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THC: The Fine Line Between Indulgence and Euphoria

I’ll never forget the patient that made me pivot and shift my perception and preconceived notions about the definition of euphoria. 

In March of 2018, Governor Phil Murphy, in his first days of office, signed Executive Order 6 into law with provisions expanding the New Jersey Medical Marijuana Program. The largest noticeable change for the program was the addition of anxiety and chronic pain as qualifying conditions, exponentially expanding access to medical cannabis for patients across the state.  After weeks of repeatedly counseling the same type of new patients, the daily routine became just that… routine.

One early-spring day, a casually dressed 34-year-old gentleman came to our facility and sat down with me for his new patient counseling session. With the expectation that this was another standard GAD or chronic pain case, I prepared to engage in a quick in-and-out session. Instead, his silent, stoic nature broke down in front of me as soon as we began speaking.

He shared his devastating story involving a motor vehicle accident 4 months prior, where he first-handedly witnessed the loss of his wife and two children in the fatal crash. As a fairly new father at that time, I couldn’t begin fathoming the trauma and anguish that he was experiencing underneath his seemingly cold exterior. There were no words or condolences that I could’ve expressed to him that could change his situation, but he entered our dispensary doors for a purpose and I was there to help guide him. After months of experimenting with traditional selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines, he admitted that cannabis was the only thing that made him feel at peace after the incidence. The only thing that allowed him to sleep; to deal with life; to get up in the morning; to forget…. was cannabis.

The primary psychoactive constituent in cannabis is delta-9-tetrahyrdrocannabinol (THC). This phytocannabinoid is responsible for causing euphoric effects commonly associated with “getting high”. However, unlike amphetamines and LSD that produce euphoria via dopaminergic pathways, THC utilizes our body’s endocannabinoid system mimicking the molecular structure of anandamide: the bliss molecule

The difference between a recreational consumer seeking relaxing indulgence and a PTSD patient looking for life-normalizing euphoria boils down to one key factor: intent. In a patient’s quest to self-discovery with cannabis, responsible consumption for mental, physical, and spiritual well-being must be prioritized. Cannabis doesn’t carry a physical dependency like alcohol or opiates, but positive psychological experiences of euphoria may be strong and compelling enough to foster an unhealthy reliance on its usage. 

The difference between a recreational consumer seeking relaxing indulgence and a PTSD patient looking for life-normalizing euphoria boils down to one key factor: intent.

With May serving as mental health awareness month, how do we use cannabis for mental health and well-being responsibly to ensure we don’t cross that fine line between indulgence and euphoria? 

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