Smoking or consuming cannabis can work as a bronchodilator to release bronchospasm associated with asthma. However, it also has the capacity to trigger bronchospasm. Although there is some promising evidence to suggest cannabis use for asthma, there’s also contradictory evidence. The state of Michigan rejected medical cannabis use for asthma in 2013, but later changed it's medical marijuana status to legal. Multiple other states have also changed their cannabis policies to legal in the US.
Asthma is a common inflammatory condition of the airways, characterized by bronchospasm and airflow obstruction. Asthma symptoms show up as tightness or pain in the chest and airways resulting in shortness of breath in what is known as an asthma attack. Both genetic predisposition and environmental factors play a role in asthma.
In a 2000 study published in the journal Nature, a respected researcher, Daniele Piomelli, showed cannabis and THC can produce a strong bronchodilation effect on the airways.  The general effects of smoking cannabis on the lungs are widely mixed, with light and moderate use causing small to no damage to the lungs. Marijuana and asthma, while heavy use is understood to be associated with increased incidence of bronchitis. Due to the fact that cannabis smoke shares many of the same compounds as tobacco smoke, physicians have long been concerned about the possible increased risk of pulmonary disease from smoking cannabis. Multiple studies of cannabis or marijuana smokers have found damage to the mucosal tissue lining the airways and evidence of inflammation.  Although, in a meta-analysis review of the available literature in lung function and disease did not detect any evidence of adverse effects of moderate cannabis use on lung function.  One fascinating study hypothesized that, in the short term, cannabis smoking improved lung function by stretching the lungs, while in the long term, it damaged the lungs through the exposure to smoke.  Thinking of smoking marijuana for asthma attack? Well, it depends. Read on to learn more.
Ancient Egyptians treated respiratory conditions like asthma by inhaling the vapors from herbs placed on heated bricks. Smoking medicinal plants as a treatment for asthma was common into the 20th century, with the most popular being the Jimsonweed cigarettes, Cigars de Joy.  Henry Hyde Salter, a 19th-century physician, wrote that cannabis was commonly used as a tincture for the treatment of asthma.  In the early 20th century, asthma was thought of as a psychological disorder, with it only being found as an inflammatory condition in the 1960s.
As documented in the study published in Nature, both airway dilation and bronchospasm are controlled by the endocannabinoid system, through production of anandamide in lung tissue that interacts with CB1 receptors in those tissues. As covered in a small scale trial from 1975, Doctor Donald Tashkin at the University of California, conducted an experiment on eight otherwise healthy patients with stable bronchial asthma. In one of the experiments, he had the participants exercise until they suffered an acute asthma bronchospasm. During the attack, the patients smoked either placebo marijuana or two percent THC marijuana. The participants receiving the placebo took 30 to 60 minutes to recover from the bronchospasm. The group receiving the marijuana recovered “immediately” according to the researchers.  Research confirms THC’s benefits and bronchodilatory effects, which are fascinatingly comparable to isoproterenol, a potent bronchodilator used in asthma cases.  For more information, read The Endocannabinoid System Explained.
In a review of the preclinical data on the effects of CBD on inflammation, it was found that CBD could be of value in treating inflammatory lung diseases such as asthma and COPD, due to the nature of CBD to reduce the protein concentration and production of the proinflammatory cytokines (TNF and IL-6) and chemokines (MCP-1 and MIP-2) in a mouse model.  A later study conducted by researchers in Brazil tested this observation concerning cytokine production in a mouse model of asthma and the results supported the potential for CBD to modulate inflammatory response in asthma. 
In the University of California study, Tashkin effectively treated bronchospasm with cannabis containing two percent THC, which is one eighth as potent as today’s average medical cannabis. The study supports the idea that small micro doses of THC are all that’s required to dilate the airways. Later studies put the optimal inhaled dose of THC at a tiny 200 mcg. That would seem to show that very small doses of high-THC cannabis may be the optimal approach. Cannabis strains that contain bronchodilatory terpenes such as pinene, may also be of value. Recent preclinical research supports the anti-inflammatory effects of CBD in asthma, so combining THC and CBD would likely be a more effective approach. Usually, a large anti-inflammatory response with CBD is noted at around 15 mg. Because cannabis is a known allergen, care should be observed to avoid symptoms of asthma caused by cannabis exposure. 
Oral cannabis tinctures may take too long to work for acute asthma attacks due to the amount of time it takes for the medicine to metabolise in that form (roughly 30 to 60 minutes). A sublingual dose may prove more effective; by using a dropper under the tongue.
Great care must be taken with smoked cannabis due to the fact that some people react to the smoke and vapor with bronchospasms. Begin with a micro dose level of inhalation when stable, before a bronchospasm, to determine how it may be tolerated. It is important to utilize very clean cannabis with low microbial and mold/yeast counts, since these pathogens can irritate the airways or cause secondary lung infections.
High-THC weed varieties high in the terpene pinene are recommended to treat asthma symptoms, due to pinene’s nature as a bronchodilator. Strains high in cannabidiol (CBD) are typically dominant in the terpene myrcene, however with so many varieties available today, you can likely find a strain or two that have been engineered to contain pinene. Type II CBD:THC vartities with terpene profiles that express high levels of pinene are available. Blue Dream is one of the strains most widely available that is high in pinene, though it still contains considerable levels of myrcene. Other myrcene strains that contain pinene include Purple Urkle and Grape Ape. Varieties such as Pinene Kush, that are pinene-dominant, may also be of value. For more information, read our Ultimate Guide To Terpenes.
Generally speaking, cannabis or CBD edibles can help with asthma due to their nature to work over a longer time period than smoking does, and due to the fact they don't need to be inhaled. Although, as mentioned earlier, one needs to exercise caution when using any cannabis product with asthma.
Shortness of breath may be experienced when someone has consumed too much THC from marijuana or cannabis strains high in THC, resulting in side effects such as anxiety, panic attacks, hallucinations, rapid heart rate, or difficulty breathing. This is why starting low and slow is very important when using cannabis products, especially in first time users.
Edibles can produce a stronger effect and hit harder partly due to the fact they're processed by the digestive system and not the lungs, such as in smoking cannabis. Because they're metabolized differently, not only do the effects last longer in the body, they can also be more potent.
Most pulmonary experts would agree that vaping e-cigarettes that are free from tobacco may be less toxic than more traditional forms of smoking, however that doesn't mean that vaping is an entirely safe, toxin-free alternative to smoking. In fact, it comes with it's own serious long-term health consequences.
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