https://www.wsj.com/articles/marijuana-edibles-alcohol-questions-answered-11670278950?st=uinjxu6xnyhaa55&reflink=desktopwebshare_permalink
My friend made a bold declaration recently: She was going to stop drinking alcohol at home and take cannabis edibles instead because she thinks they’re healthier.
Are edibles actually better for you than alcohol—or at least less bad? More people are asking the question as edible products containing cannabis, often in gummy form, become widely available. As people explore other ways to relax, cannabis aficionados say that compared with alcohol, edibles have fewer calories, don’t disrupt sleep, and aren’t linked to diseases like cancer.
Making accurate comparisons between the vices is complicated by the fact that one has been around (and legal) for much longer than the other. We have decades of research on alcohol and a growing body of research is showing the health risks of smoking marijuana. Less well-studied are the health impacts of taking edibles, especially over the long term.
Both alcohol and edibles containing the psychoactive ingredient THC can impair your judgment, attention span, and coordination. That impairment can harm your ability to drive and raise your risk for other accidents, including falls, a particular concern for the elderly. Alcohol and THC both carry a risk of addiction.
The vices differ in other ways. Alcohol has well-researched links to cancer and heart disease. Cannabis edibles don’t have known links to such diseases, although some can temporarily elevate your heart rate. Edibles can cause short-term psychosis, raising the risk that a user could harm themselves or others. Researchers are still studying the long-term effects of edibles, including the possible risk of chronic mental health issues.
Cannabis Basics
To assess the health impact of edibles, it helps to understand that there’s a difference between the two components of the cannabis plant.
THC, or tetrahydrocannabinol, is the main psychoactive component of marijuana and is what causes the high. Cannabidiol, or CBD, used as a remedy for pain, sleep, and other health issues, doesn’t produce the high that THC does, doctors say.
Many edibles contain both THC and CBD. Potential health risks for the most part come from THC. However, CBD can interact with prescription drugs in ways that can be dangerous.
Cancer and Heart Risks
Smoking marijuana delivers toxins and carcinogens to the body, which are harmful to the lungs and cardiovascular system, according to the U.S. Centers for Disease Control and Prevention. There is no concrete evidence so far indicating that cannabis edibles are linked to cancer, researchers and doctors say.
Alcohol consumption is responsible for an estimated 5% of new cancer diagnoses and 5.8% of cancer deaths worldwide, according to the National Cancer Institute.
The THC in a gummy can elevate your heart rate for several hours, but it is unclear if that is associated with cardiovascular events like heart attacks, says Jeff Chen, co-founder and Chief Executive of Radicle Science, a startup running crowdsourced clinical trials on non pharmaceuticals and former executive director of the UCLA Cannabis Research Initiative.
“If you have a pre-existing heart condition, anything that artificially elevates your heart rate could put more strain on the heart, and you may want to avoid THC,” says Dr. Chen.
Psychosis
The main known risk of edibles with high amounts of THC is short-term psychosis, including feelings of paranoid delusions, suspiciousness, and possibly hallucinations, researchers say. Short-term psychosis can happen when people take too much THC, which is easy to do inadvertently with edibles because the active ingredients can take some time to kick in, doctors and researchers say. Unlike alcohol, it can take up to one or two hours for someone to feel the effect of THC edibles.
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Because gummies and other edibles don’t take effect immediately, some people consume more than they should. That increased dosage of THC raises the risk of short-term psychosis, says Nora Volkow, director of the National Institute on Drug Abuse. She adds that those prone to psychosis because of a personal or family history might want to avoid THC products. Psychosis is when someone experiences some loss of contact with reality.
Another potential health risk of THC edibles when taken in high doses is vomiting with intense stomach pain. This typically happens with long-term heavy use of THC products, says Dr. Volkow.
Prescription Drugs
Both THC and CBD affect an enzyme system in the liver that is responsible for metabolizing drugs. This means they can interact with other medications you might be taking. Alcohol can also interact with medications.
Drug interactions can be a big issue for elderly people, a fast-growing group of cannabis consumers, who often take many prescription medications.
How Much Is Too Much
U.S. dietary guidelines recommend that men limit alcohol intake to two drinks or fewer a day and that women consume no more than one drink a day. The guidelines apply to beer, wine and liquor. There is no equivalent guideline for cannabis, says George Koob, director of the National Institute on Alcohol Abuse and Alcoholism.
Five milligrams of THC is often considered a standard single dose, but first-time users should consider consuming less, says Staci Gruber, director of the Marijuana Investigations for Neuroscientific Discovery (MIND) program at McLean Hospital in Belmont, Mass.
Most states with legalized cannabis define a standard dose in an edible as containing 10 milligrams of THC, says Dr. Chen. That amount might be too much for some, particularly infrequent users who haven’t built up a tolerance, he says.
The effects of THC edibles peak 1.5 to three hours after ingestion and last five to eight hours, depending on the dose and the person, according to studies by Tory R. Spindle, assistant professor in the behavioral-pharmacology research unit at Johns Hopkins University School of Medicine.
It is best to know what you are consuming. Just as alcoholic beverages list ABV or alcohol by volume so you know how strong a drink is, buying cannabis from a licensed dispensary helps ensure that the products are licensed and have been through quality manufacturing practices, tested for purity and potency, and lack harmful contaminants, Dr. Chen advises.
