Fatal Marijuana Overdose is NOT a Myth

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It seems that not a day goes by that I do not see some post on social media claiming that there has never been a death due to marijuana overdose. There’s just one problem with this: it simply isn’t true. In fact, spreading this myth is quite dangerous because it could well encourage someone to ingest a fatal dose of marijuana in the false belief that there is no such thing as marijuana poisoning.

The truth is that although marijuana is one of the safest drugs around, far safer than opioids, alcohol, Tylenol, or antidepressants, it is still toxic when the dose is large enough. So, let’s take a look at the real facts.

The Real Facts

The CDC WONDER database is a public access database which records every death certificate filed in the United States between 1999 and 2014; according to this database there were 287 deaths due to cannabis or its derivatives in 2014. Numbers of deaths are calculated using UCD codes X40-44 (accidental drug poisoning), X60-64 (drug suicide), X85 (drug homicide), Y10-14 (drug poisoning of unknown intent) and MCD code T40.7 (Cannabis and its derivatives). Cannabis poisoning trends from 1999 to 2014 are given in Figure 1.

However, the majority of these deaths involved drug mixing, i.e. the co-ingestion of a fatal combination of marijuana and some other toxin such as alcohol, an opioid, cocaine, or some other drug. Note that this is not the same as saying that marijuana was present in the toxicology report; what this means is that a fatal dose of marijuana was present in addition to a fatal dose of some other drug or drugs. However, if we remove all the cases which involved drug mixing and look only at those cases where a fatal dose of cannabis alone was present, we still have 18 deaths due to poisoning by cannabis alone in 2014. Trends in poisoning by cannabis alone are given in Figure 2.

So how does cannabis poisoning stack up against rates of poisoning by other drugs such as heroin, prescription opioids, alcohol, cocaine, benzodiazepines, Tylenol, or antidepressants? As we can see from Figure 3, there are far fewer deaths due to cannabis per year than any of these other drugs.

What About Caffeine?

Although there is an ICD-10 code for caffeine poisoning, T43.61, the CDC WONDER database does not break things down this finely, but instead lumps caffeine together with other psychostimulants with abuse potential, such as methamphetamine, amphetamine, and Ritalin under the more general ICD-10 code T43.6; therefore there is no way to calculate the number of caffeine poisoning deaths per year using CDC WONDER. However, as there are a number of news reports of caffeine poisoning deaths each year it may be reasonable to assume that caffeine and cannabis are similar in their toxicity.

How Toxic is Cannabis?

Benno Hartung et al. (2014) report that the lethal half dose (LD50) for THC in humans is estimated to be around 30 mg/kg. This means that approximately 2 grams (.07 ounces) of pure THC has a 50% chance of killing a 150 pound man. This is the amount of THC found in .35 ounces of high grade weed with 20% THC content. Moreover, the DEA reports that concentrated THC derivatives known variously as “wax,” “dabs,” or “butane hash oil” consisting of up to 80% THC are now available on the streets; one tenth of an ounce of these would contain a lethal half dose of 2 grams of THC. Robert Gable (2004) also reports that the lethal half dose of marijuana is about 15 grams or one half ounce; however, he does not specify the THC percentage of the marijuana. It is likely that you are in more danger of consuming a fatal overdose if you eat your cannabis products than if you smoke them.

So please do not believe wild made up stories you will read online about how you would have to ingest over 1,000 pounds of marijuana to die or Wikipedia articles with made up numbers which cite no sources. Cannabis is indeed much safer than alcohol, Tylenol, or Prozac, and many, many times safer than prescription opioids, but it is still possible to ingest enough to kill you. Heck, even water will kill you if you drink too much too fast. Therefore, these internet memes which claim that there has never been a death due to marijuana are not only false, they are irresponsible and may in and of themselves lead to increased marijuana poisoning deaths by encouraging reckless behavior.

 

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The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Rehabs.com. We do believe in healthy dialogue on all topics and we welcome the opinions of our professional contributors.

What Are Your Thoughts on this Topic?

  • http://www.Wendi.com/ Wendi Friesen

    Great article, really good information. I did not know there was a lethal dose of thc, and it does seem it would be tough achieve that. But obviously some do.
    I send many of my clients to your site to learn about harm reduction, and also to your alcohol detox page.

    • elcuervo

      There is NOT a lethal dose, and I challenge anyone to prove otherwise – not one in all of recorded history attributed to cannabis and cannabis alone.

  • George A Parks

    The biggest flaw in calling these figures “facts” besides the obvious problem of overstatement and hyperbole is that the level of blood concentration claimed to be a “lethal dose” of cannabis was determined in studies on rats, not humans. Of course, large doses of marijuana especially high THC concentrations may be toxic especially to people with pre-existing vulnerabilities which may without other drugs cause enormously large doses of THC be fatal, but it still seems dying of cannabis use (overdose) alone is largely unsubstantiated and hardly worth signaling the alarm implied by these misleading “facts.” Alcohol overdose is what needs more exposure because of its wide use by naive youth and it clear overdose potential.

    • Kenneth Anderson

      Actually, George, Figure 3 makes it quite clear that cannabis is far less toxic than alcohol, Tylenol, or antidepressants. In fact, antidepressant poisoning kills many more Americans each year than alcohol poisoning.

  • elcuervo

    This is a stretch of imagination. Not one single death attributed to to cannabis alone has ever been recorded, and putting up a chart that says otherwise does not make it so. Please do not make up stories about how “lethal” cannabis is without real facts — and real facts are about cannabis are actually widely available. If you actually have a source that shows a real cannabis death, publish it. It would be the first one ever in the history of the world, so it should be a heckuva scoop over all the journalists that have ever gone before. Otherwise, apologize for lying and shut up.

    • Kenneth Anderson

      I did publish the source–it is the CDC WONDER database which compiles every death certificate filed in the United States. 287 death certificates were filed in 2014 listing fatal cannabis overdose as cause of death. It is a public access online database–go run the numbers for yourself.

  • Sarijuana

    What takes place in the body to cause the fatal cannabis overdose? Stopped the heart? Stopped breathing? From what I have read, overdoses from drugs and alcohol happens from the affect on the part of the brain called the mendulla, or brain stem, which controls the vital functions of our body and also has receptors that receive drugs like opiates and alcohol. There are no cannabinoid receptors in this part of the brain, and that’s why there are no fatal overdoses. I may be off base here, but until you can tell me the exact way cannabis killed the people you are talking about I will have to figure that your numbers don’t really work in the real world.

  • Silver Damsen

    It is frustrating that previous commentators are saying that there is no data that says that cannabis is lethal, despite the fact that in 3rd paragraph of the article Kenneth Anderson gives his source for his findings on the number of deaths related to cannabis and other drugs, the CDC Wonder, and he does this even as a link so that readers can go there themselves and double-check his data.

    The purpose of Anderson’s article is also not to scare anyone about the dangers of cannabis, since it remains one of the “safest” drugs around. Anderson’s point is that caffeine and Tylenol can kill people too, so know what a safe amount is for any drug that one consumes from cannabis (if one partakes) to Tylenol to prescription opiates to heroine.

    In other words, the truth on drugs will make for safer use. I am going to have to agree strongly with that because it is so very logical. What continues to be frustrating is that while the truth is available many people (for a variety of reasons) seem unable to grasp what this truth is.

    • Sarijuana

      From Benno Hartung et al. (2014) “To our knowledge, these are the first cases of suspected fatal cannabis
      intoxications where full postmortem investigations, including autopsy,
      toxicological, histological, immunohistochemical and genetical
      examinations, were carried out. The results of these examinations are
      presented. After exclusion of other causes of death we assume that the
      young men experienced fatal cardiovascular complications evoked by
      smoking cannabis.”

      Yes they did the autopsy and research, but the assumption is still an assumption. Because I have a friend who lost a teenage son, and two autopsies were done and still no cause of death was presented, and even though we know he was a regular cannabis user, and they never even found the cannabis in the autopsies, I remain a skeptic of assumptions drawn in this fashion.

      Cause of death is not as finite as you may think. Another thing to consider is that cannabis IS in the spotlight, and it is up to the medical examiner to determine cause of death. An anti-cannabis doctor may be more likely to determine COD then a doctor trained in the endocannabinoid system (as most practicing healthcare professionals ARE NOT). This is a fairly new science, and the methods use to determine COD with cannabis using the current methods may not be the way to go. It’s like fitting square pegs into a round hole.

    • Jack Shuman

      Silver Damsen said, “the truth on drugs will make for safer use.” The question remains, has this .gov website supplied the truth? I’m doubting it. But as I stated before, I promote the safe use of everything. I believe that substance use is most enjoyable in moderation, I promote wearing earplugs around noisy equipment, and please wear eye protection where appropriate.

  • Laura Bezzeg

    US Drug Enforcement Agency administrative law judge Francis Young wrote:

    “Drugs used in medicine are routinely given what is called an LD-50. The LD-50 rating indicates at what dosage fifty percent of test animals receiving a drug will die as a result of drug induced toxicity. A number of researchers have attempted to determine marijuana’s LD-50 rating in test animals, without success. Simply stated, researchers have been unable to give animals enough marijuana to induce death.”

    “At present it is estimated that marijuana’s LD-50 is around 1:20,000 or 1:40,000. In layman terms this means that in order to induce death a marijuana smoker would have to consume 20,000 to 40,000 times as much marijuana as is contained in one marijuana cigarette. NIDA-supplied marijuana cigarettes weigh approximately .9 grams. A smoker would theoretically have to consume nearly 1,500 pounds of marijuana within about fifteen minutes to induce a lethal response.”

    So if the rabid anti-cannabis DEA considers fatally overdosing nigh well impossible who is this man to say otherwise. Show me your research.

    • Kenneth Anderson

      This is what the high court which overturned Judge Francis
      L. Young’s ruling had to say (Federal Register Vol. 54, No. 249 Dec 29, 1989 p.
      53782-3):

      “The Administrator finds that the administrative law
      judge failed to act as an impartial judge in this matter. He appears to have
      ignored the scientific evidence, ignored the testimony of highly-credible and
      recognized medical experts and. instead, relied on the testimony of
      psychiatrists and individuals who used marijuana. The administrative law judge
      relied heavily on anecdotal accounts of marijuana use by both physicians and
      seriously ill persons. The administrative law judge’s findings of fact ignored
      any evidence presented by the Government for example, in his findings regarding
      marijuana and nausea and vomiting associated with chemotherapy. Judge Young
      cites many of the physicians presented by the pro-marijuana parties by name as
      accepting marijuana as “medically useful” Not once in his findings or
      discussion does the judge acknowledge or mention the Government’s experts. Not
      once does the judge mention why he chose to find the pro-marijuana parties’
      evidence more credible. The administrative law judge failed to acknowledge the
      position of a major organization of physicians, the American Medical Association;
      and those of organizations whose existence is dedicated to the treatment and
      study of the diseases at issue such as the American Cancer Society, the
      National Academy of Ophthalmology and the National Multiple Sclerosis Society.
      He chose instead to rely on the testimony of a very small number of physicians.
      Most significantly, the administrative law judge did not follow the standard
      for “accepted medical use in treatment in the United States,” and
      “accepted safety for use* * * under medical supervision” established
      by the Administrator in previous scheduling proceedings. The administrative law
      judge chose, instead, to develop his own standard for both accepted medical use
      and accepted safety; standards which were specifically rejected by the Administrator
      in the scheduling of 3,4-methylenedioxymethamphetamine (MDMA).

      “The administrative law judge did not even apply his
      own standard consistently. While the administrative law judge found that
      marijuana had an accepted medical use in treatment of nausea and vomiting
      associated with chemotherapy; of spasticity associated with multiple sclerosis
      and amputation; and of pain associated with hyperparathyroidism: he concluded
      that it did not have accepted medical use in treatment of glaucoma. His
      rationale was that in applying his standard of accepted medical use, which is that
      a “significant minority” of physicians accept marijuana as medically
      useful, there were not enough physicians to establish such a “significant
      minority” with respect to glaucoma. In contrast, he found that one
      physician’s opinion was sufficient to establish an accepted medical use of
      marijuana with regard to hyperparathyroidism, because that was a rare disease.

      “The Administrator rejects the administrative law
      judge’s findings and conclusions. They were erroneous; they were not based upon
      credible evidence; nor were they based upon evidence in the record as a whole.
      Therefore, in this case, they carry no weight and do not represent the position
      of the agency or its Administrator. The inadequacy of Judge Young’s analysis of
      the case is exemplified by his acceptance of, and reliance upon, irresponsible
      and irrational statements propounded by the pro-marijuana parties. Such
      statements include the following: “marijuana is far safer than many of the
      foods we commonly consume. For example, eating ten raw potatoes can result in a
      toxic response. By comparison, it is physically impossible to eat enough
      marijuana to induce death.” That such a statement would come from the
      proponents of marijuana is understandable. To give it the weight of an
      administrative law judge’s finding is appalling.”

      Clearly Judge Young cared nothing about scientific evidence
      since he makes the statement in 1988 that “A number of researchers have
      attempted to determine marijuana’s LD-50 rating in test animals, without
      success. Simply stated, researchers have
      been unable to give animals enough marijuana to induce death” when in fact
      the LD50 had been established by Phillips et al. in 1971.

      Phillips, R. N., Turk, R. F., &
      Forney, R. B. (1971). Acute toxicity of Δ9-tetrahydrocannabinol in rats and
      mice. Experimental Biology and Medicine, 136(1), 260-263.

  • Jack Shuman

    This information is from a .gov website and as we know we can all trust the government to give us good information, tax us fairly, run our lives, and tell us when to join the armed forces and fight a war they started.

    Seriously, even if some of this information is true (because a doctor put down marijuana as the cause of death?), I don’t think the fear of death is what motivates people to ease off the bong.

    I’m sure that common sense should prevail with the use of any drug, food, tool or piece of equipment, but I don’t put much stock into what a government site is telling people about marijuana or its use.

    Before pot cured ailments, this is what the government used to tell us: link to youtube.com

    • http://www.ACunningLinguist.com Rock

      It’s nowhere on the government website that the author cited.

  • Mazoola

    It’s absurd to argue no one, anywhere, has ever died as the result of ingesting cannabis — if only by triggering an asthmatic or allergic reaction. Admittedly, that’s not the same thing as an overdose, but at least admitting there are dangers, no matter how remote, is the first step towards recovery.

    That said, I have a hard time accepting the LD50 of 30 mg/kg proposed by Hartung, et al. — especially for smoked cannabis. Earlier studies showed an LD50 between 92 mg/kg and 128 mg/kg in monkeys — but only for IV administration of THC. (Worrisomely, based on the write-up I have at hand, this may have used synthetic delta-9 THC.) Researchers could not determine an LD50 for oral ingestion, as dosages as high as 3 g/kg failed to kill half of the test subjects.

    Furthermore, ingestion of 1 gm/day or more of THC is far from uncommon for medical users, especially ones attempting to follow Rick Simpson’s protocol for cancer treatment. If 2 gm/day was actually a fatal dose for 50% of the population, we’d be seeing far more deaths.

  • Danny Gunter

    Is any substance safe? No air and water can kill you too!

  • http://www.ACunningLinguist.com Rock

    I couldn’t find any of those charts or articles on the CDC Wonder Database doing a search there for “marijuana poisoning deaths”. The only marijuana related death article I saw said a 19 y/o ate an entire edible cookie which was supposed to be six doses and jumped off of a fourth story balcony after becoming hostile and agitated. That is a horrible thing, but it’s a lot like blaming alcohol for drunk drivers. I think this falls on the consumer, not the substance. I wouldn’t expect an unbiased report from for profit rehabs.

  • http://www.ACunningLinguist.com Rock

    More research seems to suggest that the false data and charts were fabricated purely for this article and to use further fear mongering to promote paid drug rehabs. The Truth About Addiction and Recovery by Stanton Peele was a great eye opener for me. It freed me from bad behaviors and labels that Twelve Step programs only reinforced. (I haven’t been drunk since 1984)

    • Kenneth Anderson

      You will actually have to extract the data from the database by entering the codes I gave you, just as I said in the article. I did not say these charts were on the CDC website.

  • Butch Plude

    As a medical marijuana patient who tested at over 1000ng / ml I would like to remindicate you I am not dead but thriving at close to 1000 times over the legal limit. Your data is flawed. You will not find one death from cannabis on its own but you will find that other compounds like opiates and alcohol have killed millions.

  • julz.kayla@outlook.com

    Only less that 45% of people who try weed feel these feelings of dying & stomach cramps, hearing their blood ryshing through their bodys, headache, sweats, dizzyness etc & other ill feelings only because of 1 or 2 reasons, . . . .
    1)If they are trying it for the first time or the first time in a long time & they have a bit too much
    OR
    2) A small persentage of people ARE HAVING A ALLERGIC REACTION.
    I am allergic to weed & get these reactions & ill feelings everytime i have tried to smoke weed & i have tried it alot, & i get the same sick, dying feelings everything

  • Jotip

    If any of this were accurate, I’d be dead.

  • Charles

    Somewhere along the line I’d be too damn high to get through a half ounce. In fact, a whole joint would have me couch locked for hours with no desire to roll another. A single joint usually lasts me 3 sessions. That’s three intense highs for $10 of legal Segerblom Haze with 22% THC (Nevada). Much cheaper than alcohol, much safer, better high, no hangover what so ever, no danger of killing my liver, no desire to fight or raise hell… just mellowness. I’ll never drink alcohol again. That said, I always drank at home and never went to bars or drove when I drank. Same thing when I smoke. Just get things ready (food, soft drinks, etc.) before smoking and enjoy the ride and stay home. That’s my way of doing things.