From the Guidelines
Cannabis use is associated with several side effects, including cannabinoid hyperemesis syndrome, cardiovascular issues, respiratory problems, oncologic risks, psychiatric disorders, and impaired driving safety, which can be managed by understanding the degree of risk and taking appropriate measures. According to the ASCO guideline 1, clinicians, adults with cancer, and caregivers should be aware of the potential long-term side effects of cannabis and/or cannabinoid use. The side effects of cannabis use can be categorized into several areas, including:
- GI: Cannabinoid hyperemesis syndrome, which is characterized by cyclical emetic episodes, can occur after long-standing cannabis use, and treatment focuses on cannabis cessation 1.
- Cardiovascular: Cardiovascular side effects may include arrhythmias and orthostatic hypotension, but there is no evidence that cumulative lifetime use is associated with a higher incidence of cardiovascular disease or associated mortality 1.
- Respiratory: Conflicting data exist regarding cannabis use and respiratory disease, often confounded by concomitant nicotine use, and it remains unclear if cannabis use is associated with impaired lung function, asthma, chronic obstructive pulmonary disease, and pneumonia risks 1.
- Oncologic: No clear evidence demonstrates that cannabis inhalation increases the risk of lung cancer, and the association between cannabis use and cancer development remains unclear, except for a possible link with testicular cancer 1.
- Psychiatric: Chronic cannabis use carries long-term psychiatric risks, which may be correlated with cumulative exposure, including age of first use, and may be associated with an increased risk for developing depressive disorders and exacerbating psychiatric disorders in vulnerable individuals 1. To manage these side effects, it is essential to understand the degree of risk and take appropriate measures, such as:
- Monitoring liver enzymes with CBD use and considering possible CBD effects in the setting of new or worsening hepatotoxicity 1.
- Avoiding high-dose cannabis use to prevent the development of cannabis hyperemesis syndrome 1.
- Being aware of the potential cardiovascular side effects and taking measures to mitigate them 1.
- Understanding the potential respiratory risks and considering alternative consumption methods, such as vaporizing or edibles 1.
- Recognizing the potential psychiatric risks and taking measures to mitigate them, such as gradual tapering of use rather than abrupt cessation 1.
- Avoiding driving under the influence of cannabis, as it can increase the risk of motor vehicle accidents 1.
From the Research
Side Effects of Cannabis Use
The side effects of cannabis use can be acute or long-term, and may vary depending on the individual and the method of consumption. Some of the common side effects include:
- Mental slowness and impaired reaction times 2
- Anxiety and accentuation of anxiety 2
- Impaired coordination and performance 3
- Suicidal ideations/tendencies and psychotic symptoms 3
- Hyperemesis syndrome, fear, distrust, and a profound state of unease 4
- Hallucinations, ataxia, stupor, and seizures 4
Long-Term Effects
Long-term effects of cannabis use may include:
- Mood disorders and exacerbation of psychotic disorders in vulnerable people 3
- Cannabis use disorders and withdrawal syndrome 3
- Neurocognitive impairments, including impaired memory and attention 5
- Cardiovascular and respiratory diseases 3, 4
- Adverse effects on adolescent psychosocial development and mental health 6
Management of Side Effects
The management of cannabis side effects depends on the individual and the severity of the symptoms. Some of the ways to manage side effects include:
- Symptom-directed supportive care for acute intoxication 4
- Avoiding driving under the influence of cannabis to reduce the risk of motor vehicle crashes 2, 4
- Avoiding cannabis use in vulnerable individuals, such as those with a history of psychotic disorders 2
- Considering the risks and benefits of cannabis use, particularly in earlier ages 5