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Can You Overdose or Die From Consuming Cannabis?

August 7, 2014

Can you overdose on cannabis? No. The number of people who have died due to cannabis overdose, in all of recorded history, is zero.

That’s one of the most well-known facts in the cannabis library. But is it really true? And if so, why?

Yes, it’s true. Cannabis itself cannot kill the human body. But let’s be clear: It is very possible to “overdose” on cannabis in the sense of overconsumption. Most experienced cannabis consumers have, at one point or another, gotten themselves to a place they didn’t want to be. You didn’t check the dosage on that edible, and now you’re regretting it. You’re uncomfortable. You may be feeling downright miserable. It’s okay. You’re not going to die. It will pass. Lesson learned.

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Why is that, exactly?

It’s possible to die from opioid overdose or alcohol poisoning. But cannabis acts on the body and mind in a way that’s very different than opioids or alcohol.

We’re all familiar with the tragic phrase “died of an overdose,” but when opioids like fentanyl, Oxycontin, or heroin are the cause, there’s a specific mechanism that leads to death. As Oxford University anesthesiology professor K.T.S. Pattinson has observed, “In drug addicts, respiratory depression is the major cause of death.” In other words, during an opioid overdose the victim falls unconscious and the body forgets to breathe.

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What scientists call “the fundamental drive to respiration”—i.e., what tells the body to breathe—originates low in the brainstem, in an area known as the pre-Bötzinger complex. Opioids don’t just suppress pain and increase feelings of pleasure; they also depress the pre-Bötzinger complex, which causes breathing to become slow and irregular. In an overdose, breathing shuts down completely and death occurs due to lack of oxygen.

can you overdose on weed? opioid receptors in brain

Brain areas with high densities of opioid receptors. (Note: this map of where opioid receptors are located is not meant to be comprehensive. There are multiple types of opioid receptors located throughout the brain at different levels.)

Opioid receptors are found in many areas of the brain, including the pre-Bötzinger complex in the brainstem, which controls breathing. This is a major reason why opioid overdose can be deadly, as opioids affect this critical brainstem region.

In some cases, an opioid overdose can also depress the brain’s mechanism that regulates the heart and blood circulation, leading to a drop in blood pressure and heart failure. Alcohol poisoning can become lethal when the alcohol overwhelms the liver’s ability to clear it, and alcohol in the blood anesthetizes those same brain systems that regulate breathing and blood pressure. They shut down, which leads to death.

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Why doesn’t cannabis have the same effect? Because cannabinoids act on specific receptors that are not concentrated in the brainstem, where breathing and heart rate are controlled.

Cannabinoid receptors are most highly concentrated in the basal ganglia, the hippocampus, and cerebellum, which control cognition and movement. Those same receptors appear in scant numbers in brainstem areas like the pre-Bötzinger complex.

can you overdose on weed? cannabinoid receptors in brain

Brain areas with high densities of cannabinoid receptors. This map is not meant to be comprehensive. Compare it with the opioid receptor map above to highlight some of the key similarities and differences between opioid and cannabinoid receptor densities.

Cannabinoid receptors are also found in many areas of the brain, but not so much in the breathing center of the brainstem (pre-Bötzinger complex). CB1 receptors, one of the most abundant receptors in the brain, are found in many regions.

In a 1990 study of cannabinoid receptors, researchers with the National Institutes of Health (NIH) reported that “sparse densities [of cannabinoid receptors] in lower brainstem areas controlling cardiovascular and respiratory functions may explain why high doses of THC are not lethal.”

To summarize, opioid and alcohol overdose can shut down the body’s breathing and blood circulatory systems that are located in the lower brain stem. Cannabis does not have the ability to affect those lower brain stem systems in the same way. While it is very possible to overdo your cannabis intake, it’s not possible to die from a cannabis overdose.

References:

Herkenham M, Lynn AB, Little MD, et al. Cannabinoid receptor localization in brain. Proc Natl Acad Sci USA. 1990;87(5):1932-6.

Le merrer J, Becker JA, Befort K, Kieffer BL. Reward processing by the opioid system in the brain. Physiol Rev. 2009;89(4):1379-412.

Pattinson KT. Opioids and the control of respiration. Br J Anaesth. 2008;100(6):747-58.

  • Tychebla Ninja

    I think the argument made in this article is incomplete. What about synthetic cannabinoids? It is a known fact that people died from smoking synthetic THC analogues. So, there must be something more going on beyond what you described, such as, e.g., the fact that some synthetic cannabinoids are full agonists of the cannabinoid receptor.

    • Sonny Bono

      I think many of the stories you’ve heard about synthetic cannabinoids were actually confused with bath salts and other non-cannabinoid formulas. Also, there are literally hundreds of formulas for synthetic cannabinoids and many of the products which utilized them had extra toxic chemicals added to sell as “incense.”

    • Dove Paradise

      I think you are way off here. This article is about cannabis. Not something fake and engineered. Hence, “synthetic”. Are you even aware of the synthetic process steps and what is put into it? Even synthetic opioid pills are different from company to company. Some people can take Percocet in the brand name and some people have to take the generic brand because the name brand makes them sick. So not only are the synthetic formulas different from company to company, they will never be as safe the original cannabis.

      • Tychebla Ninja

        Hi Dove. I’m sorry but I’m afraid I’m right on spot here. Yes, this article is broadly about cannabis. However, the main argument being made as to why a fatality due cannabis consumption is unlikely to occur is due to the fact that the brain stem does not apparently have enough cannabinoid receptors (in contrast to drugs that act on the opiod receptors). The brain stem is where heart and lung function is regulated. Since the author makes a statement about the cannabinoid receptors, I think it’s fare to accept the article is about cannabinoid receptors as well and not just cannabis. I think we should both agree on that. So, if the article is about the cannabinoid receptors, then the compounds I mentioned automatically become relevant because these compounds act on this receptor. In addition to what is stated in this article, the article that I included below for your reference reports that some synthetic cannabis analogs tend, unlike THC, to be full agonists of the cannabinoid receptor, which makes their potency to be “one hundred or more times greater than THC” (according to Paul Prather, PhD, professor of pharmacology and toxicology at the at University of Arkansas for Medical Sciences). These are the compounds that are responsible for fatalities in spice overdose incidents. So, the conclusion is that it’s not because there are not enough cannabinoids in the brain stem that prevent cannabis fatalities but rather the fact that THC is not as effective to activate cannabinoid receptors in a manner that would cause death. In other words, THC has very little, if anything to do with being safe by simply being a cannabinoid drug (rather an an opiod drug) because other cannabinoids are known to cause deaths. I hope I made myself clear now. http://www.forbes.com/sites/alicegwalton/2014/08/28/6-reasons-synthetic-marijuana-spice-k2-is-so-toxic-to-the-brain/#1a405c9549eb

        • lovingc

          Prove it. I don’t think you know what you are talking about.

    • lovingc

      Whole plant is safe, concentrates also but easier to over do,synthetics are chemicals designed by men and are not tested unless you volunteer to be a lab rat, which is what those users do when they ingest mystery drugs. I know I used to do that in the seventies. No more for me.

    • HD Analytics

      Synthetic “cannabinoids” are cannabinoids in name only. The chemical structures of the majority of the commonly abused synthetic cannabinoids are completely unrelated to natural cannabinoids. These synthetic “cannabinoids” do have an increased affinity for cannabinoid receptors. However, I suspect that the synthetic structures most likely have off-target effects that cause their toxicity. I.E. the deaths are a result of interactions with receptors other than cannabinoid receptors. I have no evidence for this other than the structures of the compounds and my background in medicinal and natural products chemistry. Further studies would be needed to confirm or deny this hypothesis.

    • Bruce Blaney

      The key word here is synthetic. That is the pharmaceutical industries attempt to put a patent on cannabis for their own profit.

  • Realtor Rod

    Many have passed (greened) out, likely some of those have met their maker as a result.

    • Daniel Valentine

      No death caused by Cannabis has ever officially been recorded in HISTORY. So, no, not “likely.”

  • Aaron

    Agreed. K2 and all that other Bolagne people are synthesizing is not THC and not safe. If marijuana was legal this stuff wouldn’t even be around. People arguing that there needs to be more medical studies before legalization is crap. People have been using marijuana for 5000 years without any major social or health issues. There’s your study.

    • Tychebla Ninja

      As much as I would like to fully support your idea, some research shows that people who seek the high from spice, aren’t necessarily interested in the natural cannabis itself. They really seem to be interested in these dangerous drugs solely. So legalizing may solve some problems: it will prevent those who can’t get access to real cannabis turning to this stuff instead and dying in the process due to overdose, but there is an independent market for spice users who seek the more intense high spice gives them, unfortunately.

  • Darius A Stokes

    Anything that produces energy itself burns it to. Through our bodies photosynis process like a plant consuming carbon dioxide and making oxygen coming from your ears.
    So you have to always eat first before you smoke always. Basically what you burns while your smoking because of energy transfer. it speeds up your metabolism.

    Because it produces oxygen.

  • Юрий Коробейников

    I heard many stories from survivors, but I heard not a single one from one who died.

    • SeoKungFu

      scyka blyat, opyat !!!

  • kyle

    this is very interesting topic! Question as we now know from reading this opioids can slow or even shut down breathing/cardiovascular systems but im sure im not the only one that has experienced a faster (or slower) heart rate? Now im not disagreeing with the topic but does cannabis influence heart rate at all? or is it the fact of being high that you just tend to focus on the heart beat its self?

    • Daniel Valentine

      Absolutely, Cannabis lowers the blood pressure which the body compensates for by raising the heart rate. This feeling is generally not linked to anxiety, or to heart failure, but simply as a common side effect of lowered blood pressure.

  • NefariousMe

    I felt dead til my first puff