Cannabis-infused chocolate fountains flow at weddings. Buttenders pour cannabis cocktails. And as sales of edibles increase, cannabis brands are touting the idea that the products may offer a healthier alternative to bongs or blunts.
“Edibles allow you to enjoy cannabis without the negative side effects of smoking,” says the website of Kiva, which makes cannabis chocolate bars and fruit-flavored gummies.
Consumers are increasingly asking if this is true, but the answer is complicated. There is little research comparing the health effects of foods and smoking head-on. What we know so far comes largely from limited data, anecdotes, and conclusions from researchers and clinicians.
“There’s a lot of nuance there,” said 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 hits almost immediately and then wears off within a few hours. But cannabinoids in edibles take their time traveling through the gastrointestinal tract. It can take anywhere from 30 minutes to several hours for users to feel the effects, said 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 occurs, said Dr. Colin Reiff, clinical assistant professor of psychiatry at NYU’s Grossman School of Medicine.
As a result, users can end up taking an extra bite of a brownie or eating another piece of gum to feel more of an effect — and end up very high when the drug finally kicks in, sometimes causing paranoia, delusions and panic attacks. These effects usually subside within a few hours, but people may experience rapid, racing heartbeats, prompting some to seek medical attention.
“I see much more negative results in people using edibles,” Dr. Reif said.
A study of marijuana-related emergency department visits at a large hospital in Colorado found that people who took edibles were more likely to end up in the emergency room. (Total intakes were higher for smokers, likely because many more smoked than used edibles, according to state cannabis sales data.) People who took edibles were also more likely to experience cardiovascular or acute psychiatric symptoms than those who smoked.
Far more people consume edibles safely each 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, said 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, this high can be pleasurable. for others, fear and anxiety may take over.
Edibles may have less potential for addiction, Dr. MacKillop said, because in general, the sooner a person feels the effects of a drug, the more likely the user will 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 has the potential to damage your lungs.
Cannabis smoke contains many of the same toxic chemicals and carcinogens as cigarette smoke, and the drug, when smoked, can damage lung tissue and blood vessels, according to the Centers for Disease Control and Prevention. The method also matters: When people smoke a joint or blunt, they also inhale particles from papers or wrappers, as well as particles from the cannabis itself, both of which can damage the lungs.
Vapes heat cannabis through a different method than joints, bongs and pipes, so the vapors can help consumers avoid harmful compounds like carbon monoxide and tar, Dr. Barrus said. But the vapors still expose the lungs to irritants, and some evidence has found that the vapors produce hazardous emissions. Cases of vaping-related illnesses and injuries caused by contaminants in vaping have concerned doctors for years.
People who smoke cannabis appear to be at increased risk of bronchitis, and it’s clear that smoke can significantly irritate the lungs, Dr. Barrus said. But studies have not conclusively proven that smoking cannabis can cause lung cancer the way smoking does.
