Dr. Junella Chin April 13, 2020
Editor’s note: Dr. Junella Chin is physician based in New York, where she treats adults and children in her integrative and holistic medical practice. Dr. Chin co-authored the book Cannabis and CBD for Health and Wellness with Aliza Sherman, and is the co-founder of Medical Cannabis Mentor, an online educational platform.
Dr. Chin offered this FAQ to her patients, and we think it answers some of our readers’ most pressing questions about cannabis and COVID-19.
Many of my patients are asking about ways to use cannabis mindfully to lower their stress or make these times of social distancing and self-quarantining less difficult. There’s also a lot of confusion about the effects of cannabis on the immune system.
Here are some of the most commonly asked questions and what I recommend for smart, sensible cannabis use in the time of COVID-19.
Should cannabis users refrain from smoking?
I have been encouraging patients and adult use consumers to consider exploring oral forms of cannabis: tinctures, capsules, edibles and drinkables instead of inhaled forms of cannabis. Avoiding lung irritation is the first line of defense against this illness.
Any inhaled substance may affect the respiratory system. Cannabis smoke can cause visible lung irritation and microscopic injury to the pulmonary epithelium (the tiny cells that line most of the respiratory tract as respiratory mucosa). Exposing lung tissue to vape aerosols (e-cigarettes) can increase the release of inflammatory cytokines, macrophages, neutrophils, and lymphocytes. Basically, the lung tissue is trying to mount an “immune response.”
Most healthy individuals can recover from this lung irritation—but right now, I recommend you reduce your exposure to all irritants. Keep your house dust-free. Get out into fresh air. Lower your use of aerosol products. Don’t inhale bleach, ammonia, or anything with a noxious odor—even small doses can irritate the eyes, skin, and respiratory tract.
Studies also show that angiotensin-converting enzyme-2 (ACE2) receptor increases in the lungs of smokers and patients with COPD. This makes smokers of anything more susceptible to COVID-19, and this is why scientists and physicians are recommending that users who smoke or vaporize stop. Of equal concern is the coughing that often occurs when inhaling products. Coughing can disperse COVID-19 pathogens into the air, and this is what we all want to avoid.
Bronchitis is another well-known side effect of cannabis smoke. It’s not uncommon for regular users to develop a cough, chest congestion, and some phlegm. These symptoms are usually temporary and go away when you stop smoking, but it’s best to avoid them in a respiratory flu pandemic.
It’s also allergy season, so everyone’s respiratory health is going to be compromised.
Also, be aware that the degree of lung injury depends on multiple host factors:
- Elderly patients are more vulnerable to lung injury than younger people.
- People with allergies are more susceptible to bronchospasm than nonallergic people.
- People with reactive airway disease, cardiovascular disease, diabetes, and auto-immune diseases are also more at risk.
What’s the difference between cannabis and tobacco smoke?
The inhalation patterns of cannabis smoking are different than cigarette smoking. Compared to tobacco, cannabis inhalations are 66% larger in puff volume and a 33% larger in inhaled volume. Cannabis smokers also hold their breath four times longer and take in five times the concentration of carboxyhemoglobin. Carboxyhemoglobin is formed in carbon monoxide poisoning and leads to oxygen deficiency in the body.
Is vaping less dangerous than smoking?
The long term effects of vaping aren’t entirely known, but not are all vaporizers are the same.
If using vape pens, watch out for oil cartridges that are thinned with PEG (polyethylene glycol – it produces hazardous chemical byproducts which destroy lung tissue) or Vitamin E acetate, which have been linked to lung injury and chemical pneumonia. One way to avoid Vitamin E acetate is to buy cartridges in the legal market. Most, if not all, of the tainted products were found in the illegal market.
If you use a flower vaporizer, the key to a healthier draw is temperature control—a joint burns at around 950 degrees. Vaporization occurs at 350-400 degrees — the sweet spot is around 390 degrees. That temperature variance makes a big difference if you want to protect fragile lung tissue.