DEAR DR. ROACH: I live in a large community. More and more of my peers are using THC gummies sold over the counter at smoke shops as a substitute for smoking marijuana. Are there any studies being conducted on the safety of imbibing these small amounts of THC? Also, are there any studies being conducted on other drug interactions when imbibing these small amounts of THC? — K.B.
ANSWER: The question of whether cannabis is safe and effective for treatment of many medical conditions is largely open-ended, although there is strong evidence that purified cannabis extracts (especially cannabidiol or CBD, a nonpsychoactive component of cannabis) are successful with some types of epilepsy. Cannabis may be smoked, vaped or consumed.
As you say, many users are turning to edibles for both recreational and medicinal use. There are many forms of edibles, not just “gummies.”
Although edibles avoid the inhaled smoke that can cause lung damage, edible forms of cannabis have the potential for at least two types of increased toxicity. The first is in children who mistake the edibles, especially gummies, for candy and become dangerously intoxicated. These products must be kept away from children, regardless of the laws in your state. The second is that inexperienced users may not wait long enough for the ingested cannabis to take effect (some users will not notice effects for up to 90 minutes or more). So, they decide to ingest additional doses and end up consuming far more THC, the psychoactive component of cannabis, than they expect.
The amount of THC in edibles ranges from less than 1 mg to 10 mg, or more, per dose. Even a single 10 mg dose may not be small for some people, so inexperienced users should start low and increase slowly. Emergency room visits for intoxication are much more common with THC edibles than with smoked cannabis; however, inpatient hospitalization is rarely required in adults.
The data on drug interactions with cannabis are incomplete. I found evidence for potential drug interactions with several drugs, especially warfarin (Coumadin), clobazam, theophylline, clozapine and olanzapine. By no means is this a complete list, as there may be others. Small amounts of THC are less likely to cause significant drug interactions.
