A survey of more than 1,100 people with suspected or diagnosed CHS offers one of the clearest looks yet at the condition, including a notable finding: exclusive vape cartridge users reported symptoms appearing sooner than exclusive flower smokers.

By Riley Kirk, PhD and Codi Peterson, PharmD

Cannabis is known for helping fight nausea. It can calm the stomach and help patients deal with chemotherapy, chronic illness and pain. It is even FDA-approved for chemotherapy-induced nausea and vomiting in certain forms. But for a small group of heavy cannabis users, something strange can happen.

Instead of calming the stomach, cannabis can begin to trigger waves of nausea and severe vomiting. Some people end up going to the emergency room repeatedly before anyone realizes what is happening. The condition is called cannabinoid hyperemesis syndrome, or CHS.

For years, CHS has existed in a gray area between cannabis culture and medical science. Many physicians fail to recognize it, leading to prolonged symptoms and repeated emergency room visits. At the same time, some patients are misdiagnosed with CHS simply because they disclose cannabis use. Many consumers have never heard of the condition, leaving those who develop it spending months, or even years, trying to understand why they keep getting sick.

Part of what makes CHS so confusing is the gap between cannabis use, the early onset of general symptoms and the later phase of relentless vomiting. People can consume for years, even decades, without getting sick, only to suddenly develop the syndrome. Researchers still do not know exactly what causes it, although previous work has suggested that there may be a genetic link that makes some people more likely to develop CHS than others. Many cannabis consumers have also wondered whether CHS could be related to pesticide exposure, other medications or compounds in the plant beyond THC.

CHS is also a touchy subject in cannabis media because the condition is real, but the hype around it often gets distorted or weaponized. That broader tension has surfaced before in High Times coverage, including “Is Cannabinoid Hyperemesis Syndrome Real? If So, Should It Be on Warning Labels?” and “CHS, Cannabis Vomiting Syndrome, Is Real. The Hype Is Weaponized.” From our perspective, ignoring CHS does not help patients, and exaggerating it does not help the cannabis community either.

As cannabis legalization spreads, researchers are finally starting to gather better data about the condition and the kinds of cannabis use patterns linked to it. Our team surveyed more than 1,100 people with suspected or diagnosed CHS, and our recently published research paper offers one of the largest looks yet at how people with the condition use cannabis and experience this still-mysterious syndrome.

Our research group is made up of independent cannabis researchers, clinicians and patients who support cannabis reform and medical cannabis use. At the same time, we believe the plant deserves the same careful study as any other medicine. No external funding was involved in this survey, and none of the researchers have conflicts with alcohol or pharmaceutical companies.

Why We Wanted to Research CHS

Our goal was to better understand the condition and figure out who in our community is being affected so doctors can provide better care and consumers can recognize the warning signs earlier.

Prohibition slowed cannabis research for decades, but broader legalization is now opening the door to better real-world data. Understanding rare side effects like CHS is part of that process. CHS may not be a “good look” for the cannabis industry, but ignoring it does not make it go away. If anything, it only increases the risks for the people affected.

While the underlying cause of CHS is still unclear, our goal is to better understand who in our community is affected and why, so we can support clinicians in providing better care and empower individuals with the knowledge needed to recognize and respond to it earlier. Cannabis has been consumed for centuries without documented CHS in the medical literature, but newer extraction techniques, emerging hardware devices and modified growing methods are introducing additional variables worth considering.

What CHS Actually Looks Like

Many people think CHS is just vomiting from taking too much cannabis. But while that can happen when someone overindulges, CHS is different and tends to follow some recognizable patterns. It causes repeated cycles of nausea, vomiting and stomach pain in some heavy cannabis users. Many patients report that hot showers or baths temporarily relieve symptoms.

Doctors often divide CHS into three distinct phases. The first is the prodromal phase. This is when symptoms begin but vomiting has not yet become severe. Many people feel nausea, stomach discomfort or loss of appetite during this time. One of the more important findings in our survey was that these early symptoms were most often reported in the morning. Many respondents described waking up feeling sick to their stomach before the day even started.

Weeks to months later, during the hyperemetic phase, the vomiting begins. Nausea and abdominal pain become much more severe, and this can happen several times a day, or even all day. Recognizing those early morning symptoms may help consumers and doctors identify CHS sooner and avoid months of confusion and harm from chronic vomiting.

Recognizing those early morning symptoms may help consumers and doctors identify CHS sooner and avoid months of confusion.

Riley Kirk, PhD and Codi Peterson, PharmD

One pattern that stood out clearly in our survey was how frequently people with CHS were using cannabis. Nearly all participants, 96.5%, said they used cannabis at least daily, and about 45% said they used it six or more times per day around the time their symptoms developed.

In other words, the typical person in the study was not an occasional user. They were using cannabis many times throughout the day. That does not mean everyone who uses cannabis daily will develop CHS. Most cannabis users never experience the condition. But the data suggests that heavy and frequent use may increase the risk for some.

How People With CHS Are Really Using Cannabis

The survey also looked at how people were consuming cannabis. Smoking flower was the most common method. Using vape cartridges was the second most common, and many respondents reported doing both.

When we looked only at people who reported using one method, an interesting pattern appeared. People who only smoked cannabis often reported many years of use before CHS symptoms began. People who only used vape cartridges often reported a much shorter timeline. Some said symptoms started after only one or two years of use.

Researchers do not yet know exactly why this pattern appears. One possibility is that modern vape products can deliver very concentrated doses of THC quickly and easily while also concentrating other components of the product. More research will be needed to understand that difference, but the pattern stood out clearly in our data.

Could Contamination Be the Cause?

Some people have suggested that CHS might be caused by pesticides or contaminated cannabis. While we still do not know the full story of CHS, our survey data did not support that idea as the main explanation. Participants reported getting cannabis from many different sources. Some bought from licensed dispensaries, while others used unlicensed markets or homegrown cannabis, and symptoms looked similar across all groups.

Where the cannabis came from did not appear to change how CHS developed in this survey. That finding adds to growing evidence that CHS is more likely linked to heavy exposure to THC over time than to any one market source. It is certainly possible for people to get sick from contaminated cannabis, which remains a real issue in both regulated and unregulated markets. But we also know from patients’ experiences that multiple people can use the same brand, strain, formulation or dispensary, and one might develop CHS while the others do not.

Sex Differences

We also found differences between men and women. Women reported more symptoms overall and were more likely to experience longer vomiting episodes than men, episodes that can last several days or even longer than a week.

Some women reported that symptoms became worse during their menstrual cycle, though not everyone noticed that effect. Researchers still do not know why these differences exist. Hormones may play a role, but again, more research is needed, and we hope these results can help inspire future studies.

What Should the Average Cannabis Consumer Know?

For most cannabis users, the takeaway is simple: CHS appears to be linked to heavy and frequent cannabis use over long periods of time. There is also some research suggesting genetics may play a key role in who develops it, which may help explain why some long-term, high-dose consumers are affected while others are not.

But for people who use cannabis many times a day for years, it may be helpful to know the early warning signs: recurring morning nausea, stomach pain that does not seem to have another cause, unusual ongoing abdominal symptoms and cycles of vomiting that improve only when cannabis use stops. Recognizing those patterns earlier may help people avoid repeated emergency visits and months of uncertainty.

Cannabis Science Is Growing Up

For a long time, cannabis research was limited by prohibition. Scientists struggled to study the plant and its compounds in meaningful ways. Now that cannabis laws are changing, the science is finally starting to catch up. That means studying the benefits of cannabis. It also means studying rare side effects like CHS.

Being honest about both sides does not weaken the cannabis movement. If anything, it strengthens it, because real science builds trust. The cannabis community deserves the same level of research and understanding that exists for any other medicine. The more we learn about cannabis, the better people can use it safely and responsibly, and that is a win for everyone.

Being honest about both sides does not weaken the cannabis movement. If anything, it strengthens it, because real science builds trust.

Riley Kirk, PhD and Codi Peterson, PharmD

Our team took on this research project because we care deeply about the cannabis community and the plant, and we wanted to start getting to the bottom of what may be causing CHS, or at the very least reduce the amount of time and trial and error that patients experience when they go to the ER with it. Although CHS can be a touchy subject, we feel it is important for this information and data to come from patients, advocates and medical professionals within the industry rather than from outside the space, where the narrative can be taken out of context and weaponized.

You can read the full paper, “Cannabinoid Hyperemesis Syndrome: A Survey-Based Approach to Understanding Symptoms and Cannabis Use Patterns”, here.

This article is based on peer-reviewed research published by the authors. It does not constitute medical advice. If you are experiencing symptoms consistent with CHS, consult a healthcare provider.

<p>The post Why Some Heavy Cannabis Users Can’t Stop Throwing Up, According to New Research first appeared on High Times.</p>

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After years of surgeries, rehab and a recovery machine built for return-to-play, the former NBA forward stopped asking whether cannabis could help and started asking harder questions about how it actually worked.

Al Harrington didn’t come out of basketball looking for another celebrity weed lane.

He came out of it with a body that had absorbed 16 seasons of professional punishment, a long and personal relationship with the plant, and a growing suspicion that most of the recovery industry, cannabis included, wasn’t asking serious enough questions.

That’s the more interesting story. Not that a former NBA star believes in cannabis. Plenty of them do. Not that he has a product line. Plenty of them have that too. What separates Harrington, at least right now, is that he sounds genuinely less interested in the wellness pitch than in whether the products behind it were actually built to do something real.

He got there the hard way.

“What frustrated me most was how little focus there was on the long-term,” Harrington told High Times, reflecting on traditional pain management and recovery after retirement and multiple surgeries. “Traditional rehab is usually about getting you back on the court, but there’s not always a real plan for what comes after that. There should be more attention on what habits, routines, and treatments need to become part of your lifestyle so you can stay healthy long after the rehab process is over.”

That’s a bigger idea than sports medicine usually allows. The whole recovery machine is built around return-to-play. Patch the guy up, get him moving, get him back out there. What happens to the body after the season ends and the cameras move on is a different conversation, one that professional sports has never been especially good at having.

Cannabis entered that gap for Harrington first as relief, then as something else.

“Once it became part of my daily routine, I started noticing benefits that went beyond a specific injury,” he said. “I was feeling better overall, and that made me curious about what was actually happening in the body. That curiosity pushed me to start asking deeper questions about how recovery really works.”

That’s the turn. Not from pain to comfort, but from relief to investigation.

And once you start asking what is actually happening in the body, you start asking harder questions about the products built around those promises. About formulation. About delivery. About absorption. About whether the people making them are doing anything more rigorous than dressing up old ideas in clean packaging.

The cannabis wellness boom gave us plenty of sleek bottles, soft-focus promises and celebrity-backed products that seemed designed to sell a mood more than solve a problem. Harrington, by his own account, started moving in the opposite direction.

“That shift happened when I started talking to people who were actually doing serious work in the space,” he said, describing when he stopped treating CBD as a trend and started caring about the mechanics behind it. “Hearing about clinical trials and seeing real data made me realize it was more than just a trend. Then connecting with Avicanna opened my eyes to the level of innovation happening with formulations and delivery systems. That was a game changer for me.”

That’s where Avicanna comes in. The Toronto-based biopharmaceutical company has spent nearly a decade doing serious cannabinoid R&D, running more than 25 pre-clinical and clinical trials and commercializing products across 24 international markets. Its work with re+PLAY centers on patented transdermal delivery technology designed to push cannabinoids deeper into tissue than standard topical creams reach. A real-world evidence study on musculoskeletal pain involving 71 patients showed a 35.4% improvement in health-related domains after one month. A separate study on a rare skin condition was led by the head of dermatology at Toronto’s Hospital for Sick Children. These are company-affiliated studies, worth reading with that in mind. But they’re real, and they represent exactly the kind of technical credibility Harrington says he started looking for.

“My relationship with Avicanna really pushed me toward the science,” he said. “Aras [the co-founder and CEO] was able to break things down in a way that made sense, and then he’d back it up with studies. That made it easier to really dive into the research and understand what was happening beyond just personal experience.”

None of this came from nowhere. Harrington has been in cannabis long enough that his credibility doesn’t depend on this relaunch. He founded Viola, one of the more recognized athlete-built brands in the space, and has been publicly connecting cannabis to pain, recovery and personal history for years. The name itself came from his grandmother Viola, whose experience with medical cannabis helped shift his thinking about the plant entirely.

He brought that up here, too.

“For me, it wasn’t just about being an athlete,” he said. “Growing up, I was always told cannabis was a gateway drug. That mindset stuck with me for a long time. But when I saw how it helped my grandmother medically, it completely shifted my perspective and made me approach the plant with a lot more openness and curiosity.”

That might be the most relatable part of his story. Not the fame, not the 12 surgeries, not the entrepreneurial success. The fact that he arrived at cannabis with the same skepticism millions of Americans did, then stayed around long enough to get genuinely demanding about it.

“I was approaching it from the perspective of someone who put their body through an 18-year professional career,” he said, on whether he noticed most cannabis wellness products weren’t asking the same questions he was. “I was looking for real solutions for long-term wear and tear. A lot of products in the space weren’t necessarily being developed with that kind of athlete-level demand in mind.”

That’s a sharp observation, and not just for athletes.

Cannabis has matured as an industry. That maturity doesn’t automatically produce rigor. There is still a lot of language in this space pretending to be insight. A lot of products that want the credibility of science without doing the harder work of earning it. Harrington seems increasingly aware of that gap, and increasingly uninterested in pretending it doesn’t exist.

“Doing it right means having intention behind it,” he said. “You need a real plan for what you’re trying to address and how cannabis fits into your overall wellness. It’s about respecting the plant and using it responsibly, not abusing it. That’s the difference between real wellness and hype.”

In an industry that still too often rewards noise, that line sounds almost radical.

Because the most interesting thing about Al Harrington’s cannabis story in 2026 isn’t that he’s still in it. It’s that after 16 seasons, 12 surgeries, a grandmother’s healing and a decade of watching an industry take shape around him, he sounds less like a celebrity endorser and more like the kind of consumer this market badly needs more of. One who wants the plant, but also wants the proof.

At a time when cannabis brands still sell the feeling first and the details later, Harrington keeps asking about the details.

In this industry, that might be the sharpest edge of all.

<p>The post The NBA Put Al Harrington Through 12 Surgeries. Cannabis Helped Him Cope. Science Made Him Look Closer. first appeared on High Times.</p>

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The Wall Street Journal keeps pairing real concerns about teen cannabis with a familiar implication: legalization made the problem worse. But national trend data, recent policy research (and even the DEA’s own youth-facing materials) still don’t show that legal adult markets drove a youth-use surge.

The Wall Street Journal has now run back-to-back pieces nudging readers toward the same conclusion: legal cannabis may be for adults on paper, but in practice it is making marijuana easier for teens to get, easier to hide and harder for schools to control. First came the March 4 school-panic piece about students vaping pot in bathrooms and even during class. Then came the March 14 health piece, which warned that even low-level teen cannabis use is linked to worse mental-health and academic outcomes.

The problem is not that the Journal found fake science. It didn’t. Teen cannabis use can be risky. High-THC products are real. Adolescents should not be using them. But that still does not prove legalization caused a rise in youth use, and it definitely does not justify treating legal adult markets as the obvious villain every time a teen-cannabis story needs one.

That’s the sleight of hand in this coverage. The Journal keeps blending together three separate claims and hoping readers won’t notice the seams.

Also read: Teens Didn’t Just Discover Weed. So Why Is The Wall St. Journal Acting Like They Did?

One claim is that cannabis can be harmful for teens. That is supported by a substantial body of research, and the March 14 article leans on exactly that. Another claim is that today’s commercial products can be far more potent than the flower most people think of when they picture old-school marijuana. Also true. But the third claim—the one doing the political work—is that legalization has made teen cannabis use worse in a broad, population-level sense. That is the part the data do not cleanly support.

Start with the basic trend line. Monitoring the Future, the long-running national survey of U.S. students, continues to show that teen cannabis use is not exploding. The 2025 and 2026 releases show levels that are low by historical standards, and the longer arc is downward from past peaks. The National Institute on Drug Abuse’s summary of Monitoring the Future says adolescent drug use generally remained low in 2025, while the 2026 report shows only small year-to-year movement in cannabis use rather than some legalization-era stampede.

That long-run pattern matters because the media story so often runs in the opposite direction. Readers are handed a string of anecdotes—students passing vape pens, schools buying sensors, administrators describing bathroom cat-and-mouse—and invited to infer that legalization must be fueling a youth crisis. But anecdote is not a trend, and school visibility is not the same thing as overall prevalence. In fact, even the Journal’s March 4 article acknowledged that teen cannabis use overall had declined slightly since 2019, even while school officials said they were seeing more on-campus use. Those two things can coexist without proving legalization caused more kids to use marijuana.

That distinction is where the scare story starts to wobble.

The best recent policy research does not show a youth-use surge driven by recreational marijuana laws. A 2024 study in JAMA Psychiatry examining Youth Risk Behavior Survey data from 1993 to 2021 found no evidence that recreational marijuana laws encouraged youth marijuana use. A separate 2024 study in JAMA Pediatrics looking at legalization and retail sales through 2021 found no net increases in adolescent cannabis, alcohol, cigarette or e-cigarette use associated with recreational legalization or retail sales.

That does not mean every concern is fake. It means the broader causal narrative remains weak.

And yet that weak causal narrative is exactly what the Journal keeps advancing. The March 14 piece says legalization in many states has made it easier for teens to access highly potent and convenient forms of cannabis. The March 4 piece similarly frames legalization as making marijuana culturally acceptable and easy to get. Notice the move: the articles do not have to prove that teen use shot up statewide after legalization if they can instead make legalization feel like the background explanation for every school bathroom vape alarm and every worried quote from an administrator.

But “more potent products exist in legal markets” is not the same claim as “legalization increased teen use.” “Schools are seeing more vaping incidents” is not the same claim as “more teenagers are using cannabis overall.” And “adolescent cannabis can be harmful” is definitely not the same claim as “legalization failed.” Those are separate propositions. The Journal keeps stacking them together as if they add up to one obvious conclusion. They do not.

There is also a simpler explanation for some of what schools are seeing: devices changed, visibility changed and enforcement changed. Vapes are easier to conceal than joints. Edibles are easier to mistake for ordinary snacks. Sensors and cameras make it easier to catch activity that once would have gone unnoticed. On-campus detection can rise even while overall use is flat or falling. That is not a pro-cannabis talking point. It is just the difference between surveillance and prevalence.

Even the DEA’s own youth-facing materials now concede the bigger point prohibitionists keep trying to dodge: youth marijuana use has declined over the long term. The agency’s “Just Think Twice” messaging acknowledges that past-year cannabis use among 8th, 10th and 12th graders fell from 1995 to 2025. That does not settle every debate about legalization, potency or youth risk. But it should at least retire the lazy storyline that legal weed unleashed some new teen-use boom.

What the Journal is doing instead is more subtle and more familiar. It is taking real science about teen risk and using it to support a broader panic narrative about legalization. That panic is emotionally intuitive. It is also much less supported by the actual trend data than these stories would have readers believe.

Protecting kids is a serious issue. So is getting the story right. If the concern is youth access, then talk honestly about diversion, parental storage, packaging, enforcement and school policy. If the concern is potency, then argue about potency. If the concern is adolescent brain health, make that case directly. But don’t keep laundering a weak legalization narrative through every alarming teen-cannabis anecdote you can find.

The science on teen risk is real. The Journal’s legalization-is-to-blame implication is the part that keeps failing inspection.

Photo: Shutterstock

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When California legalized adult-use cannabis, it did something bold and imperfect. It moved faster than science.

That was not recklessness. It was necessity. For decades, federal law treated cannabis as a Schedule I substance, effectively blocking large-scale, real-world research into its health, economic, environmental, and social effects. States that chose legalization were forced to build the plane while flying it.

Now, California is doing something rare in American drug policy. It is paying to understand the consequences of legalization, honestly and at scale.

Quietly, the California Department of Cannabis Control has awarded nearly $80 million since 2020 to fund academic research on cannabis. In late 2025 alone, the agency approved close to $30 million for 22 new projects across the University of California system and California State University campuses. The work spans public health, labor safety, environmental protection, taxation, consumer behavior, and criminal justice.

This is not prohibition by another name. It is legalization growing up.

Why the State Is Funding Cannabis Research at All

The DCC says it plainly on its website. Cannabis remains a Schedule I drug under federal law. That designation comes with strict limits on who can study it, how it can be studied, and what products can be used. As a result, the United States knows far less about cannabis than it does about alcohol, tobacco, or prescription drugs that cause far more documented harm.

California decided not to wait.

Some of the revenue collected from legal cannabis taxes is now being routed back into research to study the effects of adult-use legalization in the real world. Not lab rats. Not outdated government weed. Actual products, actual consumers, actual communities.

The goal is not to relitigate legalization. It is to make it work better.

What California Is Studying, Broadly

Look past the grant titles and a clear picture emerges.

Researchers are examining how cannabis vape packaging and warning labels affect young adults’ perceptions and purchasing behavior. Others are studying THC-infused beverages to understand onset time, absorption, and impairment under real consumption conditions. Several projects focus on older adults, a fast-growing segment of cannabis consumers often ignored in public debate.

There is also serious attention being paid to labor and environment. Studies are underway on pesticide exposure among cannabis workers, crop yields across cultivation styles, water use, wildlife impacts, and the environmental benefits of licensure versus unregulated grows.

On the policy side, California is funding research into taxation, pricing, illicit markets, tribal cannabis partnerships, equity outcomes, and how local zoning decisions affect housing and displacement.

This is not a moral investigation. It is a systems audit.

Legalization Under the Microscope

One of the more honest aspects of this research push is that it does not assume legalization solved everything.

Multiple projects explicitly ask why unregulated cannabis markets persist years after legalization. Others look at how taxes and prices influence consumer behavior across more than 20 states. Some examine whether equity programs are delivering meaningful participation or simply good intentions.

That level of self-scrutiny is unusual in drug policy. It is also necessary.

Legal cannabis is no longer an experiment. It is a regulated industry employing hundreds of thousands of people and serving millions of consumers. The question is no longer whether cannabis should be legal. It is whether the rules governing it actually reduce harm and expand access, or simply create new barriers.

This Is What Normalization Looks Like

There is a temptation to read any state-funded cannabis research as a prelude to crackdowns or restrictions. But the scope of California’s research suggests something else entirely.

Cannabis is being treated like alcohol, tobacco, and pharmaceuticals are treated. Studied continuously. Adjusted based on evidence. Regulated with the assumption that people will use it, not the fantasy that they will not.

That is what normalization looks like.

The irony is hard to miss. For decades, prohibition prevented meaningful cannabis research. Now legalization is funding the science prohibition blocked.

Why This Matters Beyond California

Because California is often the policy laboratory for the rest of the country.

Findings from these studies will shape labeling rules, worker protections, environmental standards, tax structures, and consumer education. Other states will borrow them. Federal agencies will cite them. Courts will reference them. The data will outlive the political moment that produced it.

Cannabis advocates often say they want policy guided by evidence rather than fear. This is what that looks like when it actually happens.

Not headlines. Not hype. Not panic.

Just a state admitting that legalization is not the end of the conversation. It is the beginning of a more honest one.

Cannabis did not wait for permission to exist. Now, California is doing the work to understand what that existence really means.

Photo: Shutterstock

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For decades, cannabis has been treated as a public menace while alcohol and tobacco were folded into daily life, policy frameworks and corporate profit models. A newly published scientific analysis out of Canada once again flips that logic on its head.

A peer-reviewed study published January 27 in the Journal of Psychopharmacology finds that alcohol and tobacco cause far greater overall harm to both individuals and society than cannabis. The research evaluates not just health risks, but the broader social damage associated with drug use, including injury, economic cost and harm to others.

The paper, titled Drug harms in Canada: A multi-criteria decision analysis, was authored by an international group of researchers and can be accessed here.

The findings are striking but consistent with prior global research. When all factors are weighed together, alcohol ranks as the most harmful drug overall, followed by tobacco. Cannabis sits far lower on the scale.

How the study measured harm

The researchers used a method known as multi-criteria decision analysis, a framework previously applied in the United Kingdom, the European Union, Australia and New Zealand.

A panel of 20 experts from six Canadian provinces evaluated 16 psychoactive substances, including alcohol, tobacco, cannabis, cocaine, methamphetamine, opioids and benzodiazepines. Each substance was scored across 16 categories of harm.

Ten categories measured harm to the user, including mortality risk, physical health damage, mental health impact and dependence. Six additional categories measured harm to others, including motor vehicle injuries, violence, environmental damage and economic cost.

After scoring each substance and weighting the relative importance of each category, alcohol emerged as the most damaging overall, with a cumulative harm score of 79. Tobacco followed at 45. Cannabis scored 15.

In other words, cannabis ranked far below alcohol and tobacco in terms of total population-level harm.

This isn’t new. That’s the point.

The Canadian findings align closely with earlier studies led by British neuropsychopharmacologist David Nutt, including a landmark 2010 Lancet paper that first drew international attention to alcohol’s outsized harm.

More recently, a 2024 U.S. study published in the Journal of Studies on Alcohol and Drugs found that secondhand harms from alcohol use were substantially more prevalent than harms caused by other drugs.

The consistency across countries and methodologies matters. These findings are not an outlier, and they are not driven by cannabis advocacy. They are driven by data.

What the study does and doesn’t say

The authors are careful to clarify that these harm scores reflect population-level impact, not the inherent danger of a substance in isolation.

Alcohol’s high ranking is not only about toxicity. It reflects how widely alcohol is used, how socially normalized it is and how weakly it is regulated relative to its risks.

Cannabis, by contrast, scores lower in part because it causes fewer harms to others. It is far less associated with violence, fatal accidents and long-term disease burden at the population level.

At the same time, the study does not claim cannabis is harmless. It acknowledges health risks, particularly for certain populations and patterns of use. The takeaway is not that cannabis should be ignored by regulators, but that drug policy should be proportional to actual harm.

As the authors note, the findings also reflect the current policy environment. Alcohol’s high harm score underscores what they describe as a failure to adopt proven policies to reduce alcohol-related damage, despite decades of evidence.

Why this matters now

As cannabis legalization continues to evolve across North America, the disconnect between scientific evidence and public policy remains stark.

Cannabis businesses face advertising bans, banking restrictions and criminal penalties that alcohol and tobacco companies do not. Meanwhile, alcohol remains deeply embedded in social life despite its well-documented risks.

This study does not argue for replacing one substance with another. It argues for honesty.

If governments claim to base drug policy on public health, then the relative harms of substances must be acknowledged. Otherwise, enforcement becomes less about safety and more about tradition, stigma and political convenience.

For readers who have long questioned why cannabis is treated differently, this research provides something valuable: confirmation grounded in evidence, not rhetoric.

The data is not radical. The implications are.

Photo: Shutterstock

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New Canadian research shows medical cannabis can help with pain, mood and quality of life, but outcomes vary widely by product, dose and patient.

As cannabis policy debates intensify across North America, a newly published Canadian study offers something that has become rare in the medical marijuana conversation: perspective.

The study, published online January 29 in the Canadian Journal of Pain, followed adult patients authorized to use medical cannabis across Canada for 24 weeks, tracking outcomes related to chronic pain, sleep, anxiety, depression and overall quality of life. The results show consistent, measurable improvements across multiple categories. They also show something that often gets lost in cannabis coverage. On average, the improvements were real but modest, the kind of signal clinicians take seriously while still pushing for clearer guidance on products and dosing.

That distinction matters, and it does not undermine cannabis. It grounds it.

Titled Canadian real-world evidence: observational 24-week outcomes for health care practitioner authorized cannabis, the paper draws on data from the ongoing Medical Cannabis Real-World Evidence study. Participants were adult patients authorized by health care practitioners to use medical cannabis and were able to select from Health Canada-verified products. Outcomes were measured using widely accepted clinical tools, including PROMIS Pain Interference, the Numeric Pain Rating Scale, GAD-7 for anxiety, PHQ-9 for depression and EQ-5D for quality of life.

Across nearly every measure, patients reported improvement. Pain interference scores declined. Anxiety and depression scores dropped. Sleep duration shifted modestly toward healthier ranges. Quality of life improved.

These changes were statistically significant, meaning they were unlikely to be due to chance. They were also real to the patients reporting them. But by week 24, the average changes did not reach the thresholds often used to define a clearly noticeable clinical improvement. That does not mean medical cannabis did not work. It means the average effect was not large and outcomes varied widely from patient to patient.

Most participants in the study were using medical cannabis primarily for chronic pain, with sleep issues, anxiety and depression also common indications. Improvements tended to appear early, often within the first six weeks, and then stabilized over time. Pain severity scores fell by a little over one point on a ten-point scale. Anxiety and depression scores declined by roughly two to three points. Quality-of-life scores improved modestly.

In medicine, averages matter, but they can also hide important differences. Some patients likely experienced meaningful relief. Others less so. The study’s authors repeatedly emphasize variability, noting that outcomes likely depend on factors such as product type, cannabinoid composition, dose, route of administration and individual patient context.

That variability is not a weakness of the data. It reflects the reality of cannabis.

Unlike a single standardized pharmaceutical, medical cannabis encompasses hundreds of products, wide ranges of THC and CBD concentrations and multiple methods of consumption. Expecting uniform outcomes from such a diverse therapeutic category has never been realistic. This study helps explain why.

The authors are careful not to overstate their findings. Rather than presenting cannabis as a cure, they describe it as a therapy that may offer incremental benefit for some patients, particularly in the early stages of treatment, while underscoring the need for better guidance around dosing, product selection and long-term use.

The study also acknowledges clear limitations. It was observational, not randomized and did not include a placebo group. Attrition was high, with roughly half of participants no longer reporting outcomes by week 24. Some patients cited cost, side effects or lack of perceived benefit as reasons for dropping out. Others stopped responding without explanation.

These challenges are common in long-term real-world cannabis research and are openly discussed by the authors. Rather than weakening the findings, that transparency strengthens them.

The study’s funding is also worth noting. It was partially backed by Medical Cannabis by Shoppers, Avicanna and the mymedi.ca platform, cannabis companies with little incentive to downplay results. Yet the paper resists hype, carefully outlining its limitations and avoiding sweeping claims. In a space often driven by promotion, that kind of restraint adds weight to the data.

In a cannabis landscape often dominated by extremes, this study occupies a more useful middle ground. It does not support fear-based narratives suggesting cannabis is ineffective or dangerous. It also does not reinforce cultural or commercial claims that cannabis is a universal solution for chronic pain, anxiety or sleep disorders.

Instead, it suggests something more grounded. Medical cannabis can help some patients in measurable ways, but outcomes are modest on average and highly individualized. That reality points not toward prohibition or hype, but toward better research, clearer labeling, improved patient education and more personalized approaches to treatment.

As cannabis continues its slow shift from counterculture symbol to regulated medical option, this kind of evidence is exactly what the field needs. Not sweeping claims, but careful data. Not miracles, but tools.

The takeaway is not that medical cannabis falls short. It is that cannabis science is growing up. And for patients, clinicians and advocates who care about long-term credibility, that is progress.

Photo by Sander Sammy on Unsplash

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Once again, it’s debunking time.

The New York Post headline — “Bombshell cannabis study reveals hidden risks of medical pot” — is a textbook example of how cannabis continues to be treated differently from almost every other therapeutic substance in mainstream media. The problem is not the study itself, but what this media outlet does with it.

The UCLA-led review published in JAMA does not conclude that medical cannabis is dangerous, fraudulent, or a failed therapy. What it actually concludes is something far more modest and far more common in medicine: that the evidence base is uneven, incomplete, and in need of better research.

That is something cannabis advocates have been saying for decades, and it is an argument for expanding research, not restricting access.

What the Study Actually Says (and What It Doesn’t)

Dr. Michael Hsu, the study’s lead author, states plainly: “Further research is crucial to better understand the potential benefits and risks of medical cannabis.”

The review examined more than 2,500 studies published between 2010 and 2025, narrowing its focus to roughly 120 higher-quality papers. Its conclusions are careful and measured.

The authors found strong evidence for FDA-approved cannabinoid medicines in limited contexts such as chemotherapy-induced nausea, HIV-related appetite loss, and rare pediatric epilepsies. For other common uses, including chronic pain, anxiety, and insomnia, the evidence is mixed or insufficient, not disproven. The review also notes potential risks associated with high-potency, frequent use, particularly among adolescents or people with certain vulnerabilities.

Crucially, the authors acknowledge that the review is not systematic, lacks formal bias assessment, and relies in part on observational studies that are vulnerable to confounding factors.

Most importantly, the paper calls for more rigorous research, not restriction, prohibition, or panic.

How the Media Distorts That Message

The New York Post follows a familiar pattern, treating scientific uncertainty as evidence of danger.

Rather than explaining that cannabis research has been structurally limited for decades, and that product variability makes standardization difficult, the article reframes uncertainty as “hidden risks” and “overestimated benefits,” implying deception or irresponsibility.

You cannot claim benefits are “overestimated” when the core issue is that they have not been studied at scale. Lack of evidence is not evidence of lack, especially when real-world use spans millions of patients.

If this logic were applied consistently across medicine, the headlines would be absurd.

We could just as easily write “Antidepressants overhyped” or “Psychiatry exposed” because outcomes vary and effect sizes are modest.

In reality, that kind of variability is normal in medicine and usually prompts better research, not moral panic.

Risk Is Not Unique to Cannabis

The review notes elevated risks associated with frequent, high-potency use, particularly among adolescents or people with cardiovascular or psychiatric vulnerabilities.

This is not unique to cannabis. Similar cautions exist for alcohol, benzodiazepines, opioids, stimulants, and even antidepressants.

Yet those substances are rarely framed as “bombshell risks” every time new data emerges.

The study itself recommends screening, patient education, dosage awareness, and clinician oversight. In other words, standard harm reduction.

The most important takeaway is not that cannabis does not work, but that cannabis research has been fragmented and underfunded due to decades of prohibition. Researchers are still trying to study a complex plant using tools designed for single-molecule drugs.

If I were writing the headline, it might read: “Major review highlights need for stronger cannabis research as use outpaces evidence.”

But that doesn’t generate fear, so it probably wouldn’t get the clicks.

Photo by Tonik on Unsplash

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From pleasure and connection to harm reduction and policy failure, a look at what decades of drug enforcement got wrong about human behavior.

The conversation around drugs has long been framed by cost. Policymakers calculate the billions lost every year to productivity gaps, hospitalizations, law enforcement and incarceration. The U.S. alone spends an estimated $193 billion annually dealing with the fallout of illicit drug use, according to the National Institute on Drug Abuse.

Yet there is a blind spot. People do not only use drugs because of the usual suspects: trauma, poverty or pathology. They also use them because they feel good. Pleasure. Connection. Belonging. A stronger sense of self.

There is an old joke that goes: “Do you know what’s the problem with drugs? That they feel too good.” And it is spot on. Ignoring this basic human driver has a cost of its own.

Researchers and frontline harm-reduction workers are now introducing a radical, almost counterintuitive idea: what if drug policy and education started not from fear, but from pleasure? What if acknowledging the real reasons people use could reduce overdoses, improve mental health and save governments millions?

As Valentine and Fraser noted in their 2008 study of methadone patients: “Although pleasurable and problematic drug use are often thought to be mutually exclusive, pleasure is reported from both the effects of drugs such as heroin and methadone and from the social worlds of methadone maintenance treatment.”

This is the frontier of “pleasure management” or “pleasure maximization,” a new way of thinking about consumption that blends economics, public health and lived experience. Daniel Bear and colleagues argue that harm reduction too often “foregrounds risks at the expense of benefits.” Their framework of Mindful Consumption and Benefit Maximization (MCBM) begins by asking users why they consume, what benefits they seek and how to reduce risks while preserving those benefits.

Zara Snapp, director of Instituto RIA in Mexico, reminds us that this is not a new invention. She points to ancestral traditions across Latin America where psychoactive plants were used to foster vision, knowledge and connection to the sacred. In this sense, today’s debates about pleasure management are part of a much longer human story about using substances for meaning and wellbeing, not only risk.

Silvia Inchaurraga, a psychoanalyst and president of ARDA (the Harm Reduction Association of Argentina), frames it in terms of rights: “The concept of harm reduction cannot stand without legitimizing the right of people to consume drugs… interventions must always start from recognition of this right and the user as a citizen.” She argues that pleasure management challenges abstentionist logics that seek to eliminate risk altogether, instead of acknowledging that people use for multiple reasons, including wellbeing.

Why People Really Use

A 2017 systematic review by Guise and colleagues looked at 41 studies on why people initiate injection. They found that choices were rarely about desperation alone. People began injecting to seek pleasure, respond to rising tolerance, secure belonging and cope with trauma.

Sexual pleasure is another driver. In a study of African American MDMA users, Khary Rigg found four main motives: altering the effects of marijuana and alcohol, enhancing sexual pleasure, prolonging performance and encouraging partners to experiment. As one participant put it, ecstasy was a tool for “freaky” sexual experiences.

These findings break with stereotypes. While White ravers often describe MDMA use in terms of empathy or connection with music, Rigg’s participants focused on sex. The difference is more than cultural nuance. It is a reminder that pleasure is not monolithic. Harm-reduction messages need to be specific to the communities they aim to serve.

Even in contexts we label “problematic,” pleasure is part of the story. Valentine and Fraser’s methadone patients said they enjoyed not only the effects of heroin or methadone but also the social life that treatment programs created. Methadone clinics were not just about survival. They were also spaces of joy and belonging.

Harm Reduction From Below

If pleasure motivates use, it also motivates care: people are not reckless, and often develop their own strategies to balance enjoyment with safety.

In Brooklyn, queer nightlife workers told researcher Tait Mandler how they carefully balanced chemicals to sustain performance and avoid harm. Far from reckless, this was intentional “curation” of highs and safety.

Snapp sees the same thing across Latin America. “Managing pleasure means understanding that people seek connection, empathy and a sense of being interconnected. Substances can help foster that, to generate greater awareness,” she told me. She also points to drug-checking services like Checa Tu Sustancia in Mexico and Échele Cabeza in Colombia, where users are asked why they consume, how often, and why they test their substances. “The answers were simple: to enjoy it, to feel good. And the outcome is fewer ambulance calls, fewer overdoses, and less strain on public resources.”

In Argentina, Inchaurraga and ARDA have carried this into public campaigns for decades, with slogans like “Si te picas, léeme” [If you inject yourself, read me] (2000), “Si consumís igual tenés derechos” [If you consume, you still have rights] (2005), and most recently, “Chequeaste tus pastis?” [Did you check your pills?] (2024). These messages, shared in clubs, festivals and universities, normalize dialogue about both risks and pleasures, making harm reduction visible in everyday life.

For Snapp, these services embody collective care. They are not only technical interventions but spaces where people can talk openly about their practices, share strategies and make better decisions together. She also contrasts this with how alcohol and tobacco are normalized despite the enormous harm they can cause, arguing that pleasure management offers “another side of the coin,” a chance to build healthier cultures of enjoyment and self-regulation.

Sheila Vakharia, managing director of research at the Drug Policy Alliance, reminds us that harm reduction itself was born as a peer-led practice: people who used drugs organized to keep each other safe, insisting that their motives, from coping to connection to joy, were valid. “Harm reduction was started by people who use drugs to keep one another safe… many harm reductionists acknowledge that maximizing pleasure while reducing risk should be a key part of the work,” she says.

Even formal services reflect this shift. In Frankfurt, Duncan and colleagues documented how supervised drug-consumption rooms created not only safer conditions but also new kinds of pleasure: safety, dignity and belonging (Duncan et al., 2017).

Taken together, these stories show that pleasure management is not an abstract concept. It is visible in clubs, in clinics and in communities. What is missing is recognition and support from policymakers.

The Real Costs And Potential Savings

If people and communities are already managing their consumption, the question becomes: why is policy not keeping up, and what is that lag costing us?

Most public spending on drugs is reactive and punitive. Police budgets, courtrooms, prison beds and emergency room visits absorb the majority. Very little goes to preventing those costs by addressing why people use in the first place.

These are not inevitable costs. As a Drug Policy Alliance report shows, they are the direct result of the global war on drugs, a policy that not only maximizes harm but also disproportionately impacts low-income communities, women, Black people and Latinos. In other words, governments are not just overspending; they are overspending on policies that worsen the very problems they claim to solve.

The research is clear. In a study of sexual minority adults using the 2017 National Survey on Drug Use and Health, Yockey and colleagues found that 21.9% reported tranquilizer use in the past year. Risk factors included being female, over 35, polydrug use and loss of pleasure in once pleasurable activities. In other words, depression and stress were fueling consumption. Addressing these realities before they spiral into crises is far less expensive than waiting for overdoses or hospitalizations.

Inchaurraga emphasizes the economic dimension: “Policies that criminalize end up multiplying costs. What we need are policies that reduce harm and recognize the motivations of use. That is where the savings are.” Her association’s programs back this up with numbers. In one early study of injection-kit distribution in Rosario, 5 to 6 of every 10 people reached entered health services for HIV testing, counseling or treatment. More recently, ARDA deployed more than 100 harm-reduction devices at parties across five provinces, reached over 21,000 people with information, and tested 1,600 drug samples, finding that 18% contained something different than expected. These interventions reduce overdoses, cut hospitalizations and connect users to care, lowering long-term costs.

Vakharia adds a policy perspective: “The policies we have drafted and passed to allow for adult use of marijuana are probably the clearest illustration of our acknowledging pleasure as a motivator.”

And Snapp connects the dots to human rights: “According to the United Nations, more than 83% of people who use illegal drugs do so without developing problematic patterns. This framework responds to them and the need for information, services that don’t demand abstinence and ultimately a safe supply through legal regulation.” She also notes that while resistance persists (critics often claim that talking about pleasure “promotes use”), some governments are beginning to adopt the language. In Uruguay and even in Iztapalapa and Mexico City, local officials have started to frame public programs around the idea of managing pleasure, signaling that the concept is entering mainstream policy debates.

Inchaurraga observes the same dynamic in Argentina: public health discourse often accepts harm reduction only as HIV prevention, but resists legitimizing pleasure as a health goal. This, she warns, leaves rights unaddressed and perpetuates stigma.

Compare this with what governments currently spend on police, prisons and courts. These investments not only fail to reduce use but also compound costs through stigma and exclusion. International models back up the alternative. Studies of supervised consumption spaces in Europe and Canada show that these services prevent HIV infections, reduce emergency calls and lower overdose deaths. Each avoided overdose can save tens of thousands of dollars in hospital care. Every avoided arrest frees up courtrooms and prison cells.

The real cost of drug use is not that people seek pleasure. It is that policy continues to ignore it.

Toward Pleasure Management

The evidence points in one direction. Harm reduction alone is not enough. To cut costs and improve lives, policy must embrace pleasure management.

Pleasure management is not a break from harm reduction but an extension of it. For decades, grassroots harm-reduction programs have recognized the dimensions of pleasure and the right to sovereignty over one’s body. What is new is the visibility and urgency of these approaches in a global landscape where criminalization has failed, and people are politicizing to demand pragmatic, rights-based responses.

Bear and colleagues’ Mindful Consumption and Benefit Maximization framework is one proposal. It critiques harm reduction for focusing on risks while sidelining benefits, and urges educators to help people reflect on motives, desired effects and strategies to maximize benefits while minimizing harms.

Other researchers, like David Nutt in the UK, have reinforced this point with comparative harm rankings. His landmark Lancet study found that alcohol, a legal drug, causes more overall harm than heroin or crack cocaine—largely because of its massive impact on others through violence, accidents, and social costs. The implication is clear: prohibitionist classifications do not match real-world evidence of harm.

Snapp and Instituto RIA stress the cultural and political importance: “We see this as deeply linked to self-care and collective care… understanding that people who use substances, even controversial ones, do so, often, to feel good or to alleviate some pain, which also connects to wellbeing.” She frames it not just as a pragmatic tool but as part of a rights-based drug policy, arguing that recognizing pleasure is also about protecting dignity and ensuring that people who use drugs are treated as people with agency, not pathologized or excluded. These programs also serve as important spaces to politicize and organize the drug policy reform movement.

Inchaurraga and her colleagues at ARDA take a governance view: interventions should begin from recognition of the right to consume as citizens, not criminalize it.

Even in supervised consumption rooms, Duncan et al. found that pleasure and safety can coexist. People reported new forms of satisfaction in being treated with dignity and care. Mandler’s work in Brooklyn nightlife shows the same: users already regulate dosage, timing and substance choice to balance fun with function. These grassroots strategies are proof that pleasure management is real and scalable.

Three pillars stand out:

• Mindful use. Integrate MCBM concepts into education so people think intentionally about consumption.
• Community spaces. Support safer-use environments that reduce emergencies and create belonging.
• Tailored messaging. Recognize that motivations differ by culture, gender and context. Harm reduction must reflect those realities to work.

As Vakharia concludes: “Pleasure and recreation are among the biggest motivators for substance use of all kinds, so it needs to be incorporated into conversations about safety and policy.”

From Fear To Pragmatism

Drug policy has long been guided by fear. Billions are poured into punishment and cleanup while one of the biggest drivers of use, pleasure, is ignored. The result is a system that is both costly and ineffective.

The evidence from researchers and practitioners points to a different path. Mindful consumption, community spaces and culturally tailored messaging all show that pleasure management is not only possible, it is already underway. People are planning, moderating, sharing and experimenting responsibly. Services that acknowledge this reality reduce emergencies, save lives and cut costs.

These shifts are not only local. At the international level, the consensus that has long underpinned global drug control is starting to crack. In 2025, Colombia led a historic resolution at the UN Commission on Narcotic Drugs, securing the first-ever independent review of the drug control treaties. For the first time, prohibition itself will be under external scrutiny. Pleasure management and harm reduction are part of this broader paradigm shift away from punishment and toward evidence, rights, and pragmatism.

For governments, the choice is stark. Keep spending on prison beds and ER visits, or redirect a fraction of that money toward interventions that reflect why people actually use drugs. The return on investment is obvious.

Pleasure management is not a luxury. It is rights-based, pragmatic economics and smarter public health. And above all, more just and more humane.

Disclaimer: This article discusses emerging research and policy debates around drug use and harm reduction. It is not intended to promote or encourage substance use. Readers should comply with applicable laws and consult health professionals for medical advice.

This story was originally published on Forbes in August 2025 and has been updated and adapted for High Times with permission.

Photo: Shutterstock

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The science of sleep: an ephemeral paradise. Colors, flashes, digressions, backdrops, and shapes. Raw intensity. Dreams within dreams. There’s an architecture in the arms of Morpheus. And for frequent cannabis smokers, a joint can act as the great conciliator. Light up, smoke, and drift off.

But, but, but: what happens to sleep when regular pot smokers stop using it? Does anything change? Do dreams become more intense? Do nightmares surface? Are there alterations within the dream phenomenon? Does something reset and return us to square one?

“It’s likely that cannabis slightly alters the REM phase and the sleep phase, possibly leading to fewer dreams,” according to Diego Golombek, biologist and expert in chronobiology, the science that studies the biological rhythms of living beings. In short: the “REM phase” is the stage of sleep characterized by intense brain activity, similar to wakefulness, and is where most vivid dreams occur.

However, there is little scientific evidence on this. But some certainties, deductions, or hints are emerging. “Any pharmacologically induced sleep, in the long term, worsens the quality of sleep. It causes us to wake up more often and alters the architecture of sleep itself,” Golombek continues.

Indeed, cannabis can improve sleep; especially for those with chronic conditions such as pain, PTSD, or parasomnias. “There is scientific evidence that confirms that people do sleep a little better with cannabis. But it depends on the type of cannabis and the specific strain. Therefore, pharmacologically, it’s impossible to work with something so variable,” explains the specialist.

Specifically, cannabinoids increase the activity of circuits that promote sleep. There is a neurotransmitter called adenosine that promotes sleep and is precisely the one that caffeine blocks. That’s why caffeine “wakes you up,” and cannabinoids increase the effects of adenosine, which causes sedation and promotes calm.

“If you are chronically using cannabis—smoking it, taking pills, oils, or whatever—the system gets used to it and becomes overwhelmed, and the receptors tend to adapt. Therefore, if you abruptly stop a chronic treatment, the system will crave it. This is called tolerance. Consequently, there will be a reappearance of symptoms, even stronger than before.”

Therefore, altering sleep architecture and transforming REM sleep could have some impact on the appearance of nightmares. Once unleashed, dreams can strike back like lightning. The human body is itself a system of balances, constantly establishing equilibrium points. And once altered, it’s difficult to restore them. If dreams become clearer, don’t worry: at some point, everything makes sense. Without the green veil, the unconscious screams louder.

“Cannabinoids are not a cure. At best, they are a symptomatic treatment. That’s why when, you stop using them, everything you had before can return, and even with greater intensity,” Golombek insists.

When the fire goes out, Morpheus ignites other visions. Thus, abruptly stopping chronic marijuana use can lead to sleep disturbances. Now, is there any advice for improving sleep hygiene? “Grandma’s advice is useful,” Golombek says reassuringly. “Common sense advice.” Here you go, High Times readers, take note: “Go to bed and wake up at roughly the same time, even on weekends. Eat a light dinner. No light at night. Any stress-reduction technique is welcome: meditation, breathing techniques. In this case, not pharmacological ones. And, as mentioned, be careful with abruptly stopping any medication or substance use.”

In the United States, lines of research are opening up to delve into new evidence about cannabis use and sleep, though research is still in a fairly primitive stage. “There’s still research to be done, isolating suitable compounds and continuing to test what effects they have. With sleep, we haven’t yet reached that level of scientific research and certainty,” Golombek laments.

However, anecdotal evidence abounds. We did a poll on High Times’ Instagram on whether when you detox, your dreams get “Wild AF” or not. The answer? 76% of people said they experience insanely vivid and intense dreams when they go on a tolerance break.

Meanwhile, a truth remains: when the body remembers, sleep answers with vivid memories.

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Charcoal filters have quietly become one of the most successful products in modern cannabis culture. They look scientific, they promise a smoother experience, and they come wrapped in the language of harm reduction. Cleaner smoke. Less tar. Same high.

It sounds reasonable. Responsible, even.

The problem is that activated charcoal does exactly what it is designed to do, and once you understand that, the marketing starts to fall apart.

Activated charcoal is not a neutral material. It is engineered to remove volatile organic compounds from air and smoke. That is why it is used in industrial filtration systems, respirators, odor control units and, yes, cannabis grow rooms, where carbon filters exist for one specific reason: to strip terpenes from exhaust air so the room does not smell like weed.

That last part is not a metaphor. It is literally the point.

So when companies tell you that running cannabis smoke through activated carbon somehow preserves flavor and character while only removing “bad stuff,” they are asking you to ignore how the material is used everywhere else.

What the science actually shows

Okay, this is where we start saying things like “gas phase,” “particulate phase,” and… “p-benzosemiquinone” (whatever that means). So it’s completely normal to feel your brain reaching for the remote.

This is the part where Chief Wiggum would cut in with: “Slow down, egghead.”

Fair. So here’s the short version before we go any deeper.

The short version: activated charcoal is designed to grab volatile compounds from smoke. Terpenes are volatile compounds. THC mostly is not. So charcoal filters tend to strip aroma and nuance first, subtly flatten the experience, and only modestly affect THC. The smoke feels smoother, but the weed itself feels less alive.

There is no single, definitive peer-reviewed study that directly measures terpene and THC loss from cannabis joints smoked through charcoal filters. That part matters, and it is worth being honest about.

What does exist is decades of well-established research on charcoal filtration and smoke chemistry, primarily from the tobacco world, and the conclusions are remarkably consistent.

A major peer-reviewed paper published in Chemical Research in Toxicology found that adding activated charcoal to cigarette filters reduced gas-phase free radicals by up to 70% to 88%, while having little effect on particulate-phase radicals.

Another study showed charcoal filters reduced p-benzosemiquinone, a highly reactive and toxic gas-phase compound, by 73% to 80%.

Across multiple studies, the same pattern repeats. Activated charcoal is extremely effective at removing gas-phase compounds. It is far less effective at removing particulate-bound compounds.

That distinction is the key to understanding what happens when you use these filters with cannabis.

Why terpenes are the first thing to go

Terpenes are volatile, aromatic and mobile. They exist largely in the gas phase of smoke and evaporate easily. From a chemistry standpoint, they are exactly the kind of molecules activated carbon is designed to adsorb.

This is not controversial. Activated carbon is routinely used in environmental science to remove limonene, pinene and other terpene-like volatile organic compounds from indoor air streams.

So when a charcoal filter cools cannabis smoke and increases contact time at the mouth end of a joint, the outcome is predictable. A meaningful portion of terpenes never makes it past the filter.

You may still taste something, but you are not getting the full expression of the flower you rolled.

This is also why people describe charcoal-filtered joints as flatter, more generic or less strain-specific, even when the THC percentage on the label looks impressive.

What about THC

This is where things get more subtle, and where much of the confusion lives.

THC behaves differently from terpenes. Most THC travels in smoke attached to tar droplets rather than as a free gas. Activated charcoal is much better at trapping gases than particulates, which means THC loss is real but generally smaller.

Even in tobacco studies using heavy charcoal loading, nicotine reduction typically ranged from about 10% to 30%, while gas-phase compounds dropped far more dramatically.

Translated to cannabis, the most defensible conclusion is that charcoal filters reduce some THC, but not nearly as much as they reduce terpenes.

This matters because the high is not just about THC milligrams.

Why the high feels different anyway

Terpenes do more than smell nice. They influence the onset, intensity and the qualitative shape of the experience. Strip enough of them out and the high changes, even if THC delivery stays relatively similar.

That is why users report charcoal-filtered joints feeling muted, less heady or oddly incomplete. It is not placebo. It is chemistry interacting with perception.

You are still getting high. You are just getting a simpler version of it.

The “reduces tar” claim, explained

Charcoal filter marketing loves the word “tar,” but tar is not a single substance. In smoke science, it is a lab-defined metric that includes everything particulate except nicotine and water.

Charcoal filters primarily remove gas-phase toxicants, not particulate tar. Multiple tobacco studies show this clearly.

And here is the part that rarely gets explained. If you actually reduced particulate tar in a joint in a meaningful way, you would also reduce THC, because that is where THC lives.

That contradiction sits at the heart of the marketing.

So were people lied to?

Not exactly lied to, but definitely not told the whole story.

Charcoal filters do reduce certain harmful combustion byproducts. They do smooth the smoke. They do reduce irritation for many users.

What they also do is selectively remove terpenes and subtly change the high, and that tradeoff is almost never made clear.

If your priority is smoother smoke and fewer harsh compounds, charcoal filters may make sense.

If your priority is flavor, nuance and the full expression of cannabis, they work against you.

The bottom line

Charcoal filters do not clean cannabis smoke. They selectively strip it.

Mostly terpenes. Some THC. And a lot of what makes weed feel alive.

That does not make you wrong for using them, but it does mean the story you were sold was incomplete.

The truth is simple. If your joint tastes flatter and feels less dimensional, your charcoal filter probably did exactly what it was designed to do.

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