For every cannabis user, there, perhaps, comes a breaking point, a moment where euphoria, relaxation, or other intended positive effects turn to nausea, anxiety, or feelings of being strung out. For Christi, a regular cannabis user who resides in Bloomfield, that breaking point came 10 years ago when he and some friends bought “a lot of weed” and decided to smoke it all at once.
“I was high for three days straight,” he tells Pittsburgh City Paper with a laugh. “I remember my friend put me in her bed, brought me some frozen pizza, and turned on the movie Rent, the musical, on Netflix, which is the only time I’ve ever seen Rent, and I don’t remember any of it.”
Since then, Christi, a medical cannabis patient who considers himself a “lightweight,” has been careful to avoid a similar experience. “I just felt really out of it,” he says and compares it to being in a “really, really detailed dream” that he couldn’t wake up from. “After 12 hours I was like, I’m kind of done with this now; can I just be normal? It was awful.”
While cannabis provides many reported benefits from stress reduction to pain management, overdoing it can result in something the community has dubbed “greening out,” a sort of THC hangover that dampens what, for many, is an otherwise helpful treatment. The unfortunate side effect may lead some to pursue “T-breaks,” or tolerance breaks — time away from cannabis that can range anywhere from a few days to several months, depending on the person.
It’s believed that a T-break gives the body time to reset to a level where smaller amounts of cannabis are necessary to achieve intended results, saving the patient potential headaches and, from a financial standpoint, money spent at the dispensary.
The concept of greening out contributes to the continued discourse surrounding cannabis as it undergoes a major expansion in the United States. This includes Pennsylvania, where a medical marijuana program went into effect in 2016. Legislators are now pushing for recreational cannabis to — as Pa. Gov. Josh Shapiro recently characterized it — compete with neighboring states like Ohio, New Jersey, and New York, where cannabis restrictions have become more relaxed.
But even as a majority of Americans across party lines have accepted cannabis, serious research around it is still new. And unlike medications prescribed by doctors, which come with exact dosages and a list of potential side effects, cannabis users are left searching for the perfect strains and amounts that work for them, which could lead to greening out as patients test their limits and sample various products.
Even then, there are justifiable fears that discussing any negative side effects of cannabis could cause a backslide into stigmatization and criminalization. And while studies show that cannabis carries far fewer risks than other drugs — as overdoses can happen with both prescription and illegal substances like heroin, cocaine, or methamphetamine — Christi believes cannabis can become “too much of a good thing.”
How to avoid a green out and recover from it depends on the person, says Christi. “I know myself better both as a person and as somebody who uses cannabis,” he says, adding that he mostly uses it now as a way to treat his insomnia. Even so, he does take occasional T-breaks.
“Usually one or two hits off my pen will knock me out, but it was taking me five or six,” he says, adding that he scaled back for about three weeks. Taking a T-break of about two weeks was also helpful, he says, before he had his top surgery, explaining that cannabis can interfere with anesthesia.
Bill has been a Pa. medical cannabis patient since 2016, mostly to treat chronic back pain. During that time, he says he has greened out. “There’s definitely some paranoia that happens,” he tells City Paper. “I also notice the quantity of what I’m smoking increasing as well.”
For him, overdoing it on cannabis means doing “all the grimy stoner things of digging through my pipes for resin and all that sort of stuff.”
He says his most recent T-break lasted for nine months. “I think I’ve done couple-week breaks or a month every once in a while, but I don’t find them rewarding,” he adds.
While cannabis users are left experimenting with T-break durations, some researchers are making strides in figuring out the green-out phenomenon. CP spoke with Tom Fontana, a licensed mental health counselor and drug and alcohol educator at the University of Vermont’s Center for Health and Wellbeing. Fontana positions the school’s work on cannabis use as being some of the earliest, including when it comes to T-breaks and greening out. The Center even published “T-Break: Take a Cannabis Tolerance Break,” a step-by-step resource guide that takes readers through the process.
Fontana tells CP that the subject of cannabis use often comes up in discussions with students.
“We look at this idea of balance — how much are you using, how is that going for you?” he explains. “More often, when you look at the use curve of people who use cannabis, they tend to use it infrequently, or very frequently.”
Fontana has found that subjects hit a point where tolerance turns into what he and other researchers call “drug sensitization,” the point at which the negative side effects of cannabis like anxiety and nausea kick in. He agrees that, when it comes to choosing the length of a T-break, certain periods, such as the widely held belief that it takes two weeks for the body to eliminate THC, are arbitrary.
“Within the first week to 10 days, you’re going to get the chemical tolerance reduced,” he says, adding that even three to five days can make a difference. For those looking to wipe the slate completely clean, however, Fontana recommends 21 days “if possible.”
Fontana believes that taking T-breaks, regardless of length, can help people take a step back and explore their relationship with cannabis, especially as the industry changes and produces more potent strains. “And I think it’s up to the individual, and there’s still no gold standard on that. Realistically, with the potency of weed going up, for people who want to use it more regularly into the future, we’ll probably have to think about some level of moderation.”
Rather than advocate for abstinence, Fontana wants people to develop healthy relationships with cannabis, whether they’re using it for medical reasons or fun. Once the benefits of cannabis become clear to a person, he believes the focus should be on the long term.
“If it helps, how do we keep it helping you because we know tolerance is such a real thing with cannabis,” he says. “But then it stops working, and we're left feeling truly more isolated, sometimes both socially and emotionally. And so just thinking about that would be helpful in conversations with people, but we don't always have that sophisticated conversation.”
As for recognizing when greening out happens, Christi recommends you “trust your body.”
“If your body is telling you to stop, listen to it,” he adds.
Once the decision is made, Bill believes approaches to T-breaks should be up to the individual. Embarking on one can be rewarding without resorting to extreme measures, like throwing out their glass pieces or vape pens.
“I think it would just save people a lot of literal and figurative headaches if they just disengaged or practiced [T-breaks] more often,” he says, stressing that it also doesn’t have to be a solitary experience. “Talk to your friends; see if they feel the same way. Get a little support. Support always helps.”
