I recently received emails from an old college buddy who'd recently smoked pot for the first time ... and had a terrible anxiety attack. He sent me a study from England that showed 50% of participants in a study had experienced paranoid thoughts when injected with a heavy dose of pure THC.
Now he was now afraid to try cannabis again. I wrote back questioning the research (it's true that too-high dosages of injected THC can freak a lot of people out) and pointing him to studies showing that yes, around 10% of people getting high for the first time (especially in an unstable setting) can experience a bout of anxiety - but subsequently do fine with pot.
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 in a Princeton dorm, resulted in a massive panic attack on my part. Why? I was entirely unprepared for the cannabis effect ... plus my friends and I were deathly afraid of getting caught and sent to prison for 20 years in New Jersey ... and I myself was afraid of losing control, and even going crazy - and yes, I panicked when I did lose control.
My three friends were even more uptight than I was, so I had no help from them. However, the very next weekend we smoked again - with zero anxiety or paranoia. And 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 marijuana induces anxiety attacks.
2) Smoke or Vape It, Don't Inject or Eat It: Numerous bio-chemical studies show that when eaten or injected, THC goes first through the liver instead of directly to the brain as it does when smoked or vaped. And 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.
3) Balance THC & CBD: Smoking cannabis delivers a host of related chemicals to the brain. Isolating THC is a big mistake in my opinion, even taking just CBD isn’t advised - smoking and vaping are optimal. Cannabis pills and edibles in general are not to my liking - because they lack the whole symphony of chemicals that natural pot includes when smoked.
Here's some good NIH research: Psychoactive Chemicals In Cannabis
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 freak-out? 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 are now organizations 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.
In most cities you can find a sitter quite readily: Campus Psychedelic Groups & also Multidisciplinary Association for Psychedelic Studies:
In Sum: sometimes first users do have a panic attack when trying pot. This possibility can be reduced greatly by proper administration of dosage, ingestion format, set, and setting. The High Together App can effortlessly be used as part of this program. Our aim is to minimize risk and upset, while maximizing all the cannabis benefits.
For our online guidance program, please visit our High Together App page.