Your Dose of Cannabis Education
Your Dose of Cannabis Education
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Your Dose of Cannabis Education is based on data from the studies and reviews published in the current peer-reviewed medical journals. Whether you are a healthcare provider, patient, caregiver, an individual working in the healthcare sector, or just a curious person, you can benefit from Your Dose of Cannabis Education.
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2026-01-29
In adults, cannabis use is not typically associated with a decrease in respiratory drive. Is the same true for pediatric patients?
No - in the case of pediatric cannabis exposures, the common findings include confusion, agitation, lethargy, tachycardia, ataxia, and vomiting, BUT "more concerning findings are hypotension, coma, respiratory depression, and seizure, which occur in Pepin, L. C., Simon, M. W., Banerji, S., et al. (2023). Toxic tetrahydrocannabinol (THC) dose in pediatric cannabis edible ingestions. Pediatrics, 152(3), e2023061374. https://doi.org/10.1542/peds.2023-061374
2026-01-28
Is dizziness a common side effect of THC?
There is good evidence that dizziness is among the most common non-serious adverse neurological side-effects of medical cannabinoids. For example, a systematic review covering a 40-year span of studies found that dizziness occurred in 15.5% of patients exposed to cannabinoid therapy.Wang, T., Collet, J. P., Shapiro, S., & Ware, M. A. (2008). Adverse effects of medical cannabinoids: A systematic review. Canadian Medical Association Journal, 178(13), 1669-1678. https://doi.org/10.1503/cmaj.071178
2026-01-27
Some cannabis consumers present to the ER with severe anxiety or psychosis requiring pharmacologic management. What medicines are approved to treat the anxiety or psychosis associated with cannabis use?
Although most cases of cannabis intoxication are mild and self-limited, some individuals present to the ER with severe anxiety, agitation, or psychosis requiring pharmacologic management. No medications are approved specifically for treating the anxiety, panic, or psychosis associated with cannabis intoxication. "Severe agitation or anxiety is controlled with benzodiazepines. Psychosis usually responds to a second-generation antipsychotic agent, and the dosage can be adjusted to account for the severity of the psychosis." (Gorelick)Gorelick, D. A. (2023). Cannabis-related disorders and toxic effects. The New England Journal of Medicine, 389, 2267-2275. https://doi.org/10.1056/NEJMra2306065 Weinstein, A. M., & Gorelick, D. A. (2011). Pharmacological treatment of cannabis dependence. Current Pharmaceutical Design, 17(14), 1351-1358.
2026-01-26
Does THC bind to plasma proteins?
According to the FDA's highlights of prescribing information for an orally administered THC-based product (Marinol), THC is highly bound to plasma proteins and may displace other drugs that also bind to these proteins. Adverse reactions can occur when THC is used concurrently with other highly protein-bound or narrow therapeutic index drugs, such as warfarin, cyclosporine, or amphotericin B, particularly when initiating or increasing the THC dose. Food and Drug Administration (FDA). (2005). Marinol (dronabinol) capsules: Highlights of prescribing information.U.S. Department of Health & Human Services. https://www.accessdata.fda.gov/drugsatfda_docs/label/2005/018651s021lbl.pdf
2026-01-23
What cytochrome p450 isoenzymes are induced by the polyaromatic hydrocarbons found in cannabis smoke?
Polyaromatic hydrocarbons present in cannabis smoke, as well as in tobacco smoke, have been shown to induce CYP1A2 activity. This enzyme induction can increase the clearance of drugs metabolized by CYP1A2, potentially leading to reduced plasma concentrations and reduced therapeutic efficacy. For example, chlorpromazine and other typical antipsychotics are metabolized by CYP1A2. In one study, cannabis smokers exhibited a 50% increase in chlorpromazine clearance, while individuals who smoked both cannabis and tobacco experienced an even greater increase of 107%. Similarly, patients who reported smoking cannabis demonstrated greater clearance of theophylline, (also a CYP1A2 substrate), compared with those who did not smoke cannabis. There is no evidence that orally consumed cannabis induces CYP1A2 activity. Jusko, W. J., Schentag, J. J., Clark, J. H., Gardner, M., & Yurchak, A. M. (1978). Enhanced biotransformation of theophylline in marihuana and tobacco smokers. Clinical Pharmacology & Therapeutics, 24(4), 406-410. https://doi.org/10.1002/cpt1978244406
Lopera, N. C., Ruiz, J. A., Rojas, C. A., & Manrique-Abril, F. G. (2023). Cannabinoids and the endocannabinoid system: An overview of their potential role in clinical practice. Frontiers in Pharmacology, 14, 1123457. https://doi.org/10.3389/fphar.2023.1123457
Stout SM, Cimino NM. (2014) Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: A systematic review. Drug Metab Rev Feb;46(1):86-95.
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