What Happens When You 'Green Out'?
Greening out is a colloquial term for experiencing unpleasant, overwhelming effects after consuming too much cannabis. The primary psychoactive compound, delta-9-tetrahydrocannabinol (THC), acts on the body's cannabinoid receptors, particularly CB1 receptors in the brain. When too much THC floods the system, these receptors become overstimulated, leading to adverse reactions.
The symptoms of greening out can be both psychological and physiological, and their intensity varies depending on the individual's tolerance, the product's potency, and the method of consumption. Edibles, in particular, are notorious for causing greening out because their effects are delayed and often more potent and prolonged than with inhalation.
Common symptoms of greening out include:
- Psychological: Intense anxiety, panic attacks, paranoia, confusion, and a feeling of depersonalization.
- Physiological: Nausea, vomiting, dizziness, cold sweats, and a rapid or irregular heart rate (tachycardia).
Immediate Non-Pharmacological Strategies for At-Home Management
For mild to moderate symptoms of greening out, the most effective approach is supportive care and waiting for the effects to subside. The feeling is temporary and will pass, typically within a few hours, though it can take longer with edibles.
Here are some key steps to take:
- Find a Safe, Calm Space: Move to a quiet, familiar environment away from loud noises, bright lights, and social pressures. A bedroom or a comfortable couch is ideal. This reduces sensory overload that can worsen anxiety.
- Hydrate and Snack: Sip water or juice to stay hydrated and potentially stabilize blood sugar, as low blood sugar can exacerbate dizziness. Avoid alcohol or caffeine, which can increase anxiety and dehydration. A light snack like toast or crackers can also help.
- Practice Deep Breathing: Focus on slow, deep breaths to help calm your nervous system and regulate a rapid heart rate. A simple technique is to inhale for a count of 4, hold for 4, and exhale for 4.
- Grounding Techniques: Engage your senses to distract yourself from anxious thoughts. Try the 5-4-3-2-1 method: name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.
- Chew Black Peppercorns: Some anecdotal evidence and scientific reasoning suggest that chewing or smelling black peppercorns can help. They contain the terpene beta-caryophyllene, which can bind to CB2 receptors and may mitigate some of THC's effects.
The Pharmacological Role of Cannabinoids and Terpenes
While it seems counterintuitive to use more cannabis, some compounds found in the plant itself can aid recovery.
Cannabidiol (CBD)
CBD is a non-psychoactive cannabinoid that has been shown to have anti-anxiety properties. It interacts with the same cannabinoid receptors as THC but in a different way, which can help to counteract the intense psychoactive effects of THC. Administering a few drops of a CBD tincture or a CBD gummy can potentially bring down the intensity of a high. Research into its precise mechanism for this specific application is ongoing, but many users report significant relief.
Terpenes
In addition to the beta-caryophyllene found in black pepper, other plant compounds known as terpenes can play a role. Limonene, which gives lemons and other citrus fruits their scent, is believed to have stress-relieving properties. Smelling a fresh lemon or adding a piece of zest to water can provide a calming effect. Another terpene, pinene, found in pine nuts and certain cannabis strains, is also thought to have a calming effect and improve clarity.
Medical Intervention for Severe Symptoms
While most cases of greening out can be managed at home, certain severe symptoms require immediate medical attention. There is no specific medication to reverse a cannabis overdose, but medical professionals provide supportive care to manage distressing symptoms and ensure safety.
When to seek immediate medical help:
- Persistent rapid or irregular heartbeat.
- Severe chest pain.
- Difficulty breathing.
- Extreme paranoia, panic attacks, or hallucinations that don't respond to calming techniques.
- Loss of consciousness.
- Severe, persistent vomiting.
In a clinical setting, medical staff may use specific medications to manage severe symptoms:
- Benzodiazepines: For severe anxiety, panic, or agitation, low-dose benzodiazepines like lorazepam (Ativan) or diazepam (Valium) may be administered. These work by increasing the action of GABA, a major inhibitory neurotransmitter in the brain, to calm the central nervous system. Their use requires caution and careful monitoring of vital signs.
- IV Fluids: Intravenous (IV) fluids may be given to address dehydration, which is common with vomiting, and to help flush the system.
- Other Symptomatic Medications: Anti-nausea treatments may be used to control severe vomiting, and cardiac monitoring may be implemented for heart-related concerns.
Comparison: At-Home Management vs. Clinical Intervention
| Feature | At-Home Management (Mild-Moderate) | Clinical Intervention (Severe) |
|---|---|---|
| Environment | Safe, quiet, familiar space | Emergency room, hospital |
| Immediate Action | Relax, hydrate, deep breaths | Call 911, transport to hospital |
| Pharmacology | Natural compounds (CBD, terpenes in lemon/pepper) | Prescribed medications (Benzodiazepines, anti-nausea) |
| Monitoring | Self-monitoring, with a trusted friend | Continuous professional monitoring (vital signs, heart) |
| Fluid Administration | Sip water, juice, electrolyte drinks | Intravenous (IV) fluids |
| Primary Goal | Let the high pass naturally | Stabilize patient, manage dangerous symptoms |
| Duration | Hours (potentially longer for edibles) | Observation period (hours to overnight) |
Conclusion
While a greening out episode can be intensely frightening, it is generally not life-threatening. Supportive care at home, focusing on a calm environment, hydration, and relaxation, is effective for most instances. Understanding the pharmacological actions of both THC and complementary compounds like CBD can also aid in management. For severe symptoms, including extreme anxiety, severe vomiting, or cardiovascular distress, seeking medical attention is the safest course of action. In a hospital setting, targeted medications and supportive care can be administered under professional supervision. Ultimately, prevention through mindful consumption remains the best strategy for avoiding such an experience.
For more detailed information on clinical interventions, consult reliable medical resources such as the Medscape Reference on Cannabis-Related Disorders Medication.
