COVID-19 & CANNABIS: A Good Or Bad Combination?

Are cannabis users more at risk for COVID-19? Should we stop smoking now? How else can we use the plant during the pandemic? Your questions answered by Dr. Junella Chin, co-founder of Medical Cannabis Mentor.

Handshaking will likely give way to bowing or touching your heart. People will probably begin to wink at each other since smiles are harder to see beneath a face mask. Sharing anything –, an intimate meal in a crowded restaurant, a stranger’s bed, even a whispered secret — is to be avoided. For cannabis users, the time-honored tradition of sharing joints, pipes, and bongs is out of the question.

I’m an integrative physician based in New York. Over the last 15 years, I have prescribed cannabis to over 10,000 patients. Many of them have questions about the safety of using the plant. There is also confusion about the effects of cannabis on the immune system. Here are the most commonly asked questions and my recommendations for smart, sensible cannabis use as this pandemic rages on.

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 reducing 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 the 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.

NOTE: If you have an illness that requires stronger doses of inhaled medicine, using concentrates is a good harm reduction option.

The inhalation patterns of cannabis smoking are different from cigarette smoking. Compared to tobacco, cannabis inhalations are 66% larger in puff volume and 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.

The long-term effects of vaping aren’t fully known, but not 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. 

Clearly, vaporizers with technology that allow for temperature control are worth the investment. Some brands worth looking into include Firefly 2+, Crafty, and Pax 3.

If vaporizing, be sure to follow these harm reduction methods: 

• Flower vaporizers are preferable to vape pens 
• Wash your hands before and after a vaporizing session
• Sterilize the mouthpiece with an alcohol swap between inhalations 
• Take small “sips” of vapor. The smaller the sip, the more control you will feel, and the less coughing will occur 
• Keep your temperatures as low as possible
• Vaporize outside and away from people. When exhaling, be sure that you are not facing another person. Don’t vape on the street if people are behind you.

When COVID-19 attacks the respiratory lining becomes injured, causing inflammation. This irritates the nerves in the lining of the airway and can spread into the gas exchange units (alveoli). This article illustrates the changes COVID-19 can have on the lungs.

Normal, healthy lung tissue is light and fluffy, like whipped cream. COVID-19 coats the lung tissue with a yellow ooze and turns the lung texture to marshmallow. This thick coating blocks the free flow of oxygen. As the virus invades and takes over, patients lose their ability to breathe and may need a ventilator. At this point, the marshmallow coating of the lung tissue begins to stiffen and the lungs’ capacity to take in oxygen diminishes. This is often the point when the patient’s life hangs in the balance. 

This virtual reality video brilliantly illustrates COVID-19’s path of destruction. 

No, I do not believe you have to abstain from cannabis but you should explore alternatives to inhaling.

Cannabis clearly has medicinal and therapeutic benefits. It is anti-inflammatory, anti-anxiety, anti-pain, antiviral, and immune-modulating. THC in small doses has been found to be a bronchodilator and has been shown to quell the cytokine storm (when the immune system goes into overdrive and causes an inflammatory flare) in animal models.  

Cannabinoids have also been shown to decrease the overall inflammation in the body, which means it’s one less thing for your body to fight against. You can also lessen inflammation through diet and regular restorative sleep. Anything that reduces inflammation or stress in your body and mind benefits your immune system. So whether you’re using cannabis for muscle spasm, to keep calm, or to sleep – it can be a therapeutic adjunct to your self-care, wellness or health regimen. 

CBD has antiviral and antibacterial properties, but its main virtue is that it decreases inflammation. As mentioned above, the common thread of all disease states is chronic inflammation. Diseases as diverse as diabetes, low back pain or migraines that come are all the result of some underlying inflammation. Reduce the inflammation and very likely you’ll reduce the symptoms of many illnesses.

In the last few months, I have been encouraging patients and adult-use consumers to change the way they’re consuming. Definitely explore edibles and drinkables. See if a 5 mg or 10 mg chocolate bar or drinkable works for you, or experiment to find your optimal dose. Just start low and go slow. Once you know your dose, edibles or drinkables can turn a hike through the woods or a park into a more sensory adventure. You smell, see and hear nature more vividly. You’ll likely feel closer to the people you’re with, even if you are 6 feet apart. Remember that ingesting takes an hour or two for effects to kick in — so time your dosing accordingly!

Cannabis interacts with GABA receptors in our brain. GABA tells our body to power down. It reduces the fight or flight response, which is associated with stress. This can be extremely helpful during this time of uncertainty and when many of us are afraid for our own health or the health of loved ones. Cannabis can also help with panic attacks and insomnia as the prevalence of depression and PTSD mounts in response to this pandemic. 

It’s important to mention that a lot of people with anxiety might be on prescription medication or antidepressants. So be careful when you are supplementing with cannabinoids as they can interact with these meds and make their effects more powerful. Talk to your doctor to be sure you’re not overconsuming one or the other. If the doctor increases your Zoloft that doesn’t mean you should also up your cannabis intake.

1. Brazil nuts are the richest known source of selenium, a trace element that is essential for your thyroid and immune system. Be careful not to over-consume because you can get selenium toxicity — just 2 nuts per day.
2. Spirulina is a blue-green algae  rich in protein, vitamins, minerals, and antioxidants to boost the immune system and help protect against allergic reactions. It has antiviral and anticancer properties!
3. Vitamin D3 helps modulate innate and adaptive immune responses. Vitamin D deficiency is associated with increased autoimmunity and susceptibility to infection.
4. Goji berries are packed with antioxidants and known for their immune-enhancing  qualities and ability to fight harmful free radicals and inflammation. Full of vitamins A & C.
5. Exercise! It helps move lymph fluid through the lymphatic system. Lymph fluid contains white blood cells which fight infection.
6. SLEEP! Without restorative sleep, optimal immune function is nearly impossible!

• Smoking cannabis raises the risk of COVID-19 complications. Since it can irritate the nasal passages and respiratory system, you are weakening your immune defenses and increasing your susceptibility to any infection, including a cold or flu. Minimizing inhalation in favor of edibles, drinkables, tinctures is safer and smarter.
• Don’t share joints, pipes, or vaporizers. This will help stop the contagion. So does frequent hand washing (especially after opening a door or touching your face), social distancing, and reducing the number of people you come in contact with. 
• This new enemy is invisible and deadly. Many people are asymptomatic and still carry COVID-19. You may not be coughing or having a fever, but lack of symptoms are not accurate ways of determining your health or anyone else’s. 

For more info: Hello@medicalcannabismentor.com