Greening Out: When Too Much Marijuana Becomes More Than a Bad High

Greening out is what people call it when marijuana stops feeling relaxing and becomes overwhelming.

The person may vomit, shake, sweat, lose their balance or become convinced that something terrible is happening. Some grow pale and quiet. Others panic, become paranoid or lose track of where they are.

Most episodes pass. That does not mean every episode is harmless.

Someone who is severely impaired can fall, choke while vomiting, wander into traffic, drive, hurt themselves during a panic or experience a psychiatric crisis. There is also no guarantee that a vape, gummy or street product contains only the substance the person expected.

What does it mean to green out?

To green out, or to be greened out, is to take more cannabis than the body can handle and tip from high into sick. The color is the clue: people go pale, or faintly green, right before they vomit. In the United Kingdom the same thing is called a whitey, for the same reason. Greening out, green out, greened out, and whiting out all describe one event.

It is not an allergy. It is not poisoning in the usual sense.

It is a dose that overshot, arriving in a body that was not ready for it. That framing matters, because it tells you what helps. Time, and not much else.

Is greening out real?

Yes. Emergency departments in states with legal cannabis see it routinely, and edibles account for a share of those visits far out of proportion to how little of the market they are, per a 2019 Colorado study (abstract on PubMed). It is real, it is common, and it is almost always survivable. What it is not is a sign that someone is allergic, that the product was laced, or that they are having a heart attack, though it can feel like all three.

Why Does Greening Out Happen?

Greening out generally occurs when someone consumes more THC than their body can comfortably tolerate.

Edibles are a common reason. They can take between 30 minutes and two hours to produce intoxicating effects. A person may decide that the first dose “did nothing,” take more and then have both doses begin working later. The resulting effects can also last longer than expected. CDC cannabis poisoning guidance

The risk may be greater when someone:

• Has little experience with marijuana
• Uses a high-potency product
• Eats an edible without understanding the dose
• Takes another dose too soon
• Uses concentrates or strong vape products
• Combines marijuana with alcohol or other drugs
• Has a history of anxiety or panic
• Uses in an unfamiliar or stressful setting
• Does not know what the product contains

Legalization has not made every cannabis product mild or predictable. Potency, dosing and individual reactions still vary substantially.

Symptoms of Greening Out

Symptoms can include:

• Severe anxiety
• Panic attacks
• Paranoia
• Dizziness
• Sweating or chills
• Nausea and vomiting
• Shaking
• Rapid heart rate
• Poor balance
• Confusion
• Extreme tiredness
• Difficulty following a conversation
• Feeling detached from reality
• Fear of dying or “going crazy”

Large doses can also contribute to hallucinations, severe agitation or psychotic symptoms, particularly in someone with underlying risk factors.

What Should You Do?

If the person is awake, breathing normally and not in immediate danger:

• Move them somewhere calm and quiet.
• Have them sit or lie down safely.
• Stay with them.
• Speak slowly and use short sentences.
• Reassure them that help is available.
• Do not let them drive.
• Do not give them alcohol, Xanax or another drug.
• If they vomit, position them to reduce the risk of choking.

How long does greening out last?

It depends almost entirely on how the cannabis went in.

These are typical ranges, not promises; the edible timing comes from the CDC guidance linked above. A large edible dose in someone who rarely uses can still be felt the next morning. Smoked cannabis is the easier case: the peak is early and the decline is steady, which is why a smoked green out usually resolves on a couch within a couple of hours.

Greening out from edibles, carts, and dabs

Edibles are the reason most green outs happen and the reason they last. THC eaten is converted by the liver into a form that is stronger and slower, so the wave arrives late and stays. A cart or a dab delivers a large amount of THC in one breath, so the green out is fast and sharp rather than long. Neither is safer. They are different shapes of the same mistake.

Can you die from greening out?

A fatal overdose caused solely by cannabis is unlikely, in the CDC’s words. That does not make it harmless, and it is the honest answer to the question people are really asking at 2 a.m.

The deaths connected to greening out come from around it, not from it.

• Choking on vomit while lying on the back, or while too sedated to turn
• Falls, especially in a bathroom, and wandering into traffic or water
• Driving
• Heart strain in someone with existing heart disease, since THC raises heart rate
• A product that was not only cannabis: synthetic cannabinoids, or an edible from an unknown kitchen
• Alcohol taken at the same time, which multiplies the nausea and the sedation
• Children, who can become dangerously sedated on doses adults tolerate

So the answer is no, and also: keep them on their side, keep them off the stairs, and keep the car keys.

How to stop greening out, or get unhigh faster

There is no way to sober up quickly from cannabis. Nothing absorbs it, nothing reverses it, and nothing speeds the liver. What exists is a short list of things that make the wait more bearable and a longer list of things people try that do nothing.

What helps:

• Lying down in a quiet, dim, cool room, on the side if nauseated
• Water in small sips, and something sweet if they can keep it down; low blood sugar makes the shakes worse
• Slow breathing, counted out loud by someone calm
• A reminder, repeated as often as needed, that this is a green out, it is temporary, and it will pass
• Sleep, once vomiting has stopped

What does not help, or hurts:

• Alcohol, which deepens the nausea and the spin
• Caffeine or energy drinks, which raise the heart rate that is already frightening them
• A hot shower alone, which is a fall waiting to happen
• Xanax or any other sedative from a friend
• More cannabis, on the theory that a different strain will balance it

Chewing black peppercorns, a folk remedy that circulates online, is harmless and unproven. CBD is the same: some people swear by it, the evidence is thin, and a CBD product of unknown origin adds one more unknown. The single most effective treatment is time in a safe place with a person who is not panicking.

What to do when someone is greening out

Stay. Get them lying on their side. Take the keys. Keep the room quiet and the crowd out. Do not argue with what they believe is happening. Check breathing every few minutes, and use the 911 list above if anything on it appears. That is the whole job, and it is enough.

Greening out is not cannabinoid hyperemesis syndrome

A different problem gets confused with it. Cannabinoid hyperemesis syndrome, or CHS, is repeated bouts of severe vomiting in people who have used cannabis heavily for months or years, often relieved for a short while by hot showers. It is not caused by one big dose. It is caused by long, daily use, and the only reliable treatment is stopping. Someone who greens out once needs a couch. Someone who is vomiting in cycles every few weeks and standing in the shower for relief needs a clinician, and the cannabis is the cause.

How to prevent greening out

• An edible taken again before the first dose landed is the most common cause; the wait is longer than people expect
• Treat carts and dabs as a different drug from flower, because in effect they are
• Do not mix with alcohol
• Eat first
• Use with people, somewhere familiar, with a way home that is not driving
• Buy from a licensed New Jersey dispensary, where the dose on the label is at least a real number

Does Greening Out Mean Someone Needs Detox?

Not necessarily.

One episode may result from inexperience, an unexpectedly potent product or taking too much of an edible. Marijuana withdrawal is also not ordinarily medically dangerous in the same way that alcohol or Xanax withdrawal can be.

But people who use marijuana heavily can experience real withdrawal symptoms after stopping, including:

• Irritability
• Anxiety
• Insomnia
• Vivid dreams
• Reduced appetite
• Restlessness
• Depressed mood
• Headaches
• Strong cravings

Those symptoms can make stopping difficult, particularly when marijuana has become the person’s only way to sleep, eat, relax or manage uncomfortable emotions.

A detox assessment becomes more important when marijuana is being combined with alcohol, opioids, Xanax or other substances. The greatest medical risk may come from one of those additional drugs.

When Marijuana Becomes the Organizing Force

Marijuana is legal for adults in New Jersey. That does not answer whether someone’s use is healthy.

The better question is what marijuana is doing to the person’s life.

It may be time to seek help when someone:

• Uses from morning through night
• Needs increasingly potent products
• Repeatedly greens out but keeps using
• Cannot sleep or eat without marijuana
• Drives while impaired
• Experiences recurring panic or paranoia
• Misses work, school or responsibilities
• Tries to stop and cannot
• Withdraws from relationships
• Regularly combines marijuana with other drugs

A bad high may pass within hours.

The pattern underneath it may continue for years. If that pattern sounds familiar, read How Do You Know When Someone Needs Detox?