Holding the “Hit” ? Is There Additional Medical Benefit

The question I am addressing today is the issue of holding the “hit” in when smoking cannabis and in particular for medical benefit. Don’t Bogart that joint was a mantra of the sixties but does it have any bearing on the medical benefits? Does it really get you higher when you hold your hit in? Do you derive more benefit? These questions have been answered and we will review the data and the conclusions derived from several studies.

These Studies have explored puff volume and number of puffs, breathhold and potency as variables that may influence both physiological and subjective effects of cannabis smoking. Cannabis is the most wildly used illegal drug in the United States. A common habit among users has been breath holding, with the perceived benefit of maximizing the absorption of delta 9-tetrahydro-cannabinol (THC) and thereby increasing the high or medical benefit. Breath holding may contribute to an increase of detrimental effects from cannabis smoking. It is interesting that this method of smoking does not seem to occur with tobacco smoking and studies confirm breath hold duration does not increase the absorption of nicotine. A typical breathhold time has been observed to be in the 10-15 second range during non lab recreational smoking.

The articles used for this article range from 1989 to 1995.

The earlier paper entitled Breathhold Duration and Response to Marijuana Smoke was published in 1989 in Pharmacology Biochemistry & Behavior. Zacny and Chait. These researchers used varying durations of the breath hold being: 0, 10, and 20 seconds during nine different sessions. Each time limit was used in three sessions (totaling 9) and were chosen randomly; not done in a sequence but varying. They measured heart rate, mood and carbon monoxide.

Results of the study were; the sensitivity of the response to breath holding when smoking cannabis is small. The effect of time after smoking had effect on the variables measured but breath hold itself had scant evidence that cannabis effects were responding to the breath hold maneuver.

The study entitled Response to marijuana as a function of potency and breath hold duration by James P. Zacny and L.D. Chait was published in Psychopharmacology in 1991. This study by the same authors of the previous study looks at breath holds of 0 and 20 seconds using cannabis and a placebo. The subjects were exposed twice to each of four conditions: placebo at 0 seconds, placebo at 20 seconds, cannabis at 0 seconds, and cannabis at 20 seconds. The subjects could not vary the number of puffs and the puff volumes were standardized. The effect on expired carbon monoxide, which was used as a monitor of smoke intake changed with increasing time of the breath hold for both placebo and cannabis. Heart rate changed minimally by breath hold duration mood was inconsistently affected again showing that increasing the time of the breath hold is not a contributing factor. Potentiating of the intoxication from cannabis (and presumably medical benefits) is not increased by holding ones breath for long periods of time.

The last study in this review is Marijuana Smoking: Effects of varying Puff Volume and Breathhold Duration by Julian L. Azorlosa et al in 1995 published by The Journal of Pharmacology and Experimental Therapeutics. This paper examined two different parameters, study one: subjects were given varying quantities of smoke per puff with a ten second breath hold. The second study subjects were given a controlled puff of 60 ml with a varying breath hold times of either 0, 10, or 20 seconds. Higher puff volumes and higher potency conditions were associated with increased plasma levels, THC levels being immediately maximal after smoking. This maximal effect decreases rapidly, declining 20% over a 45 minutes. Results demonstrated that the puff volume within the limits described were a major determinant of the THC exposure and the total smoke volume may have an even larger effect on the patients subjective feels after exposure.

Study two subjects took 10 puffs holding their breath for either 0, 10, or 20 seconds. The study incorporated the breath hold times in different sessions using either 1,75% or 3.55% THC. Results for 10-second and 20 second breath hold when using the higher potency cannabis demonstrated a higher plasma level of THC then other testing conditions. The breath hold data shows an enhanced absorption at about 10 seconds whereas a 20 second breath hold does little to enhance THC levels.

Results of these studies point to the puff number, cumulative puff volume, and potency as factors in enhancing THC levels. Somewhere between 0 and 10 seconds for the pause between inhalation and expiration should be adequate for absorption, any time over this may add greater insult to the lungs. We are talking about smoking in this article, vaporizers do not necessarily follow suite to smoking, as one is particulate (smoking) and the other is vapor (vaporizer), the two likely having different properties and distribution characteristics within the lungs.

The take home is that increasing the potency, number of puffs, and a limited pause between inspiration and expiration ( < 10 sec) may enhance the subjective feelings associated with smoking cannabis. Holding ones breath beyond the 10 seconds offers no real benefit but may exacerbate the negative effects of smoking and a lesser pause may still produce the desired effects.

William W. Eckhardt/www.CannabisAsMedicine.com

Is a science writer and allied health professional, speaking on the subject of contact at: cb1cb2ty@comcast.net