High and dry: what causes cannabis cottonmouth and how to treat it?

One bad thing about consuming weed is the uncomfortable feeling of swallowing a couple of cotton balls. Cottonmouth, or a Sahara-like dry mouth and throat after consuming cannabis, is one of the strangest side effects of weed. If it strikes, all bets are off – you may find yourself gulping back water like a devil and chewing gum to get the salivating going again.

So what is it about weed that dries up your mouth and dries up your throat? And how do you ward off a cottonmouth when it strikes, or better yet, avoid it altogether?

What is cannabis cottonmouth?

Cannabis cottonmouth, or as it’s officially known, xerostomia, is when the mouth and throat dry out after consuming cannabis. When xerostomia sets in, saliva production in the mouth decreases and with less natural lubricant in the mouth, speaking and swallowing becomes more difficult. Xerostomia can develop when we consume cannabis, but it can also be triggered by aging, certain medications, or even dehydration. The term “xerostomia” refers to a symptom or sensation rather than a specific medical condition.

If you consume a lot of cannabis and then go to bed, you might even have the unforgettable experience of waking up coughing and gagging, with the feeling that your salivary glands have disappeared (write here from personal experience). Most smokers have experienced the condition at some point.

Despite the somewhat entertaining name, the Cottonmouth experience is no laughing matter. The predominant symptoms are insatiable thirst; a noticeably dry mouth, throat, and tongue; difficulty chewing, swallowing, or speaking; and chapped lips.

Additionally, feeling thirsty with a dry mouth like sawdust is also far from ideal for optimal oral health. Saliva acts as a natural cleanser for our mouth. So when it subsides, there is a greater chance for bacteria to multiply. With some cannabis delivery methods, cottonmouth can last a long time.

“Cottonmouth typically occurs during the peak effect of cannabis use and can last for several hours depending on the amount of cannabis a user ingests,” said Ethan Pompeo, founder and CEO of Green Valley Nutrition.

Since the time of onset of effects varies depending on the method of administration, cannabis smokers typically experience cottonmouth within 30 minutes to an hour, while edibles-induced cottonmouth may take an hour or more to occur but can last much longer.

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What Causes Cannabis Cottonmouth?

There is a common misconception that cottonmouth is caused by weed smoke, which dries out the mucous membranes and throat. However, all forms of cannabis use can cause cottonmouth.

“Smoking, vaping, edibles, and tinctures all activate the same cannabinoid receptors that reduce saliva production,” Pompeo said. When it comes to identifying a culprit, there is compelling evidence from animal studies that THC is an important contributor due to its effects on CB1 receptors. CB1 receptors are one of the two main endocannabinoid receptors in the human body that THC interacts with. THC binds to CB1 receptors located in different parts of our body and triggers effects like euphoria, relaxation and pain relief. There are CB1 receptors in our salivary glands, which is why THC can affect saliva production.

“The theory is that having THC on board inhibits salivation in a dose-dependent manner – so the more THC, the less salivation,” said Dr. Benjamin Caplan, MD, Founder and Chief Medical Officer of the IBD Clinic and IBD Foundation. “THC hits CB1 receptors in the brain to feel good, but it also hits comparable CB1 receptors in the salivary glands, effectively causing them to relax and stop smearing as regularly and consistently.”

As a result, the nervous system reduces saliva production and hey, your mouth is as dry as a desert. THC can also reduce moisture elsewhere in the body, drying out the eyes and inhibiting the ability to tear.

According to Caplan, the drying effects of THC are similar to tolerance. Experienced cannabis lovers may not experience the same level of throat-choking dryness as newcomers. “Just as some people stop feeling high with heavy cannabis use over time, dry mouth and dry eye symptoms also appear to decrease.”

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Is Cottonmouth Bad For Your Health?

There is no immediate danger associated with a dry mouth or throat. In the short term, it’s just uncomfortable.

However, problems can arise in the long term. “Cottonmouth can be very uncomfortable and trigger a gag reflex if left untreated or treated,” Pompeo said.

Frequent dry mouth can also lead to oral health problems. Saliva plays a crucial role in oral health by protecting the teeth and mouth from colonizing bacteria. When saliva production is interrupted for a long time, plaque can build up, which can lead to tooth decay, gum disease, oral infections such as candidiasis, and halitosis (bad breath).

Research shows that 70% of people who suffer from xerostomia regularly have tooth decay in at least one spot, compared to 56% of those who do not have dry mouth. Essentially, the evidence suggests that the more frequently the mouth is dry, the greater the likelihood of developing oral health problems.

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Tips on how to prevent and treat cannabis cottonmouth

If you want to avoid cottonmouth entirely, the only surefire way is to avoid THC. But for those who love THC-rich products, that might not be an option, so the next best choice is to use the cannabinoid mindfully.

“If you must consume THC, be careful not to overdo it,” Pompeo said. “Remember that the duration and intensity of the effects depend on the amount of THC ingested.”

Caplan pointed out that CBD can also help suppress the drying effects of THC. “Studies show that CBD can counteract the effects of THC, and these studies are supported by clinical experience,” Caplan said.

To relieve dryness when it occurs, staying hydrated is helpful, and water is best.

“You can also treat cottonmouth symptoms with saliva-stimulating products like sugar-free candy, unsweetened beverages, or chewing gum,” Pompeo said. “Drinking herbal tea and honey can reduce sore throat and sensitivity.”

It is recommended to minimize consumption of sugar, caffeine and alcohol as these substances can also dehydrate the body. Caplan advises regular cannabis users to visit their dentist and brush their teeth frequently.

And if all else fails, here’s a fun suggestion from a Reddit user:

“For years my wife has rang a bell just before she feeds me, so now when a bell is rung I start drooling, even if there’s nothing to eat. Works great for cotton mouth. Get high and ring a bell = instant mouth sloosh.”

Emma Stone

Emma Stone is a New Zealand-based journalist specializing in cannabis, health and well-being. She has a Ph.D. in sociology and has worked as a researcher and lecturer, but prefers to be a writer. She would enjoy spending her days writing, reading, walking outdoors, eating, and swimming.

Check out Emma Stone’s articles

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