High and dry: What causes cannabis cottonmouth and how do you treat it?

One bad thing about partaking in weed is the unwelcome sensation of feeling like you’ve swallowed a bunch of cotton balls. Cottonmouth, or having a mouth and throat as dry as the Sahara Desert after consuming cannabis, is one of the odder side effects of weed. When it strikes, all bets are off—you may find yourself chugging back water and chewing gum like a fiend to get saliva flowing again.

So what is it about weed that dries out the mouth and parches the throat? And how can you stave off cottonmouth when it hits, or even better, avoid it altogether?

Cannabis cottonmouth, or as it’s officially known, xerostomia, is when the mouth and throat dry out after cannabis use. When xerostomia sets in, saliva production in the mouth decreases, and with less natural lubricant in the mouth, talking and swallowing become more challenging. Xerostomia can arise 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 bunch of cannabis and then go to bed, you may even have the unforgettable experience of waking up coughing and gagging, with the feeling that your salivary glands have vanished (writing from first-hand experience here). Most smokers have experienced the condition at some point.

Despite the somewhat entertaining name, the experience of cottonmouth isn’t a laughing matter. The predominant symptoms include unquenchable thirst; a noticeably dry mouth, throat, and tongue; difficulty chewing, swallowing, or speaking; and cracked lips.

What’s more, feeling thirsty with a mouth as dry as sawdust is also less than ideal for optimal oral health. Saliva functions as a natural cleanser for our mouths, so when it wanes, there’s a greater opportunity for bacteria to proliferate. In the case of some cannabis delivery methods, cottonmouth can linger for a long time.

“Cottonmouth typically occurs during the peak effects 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 onset time of effects varies based on the delivery method, cannabis smokers will typically experience cottonmouth within 30 minutes to an hour, whereas cottonmouth caused by edibles may not kick in for an hour or more, but may last much longer.

There’s a common misconception that cottonmouth is caused by weed smoke drying out the mucus membranes and throat. However, all forms of cannabis consumption can cause cottonmouth.

“Smoking, vaping, edibles, and tinctures all activate the same cannabinoid receptors which reduce saliva production,” said Pompeo. When it comes to identifying a culprit, there’s convincing evidence from animal studies that THC is a major factor due to its effects on CB1 receptors. CB1 receptors are one of the two major endocannabinoid receptors in the human body with which THC interacts. THC binds with CB1 receptors located in different parts of our body, kicking off effects such as 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 with THC on board, salivation is inhibited in a dose-dependent manner—so the more THC, the less salivation,” said Dr. Benjamin Caplan, MD, Founder and Chief Medical Officer of CED Clinic and CED Foundation. “THC hits CB1 receptors in the brain to feel nice, but it also hits comparable CB1 receptors in the salivary glands, effectively causing them to chill out and stop lubricating as regularly and consistently.”

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

According to Caplan, the drying effects of THC are similar to tolerance. Seasoned cannabis aficionados might not experience the same level of throat-choking dryness as newbs. “Just as some people stop feeling high as they consume a lot of cannabis over time, similarly, the symptoms of dry mouth and dry eyes also seem to wane.”

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

However, over the long term, issues may arise. “Cottonmouth can be very uncomfortable and can initiate a gag reflex if not treated or managed,” said Pompeo.

Having a dry mouth frequently can also provoke oral health issues. Saliva plays a critical role in oral health by protecting the teeth and mouth from bacteria setting up camp. When saliva production is interrupted for long periods, plaque can build up, leading to tooth decay, gum disease, oral infections such as candidiasis, and halitosis (bad breath).

Research shows that 70% of people who experience xerostomia regularly have tooth decay in at least one place compared with 56% of those who don’t experience dry mouth. Essentially, the evidence suggests that the more frequently the mouth is dry, the greater the likelihood of developing oral health issues.

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

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

Caplan pointed out that CBD may also help subdue the drying effects of THC. “Studies show that CBD can counteract the effect of THC, and these studies are confirmed by experience in the clinic,” said Caplan.

To help alleviate dryness if it hits, plentiful hydration is helpful, and water is best.

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

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

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

“For years my wife has rung a bell just before she feeds me, so now whenever a bell is rung, I start to salivate even if there is no food there. Works great for cotton mouth. Get high and ring a bell = instant Mouth Sploosh.”

Emma Stone is a journalist based in New Zealand specializing in cannabis, health, and well-being. She has a Ph.D. in sociology and has worked as a researcher and lecturer, but loves being a writer most of all. She would happily spend her days writing, reading, wandering outdoors, eating and swimming.