“Greening out” describes acute cannabis intoxication, an unpleasant state occurring after consuming more tetrahydrocannabinol (THC) than the body can comfortably process. Overconsumption results in physical and psychological symptoms, including intense anxiety, paranoia, nausea, and dizziness. When assisting someone experiencing this distress, the primary goal is supportive care: creating a safe environment and managing symptoms until the effects of the THC naturally subside. The duration varies significantly, depending on the consumption method and product potency.
Securing the Immediate Environment
The first step involves removing the person from their current setting and securing a safer, less stimulating environment. Move the individual to a quiet, private area where they can sit or lie down comfortably without the risk of falling. This reduction in external stimuli helps to counteract the sensory overload often associated with high levels of THC.
A low-light setting is preferable, as bright or flashing lights can exacerbate feelings of anxiety and panic. Ensure the person remains seated or reclined at all times to prevent injury from sudden dizziness or loss of coordination. The helper must remain with the individual continuously, as the state of intoxication can shift rapidly. Being a calm, constant presence serves as a source of stability during a distressing episode.
Managing Physical Symptoms (Nausea and Dizziness)
Physical discomforts like nausea and dizziness are common manifestations of acute cannabis intoxication. To address potential nausea, encourage the person to take slow, small sips of water or an electrolyte solution. Avoid giving them large gulps of fluid, as this can trigger stomach upset or vomiting.
If the person experiences vomiting or is drowsy, position them on their side in the recovery position. This posture is important because it prevents vomit from entering the lungs, a severe complication if they lose consciousness. A light, easily digestible snack, such as dry toast or crackers, can sometimes help stabilize blood sugar, though food should not be forced if they feel nauseous.
Temperature regulation can also be erratic during this time, with individuals often feeling either too hot or experiencing chills. If the person is cold, offer a light blanket to maintain comfort and prevent shivering. If they feel overheated, gently applying a cool, damp cloth to the forehead or back of the neck can provide immediate relief. Avoid giving them caffeinated beverages or alcohol, as these substances can worsen dehydration, increase heart rate, and intensify feelings of panic.
Calming Psychological Distress (Anxiety and Paranoia)
The psychological effects of greening out, such as intense anxiety and paranoia, are often the most distressing components. The helper should maintain a calm, steady voice and demeanor, speaking in short, clear, and non-judgemental sentences. Reassure the individual that the feeling is temporary, that they are safe, and that the symptoms are a direct result of the cannabis consumption, not a medical emergency.
A helpful technique is to guide the person through a structured sensory exercise, such as the 5-4-3-2-1 grounding method, to anchor their focus to the present moment. Instruct them to name five things they can see, four things they can touch, three things they can hear, two things they can smell, and one thing they can taste. This process redirects their attention away from racing thoughts and internal distress to the concrete reality of their immediate surroundings.
Paranoid thoughts should be acknowledged without arguing or validating the content of the delusion. Encourage slow, deep, controlled breathing, perhaps by counting with them, as this simple action physically lowers the heart rate and interrupts the panic cycle. Patience is paramount, as challenging or dismissing their feelings will only increase their agitation and sense of isolation.
Recognizing When to Seek Emergency Medical Help
While most episodes of acute cannabis intoxication are self-limiting and resolve with supportive care, certain symptoms require immediate professional medical attention. The most serious red flags are those that indicate a compromise of the person’s basic physiological functions or a severe psychological crisis. Call emergency services immediately if the person has trouble breathing, experiences chest pain, or exhibits signs of a seizure.
Loss of consciousness or the inability to be fully awakened is a serious sign that requires immediate medical intervention. Uncontrollable vomiting that prevents the person from keeping down fluids for several hours is also concerning, as it can quickly lead to severe dehydration. Additionally, if the individual experiences hallucinations, severe disorientation, or acute psychosis that persists long after the expected period of intoxication, they should be taken to an emergency department for assessment. These severe reactions necessitate prompt medical evaluation.