detriments shift based on strain, dosage and other factors. Dispensary staff are a good resource.
“Our staff is incredibly knowledgeable and trained in regard to strains and dosage, and we have a range of educational materials at our store as well,” says Steve Weisman, owner and CEO of Windy City Cannabis, a South Chicago dispensary chain with four suburban locations.
If you use marijuana medically or recreationally, be sure to discuss usage with your physician.
Photo: Windy City Cannabis
The cons: Health cautions
Like smoking cigarettes, inhaling marijuana smoke carries a risk of respiratory effects, says Sahib Gill, MD, an addiction medicine physician with AMITA Health Medical Group in Westmont. Gill is also on staff as a consultant at AMITA Health Hinsdale and La Grange hospitals for detoxification and toxicology cases.
“People with respiratory conditions, like severe asthma and COPD, should not be smoking marijuana, as it can exacerbate their illness,” Gill says. “And in fact, many of the same toxic chemicals found in cigarettes are also present in marijuana smoke.”
Cannabis tinctures, topicals and edibles — such as drops, lotions or cannabis-infused chocolate — are naturally safer for your lungs.
Edibles carry their own risks, as it’s easier to ingest too much because their effects are not felt immediately. Because edibles are processed through the body’s digestive system, it can take 30 minutes to over an hour to feel the effects of marijuana’s psychoactive ingredient, THC. Trouble arises when people continue to consume more marijuana because they don’t feel an immediate high.
While vaping has often been touted as a safer alternative to smoking, research shows it also poses significant injury risk to the lungs. Plus, the vitamin E acetate in some vapes has been linked to recent vaping deaths.
“We see cases of vaping-induced lung injury throughout the country, and one of the big culprits has been bootleg vaping canisters,” says Steven E. Aks, DO, director of the division of toxicology for Cook County Health at John H. Stroger, Jr. Hospital.
Gill adds, “Researchers have found that vitamin E acetate in vape cartridges is one of the agents responsible for a lot of lung injury. The chemical is a cutting agent used to stretch the amount of marijuana or cannabis in the actual [vaping] oil, causing a reaction analogous to having a chemical burn in the lungs.”
Lungs aren’t the only organ at risk. Anyone over age 21 can legally purchase marijuana in Illinois, but young adults should proceed with caution, because of marijuana’s effect on the developing brain.
“The brain is continuing to grow, develop and make connections through the age of 25,” Gill says.
A 2013 study in the journal Frontiers in Psychiatry shows that marijuana use in adolescence can “potentially usurp normal adolescent neurodevelopment, shifting the brain’s developmental trajectory toward a disease-vulnerable state” and predispose individuals to motivational, mood and psychotic disorders.
Marijuana use is also generally not recommended for individuals with some pre-existing mental health conditions. “People with a history of or active psychiatric illness — for example, depression, severe anxiety and other mood disorders — are recommended against taking marijuana, as long-term marijuana use can worsen their underlying psychiatric illness,” Gill says.
Addiction can also be a concern. “Anyone with a history of a substance use disorder or an addiction in the past may be at risk for acquiring an addiction to marijuana,” Gill says. In fact, according to the DSM-5, 9% of individuals exposed to cannabis will develop a cannabis use disorder.
How to be safe
If you’re curious about trying legal marijuana, check out these tips for a safe experience.
- Know your dose. Recreational marijuana labeling varies, with some products providing more detailed dosage information than others. Inhaled marijuana, whether through smoking or vaping, has an immediate effect. By inhaling just a little at a time and waiting 10 to 15 minutes between inhalations, you can get an idea of the appropriate amount for you.
- For edibles, start low and go slow. It can take an hour to feel the effects of edibles. So start with a small amount, and give it time, waiting to see what its effects are. “One of the greatest pitfalls that we worry about for patients is that they take an edible and they think it has no effect,” Aks says. “So, they take more and they take more, and then this big dose stacks up and hits them. They can go down a road of a really bad, adverse reaction.”
- Don’t use marijuana and drive. Marijuana consumption slows reaction time, which increases the risk of car accidents. “By slowing your reaction time, your ability to react to a sudden stimulus while driving is slowed down. It impairs concentration,” Gill says. “Also, high-potency marijuana can increase drowsiness. So, you’re not just at risk for getting into an accident, but you’re a risk for everyone else.” Illinois law prohibits driving while high from marijuana, but as Aks notes, there is currently no standard measurement for marijuana impairment.
- Try CBD. This marijuana-derived substance does not contain psychoactive THC and so does not cause a high or have the potential for addiction or abuse. CBD — found in products from soaps to teas to chewing gum — has exploded in popularity over the past few years.