Is edible cannabis safer than smoking?
Cannabis-infused chocolate fountains are flowing at weddings. “Budtenders” pour cannabis cocktails. As sales of edibles grow, cannabis brands are emphasizing the idea that the products may offer a healthier alternative to bongs or buds.
“Edibles allow you to enjoy cannabis without the negative side effects of smoking,” says the website for Kiva, which makes cannabis chocolate bars and fruit-flavored gummies.
Consumers are increasingly wondering whether this is so, but the answer is complex. There is little research comparing the health effects of eating and smoking head-to-head. What we know so far comes largely from limited data, anecdotes, and inferences from researchers and clinicians.
“There are a lot of nuances there,” said Ryan Fandrey, 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 e-cigarettes – there are different risks to different methods.”
Edible foods are difficult to eat
When someone smokes a cigarette, the high hits almost immediately and then fades away within a few hours. But cannabis in foods takes its time traveling through the digestive system. It can take anywhere from 30 minutes to several hours for users to feel the effects, said Daniel Barros, a pharmacologist at the nonprofit research organization RTI International. This timing can vary even for experienced cannabis consumers, because the contents of your stomach affect how quickly you start taking cannabis, said Dr. Colin Reeve, clinical assistant professor of psychiatry at NYU Grossman School of Medicine.
As a result, consumers can end up taking an extra bite of cake or eating another candy bar to feel more of the effect — and end up with very high levels when the drug finally takes effect, sometimes causing paranoia, delusions, and panic attacks. These effects usually subside within hours, but people can have rapid, accelerating heart rates, prompting some to seek medical care.
“I see much more negative outcomes in people who use edibles,” Dr. Reeve said.
A study of marijuana-related emergency department visits at a large Colorado hospital found that people who consumed edibles were more likely to end up in the emergency room. (Total admissions were higher for smokers, likely because far more people smoked than used edibles, according to state cannabis sales data.) People who consumed edibles were more likely to have cardiovascular disease or psychiatric symptoms Sharper than those who smoke.
Far more people consume foods safely every day than end up in the hospital, noted Dr. Andrew Monti, professor of emergency medicine and medical toxicology at the University of Colorado School of Medicine and lead author of the study.
Edible foods can trigger more severe highs
Edibles can sometimes cause a more severe case of intoxication than smoking, because of how the body metabolizes the main compound in cannabis, tetrahydrocannabinol (THC), said James MacKillop, director of the Michael J. DeGroote Center for Medical Cannabis Research at McMaster University.
Even for experienced users, foods can have a powerful effect. For some people, this hike can be fun; For others, fear and anxiety can take over.
Edibles may be less addictive, Dr. MacKillop said, because in general, the faster a person feels the effects of a drug, the greater the chance the user will become addicted. A study conducted last year found that nearly one-fifth of people who use cannabis develop a cannabis use disorder.
The danger of smoking on the respiratory system
Smoking any substance may harm the lungs.
Cannabis smoke contains many of the toxic chemicals and carcinogens found in cigarette smoke, and the drug, when smoked, can damage lung tissue and blood vessels, according to the Centers for Disease Control and Prevention. Method also matters: When people smoke a cigarette or blunt, they also inhale particles from rolling papers or wrappers, as well as particles from the cannabis itself, both of which can harm the lungs.
E-cigarettes heat cannabis through a different method than joints, bongs and pipes, so e-cigarettes can help consumers avoid harmful compounds like carbon monoxide and tar, Dr. Barros said. But e-cigarettes still expose the lungs to irritants, and some evidence has found that e-cigarettes generate dangerous emissions. Cases of vaping-related illnesses and injuries, caused by contaminants found in e-cigarettes, have been worrying doctors for years.
Dr. Barros said people who smoke cannabis appear to be more susceptible to bronchitis, and smoke can obviously irritate the lungs significantly. But studies have not conclusively proven that smoking cannabis can cause lung cancer, as smoking tobacco does.