Cannabis ER

We’ve all been reading the headlines about cannabis-related ER visits climbing. It sounds alarming until you look at what’s actually happening in those emergency rooms. People aren’t dying. They aren’t physically ill. What’s landing them in the ER is panic — they got too high, and they’re freaking out about what’s happening to their own body. That’s a very different problem than the headlines imply, and it points to a very different solution. There is a small percentage of people who have physical reactions to cannabis, but throwing up is not death.

Back in the late 70’s maybe early ’80s, my mother went to an advertising party with her husband. Before she started her own ad sales company, my Mom oversaw all sales for an agency. There was a poster as the invitation that made a nod to pot brownies, kind of a coded, old-school warning nobody actually understood, not unlike that Seth Rogen bit in Studio when he points to the “old-school buffet,” where most people don’t realize that means that drugs are infused in the food. Needless to say, nobody should eat 6 of those mushroom-infused brownies.

Back to my Mom. They were told about the pot brownies, but they had zero idea how many to eat. They were even so excited they took a few and wrapped them up to put in my Mom’s purse for later. After indulging, they left the party in Georgetown and went to the bar, and her husband started feeling strange. Really strange. He was starting to panic. My mom suggested they just stay the night at the hotel and sleep it off, as there was no reason to rush anywhere. But he insisted on going home. So they got in the car and headed down 495. It was only a thirty-minute ride.

My mom was a small person. Her husband was a big guy. Somewhere on that highway, he turned to her and said, “Oh my god, I think I’m having a heart attack. I need to go to the hospital.” She pulled over, climbed across him, and pushed him into the passenger seat so she could drive, screaming, “Do not open the door.”

At the hospital, a young intern came out to see them. Her husband explained everything — the brownies, all of it — and told the doctor, “Listen, I’m not a pot smoker.” The doctor looked at him, clapped him on the shoulder, and said, “Well, you are now, buddy.”

He was fine. He wasn’t having a heart attack. He was having a panic attack brought on by a dose he wasn’t prepared for.

That story is decades old, but it’s the same story showing up in ER intake rooms today. The rise in cannabis-related ER visits isn’t a crisis of the drug itself — it’s a crisis of people not knowing what they’re taking, how much, or what it will feel like when it hits. That’s not a pharmacology problem. That’s an information gap.

And the gap isn’t just about dosage — it’s about how we talk about cannabis at all. I was at a dinner party recently where someone said, “You can’t get stoned here because we have young kids,” while everyone around the table was drinking freely. Nobody blinked at that. We’ve built an entire social script around alcohol — how much is too much, what a hangover means, when to call it a night — and basically no equivalent script for cannabis, even as people use cannabis more than alcohol these days and data is pointing to weed being better for you than alcohol.

Changing that starts with education, not stigma. It starts with normal, matter-of-fact conversations — the same way we teach people what to expect from a glass of wine versus a shot of tequila. And it starts at home.