The experience of using cannabis is very different for those who are trying it the first time compared to those that are familiar with its effects. The active ingredient in marijuana is THC and it causes users to feel high. This high, however, feels different the first time it is used and changes over time, especially once a tolerance has been acquired.
When someone has not used cannabis, we call that person cannabis-naive. That does not mean they are naive in general, but that they have no experience using cannabis. Also, their body is not primed to respond to the drug (more on that later). In this article we focus on patients who have not used cannabis before and provide some tips and information about what to expect and how to prepare for the experience.
In a perfect world, patients who are new to cannabis could use it under a doctor’s supervision. Unfortunately, this is not practical. Patients, therefore, have to take the medicine on their own without a healthcare provider’s supervision. Therefore, it is important to set up a nice environment and safe atmosphere for trying cannabis the first time.
The best place to try cannabis for the first time is somewhere you are comfortable. Usually, we recommend your own home because that is a place where you intimately know your surroundings. You will know where your bed is if you are tired and where the refrigerator is if you are thirsty or would like a snack. It is a good idea to have some fresh fruit or other snacks around and fluids to hydrate, especially if you get dry mouth, which is a common side-effect. Having some calming or enjoyable music can be helpful too because it will put you in a better mood.
Ask a family member or close friend to be with you when you try using it. Preferably ask someone who already knows how to use cannabis, so they can guide you and give you tips. They can also comfort you if you feel worried that you used too much. Most people will be honored when they are asked to partake in such an important part of your healthcare.
For unknown reasons, THC has no effect on a user the first time it is administered. Not infrequently, patients come to clinics like ours and tell the marijuana doctor, “I tried marijuana once when I was a teenager and it didn’t do anything for me.” The reason cannabis had no effect on them is that they were not primed yet.
The term priming was coined by doctor Matthew Roman, MD in The Clinician’s Guide to Medical Cannabis. The principle of priming is to use cannabis to prepare the body for the effects of THC. Priming means using cannabis with the expectation that it will not have a therapeutic effect but will activate the ability to use cannabis. This can be done with an oral dose of THC or by inhaling it. If an oral dose of THC is used, we suggest 10mg since this will be enough to prime the body but not enough to be too much if there is a psychoactive effect.
Sometimes patients were exposed to cannabis in the past without realizing it and in this way have already primed themselves to feel the effects of cannabis. For this reason, it is a good idea to prepare a safe environment and atmosphere in case you do get high from the initial administration of cannabis. After administering the first dose of cannabis, expect your body to be primed and wait one to two days to administer the next dose of cannabis, which will be the first time experiencing the high it produces (and the medical benefits).
The First Therapeutic Dose
After priming yourself (using cannabis the first time), the first therapeutic dose can be administered. This is the time when you really want to prepare for the first time being high. We recommend vaporizing cannabis for this for a number of reasons. Oral THC products last a long time (5-6 hours) so if too much is taken, you have to wait much longer to feel like your normal self. Also, the effect from oral cannabis takes two hours just to kick in so if you take too much you won’t know it until two hours later. This is a lot of time for patients to think that they did not take enough and eat more. There is nothing worse than taking some oral cannabis product because the first dose didn’t work, only to realize right after that the first dose hadn’t kicked in yet and was too strong to begin with.
Compared to taking oral cannabis products, vaporizing has downsides but a lot of benefits for users that are trying cannabis for the first time. The downside is that it is abrasive to the airways and causes users to cough. However, it is not as irritating as smoking cannabis (see Methods of Use). The benefit of vaporizing cannabis is that you can control how much you are administering much more carefully. While you may not be able to know the exact dose in milligrams of THC that you are inhaling, you can inhale a very small amount and then wait several minutes before repeating. Once you feel the psychoactive effect of cannabis you can stop. On the first time one to two small puffs is enough, but with repeated use the amount of cannabis inhaled can be titrated to the desired intensity. The high will only last two hours and another puff can be taken afterwards to extend the duration.
Keep in mind that most vaporizers are turned on with five rapid clicks in succession. The power level can be often adjusted with three rapid clicks. Make sure that your vaporizer is on the lowest setting when you first start using cannabis so that you don’t inhale too much in one puff. Don’t worry if you cough. That is a normal side effect that diminishes with use.
When patients are ready to try inhaling cannabis the first time, some of them don’t do it correctly. You have to inhale the vapor (or smoke) deep enough into the lungs for the THC to enter the alveoli (the tiny endings of the airways). Inhaling only to the upper chest will not be enough to deliver THC into the blood stream. Sometimes, patients cough before the vapor is deep enough and exhale it from the coughing. Here are some tips on how to inhale the cannabis properly. We recommend patients vaporize with a vape pen their first time using.
An inhalation of vapor (or smoke) is called a “drag.” There are two ways to inhale marijuana from a vape pen. The first involves taking a long inhalation while the vape pen is activated. This is more irritating to the lungs because the vapor makes contact with the upper airways the entire duration of the drag.
The second way of inhaling the cannabis is more comfortable and the way we would recommend for new users. This involves “sipping” the vape pen to fill your mouth with vapor first. The oral membranes of the mouth are less able to be irritated from the vapor and you can hold a mouthful of vapor without feeling like you have to cough. Once you sip some vapor into the mouth, then you take the vape pen away from the lips and take a quick full inhalation of fresh air into the lungs. This causes the vapor in the mouth to travel down into the airways quickly so the amount of time it is touching the walls of the airways is minimal. It also allows fresh air to chase and cleanse the airways after it is touched by the vapor. The fresh air acts like a chaser of juice after taking a shot of alcohol.
Once the vapor is inhaled deep into the lungs, hold it for a brief moment (1-2 seconds only) and exhale it. There is no need to hold you breath longer than that. Expect to cough since the act of vaping is still new to you and your lungs are not used to it. Wait 10-15 minutes after each puff because there is a delayed reaction to the effects of cannabis the first time patients feel it.
The First High
There are a lot of side effects the first time you use cannabis and feel high. You may have a feeling of deja vu throughout. Your eyes may get red so using eye drops for red eyes can be helpful. Try administering eye drops before you use the cannabis so they prevent your eyes from getting red in the first place. You will likely feel dry mouth, sometimes called “cotton mouth” because of its intensity. This will be a good time to keep some non-alcoholic drinks around. You may feel the “munchies” and get cravings for snacks. It is very common to feel your heart race. Do not worry that you are having a heart attack or anything like that. Marijuana can make you paranoid so if you feel like there may be something wrong with you or that you used too much, remind yourself that no one has died from using cannabis. Wait ten to fifteen minutes and your heart palpitations will likely go away. These side effects decrease after the first several times of medicating. As long as you don’t use too much and inhale only a tiny amount, these side effects will be minimal.
Focus your attention on how the cannabis is helping your medical conditions. If you have anxiety, see if you feel more relaxed. If you feel pain, are you able to tolerate it more? The purpose of using medical marijuana is treat your illnesses and symptoms. If it is not helping that, it’s probably not worth continuing it. On the other hand, if you feel like your symptoms are better, you can continue to use cannabis and find ways to incorporate it into your life (see Trial & Error) knowing that the side effects diminish with time and the benefits continue.
Make sure to check out our Cannabis Education section to learn everything you need to know about using cannabis as a medical marijuana patient. If you are a healthcare provider, definitely read The Clinician’s Guide to Medical Cannabis and you will be better informed about cannabis than 99% of the physicians out there.