Very few people in the cannabis industry today will ever forget the article written by Maureen Dowd in 2014 for the New York Times when she unwittingly overdosed herself on marijuana edibles (containing 11-hydroxy-THC), had a very uncomfortable experience, and yet lived to tell the story. Maybe she should've read Joe Rogan's words of advice from his tweet the previous year:
When you eat pot, it creates 11 hydroxy metabolites in your liver. It's five times more psychoactive than THC.
Unfortunately, Maureen's story isn't rare and can be quite common in states where cannabis is legal. This is especially common with tourists who are diving into their first commercially-produced THC-infused edible without understanding the product.
A review published last year in the American Journal of Health-System Pharmacy showed an increase of marijuana visits to the hospital. Researchers found:
"The number of marijuana-related ED visits has nearly doubled since the drug's use was legalized in Colorado, and the rate is higher for non-Colorado residents who are visiting the state."
In their defense, whoever sold them the candy should've given them an introduction to 11-Hydroxy-THC, the active metabolite of THC.
Most know Delta-9-THC is the cannabinoid found in the cannabis plant which creates the euphoria and psychoactive effects of marijuana is most well-known for. However most don't realize eating THC creates an entirely different compound called 11-Hydroxy-THC, a more potent form of the cannabinoid.
Interestingly, 11-Hydroxy-THC does not exist within the cannabis plant itself; it is only created through the process of digestion. How well THC is converted within the body can depend on the consumer's body chemistry and how well they metabolize other drugs.
Digestion and Enzymes
When consuming a THC-infused edible, just like all other foods and beverages, they must first travel through the GI tract to be digested. Here, enzymes produced by the liver, called "CYP Enzymes" start to break down the cannabinoids.
The molecules created by this process are called metabolites. Although most of the metabolites are inactive, 11-Hydroxy-THC is a unique metabolite because it is more potent than its parent, THC.
When smoking cannabis, THC is absorbed directly into the bloodstream through the capillaries in the lungs which produces a faster onset, but the effects will likely wear off sooner. While some THC is carried to the liver through the bloodstream, only a small amount will be converted to 11-Hydroxy-THC.
So, although it can take longer for a THC-infused edible to take effect, the duration and intensity will likely be more significant because of the creation of this metabolite.
Is 11-Hydroxy-THC More Potent?
While Joe Rogan's tweet brought attention to 11-Hydroxy-THC, he might have been a bit off in his numbers. Multiple studies have shown the metabolite to have more intense, longer lasting effects than its parent, THC; it's hard to say just how much more potent it is:
- This study suggests 11-Hydroxy-THC crosses the blood-brain barrier faster. As researchers noted, "Between 2 to 3 minutes after the intravenous administration of 11-Hydroxy-THC, the psychological high reached its peak and was of greater intensity than any they had previously experienced after taking marihuana."
- Yet, another study showed less 11-Hydroxy-THC was needed to reach a desired level of psychoactivity.
- Still, another study showed, when dosed with the same amount of each, users reported a much stronger effect from the 11-Hydroxy-THC than just THC alone.
So Why Can't I Get High from Edibles?
Just like many other drugs, people produce these enzymes, which break down chemical substances, in different levels. Some people are fast metabolizers, while others are considered slow metabolizers. Depending on how your own body produces these enzymes and how efficiently they work determines how much 11-Hydroxy-THC will be created as your liver metabolizes the THC.
Those who are considered slow metabolizers will need much higher doses to achieve the same effect as someone who is a fast metabolizer.
While tolerance certainly plays a factor, if you don't get any reaction from marijuana edibles you may be deficient in a particular enzyme, CYP2C9.
Medicinal Value of 11-Hydroxy-THC
Many patients are plagued by chronic symptoms of pain and inflammation which last all day and interfere with daily functionality. These patients may find the longer duration of effects more suitable for treating their symptoms. Combining orally ingested cannabinoids with other inhaled forms of therapy can help patients control symptoms throughout the day. The inhaled method provides immediate onset and mitigation of symptoms and then fades into the longer lasting effects of the marijuana edible.
Many chronic pain patients compare the effects of edibles to that of extended-release pain prescriptions such as hydrocodone and oxycontin; which begs the question, could 11-Hydroxy-THC play a part in reducing the number of opioid prescriptions necessary today? As with most the compounds found in cannabis, more research is needed to understand the full array of possibilities with 11-Hydroxy-THC and the impact it could have on so many people seeking solutions.