Doctors say smoking cannabis could worsen COVID-19 complications
Before the coronavirus pandemic, marijuana lobbyist Shanita Penny spent much of her time on the road, often in states where cannabis is illegal. The trips functioned as built-in breaks from her pot consumption.
But after months cooped up at home in Baltimore, and with many professional projects on hold, Penny said she’s started burning — literally — through her stash at an increasing rate.
“At the end of the third week, I was like, ‘Oh, wow, I went through this ounce pretty quickly,’ ” said Penny, 38. “Every day I was smoking a little bit more."
In a time characterized at once by unprecedented anxiety and boredom, many Americans are looking to marijuana for comfort. And that concerns health experts, who say smoking or vaping the drug could leave consumers with irritated, inflamed lungs — perhaps raising their risk of severe complications if they catch COVID-19.
Doctors are suggesting that people who smoke marijuana quit, cut back, or switch to other forms of cannabis, such as edibles or tinctures.
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Dr. Albert Rizzo, chief medical officer for the American Lung Association, said research on marijuana’s links to serious lung ailments is scant compared to similar studies on tobacco use because the federal prohibition on cannabis makes it difficult to obtain funding and approval for such work. And there’s not yet specific research about the relationship between cannabis use and COVID-19.
Still, he said, “The research we do have suggests any inhalation of plant particles and other toxins does cause inflammation in the airways. When a disease comes along like COVID-19 — a respiratory infection causing inflammation — it makes sense [that marijuana smokers] would have a higher risk of complications."
Studies on links between cannabis smoking and lung cancer has produced mixed results, but there’s clearer evidence tying heavy pot smoking to bronchitis, or lung inflammation. Rizzo said bronchitis can make COVID-19 harder to diagnose and treat.
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At the same time, Rizzo said, some people use cannabis to treat serious medical ailments, and should work pragmatically with their physicians to balance the imperative to protect their lungs with the possible return of symptoms controlled by the drug if they stop using it.
"As a party line, I don’t want to condone [marijuana smoking],” Rizzo said. “I do want truthful communication between patients and physicians, though, and I think it boils down to making that risk-benefit analysis. I certainly understand some people are using it to treat chronic pain or even just the stress of going through this COVID-19 pandemic.”
Dr. Peter Grinspoon, a Harvard Medical School instructor who also issues medical cannabis recommendations to patients in Massachusetts, echoed that advice. He said he’s telling patients who can get relief from other forms of marijuana to stop smoking it. But he acknowledged certain conditions demand the faster effects provided by inhalation, or make digesting edibles problematic, and that it’s easier to accidentally ingest too high a dose when using edibles.
“It seems like basic common sense that if you can avoid smoking anything, you should,” Grinspoon said. “I try not to stigmatize people or make them feel like they’re digging their own graves, but to the extent that it’s discretionary, I’ve been advising them to switch to low-grade edibles."
Experts also are asking consumers to ignore recent headlines suggesting marijuana or even tobacco smoking could somehow offer a kind of paradoxical protection against the coronavirus, saying the small or obscure studies they describe are dubious and shouldn’t outweigh decades of evidence proving combustion’s harmful effects on the lungs.
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Penny, for her part, doesn’t think experts are exaggerating the danger, nor that cannabis is a COVID-19 miracle cure. But while she’s stopped meeting up with friends to pass joints around socially, she feels smoking pot at home is a reasonable risk to take, given how much marijuana helps her cope with the stress of the pandemic and stay productive while isolated.
Still, to reassure herself that her lungs are working well, Penny has started using a home monitor to track her blood pressure and oxygenation levels.
“It makes perfect sense,” Penny said of official warnings to cut back on toking. “I just don’t feel like I’m in a position where I need to stop today.”
Many marijuana consumers, however, are heeding medical advice.
Courtney O’Keefe, a 39-year-old Somerville resident, uses cannabis to treat night terrors that started several years ago after a difficult period in which she was hit by a car and found her mother dead of an opioid overdose. Without marijuana, she said, “I have awful dreams — I’m waking up screaming and crying in the middle of the night.”
Because of the pandemic, O’Keefe said she’s stopped combusting marijuana, and now only takes edibles and the occasional hit off a vaporizer before bed. That way, she figures, she can tell a doctor with a straight face that any breathing issues must be illness-related.
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“I’m probably the most responsible cannabis user you’ll ever meet in your life,” she said. “I’m adapting. One of the best things about this substance is that there are so many ways to take it."
Similarly, veteran cannabis attorney and advocate Mike Cutler of Northampton said he’s switched to vaporizing marijuana flower (the plant’s familiar green buds), which is far less harsh than smoking.
“No more joints or pipes to challenge my elderly respiratory system,” he said.
But some are skeptical of the warnings from experts, arguing US health authorities and government officials have little credibility on cannabis after decades of promoting overblown fears about its medical and societal effects.
“I’m 62 and they’ve been wrong on marijuana my entire life,” grumbled Greg Hubly, who co-owns a cannabis store in Washington state.
Hubly said that, despite the pandemic, he’s continued dabbing — heating potent marijuana concentrates with a torch or electronic pen and inhaling the resulting smoke — to treat lingering pain from past broken bones and to keep his mind stimulated.
“I hear this study, I hear that study — well, no one’s studied me,” he said. “I have 47 years with this plant, and I know my physical and intellectual reactions to it. It’s helping me get through this period of high stress, as it always has. It’s let me disconnect from the [coronavirus] news conferences on TV and go out in the garden and enjoy some sun.”
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Other marijuana consumers said changing routines amid the pandemic have had a bigger impact on their pot use than health considerations.
Michael Lemon, for example, finds himself smoking more now that he’s home with his kids all day, sneaking out to his childproof stash box in the garage as necessary. Also contributing to the uptick: he’s buying more marijuana at once to limit dispensary runs.
“Look, I’ve got a 2- and a 4-year-old, so it’s been Disney Plus nonstop for 40-something days and counting,” the 38-year-old Pueblo, Colo., resident said wearily. “Marijuana definitely makes that easier to bear."
Dan Adams can be reached at daniel.adams@globe.com. Follow him on Twitter @Dan_Adams86.
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