Consuming Legalized Marijuana Is Blindsiding Out-of-Towners

Colorado visitors not used to potent marijuana are landing in emergency rooms.

Posted Feb 24, 2016

O'Dea/Wikimedia Commons
Cannabis shop in Denver, Colorado
Source: O'Dea/Wikimedia Commons

A new study advises anyone visiting a state with legalized marijuana to proceed with caution when ingesting cannabis products that you're unfamiliar with. Tourists are being caught off guard by the potency of various strains of legalized cannabis and medical marijuana.

According to the researchers, the increase of uninformed marijuana consumers has lead to a dramatic uptick in emergency room visits involving cannabis use by out-of-state visitors to Colorado since marijuana was legalized for retail sale at dispensaries in 2014.

The underestimated adverse side effects from cannabis listed in this study include: "psychiatric symptoms such as anxiety, hallucinations and altered mental status; cardiovascular symptoms such as a fast heart rate, high blood pressure or palpitations; and gastrointestinal symptoms including abdominal pain and vomiting."

The February 2016 study, "Marijuana Tourism and Emergency Department Visits in Colorado," was published in the New England Journal of Medicine. This research was conducted by doctors from Northwestern Medicine and the University of Colorado School of Medicine. From a public health perspective, the primary objective of this study (and this blog post) is to raise awareness about the unexpected consequences and adverse side effects of consuming potent marijuana. 

In November 2015, I wrote a Psychology Today blog post, “High Potency Marijuana Damages Cerebral Brain Connections,” based on a study which found that high potency “skunk-like" cannabis can damage the white matter nerve fibers in the corpus callosum. 

In that blog post, I spoke candidly about taking a big hit of high potency marijuana a few years ago that instantly took me "one toke over the line" and made me feel like I was tripping on LSD. As someone who hadn’t smoked pot in decades, it blew my mind how intensely skunk-like weed warped my perceptions of reality.

Smoking high potency marijuana triggered flashbacks to a traumatic 'bad trip' I had on psilocybin as a teenager, that had led me to stop using drugs. I have no doubt that if I ever ate a pot brownie loaded with potent cannabis while on vacation in Colorado that I would end up in the emergency room. This is something I have no interest in ever experiencing, which is why I'll "Just Say No." 

Edible Cannabis Products Can Lead to Unintentional Overconsumption

Source: BruceBlaus/Wikimedia Commons

The investigators of the recent study didn’t differentiate between how visitors to the emergency room had consumed cannabis. They did point out that edible products, such as cookies or brownies, have a delayed effect which can cause people to accidentally eat too much. Additionally, the content of edible products varies widely, so users often have no idea about the potency of the cannabis product they’re ingesting.

Dr. Howard Kim, a postdoctoral fellow in emergency medicine at Northwestern University Feinberg School of Medicine was the lead investigator of this study. Kim began the study when he was a resident at the University of Colorado School of Medicine.

After Marijuana was legalized, Kim and his colleagues in the ER began noticing that all too often out-of-towners who were visiting Colorado for business or pleasure ended up in the emergency room because they decided to try some marijuana. In a press release, Kim said,

"Emergency room visits related to cannabis use have increased more dramatically among out-of-state visitors than among Colorado residents. This may indicate that out-of-state visitors are unprepared for the adverse effects of marijuana use. People eating marijuana products often don't feel any effect immediately, leading them to eat another edible. Then they've ingested multiple products, so when the effect finally kicks in, it is much stronger."

Conclusion: The Side Effects of Marijuana Are Often Underestimated

In a press release, senior author Dr. Andrew Monte, assistant professor of emergency medicine at the University of Colorado School of Medicine said, "Everyone needs to be aware of the side effects of marijuana use." 

This new study highlights the importance of educating the public—especially any visitors to marijuana-legal states—on ways to safely use appropriate amounts of cannabis products. Kim and Monte recommend that any states considering liberalizing their marijuana policies should implement pre-emptive public health education campaigns to get the message out early about the potentially debilitating side effects of consuming legalized marijuana. 

Monte points out that the Colorado Department of Public Health and Environment's "Good to Know: Be Educated. Be Responsible." campaign has improved education of users across the state. This public health initiative has lowered the rates of emergency department visits among Colorado residents.

Unfortunately, these public service announcements often miss out-of-towners who are blindsided when they unwittingly consume marijuana that is much stronger than they expected. Although the acute symptoms that lead to an emergency room visit dissipate as the cannabis wears off, the long- and short-term side effects of overusing legalized cannabis present a wide range of public and personal health risks.

Below, Louis C.K. captures the essence of what it feels like for anyone who gets blindsided by extremely potent marijuana. 

To read more on this topic, check out my Psychology Today blog posts:

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