by Sarah Mann, MD

Many, of you have questions about Cannabis and COVID. I was just interviewed by freelance journalist Janelle Lassalle on this topic. I believe she did a great job of asking the questions that are on all of your mind. You can find my answers in their entirety here. Please check out her final article when it is ready. Her final article, along with her already extensive cannabis library, can be found here.

  • Are smokers at higher risk for contracting COVID? Cannabis smokers? People who vape? Why or why not? 
    • It is too soon to say. That kind of data will take time to analyze. The current thinking is that chronic smoking puts patients at higher risk for chronic diseases, particularly lung and heart diseases. Those chronic diseases put people at higher risk for having more severe symptoms and higher risk of death. Therefore, smoking may infer a higher COVID risk. As far as I know, there is no direct link between cannabis and COVID. As far as vaping is concerned, the data isn’t even in on what it does to the normal healthy lung. I don’t think we even know enough to speculate on the topic. 
  • Is one form of consumption less dangerous than another (i.e. smoking/combustion vs vaping)? 
    • An oral tincture or lozenge would be the safest route. Given what we don’t know about vaping, smoking, cannabis and COVID, the safest option would be to leave the lungs out of the equation. Edibles are not very reliable because the stomach is not a very consistent organ. Its ability to absorb changes  in times of stress and sleep deprivation. Which means you never know what you are going to get when you consume an edible. But anything that absorbs into the mouth, like a tincture or lozenge, will be both safe and consistent. 
  • Can you explain how COVID affects the lungs of those who are infected in layman’s terms?
    • There are different levels of severity. In mild to moderate cases, it can range from a bad cold to severe flu. In this case the infection causes an inflammatory response in the person. The lung tissue becomes congested with those inflammatory products, like plasma and white blood cells. That congestion makes it very difficult for air to pass through that tissue. In severe cases, meaning cases with respiratory failure or death, it is usually related to Acute Respiratory Distress Syndrome, or ARDS. It is a condition that has been seen many times before, including the H1N1 and SARS pandemics. Normal, healthy lung tissue is like a rubber band, constantly stretching and retracting with each breath. Now, picture that rubberband getting old and stiff, losing its ability to stretch, with a constant recoil force. That is what the lung tissue in ARDS is like. It is not only difficult to get air into the lungs, it is very difficult to get waste out of the lung. And it becomes extremely difficult to even deliver full size breaths to a patient. There is no cure for ARDS, only supportive care. Meaning that if you can get enough oxygen into them, enough carbon dioxide out of them for long enough, and you don’t have any other major complications, then you given the lungs enough time to heal themselves.
  • Do you have any insight into how cannabis use may affect those with COVID? 
    • Cannabis does have a stabilizing effect on the immune system. I suspect, when used in moderation it is beneficial. It may also be effective for symptom relief for those with milder forms of the disease. But I think it is most useful for treatment of acute cabin fever in the otherwise healthy population. A nice balanced strain, meaning it contains at least as much CBD as THC, can have a very calming effect!
  • Would cannabis’ benefits outweigh potential harm for those affected? Those at risk? 
    • At this time, the benefits seem a bit clearer than the harm. Smoking cigarettes is likely a contributing factor to mortality, so it might be reasonable to stay away from actual combustion. Stay away from black market vapes and other suspicious products that may leave your lungs vulnerable. Other than that, I would not take any drastic action until there was more clear evidence on the matter.
  • Should medical cannabis patients be looking for alternative delivery methods (i.e. edibles, topicals, transdermals, etc)? Which methods are preferable and why?
    • It really depends on the patient. As with any medication, you must weigh the risks and benefits. Inhaling cannabis, by whichever mechanism chosen, is the only option for immediate relief. The onset is in 1-3 minutes. Tinctures and lozenges take 15-30 min to kick in. So if the patient has a migraine, that might be a crucial window to aborting that migraine. If the patient has PTSD and is having a panic attack, 30 min would be an eternity. They should stick to what works. If the patient has osteoarthritis or fibromyalgia, they are typically accustomed to dealing with pain, and can typically wait that long. If it is someone who is interested in recreational use, then there is certainly no harm in waiting a few extra minutes. 
  • Is there anything else you think we need to know about COVID & cannabis use? 
    • It is most important to change your social consumption habits. If you smoke joints, everyone should have their own. If you are passing around a bong, use a “bong condom”. Get a free Zoom account and have an online circle. The question is not necessarily if you get COVID, it might be a question of when. The goal is to delay it as long as possible. Slow the spread and let the healthcare resources rebound. Give a few weeks for the first round of sick nurses and doctors to return with their new immunity. Allow time for gloves, masks and medications to be restocked. So just keep making smart choices and keep yourself protected.