Statement of Safe Use of Cannabis
1996 Tod H. Mikuriya, M.D.
Cannabis - a Tool
Cannabis is a tool like other drugs, useful for many people if informed of its effects. With realistic
expectations, responsibility and common sense, appropriate use can range from total avoidance to using
cannabis several times a day.
Uncertainty of Potency
Because of current uncertainty of supply due to its illicit status, there can be great variability in
strength. Each batch must be cautiously tried.
Cannabis, when ingested safely, is one of the most useful medicines for a variety of conditions. These
include: pain, spasticity, anxiety, depression, headache, nausea, anorexia, epilepsy, asthma,
dysmenorrhea, premenstrual tension, withdrawal from other drugs, and glaucoma.
If used igorantly or imprudently, cannabis can be harmful.
Irritation of the throat and lungs is one of the most obvious
adverse effects to the marijuana smoker, as is the inevitable
cough upon inhaling.
The cough is the body's reaction to the irritation of the
numerous constituents of the smoke. Prolonged and repeated exposure
to these irritants can lower resistance to -- and aggravate infections
from -- viruses, bacteria, or fungi.
The lesser coughing, the safer the smoke. The fewer puffs
For these reasons, and to reduce harm to the user, it is better to use the more potent flower tops of
cannabis than leaves. Vaporization is even better. There are no breakdown products from burning with
moderate temperature (350-360 degrees Fahrenheit) but THC and THC like compounds vaporize. Additionally,
freedom from irritating combustion products permit greater appreciation of aromas and tastes..
Delta 1,9 tetrahydrocannabinol (THC), the psychoactive ingredient of cannabis, is a resin that vaporizes
at 155 to 157 degrees centigrade (311-318 degrees Fahrenheit) which is lower than the combustion point of
cellulose (Fahrenheit 451). Any way to decrease exposure of the throat and lungs to products of burning
reduces harm to the cannabis user.
Dosage and Route of Administration
Starting with a small amount and gradually increasing the dose is the key to avoiding unwanted mental side
effects. This is called self-titration, where the dosage is adjusted by the user depending on his or her
Being impatient, and consequently overdosing, with oral cannabis is the most frequently mentioned abuse of
the drug in the medical literature of the 1800's. Overdosage of oral cannabis is much more intense and
longer lasting than that of inhalation. Because of the 2-3 hours before the onset of effects, a common
mistake of the inexperienced is to repeat the oral dose. This results in overdosing.
Should the user take too much cannabis, her or she may experience the mental effects of time distortion,
racing thoughts, disorientation, speeding heart rate, dry mouth, and reddened eyes. The greater the dose,
the greater intensity and longer these stimulant effects will last before sinking into a deep sleep. No
lasting harm will result, but the experience will not be forgotten!
Other Adverse Effects
Other adverse mental effects are a prolonged dullness after use, paranoia, and a fear of loss of control.
Cannabis, an effective relaxant, can cause an alienation or detachment. The price of relief of tension may
be a dulling or suppression of feelings. Insensitivity to others' feelings or their situations may result.
Set and Setting
The result of the drug is a combination of set (expectations), setting, personality, and the drug.
Best case: Enjoying a puff or two sitting at home with a friend at the end of the day.
Worst case: Taking a puff driving down the freeway, then looking sideways into the eyes of a cop.
Personality and Individual Difference
Individuals with personalities that are prone to substance abuse, allergy, sensitivity, or adverse
reactions to other medicines should exert greater caution and try the drug only if absolutely necessary.
Dependence and Withdrawal
Because cannabis is such an effective medicine for the relief of many uncomfortable conditions, using the
drug on a continuing basis is not uncommon. One must decide issues of personal risks/benefits of
continuing using cannabis.
Withdrawal from chronic cannabis use produces several nights of more intense dreaming and possibly some
slightly increased nervousness during the day. An increase in exercise, if possible, and/or small amounts
of other sedatives will ease the transition from cannabis dependence.