Are edibles safer than smoking?
Chocolate fountains filled with cannabis flow at weddings. “Budtenders” serve cannabis cocktails. And if sale of edibles are on the rise, cannabis brands are emphasizing the idea that the products can provide a healthier alternative to bongs or blunts.
“Edibles allow you to enjoy cannabis without the negative side effects of smoking,” reads the website of Kiva, which makes cannabis chocolate bars and fruit-flavored gummies.
Consumers are increasingly wondering whether that is the case, but the answer is complicated. There is little research comparing the health effects of edibles and smoking. What we know so far largely comes from limited data, anecdotes, and inferences from researchers and physicians.
“There's a lot of nuance to it,” says Ryan Vandrey, a professor of psychiatry and behavioral sciences at Johns Hopkins Medicine who studies cannabis. “You can't say in black and white that edibles are safer than smoking, or that smoking is worse than vaping – there are different risks for the different routes.”
Edibles are more difficult to dose
When someone smokes a joint, the high occurs almost immediately and then wears off within a few hours. But the cannabinoids in edibles take time to travel through the gastrointestinal tract. It can take anywhere from 30 minutes to several hours for users to feel the effects, says Daniel Barrus, a pharmacologist at the nonprofit research organization RTI International. That timing can vary even for experienced cannabis users, because the contents of your stomach affect how quickly an edible takes effect, said Dr. Collin Reiff, a clinical assistant professor of psychiatry at NYU Grossman School of Medicine.
As a result, consumers may end up nibbling an extra bite of a pot brownie or eating another gummy to feel more of an effect — and getting way too high when the drug finally kicks in, sometimes causing paranoia, delusions, and panic attacks. These effects usually disappear within a few hours, but people may have a rapid heart rate, leading some to seek medical attention.
“I see a lot more adverse effects in people who use edibles,” said Dr. Reiff.
An investigation of marijuana-related emergency department visits at a major Colorado hospital found that people who used edibles were more likely to end up in the emergency room. (Overall admissions were higher for smokers, most likely because many more people smoked than used edibles, according to state cannabis sales data.) People who used edibles were also more likely to have cardiovascular or acute psychiatric symptoms than those who smoked.
Many more people safely consume edibles every day than end up in the hospital, noted Dr. Andrew Monte, professor of emergency medicine and medical toxicology at the University of Colorado School of Medicine and lead author of the study.
Edibles can lead to more intense highs
Edibles can sometimes produce a more intense, intoxicating high than smoking because of the way the body metabolizes THC, the main compound in cannabis, says James MacKillop, director of the Michael G. DeGroote Center for Medicinal Cannabis Research at McMaster University.
Even for experienced users, edibles can have a powerful effect. For some people that high can be pleasant; for others, fear and anxiety can take over.
Edibles may have less addictive potential, said Dr. MacKillop, because in general, the faster someone feels the effects of a drug, the more likely the user is to become addicted. A study last year found that about a fifth of people who use cannabis develop a cannabis use disorder.
The respiratory risk of smoking
Smoking any substance can damage your lungs.
Cannabis smoke contains many of the same toxic chemicals and carcinogens as cigarette smoke, and the drug can damage lung tissue and blood vessels when smoked, according to the Center for Disease Control and Prevention. The method also matters: When people smoke a joint or blunt, they also inhale particulate matter from papers or wrappers, as well as particulate matter from the cannabis itself, both of which can damage the lungs.
Vapes heat cannabis differently than joints, bongs and pipes, and so vapes can help consumers avoid harmful substances like carbon monoxide and tar, said Dr. Barrus. But fumes still expose the lungs to irritants, and… some evidence has discovered that fumes generate hazardous emissions. Cases of vaping-related illnesses and injuries caused by contaminants in vapours have been concerned about doctors for years.
People who smoke cannabis appear to be at increased risk bronchitisand it's clear that smoke can significantly irritate the lungs, Dr. Barrus said. But studies have not definitively proven that smoking cannabis can cause lung cancer, as smoking tobacco does.