HARM REDUCTION.

The single most important cannabis safety rule. Start with less than you think you need. Wait longer than you think you should before taking more. This is especially critical for edibles (wait 2 hours) and for older veterans or those on multiple medications.

• Inhaled: 1-2 puffs, wait 15 minutes
• Edibles: 2.5-5mg THC, wait 2 hours
• Concentrates: very small amount, wait 15 minutes
• Tinctures: 2.5-5mg THC, wait 1 hour

Cannabis overconsumption is uncomfortable but not life-threatening for most people. Symptoms include anxiety, paranoia, rapid heart rate, nausea, and dizziness.

• Stay calm — the effects will pass, usually within a few hours
• Find a safe, quiet place to sit or lie down
• Drink water and eat something
• Avoid mixing with alcohol or other substances
• If symptoms are severe or you have underlying health conditions, seek medical attention

Regular cannabis use can lead to tolerance (needing more for the same effect), dependence (experiencing withdrawal without it), and cannabis use disorder (problematic use despite negative consequences). These are real, recognized medical conditions.

• Tolerance: develops with regular use, reversible with breaks
• Dependence: withdrawal symptoms when stopping (irritability, anxiety, insomnia, loss of appetite)
• Withdrawal: typically begins 1-3 days after stopping, peaks in the first week, resolves in 1-2 weeks
• Sleep disturbance can persist for several weeks

Approximately 2.5% of U.S. adults meet criteria for cannabis use disorder. Prevalence is higher among individuals with co-occurring mental health conditions, including veterans with PTSD. CUD involves problematic use that causes significant impairment or distress.

• Signs: using more than intended, unable to cut down, cravings, continued use despite harm
• Treatment: CBT and motivational enhancement therapy are evidence-based approaches
• The VA offers treatment for cannabis use disorder — ask your provider
• SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7)

Vaping cannabis carries specific risks. EVALI (e-cigarette and vaping product-associated lung injury) was linked primarily to illicit THC vape cartridges containing vitamin E acetate. Licensed, regulated products are safer but not risk-free.

• Only use products from licensed, regulated dispensaries
• Avoid illicit or unregulated vape cartridges
• Vitamin E acetate is the primary culprit linked to EVALI
• If you experience chest pain, shortness of breath, or cough after vaping, seek medical attention

Combining cannabis with alcohol, prescription medications, or other substances increases risks. Cannabis can amplify the sedative effects of alcohol, benzodiazepines, opioids, and sleep medications.

• Cannabis + alcohol: increased impairment, dizziness, and risk of overconsumption
• Cannabis + opioids: increased sedation and respiratory depression risk
• Cannabis + benzodiazepines: increased sedation and impairment
• Cannabis + sleep medications: increased sedation, morning grogginess
• Always discuss potential interactions with your healthcare provider