Daily Dose Q&A

2026-01-30

How does cannabis consumption alter appetite and metabolism?

Cannabinoids influence both appetite and metabolism through CB1- and CB2-receptor pathways. While CB1 activation increases appetite and promotes energy storage, it also reduces insulin secretion and may contribute to glucose intolerance. Studies suggest that the endocannabinoid system modulates taste sensation

di Marzo, V., Piscitelli, F., & Mechoulam, R. (2011). Cannabinoids and endocannabinoids in metabolic disorders with focus on diabetes. In M. Schwanstecher (Ed.), Diabetes - Perspectives in Drug Therapy (Handbook of Experimental Pharmacology, Vol. 203, pp. 75-104). Springer. https://doi.org/10.1007/978-3-642-17214-4_11 Farrimond, J. A., Mercier, M. S., Whalley, B. J., & Williams, C. M. (2011). Cannabis sativa and the endogenous cannabinoid system: Therapeutic potential for appetite regulation. Phytotherapy Research, 25(2), 170-188. https://doi.org/10.1002/ptr.3265 Matias, I., Bisogno, T., & di Marzo, V. (2006). Endogenous cannabinoids in the brain and peripheral tissues: Regulation of their levels and control of food intake. International Journal of Obesity, 30(Suppl. 1), S7-S12. https://doi.org/10.1038/sj.ijo.0803270 Tibirica, E. (2010). The multiple functions of the endocannabinoid system: A focus on the regulation of food intake. Diabetology & Metabolic Syndrome, 2, 5-10. https://doi.org/10.1186/1758-5996-2-5

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