Addiction Expert Explores Dangers of Dabbing on ‘The Doctors’

It’s a growing trend, distilling the oils in marijuana plants into a concentrate that offers a more potent high. But while this may seem appealing to those who like weed, it comes with dangers, explained addiction expert David Sack, MD, in an appearance on the Emmy-winning medical talk show “The Doctors.”

For one, the increased potency of the concentrate — known under a variety of names, including dabs, wax, shatter, budder, hash oil and honey — can be more than the user bargained for. When consumed, whether as an ingredient in marijuana edibles or vaporized and inhaled through a process called dabbing, “the euphoria is more intense and that increases the likelihood of the negative effects that can come with marijuana, such as anxiety, paranoia and addiction,” said Dr. Sack, who is the chief medical officer of Elements Behavioral Health, a nationwide addiction and mental health network. “This is not your Aunt Madge’s marijuana.”

And then there’s the process of actually making the concentrate, which is easy enough to tempt do-it-yourselfers but requires a solvent such as butane oil. Starting a fire, destroying your home, and blowing yourself up are real possibilities.

Recipe for Disaster

Joining Dr. Sack in the show’s panel discussion was reconstructive surgeon Peter Grossman, MD, medical director of the Grossman Burn Center, who said his facility is seeing an increasing number of people harmed in this way. The problem, he said, is that the recipe for making the concentrate is all over social media. “You have amateur scientists teaching other amateur scientists how to make this, and in making it, it’s incredibly flammable. … The patients that we see are massively burned with multiple injuries.”

The procedure involves flushing the ground-up marijuana with a solvent, heating it and then putting it under pressure to extract the oils. The resulting concentrate can take many consistencies, from oily to waxy, and can end up in a vaping device or heated in a bong and inhaled, or it may become an ingredient in marijuana edibles or ointments.

When a lab creates these concentrates, as is allowed in states where marijuana businesses are legal, safety protocols are followed and more expensive solvents are used to minimize impurities. When amateurs make it, however, they commonly use inexpensive butane oil, and because such production is commonly considered illegal, it is often undertaken behind closed doors, where fumes can build. It only takes a spark for things to go horribly wrong.

The Power Behind the Dab

Those who end up consuming the concentrate may not realize that one dab can equal five joints. And boosting that potency is the fact that today’s marijuana is so much more powerful than it was just a decade or two ago, Dr. Sack explained.

“So when you think about how a drug works, there are two issues. The first is, how potent and strong it is, and the other is, how fast does it get to your brain. And in the case of dabbing, it gets there right away and it’s incredibly potent.”

An effect that might take hours to achieve by smoking marijuana in the traditional manner can be achieved almost instantaneously, he said. “All of a sudden, every receptor in your brain that is sensitive to marijuana is being hammered in that first inhalation.”

Those who might be anticipating mellowing out may instead find themselves in the emergency room with extreme anxiety, paranoia or hallucinations.

For parents who worry about their teens and concentrates, Dr. Sack encouraged education — in particular, making sure your kids understand the dangers of attempting to create their own and the nasty side effects that can result from dabbing. Don’t assume they won’t be tempted, he said. When it comes to drugs, “kids are always going to be attracted to the latest, most potent form.”

There is still hope.

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