By now you’ve heard the warnings. “This is not your father’s Woodstock Weed!”* Today’s marijuana is twice, triple, or forty times stronger than the weed our parents smoked in the 60s and 70s! It’s so much more potent now that rehabs are overflowing with marijuana addicts (that drug courts put there for the clearly addictive behavior of getting caught.)
You’ve also heard about “medical” marijuana. You know, that non-toxic herb with low risk of side-effects and the lowest-chance of addiction with the mildest symptoms of withdrawal among the top-three recreational drugs? And how dangerous it would be to allow sick people to use it because it hasn’t been subjected to the approval of the same government agency that declared Vioxx safe for human use?
It’s funny, because all those scares about hyper-potent super-skunk seem to evaporate once the THC crosses over from natural plant form to patentable profitable pill. For years we’ve had Marinol®, which is a synthetic 100% THC pill. It comes in 2.5mg, 5mg, 10mg, and 20mg active doses. It was originally released as a Schedule II drug, as dangerous and possibly abused as cocaine or methamphetamine. After years of safe medical use, it was rescheduled to a safer designation (something that rarely happens), Schedule III, the realm of drugs like Ambien and certain steroids.
This despite the fact that THC is the psychoactive part of marijuana that gets you high and the Marinol® pill lacks the plant’s CBD (cannabidiol) that is an anti-psychoic that moderates the effects of THC. In essence, the government has declared that the drug that gets you way higher than the plant is somehow safer, because molecules in pill form are magic.
Now comes to me this study, Tolerance to Effects of High-Dose Oral Delta-9-Tetrahydrocannabinol and Plasma Cannabinoid Concentrations in Male Daily Cannabis Smokers, which was published in October in the Journal of Analytical Toxicology. As I give you some of the particulars of this study, keep in mind that our government won’t let doctors and researchers do these kinds of things with natural marijuana because it’s too doggone dangerous.
The development of tolerance to effects of around-the-clock oral synthetic D9-tetrahydrocannabinol (THC) (20 mg every 3.5 –6 h) was evaluated in 13 healthy male daily cannabis smokers residing on a secure research unit: 40 mg on Day 1; 100 mg on Days 2 –4; 120 mg on Days 5 –6. … Typical dronabinol doses in the United States range from 2.5 –40 mg daily…
A strong Marinol® dose is a 10mg pill, taken four times a day. I’ve taken one, just once, and as a pot smoker of 22 years, consuming world-class marijuana in the Pacific Northwest, I have never had a more paranoid, panic attack, depressed, disoriented high in my life. Most doctors will start a patient on a 2.5mg or 5mg dose. So let’s see what happens when we start 13 pot smokers on a strong dose then work that up to triple that in six days and see what happens.
In experienced male cannabis smokers, daily oral THC doses (10 –30 mg every 4 h escalating to 210 mg/day over three to ﬁve days) produced tolerance to the acute subjective effects of a single oral THC dose after 11 –16 days of dosing and to the acute heart rate and blood pressure effects after 9– 12 days of dosing. In a later study by the same investigators, the intensity of acute subjective effects from a single 30 mg oral THC challenge dose diminished 50% after four days of 60 –80 mg daily and 60 –80% after ten days of 60 – 80 mg daily. Later studies showed tolerance to the subjective effects of oral THC developing after 80 –120 mg daily for four days.
So you’re telling us that people who take anywhere from 6 to 21 100% THC 10mg Marinol® pills a day develop tolerance to the effects of THC. But pot smokers who smoke 15%-25% marijuana the night before may be too impaired to drive in the morning?
For inclusion, participants were required to be 18 –45 years old, to have smoked cannabis for at least the prior year and averaging daily use for at least three months before admission, to have used cannabis within 24 h of admission…
And, of course, not be currently in jail, prison, probation, or rehab for getting caught smoking pot. All right, so how high did these guys get?
Let’s see if I can parse this table of data. On Day One, after these guys went about 18 hours without smoking pot. Then you had them make a mark on a scale, where the left edge of the scale is “not at all” with respect to feeling “Good Drug Effect”, “High”, “Sedated”, “Stoned”, and “Stimulated”. The right edge of the scale is “most ever” at ten centimeters (a tenth under four inches). Then you measured how many millimeters from the left edge someone made their mark in each category. It’s like a “scale of 1 to 100”, but you erased all the numbers in between 1 and 100 and measured millimeters from the “1” instead.
So what happened? On Day One after they’d gone without pot most of a day, all the subjective measures of drug effect were within 1-4mm of “not at all”. Unsurprisingly, after Day Two, when they’d been given the equivalent of six strong Marinol® pills, they were quite high, but not even past the halfway mark of 50mm toward “most ever”. But then on Day Four, after totaling 26 pills worth of THC ingestion, they were roughly one-third to one-half as high. By Day Six, after a whopping 48 strong Marinol® doses, they were the least high they had been since beginning the study.
Here’s another interesting observation – the blood pressure of all these men dropped from an average of 129 : 75 to an average of 120 : 61. Remember that the next time you’re warned about the heart dangers of smoking pot.
This study found that substantial tolerance to the subjective intoxicating effects of oral THC developed after exposure to a total dose of 260 mg over four days. This is consistent with most, but not all, prior human studies. The one study that did not observe tolerance administered oral THC doses (40 mg daily for two weeks) lower than those in other studies that showed tolerance, including by the same investigators. That study involved HIV+ subjects, but it is not known whether HIV status inﬂuences tolerance development.
Thank you, science! Now while we’ve got these thirteen pot smokers in a lab pumped full of 100% pure THC pills, could you measure how many nanograms of active THC per milliliter of blood these guys have in their system? You only measured THC in blood plasma, you say? Well, that’s OK, because we simply need to divide by two to get what the result would be for whole blood. Lay it on us!
Isn’t that interesting? Here we have thirteen pot smokers who “smoked cannabis for at least the prior year and averaging daily use for at least three months before admission, [and] used cannabis within 24 h of admission….” Yet, on Day 1, after 15-18 hours of abstinence, they’re testing around 3-4 ng/ml in plasma, which works out to 1.5-2ng/ml in blood. On Day Two, after they’ve had 6 Marinol® pills, they wake up at 4.5-5ng/ml. On Day Three they’re around 5-6ng/ml and the morning of Day Four, after 26 Marinols®, they’re around 6-7ng/ml. Yet on Day Five, morning rates are around 3ng/ml, and on Day Six, after the equivalent of 48 Marinol® pills, they’re around 4ng/ml.
That’s a lot to digest and what it may mean is up for debate. We are talking about oral ingestion of THC pills. Eating THC metabolizes differently than inhaling THC. Medical marijuana has psychoactivity-moderating CBD (cannabidiol) that Marinol® pills don’t gave.
However, we are also talking about gargantuan, frequent doses of 100% THC that seem to lead to a developing tolerance to its effects, despite increasing levels of THC in the blood plasma after administration (Day Three spikes at 20ng, Day Five at 30ng, which would be 10ng and 15ng in blood, respectively.) So, why again are we considering users of inhaled 15%-25% potent marijuana smoke to be too impaired to drive at 5ng/ml (or even any ng/ml in most states and circumstances)? Especially when the drug interaction warnings on a 10ng Marinol® pill bottle read:
Patients receiving treatment with MARINOL® Capsules should be specifically warned not to drive, operate machinery, or engage in any hazardous activity until it is established that they are able to tolerate the drug and to perform such tasks safely.
Oh, yeah, I forgot. When molecules are in patentable profitable pill form, they are magic.
* When you hear that, by the way, understand that I coined that phrase.