The Straight Toke - THE Marijuana Blog

I'm 25 and I used to smoke when I was younger (16-18) but I developed anxiety/panic disorder and had to stop. Not sure if this was induced by my drinking/drugging or genetics or a little of both but I had to stop smoking because it makes me have panic attacks. Now that's I'm a successful adult I don't want to go back to being a pothead or anything but it would be cool to toke ever now and then without thinking I'm going to have a heart attack. Any suggestions? Or am I doomed to continue leading a substance-free life (8 years strong)?

First, know that you're not alone. Many people experience panic attacks while under the influence of weed. Nobody really knows why either -- for some, marijuana calms them down and prevents anxiety, and for others it induces it. We don't really understand its mechanism of action when it comes to the brain's "fight-or-flight" response; therefore the rest of this post will be based primarily on my experience over the years.

For some people, the frequency of use of marijuana is related to the likelihood of their having problems with anxiety while high. These people can smoke the occasional joint and be happy as a clam; it's when they smoke daily for a longer time that they get into trouble. If you're one of this group, the solution is simple: smoke in moderation.

For others (most in my experience), panic attacks when high can be traced back to the presence of one or more 'triggers'. These triggers can be anything, but there are a few common ones:

• Heart rate
• The fear of getting caught
• Uncomfortable/unfamiliar setting
• Music
• Unpleasant visuals

It might take some experience to figure out what your triggers are. Try to think back to panic attacks you've had in the past, and check for any constants between the various episodes. Once you've identified what your triggers are likely to be, you can find ways to minimize their influence over you. The following list provides a better explanation of the above triggers (why they're often a problem, how to minimize them, etc.)

• Heart rate
  • Problem: People under the influence of cannabis often think that their heart is beating too slow / too fast / irregularly. This causes them to fear that they are experiencing some form of cardiovascular distress (such as a heart attack).
  • Cause: It's very hard to take your pulse when stoned. I have yet to see someone who's stoned do it successfully. In every case I've seen of the "my heart is beating too _______", the person's fine -- they're just too baked to take their pulse correctly.
  • Solution: Don't take your pulse. Yes, your heart rate changes when under the influence of marijuana. Pulse rates tend to increase slightly (anywhere from +10 to +40 BPM from baseline.) This is nothing to be concerned about -- it's a documented effect on the human body (see Acute Effects of Marihuana, National Commission on Marihuana and Drug Abuse.) Whatever you think is wrong with your heart, remember: it's not. You're not having a heart attack, your heart will not explode, and no, you are at no risk of your heart stopping because you smoked pot.
• The fear of getting caught
  • Problem: People under the influence of cannabis are often afraid of getting caught by an authority figure. This fear can sometimes serve as a trigger an anxiety attack.
  • Cause: This one's pretty simple. The fear of an encounter with an authority figure causes a marked adrenal response which, when combined with the intoxicating effects of cannabis, triggers an anxiety attack.
  • Solution: This one's a bit harder, and is one of the many problems caused by outlawing the possession and use of cannabis. Those choosing to use cannabis in such a country may wish to use it in a familiar setting, surrounded by trustworthy friends. By setting up a non-threatening environment, the fear of "being caught" can be minimized and the resulting anxiety managed.
• Uncomfortable/unfamiliar setting
  • Problem: Being in an unfamiliar setting or uncomfortable setting may trigger an anxiety attack.
  • Cause: Unfamiliar settings can trigger the body's "fight or flight" response. When combined with intoxication from marijuana, this can induce panic attacks.
  • Solution: If you find that being in an unfamiliar place when high triggers panic attacks, you might try smoking at home, with friends, or in some other comfortable setting. Physical comfort can contribute to your overall feeling of security -- so comfortable couches, a moderate ambient temperature, and some relaxing music may be every bit as useful as a trip sitter. Once you've gotten to the point where you can smoke at home or with friends without anxiety problems, you can gradually try to get high in other settings further and further from home until you're comfortable toking up pretty much anywhere. Or you could simply toke only when at home / with friends -- it's not necessary that you learn to get high outside the home :-)
• Music
  • Problem: Music with a hurried tempo, or featuring unfamiliar/disorienting sounds may trigger panic attacks in some cannabis users
  • Cause: Cannabis is known to increase sensitivity to auditory stimulus in many users. This increased sensitivity, combined with complex music (or music featuring exciting/agitating sounds) may trigger an anxiety attack.
  • Solution: Everyone's got a preference when it comes to what to listen to when baked. Some people find that the melodies of Pink Floyd stimulate their mind in a pleasant way, while others may find The Dark Side of the Moon to be too intense to enjoy when under the influence of marijuana. There's no standard as to what's an acceptable level of sound -- so go with whatever you're comfortable with. Try listening to different songs when high until you figure out what styles / levels of intensity are acceptable to you.
• Unpleasant visuals
  • Problem: Users under the influence of marijuana may find that certain forms of visual stimulus induce panic attacks.
  • Cause: THC is known to increase photosensitivity. This increase in photosensitivity, combined with the other intoxicating effects of marijuana may cause some users to panic when confronted with certain forms of visual stimulus.
  • Solution: Don't watch horror movies when stoned ;-) Seriously though, the solution here is much the same as the solution for music -- over time you'll be able to figure out what is and is not good to watch when stoned. Simply avoid the images/movies/etc. that cause you to panic. If you find that you're liable to get "too into" what your watching (i.e. your stoned brain gets drawn in a little too easily), consider refraining from watching TV/movies unless you've got some good friends around. If things become too intense, take a break and talk to your friends. It's perfectly fine to pause a movie/show if you start freaking out: cannabis affects each mind differently, and any veteran smoker will understand what you're going through (although you may end up having a laugh over it later...)

How to stop a panic attack

Even if you know your triggers, even if you've smoked weed for your whole life, even if you're "always chill", it will happen -- at some point you will smoke too much and start to freak out. When this moment arrives, there are a couple things you can do to stop the anxiety attack in its tracks:

1. Stop smoking. Seriously. No, another hit will not "help to calm your nerves" -- it'll only make you higher (and thus more likely to freak out.)
2. Turn off the TV. If you're watching anything, turn it off. If you're stoned beyond what you're comfortable with, the last thing you want is to be presented with a bunch of bright, quickly-moving colors.
3. Turn off the music. If you're listening to music, you might want to consider turning it off (or at least turning it down.) When you've smoked a fair bit, music can mess with your head just as much as a movie -- so it's best to remove this possible source of panic.
4. Talk to your friends. A simple "Hey dude -- I think I might be freakin' out." will usually suffice. It is every stoner's duty and obligation to help calm those that have toked too much. Think of it as weed karma. Your friends can help talk you through your anxiety. They can assure you that no, the government has not secretly altered the weed you're smoking, there are no miniature tracking chips embedded in the joint, and that the tree you could swear you just saw move has actually been quite steady this entire time. Friends are a life saver during a pot-induced panic attack (and good for a great laugh when you're "at just the right level of high.")
5. Drink some water. Part of the reason you feel like you're dying is that your mouth is dry. Seriously. Cotton-mouth can really screw with your head when stoned -- and a glass of water will make you feel a hundred times better.
6. Chill. If you've done all of the above, you'll likely feel a lot more calm. Don't go back to toking just yet -- take some time to chill out. Talk with your friends, have a laugh, and enjoy being baked.

There are two critically important things to remember when smoking: 1) Nobody has ever died from smoking too much pot. 2) Don't check your pulse. If you keep the first point in mind, and obey the second, you'll be fine.

If you have any more questions about anxiety and cannabis, or marijuana-induced panic attacks (and how to treat them), feel free to contact me.

Your Brother in Peace,
Julius

This entry was posted on Wednesday, May 21st, 2008 at 10:58 pm and is filed under Experiences, Q/A, Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.