Marijuana Edibles and Extracts

Marijuana is commonly smoked, but it can also be consumed through various other means, including edible products, including cookies, brownies, and soft (gummies) and hard candy, and extracts of the marijuana plant, such as wax.1

Marijuana comes from the hemp plant. The stems, leaves, flowers, and seeds of the plant contain a chemical called delta-9-tetrahydrocannabinol, commonly known as THC.1 This is the mind-altering compound that causes the effects felt by eating or smoking marijuana. The amount of THC varies between strains of marijuana plants and between types of marijuana products.2 Marijuana extracts contain extremely large amounts of THC.1

Marijuana is the most commonly used drug in the United States, after alcohol.1 According to the National Survey on Drug Use and Health, an estimated 43.5 million Americans aged 12 or older (15.9% of the population) in 2018 used marijuana in the past year.3 Marijuana use has increased in recent years, especially among adolescents and young adults. Daily or almost daily use of marijuana amongst Americans aged 18-25 rose from 4.3% in 2002 to 7.3% in 2018.3

Methods of Consumption

Marijuana is typically smoked, and inhalation produces the most rapid onset and intense “high.”2,4,5 However, marijuana edibles—foods that contain marijuana—are a popular method of consumption nationwide.

A 2014 survey of adults in the U.S. saw almost 30% of respondents who had ever used cannabis reporting that they consumed it in edible or beverage form.4 Edibles are especially popular in states where medicinal and/or recreational use is legal.6

Common edibles include baked goods (e.g., brownies, cookies, etc.), candies, gummies, chocolates, lozenges, and beverages.6 They may be prepared commercially for dispensaries or be homemade.6

A method of marijuana intake that has risen in popularity in recent years is the smoking of THC-dense resin, which is extracted from marijuana plants.1 This is called dabbing. Smoking marijuana extracts requires a vaporizer, which heats and evaporates the resin so it can be inhaled. Marijuana extracts come in several different forms, including:1

  • Hash oil or honey oil, which is a sticky liquid.
  • Wax or butter, which is a soft solid with the consistency of wax or lip balm.
  • Shatter, which is a hard, transparent solid.

Effects of THC

Smoking marijuana is the fastest delivery system for THC into the bloodstream, with effects felt within 10 minutes.5 Eating or drinking marijuana slows the process, and it can take 30 minutes to an hour for effects to set in, with peak effects at approximately 3 hours.1,5 The bloodstream carries THC to the brain almost immediately. The chemical causes overstimulation within certain parts of the brain, which causes the high users experience. Short-term effects of a low to moderate dose of THC (10 to 30 mg) include:1

  • Altered senses or experience of time.
  • Impaired movement.
  • Impaired judgment and thinking.
  • Impaired memory.
  • Euphoria.
  • Sleepiness or relaxation.
  • Increased appetite.

High doses of THC can have many unpleasant negative effects including:1

  • Paranoia.
  • Anxiety or panic.
  • Psychotic symptoms such as hallucinations.
  • Nausea and vomiting.

Dangers of Edibles and Extracts

In Colorado, one of the first states to legalize recreational marijuana, edible products are responsible for the majority of health care visits due to marijuana intoxication for all ages.5 From 2014 to 2016, 10.7% of all visits to the emergency room were attributable to edible cannabis.7

Oral consumption of marijuana in an edible is strongly associated with unintentional overconsumption leading to the unpleasant and potentially dangerous effects described above.6

With effects not felt for several hours after ingestion, it can be easy for individuals—certainly for inexperienced users but even also for regular users—to consume more THC than intended.7 A single cookie may contain 100 mg and be marked as having 10 servings, but many find it difficult to eat a tenth of a cookie.5.6 Furthermore, manufacturing practices for marijuana edibles aren’t standardized and lead to products with inconsistent THC concentrations that may differ vastly from what’s marked on the packaging.5

Marijuana extracts can be extremely potent. In 2014, the average THC content in confiscated marijuana samples was 12.2%, however, the average marijuana extract contains more than 50% THC, with some exceeding 80%.8

Vaporizing THC resins, or “dabbing,” is also associated with delivering higher doses of THC—a large dose is administered in a single hit rather than a series of breaths, and with a higher THC concentration product, it can quickly lead to negative effects.9

The process of extracting marijuana concentrates is often done via a method requiring flammable chemicals.9 Amateur or at-home production of high-concentrate THC resins have resulted in a rise in potentially deadly hydrocarbon flash burns.9  The U.S. Drug Enforcement Agency reports that at least 19 people have been killed and 126 people injured by hash-oil fires in California since 2014.10

Marijuana Abuse and Addiction

Adverse effects experienced after the use of marijuana are not usually severe enough to require medical attention but using marijuana in high doses via edibles or vaporizing high-dose THC extracts may increase the severity of adverse effects.11

Long-term effects of marijuana have been linked to mental illness in some people. This includes temporary hallucinations and/or paranoia or worsening symptoms in patients with schizophrenia.1

It’s estimated that about 30% of marijuana users have some degree of marijuana use disorder, and people who begin using before the age of 18 are 4–7 times more likely to develop a marijuana use disorder than adults.8

Marijuana use disorder and marijuana addiction can be successfully treated, similar to any other drug abuse disorder.

References

  1. National Institute on Drug Abuse. (2019). DrugFacts: Marijuana.
  2. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  3. Center for Behavioral Health Statistics and Quality. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.
  4. Schauer, G. L., King, B. A., Bunnell, R. E., Promoff, G., & Mcafee, T. A. (2016). Toking, Vaping, and Eating for Health or Fun. American Journal of Preventive Medicine, 50(1), 1–8.
  5. Monte, A. A., Zane, R. D., & Heard, K. J. (2015). The implications of marijuana legalization in Colorado. JAMA, 313(3), 241–242.
  6. Barrus, D. G., Capogrossi, K. L., Cates, S. C., Gourdet, C. K., Peiper, N. C., Novak, S. P., … Wiley, J. L. (2016). Tasty THC: Promises and Challenges of Cannabis Edibles. Methods Report (RTI Press), November 2016.
  7. Volkow, N. D., & Baler, R. (2019). Emergency Department Visits from Edible Versus Inhalable Cannabis. Annals of Internal Medicine, 170(8), 569–570.
  8. National Institute on Drug Abuse. (2019). Research Report: Marijuana: Is marijuana addictive?
  9. Al-Zouabi, I., Stogner, J. M., Miller, B. L., & Lane, E. S. (2018). Butane hash oil and dabbing: Insights into use, amateur production techniques, and potential harm mitigation. Substance Abuse and Rehabilitation, 9, 91–101.
  10. U.S. Drug Enforcement Administration. (2017). 2017 National Drug Threat Assessment.
  11. National Institute on Drug Abuse. (2019). Research Report: Marijuana: What are marijuana’s effects?
About The Contributor
Ryan Kelley, NREMT
Medical Editor, American Addiction Centers
Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More