One of the most common causes of side effects in my cannabis-using patients is dehydration. Increasing your water intake is often the least expensive and most effective way to improve your health and mitigate cannabis side effects. While there is no set amount of water that’s appropriate for everyone, most people do well with 2-4 liters daily (68-135 ounces). To find the right amount for you, pay attention to your thirst, which many people confuse with hunger. Also pay attention to your urine – in the absence of caffeine, alcohol, or vitamins that darken urine (e.g. riboflavin), your urine will be clear when you’re well hydrated. And remember to count any caffeine-containing or alcoholic beverages as “anti-water” because they cause your body to excrete water even if it needs more.
Mindset and Setting
The most common negative effects of cannabis are related to the interface between a person’s state of consciousness and their surrounding environment. Adverse effects can often be prevented by paying attention to your mindset and surroundings before using cannabis.
First of all, if you’ve experienced anxiety, panic, paranoia, or confusion after taking cannabis, or if you are relatively new to cannabis, I strongly recommend only using it in a setting that is familiar and comfortable to you. Research has shown that stressful environments are more likely to cause adverse effects in cannabis users.1
While cannabis can help patients “turn the page” on stuck emotions and limiting thought patterns, it can also amplify these uncomfortable states. Patients often will not know which outcome to expect, and the intensification of uncomfortable emotions or thoughts can be distressing.
Prior to administering cannabis, take 1-5 minutes to observe and evaluate your current inner state. Use the “Inner Inventory” to evaluate the current state of your body, breath, and mood. Besides helping you find your optimal dosage when used in combination with our programs, the inner inventory is a great way to get in touch with yourself and recognize your current mindset.
While 1-5 minutes does not sound like a long time, it will probably feel like a long time. Be intentional. Make a ritual out of your cannabis use. Direct your thought power toward what you hope to get out of this experience.
Taking time for pre-cannabis introspection will empower you to participate in your response to cannabis, and increase the likelihood of “turning the page” if that is what’s needed. Furthermore, cannabis can stimulate neuroplasticity, the process of making new neural connections that’s involved in learning and the sometimes-unconscious adoption of new thought and behavioral patterns. Self-awareness and setting positive intentions will help you make the most of your cannabis-enhanced neuroplasticity, so that you can improve the way you think and feel even long after the cannabis wears off.
Conscious Reception of Food
Patients who have trouble with increased appetite after using cannabis are encouraged to take cannabis after meals, keep healthy snacks available, and to use the enhanced sensory experience of cannabis to savor their food – chew every bite thoroughly and pay close attention to the taste and the texture, as if you were a food connoisseur.
Cardiovascular Side Effects
If you experience lightheadedness after standing, or racing or irregular heartbeats, I strongly recommend using a delivery method with slower onset, such as tincture. Be careful not to overdose on cannabis and remember to stay well hydrated. If you continue to experience these symptoms, please see your healthcare provider!
In my clinical practice, I often recommend herbs or supplements that can be used in combination with cannabis to enhance benefits and reduce side effects.
Acorus calamus root, also known as “Sweet Flag” or simply “Calamus”, has long been used in Asian, European, and Native American medicine for a variety of gastrointestinal, infectious, and other conditions. When combined with cannabis, calamus root can prevent dry mucous membranes, scattered thinking, and anxiety.2 It may also be helpful as an antidote for the psychoactive effects in the case of overdose.3 The powdered root can be mixed with cannabis flowers and smoked, or a small piece of the root can be slowly sucked and chewed, or simply left in the space between the gums and the cheek. In high doses it has been reported to create its own mild visionary or hallucinogenic properties. Herbalists often recommend the American variety of acorus calamus over the Indian or Asian varieties for better safety and efficacy.
For patients who complain of fatigue from regular cannabis use, I sometimes recommend adaptogenic herbs that can increase energy levels and improve resilience to stress. Holy Basil, also known as Tulsi, and Eleuthero, also known as Siberian Ginseng, are two of my favorites.
For cannabis-associated anxiety, beyond selecting the right dosage, strain, and delivery method, I sometimes recommend adding Lemon Balm or 5-HTP.
by Dustin Sulak DO
1 Gregg JM, Small EW, Moore R, Raft D, and Toomey TC (1976) Emotional response to intravenous delta-9-tetrahydrocannabinol during oral surgery. J Oral Surg 34:301– 313.
2 McPartland, John M. “Adulteration of cannabis with tobacco, calamus, and other cholinergic compounds.” Cannabinoids 3.4 (2008): 16-20.
3 Russo, Ethan B. “Taming THC: potential cannabis synergy and phytocannabinoid‐terpenoid entourage effects.” British journal of pharmacology 163.7 (2011): 1344-1364.