How To Handle A Bad High, According To A Doctor

Photographed by Rachel Cabitt.
The last time I smoked weed, I couldn't stop the room from spinning. I felt anxious and paranoid. Worst of all, I kept thinking about how my eyelids were going to peel off at any moment (freaky, right?). It's safe to say that I was experiencing a bad high. Ever since, I've been reluctant to dabble in THC again. But it did make me curious about what causes bad highs, and whether there anything I could have done to prevent mine, or make it stop sooner.
First, the good news: While they may feel scary, bad highs typically aren't life-threatening, says Peter Grinspoon, MD, primary care physician at Massachusetts General Hospital, instructor at Harvard Medical School, and board member of the advocacy group Doctors For Cannabis Regulation.
"No one has ever died from a cannabis overdose. It's basically impossible, which is one of the wonderful things about cannabis," Dr. Grinspoon says. "But you can end up in the emergency room and it can be dangerous if you have a full-fledged panic attack."
In fact, he says that's what a bad high is — a type of anxiety or panic attack. They may occur because you're "just someone cannabis doesn't agree with, or you took too much, or because you're not used to it, or because it's a bad setting," he says. For example, maybe you decided to eat a weed brownie, then remembered you have a super-important exam the next day. Cue, stress.
That's why a bad high is often accompanied by a racing heart, panicked thoughts, sweatiness — all signs of anxiety too, Dr. Grinspoon says. Of course, because your mind is altered your thoughts may seem strange, à la my fears about my eyelids.
More good news: There are a few things you can do to alleviate your symptoms, once you feel your high taking a turn for the worse. Number one is just acknowledging that you're experiencing anxiety, but that nothing bad is actually going to happen, Dr. Grinspoon says. Remind yourself, no one has ever died from a cannabis overdose before. It's true — Dr. G said so, and he's an MD. Remind yourself that it's just a reaction you're having, and it's going to wear off.
It's also a good idea to head to a quiet place and listen to some nice, calming music. If you can, tell someone you trust what's going on, a friend who can help talk you down. Physical contact can also help, Dr. Grinspoon says, so if you're comfortable you can try asking your buddy for a hug.
That said, if none of this helps, you start to have trouble breathing, or you just can't handle the sensations, seek medical attention. "If you're having a full-blown, absolute, complete, no-holds-barred panic attack, you might have to go to the emergency room," Dr. Grinspoon notes.
To prevent your high from resulting in a panic attack, Dr. Grinspoon typically urges people to err on the side of using too little THC rather than too much, and making sure to only use in a situation where they feel safe and comfortable. "It's all about dosage, as far as I'm concerned, and the setting," says Dr. Grinspoon. "As a primary care doctor, I start people on medical cannabis and we tell people to start low and go slow."
Like Dr. G said before, some people are prone to feeling anxious when they use cannabis — it's just the way that their body reacts to it. If you tend to experience anxiety in your regular life, you may be more likely to experience it while high too. If you're determined to find a smoking ritual that works for you, stick to a low dose, and develop a game plan that you can turn to if you do have a bad high, he suggests.
But smoking weed isn't for everyone. If it doesn't make you feel good, there's probably no real reason you have to use it. Instead of forcing it, find another way to relax or have fun — ideally, something that doesn't make you obsess over your eyelids.
Refinery29 in no way encourages illegal activity and would like to remind its readers that marijuana usage continues to be an offense under Federal Law, regardless of state marijuana laws.

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