It could have been that second or third edible. Or maybe it was your first time dabbing. Maybe you tried to impress your friends with a huge bong hit topped with some hash oil after drinking all night. Whatever the cause, now you have the spins and anxiety that’s so intense you feel like you’re dying. You, my friend, are greening out.

As more places legalize cannabis for medical and recreational purposes, emergency rooms are seeing more patients for cannabis overconsumption. Dr. Eric Lavonas, an emergency physician and medical toxicologist at Denver Health Medical Center, says they regularly see about three or four cases per week.

Although no one has ever died from a cannabis overdose, it is possible to get sick from ingesting too much THC. Dr. Freddie Vista, a psychiatrist who works in addiction and rehabilitation, explains that when cannabinoid receptors are over-activated with THC, it can make a person feel ill.

Green Out Symptoms

The most common symptoms of greening out are anxiety and paranoia. It can feel like a severe panic attack, and may also include the following:

  • Extreme dry mouth

  • Chest pain

  • Confusion

  • Increased heart rate and blood pressure

  • Shaking

  • Sweating

  • Chills

  • Disorientation

  • Severe nausea or vomiting

  • Burning eyes

  • Delusions or hallucinations

  • Shortness of breath

  • Dizziness

The experience can be frightening, but it is important to remember that it isn’t deadly and it will pass. It’s estimated a person would need to ingest 40,000 times a normal dose of cannabis for it to kill them. That would be pretty hard to do.

That being said, if you continue to have a racing heartbeat and shortness of breath, it might be a good idea to head to the ER, where they can give you some meds to calm you down.

Causes of Green Out

Improper dosing is the main culprit of green out, whether you are smoking, eating, or dabbing. Modern strains of cannabis are bred for higher THC levels than they used to be. If someone smokes too much, especially if they have a lower body weight, they can potentially feel sick. Your ideal dose will depend on your brain chemistry, your size, your metabolism, and your experience (tolerance) level.

Indicas and sativas should be dosed differently. Whereas indica doses can be higher without any negative effects, sativas are better smoked in more frequent, lower doses. High doses of a sativa can cause panic attacks.

A strain’s THC and CBD levels matter. High-THC strains are more likely to cause green out, while strains with high CBD levels are less likely to. CBDs actually prevent you from getting too high by blocking THC from fully binding to cannabinoid receptors.

Edibles can take one to two hours to kick in, and a common cause of green out is when people get impatient and eat more because they think the edibles aren’t working. If you are brand new to edibles, start with a 5 mg dose and wait two hours to feel the effects. Most people find that their best dose for edibles is 10 mg, however, it can vary from person to person. Someone with a high tolerance, high metabolism, and heavy build can easily consume 20-30 mg without an issue.

Concentrates such as hash, oil, wax, and shatter can have THC levels of up to 90 percent or more, which makes it easy to overdo them. Start with small doses until you have a good feel for your personal tolerance level.

Drinking alcohol before smoking can potentially double the rate of THC absorption and is one of the most common causes of green out. As the saying goes, “Beer before grass, you’re on your ass. Grass before beer, you’re in the clear.”

How to Survive Green Out

If you find yourself feeling green, there are things you can do to help yourself until it passes. First and foremost, relax. This, too, shall pass and stressing will only make your anxiety worse. Lie down and take deep breaths, listen to music, and sleep it off if you can. You’ll feel better in a few hours. You might feel a little hung over for the next day or two, but you’ll bounce back in no time.

It’s a good idea to eat and drink something, especially something fruity like a glass of lemonade or a slice of mango. Fruits contain terpenes such as pinene and myrcene which help to ameliorate the effects of THC. Fatty foods will help your body metabolize THC faster.

You can also sniff or chew on a peppercorn. This time-tested trick should help almost immediately. Pepper contains caryophyllene, a terpene that calms anxiety.

CBD oil will help you sober up since CBDs obstruct THC from binding to cannabinoid receptors. And the good news is hemp CBD oil is legal in all 50 states, so you can find it no matter where you live.

Even though you may not feel like it, exercise is a great distraction and will release endorphins to help you clear your head. Follow up your workout with a cold shower and you’ll be feeling like a million bucks in no time.

It’s important not to encourage someone greening out to vomit. They are already dehydrated, and vomiting will only dehydrate them further.

If you feel that a visit to the ER is necessary, doctors may give you benzodiazepine to ease anxiety, intravenous fluids for hydration, and anti-nausea meds.

Although too much THC may give you a bad trip, you can ease your suffering with these tips until you feel better. If you’re trying to help a friend, Dr. Lavonas says to let them “know that they’re in good hands, that time is on their side, and they’ll be OK. And then, if the reassurance alone isn’t getting them where they need to be, then a little bit of medicine to help them relax, something for anxiety, a little bit of fluids and just… time.”

And take it easy next time.