Cannabis Anxiety Attack Help: Steps to Stop Panic

What to do during a cannabis anxiety attack

Stop use. Set down the vape, joint, or edible. THC effects peak 10 to 30 minutes after smoking and 1 to 3 hours after edibles. Anxiety from smoked THC can last 1 to 4 hours. Edible anxiety can last 6 to 12 hours.

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1. Sit or lie down in a quiet room. Dim the lights.
2. Breathe at 6 breaths per minute. Inhale for 4 seconds. Exhale for 6 seconds.
3. Drink 8 to 16 ounces of water. Avoid caffeine and alcohol.
4. Use the 5-4-3-2-1 method. Name 5 objects you see, 4 you touch, 3 you hear, 2 you smell, 1 you taste.
5. Chew 5 to 10 black peppercorns. Some users report less anxiety. Clinical evidence is thin.
6. Call 911 for chest pain, a pulse over 140 beats per minute, fainting, or thoughts of self-harm.

Most cannabis panic attacks end on their own. A panic attack from THC does not damage the heart in a healthy adult. Get urgent care if symptoms last past 4 hours or get worse.

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Why THC causes anxiety

THC binds to CB1 receptors in the brain. CB1 receptors sit in the amygdala and hippocampus, two areas that control fear and memory. THC raises heart rate by 20 to 50 beats per minute. A fast pulse can feel like a heart attack. That feeling can trigger panic.

Cannabis for Anxiety Attacks vs. Panic Attacks: The Ultimate Comparison

Risk factors raise the chance of a panic attack:

what to do during a cannabis panic attack

• High THC dose, above 10 mg for a new user
• Edibles, because the liver turns THC into 11-hydroxy-THC, a stronger compound
• High anxiety trait or a panic disorder diagnosis
• Alcohol or stimulants in the same session
• Low tolerance after a break of 1 week or more

THC vs CBD

CBD does not bind CB1 receptors the same way. A 2019 review of 14 studies found CBD may reduce anxiety in some people. Doses ranged from 300 mg to 600 mg. The evidence is mixed. CBD can also raise blood levels of some drugs. Talk to a doctor before you use CBD for panic.

When to get medical help

Go to an emergency room for:

• Chest pain that spreads to the arm or jaw
• Pulse above 140 beats per minute at rest
• Fainting or a fall
• Vomiting that will not stop
• Thoughts of suicide or self-harm
• Symptoms that last more than 4 hours

Call Poison Control at 1-800-222-1222 for edible overdose. In 2022, US poison centers logged 3,054 calls for cannabis edibles in children under 6. Adult calls are higher.

Prevention

• Start with 2.5 mg THC or less.
• Wait 2 hours before a second dose with edibles.
• Pick a strain with equal THC and CBD, such as 1:1.
• Skip cannabis when you feel stressed or sleep deprived.
• Keep a log of dose, product, and mood.

Ask a doctor or a pharmacist about drug interactions. Cannabis can change how the liver breaks down warfarin, clobazam, and some antidepressants.