I recently received emails from an old friend who'd smoked grass for the first time and had a terrible anxiety attack. He sent me a study from England that showed 50% of participants had paranoid thoughts when injected with a heavy dose of pure THC. But ... read my notes to my friend regarding this study - it's seriously flawed.
But don't get me wrong - temporary anxiety can definitely arise with first-time users, especially those leaning toward being 'control freaks' with ego mechanisms that panic when the cannabis effect shifts them from 'in control' to 'in the flow'.
My own first cannabis experience, at 19 in 1966 at Princeton, resulted in a massive panic attack on my part. Why? I was entirely unprepared for the cannabis effect ... my friends and I were deathly afraid of getting caught and sent to prison for 20 years in New Jersey ... I myself was afraid of losing control, and even going crazy - and panicked when I did lose control ... and my three friends were even more afraid than I was, so I had no help. However, the very next weekend we smoked again - with zero anxiety or paranoia. I've never felt that terrible grip of paranoia again while high.
So - why did 50% of the British research study group experience paranoid thoughts? And why did a whopping 30% of the control non-cannabis group also report panic attacks? Here are my answers to my friend:
1) Don't Overdose Pure THC: A primary error in the research was assuming that refined/processed THC on its own, in high dosages, injected suddenly into the bloodstream, replicates the experience of smoking unprocessed grass. As this paper (see below link) from NIH reports, there are over 50 psychoactive chemicals in cannabis. Taken together while smoking, they balance each other and create the unique grass-high. Shooting pure THC in high doses is not a reasonable indicator of how grass induces anxiety attacks.
Comprehensive NIH Report:
2) Smoke It, Don't Inject or Eat It: Numerous bio-chemical studies show that when injected, THC goes first through the liver instead of directly into the brain as it does when smoked. Research shows that when the liver processes THC, it converts it into another similar chemical - and this chemical, that then goes to the brain, has not been studied act all. So the British study wasn't examining the effects of THC, but rather an internally-generated chemical.
Excellent Medical Report:
Detailed THC in Liver Explanation:
3) Balance THC & CBD: Smoking grass delivers a host of related chemicals to the brain, especially also CBD. Isolating THC is a big mistake in my opinion, even taking just CBD isn’t advised - smoking and vaping are optimal, cannabis pills in general not to my liking - because they lack the whole symphony of chemicals that natural grass includes when smoked. Again I refer you to the article on all this, from NIH:
Psychoactive Chemicals In Grass:
4) Manage Set & Setting: Set and setting are seriously important - so, what set-setting controls did the research include in this? Taking a big injected hit of THC would certainly get scary without proper guidance of user attention - that’s what I’m doing with my app, to minimize an anxiety reaction. Here's a good (government-generated) discussion:
Set & Setting Reports:
5) Take Just Enough: Momentary anxiety reactions when high for the first time are natural - getting stuck in that state is relatively rare for most people. But yes, certain personality types, in certain set/setting situations, when getting high for the first time, and taking overly-processed THC by injection, will probably have a very strange first high. I again ask - why did 30% of the control group freak out? And why do many other studies not demonstrate this level of freakout? Here's one of the best discussions of this topic:
Dosage and Purity Concerns:
6) Get Guidance When Needed: In America, on most college campuses, there’s an organization called ... that provides support for people using psychedelics, including cannabis, which is indeed a mild psychedelic. There are also a number of other organizations also that provide a ‘sitter’ trained to help people take cannabis successfully the first time. I am starting to work with my app at MAPS for instance, which is a leader in this work along with their serious research into psychedelics used in PTSD therapy. In most cities you can find a sitter quite readily, if this interests you.
Campus Psychedelic Groups:
Multidisciplinary Association for Psychedelic Studies:
In Sum: sometimes first users do have a panic attack when trying grass. This possibility can be reduced greatly by proper administration of dosage, ingestion format, set, and setting. The MindfullyHigh App can be used as part of this program. Our aim is to minimize risk and upset, while maximizing all the cannabis benefits.