Nov
28
2021

Marijuana and Uncontrolled Vomiting

Marijuana was considered safe in the past, but now marijuana and uncontrolled vomiting suddenly make the news. Recently there also were reports of marijuana causing heart attacks and schizophrenia.

Abdominal pain with cannabis hyperemesis syndrome

Cannabis hyperemesis syndrome or cannabinoid hyperemesis syndrome (CHS) is a relatively new disease entity. It occurs in people who use marijuana daily for several years. But people affected by this condition often do not realize that it is an overdose of marijuana that brings on the nausea and vomiting of CHS. When they started marijuana use, they may have used intermittent doses of marijuana to treat nausea and vomiting. In intermittent doses marijuana may have been helpful, however constant use is a different story! During several years of use of marijuana, patients never had abdominal pains or vomiting, until one day CHS started.

Possible mechanisms regarding marijuana and uncontrolled vomiting

The body has its own endocannabinoid system with cannabinoid receptors that are distributed throughout the body. There are two cannabinoid receptors, CB1 and CB2. In the central nervous system, there are mainly CB1 receptors, in the rest of the body CB2. It appears that stimulation with intermittent small doses of marijuana suppresses nausea and vomiting in the hypothalamus area. However, constant stimulation of CB2 receptors in the gut with higher doses of marijuana are the cause of CHS. When a person develops cannabis hyperemesis syndrome, the only permanent cure is to stop marijuana use completely. This eliminates the CB2 receptor stimulation and allows the body to heal the gut. Researcher believe that Tetrahydrocannabinol, or THC is more powerful than the endocannabinoids. THC overwhelms the CB1 and CB2 receptors. When people who were cured of CHS restarted marijuana, their symptoms of nausea and abdominal pain returned.

In some people hot bath and hot showers help uncontrolled vomiting

Researchers noted that people reported how sometimes having a hot shower or a hot bath stopped the vomiting. The hypothalamus controls both body temperature and vomiting. A hot bath may send a signal to the hypothalamus, which interrupts the vomiting for a period of time. But with continued use of marijuana the vomiting reoccurs.

Increased strength of marihuana preparations

Dr. Wang, an associate professor of pediatrics at the University of Colorado Anschutz Medical Campus in Aurora, Colorado noted: “It’s been well documented that the amount of THC that now comes in cannabis is increasing substantially. In the ’90s the average was like 4% or 5%. Now in Colorado, it’s anywhere from 15% to 20%.” This means that THC causes more and more toxicity in patients.

In Colorado medical marijuana was legal since 2009 and recreational marijuana was legal since 2014. Dr. Wang researched the cannabis hyperemesis syndrome in Colorado. He found over 800,000 cases of vomiting in Colorado between 2013 and 2018. This was an increase of 29% from the time before marijuana became legal.

Symptoms of cannabis hyperemesis syndrome

The 5 most common symptoms of cannabis hyperemesis syndrome are continuous nausea, repeated vomiting, abdominal pain, weight loss because of decreased food intake and dehydration from fluid loss. Many people have several showers a day because it diminishes their nausea.

Three phases of cannabis hyperemesis syndrome

The cannabis hyperemesis syndrome often presents in 3 stages: the prodromal phase, the hyper emetic phase, and the recovery phase.

During the prodromal phase symptoms consist of nausea and abdominal pain early in the morning. The eating pattern is still normal in this phase. Some people increase their marijuana consumption as they hope to treat the nausea this way. This phase can last for months or years.

During the hyper emetic phase all of the 5 symptoms mentioned above can occur. This phase often continues until the patient gives up all marijuana consumption. This is when the recovery phase starts.

In the recovery phase the patient returns to a normal eating pattern. All of the symptoms gradually disappear. This phase lasts between days to months. But if the patient starts marijuana again, the symptoms return very quickly.

Treatment of cannabis hyperemesis syndrome

Patients who have severe vomiting require treatment in a hospital. The doctor starts intravenous fluids to treat dehydration. Some medicine to stop vomiting helps in the beginning. The physician must convince the patient to completely stop marijuana use, which helps to treat nausea and abdominal pain. Antacid medication like proton-pump inhibitors is useful to treat stomach lining inflammation. Frequent hot showers help to tone down nausea and vomiting. Hot showers seem to work via the hypothalamic brain center, which is responsible both for nausea/vomiting and heat perception. The physician may prescribe small amounts of benzodiazepams to treat anxiety.

By avoiding marijuana in any form THC, which is a powerful stimulus for CB1 and CB2 receptors gets washed out of the system. This allows the endocannabinoid system to rebalance itself. As long as the patient stays away from marijuana there is usually a complete recovery.

Marijuana and Uncontrolled Vomiting

Marijuana and Uncontrolled Vomiting

Conclusion

Since marijuana is legal in many jurisdictions the cannabis hyperemesis syndrome (CHS) occurs more and more often. Emergency teams at hospitals are kept busy treating these types of patients. It appears that CHS develops in patients who use marijuana regularly and use it in higher concentrations. Nausea and vomiting are the most common symptoms. Some patients can cope for a period of time by taking frequent hot showers. But eventually this home remedy does no longer work. A brief hospital stay may help the patient to recover from this syndrome. The patient needs to stay away from marijuana products to recover from CHS completely, otherwise there will be a relapse.

Oct
16
2021

Marijuana Causes Schizophrenia and Heart Attacks

Two new studies showed that marijuana causes schizophrenia and heart stacks. Marijuana use has been increasing significantly in the general population since the 1990’s. Initially many believed that marijuana would be harmless. But increasingly there are medical publications showing the opposite.

In the following I present data how the use of marijuana causes these two documented side effects, heart attacks and schizophrenia.

Schizophrenia increased since the 1990’s

A July 21, 2021 study from Denmark included all people of Denmark who were older than age 16 from January 1, 1972 to Dec. 31, 2016. The number of participants were 3 ,595 ,910 women (50.0%) and 3 ,590 ,924 men (50.0%). The total number of individuals in the study were 7,186 ,834.

Here are the figures of the percentages of cannabis related schizophrenia cases in Denmark according to the study:

  • 1995: 2% of all schizophrenia cases related to cannabis use in Denmark
  • 2000: 4% of schizophrenia cases due to cannabis use
  • 2010: 8% of all schizophrenia cases from cannabis use

The researchers found that the risk of coming down with schizophrenia heightens with increased cannabis use. Heavy users are more likely to develop schizophrenia than light users.

Cannabis use disorder

One subgroup of cannabis users are people with a cannabis use disorder. They use cannabis, but they become tolerant to it. This requires a higher dose of cannabis to achieve satisfaction. But they are unable to reduce cannabis. They spend more and more time to obtain cannabis, use it and recover from the effect. They give up other activities in favor or cannabis and they continue the use despite negative consequences. Researchers found that this group of individuals had the highest risk to develop schizophrenia. The authors of the Danish study found that patients with cannabis use disorder over the past 2 decades have increased their risk for developing schizophrenia by 3- to 4-fold. They feel it is because of the increase in use and the increase in potency of cannabis.

Heart attacks increased with cannabis use

A Canadian study assessed a cross-sectional study of 2017 and 2018.

The study in question was the American Behavioral Risk Factor Surveillance System survey of US adults. The authors zeroed into young adults (aged 18–44 yr.) with recent cannabis use and a history of a heart attack. Among 33,173 young adults there were 4,610 respondents with recent cannabis use (17.5%). 61 respondents among the recent cannabis users reported that they had a heart attack, which is 1.2%. In comparison non-cannabis users had a heart attack rate of only 0.8%. The adjusted odds ratio for cannabis users compared to non-users was 2.07. This means that the probability of getting a heart attack when using cannabis was 2.07-fold higher when compared to non-users. Also, the investigators found that a history of a heart attack had a probability of being due to cannabis use with a probability of 2.31-fold.

Cannabinoid receptors

Researchers found endogenous cannabinoids in the brain that function as messenger molecules. They need to activate their targets, the cannabinoid receptors, called CB1 and CB2. CB1 receptors are found mainly in the central nervous system. CB2 receptors are located mainly in the immune system. Reproductive organs have their own cannabinoid receptors. The lining of the uterus contains only CB1 receptors. Ovaries and testicles both use CB1 and CB2 receptors. Tetrahydrocannabinol (THC) from smoking or ingesting marijuana is the main psychoactive compound in cannabis. It stimulates these cannabinoid receptors also. But compared to the body’s own cannabinoids THC is much stronger. This leads to more pronounced effects that concern many physicians.

The overwhelming response of the cannabinoid receptors to THC leads to a blunting of the signals of the body’s own cannabinoids. This causes a breakdown in communication between neurons and body cells.

Marijuana Causes Schizophrenia and Heart Attacks

Marijuana Causes Schizophrenia and Heart Attacks

Conclusion re. marijuana causes schizophrenia and heart attacks

Legislators in Canada and many of the states in the US legalized the use of marijuana. As a result, the cannabis use in the younger age group of adults (between 18 to 44 years) has increased significantly. This means that more and more people are exposed to THC from cannabis, which overstimulates the body’s own endocannabinoid system. As explained this leads to a breakdown of communication between neurons and body cells. In time diseases like heart attacks and schizophrenia can develop, a fact overlooked by the media and the public. The overuse of marijuana leads to more than a 2-fold risk to get a heart attack and a 3- to 4-fold risk of coming down with schizophrenia. These are the facts right now. But with further increased use of cannabis researchers will likely find many other diseases that THC can trigger.

Dec
14
2019

When Natural Substances Turn Into Poison

Although people increased the use of brain stimulating substances in the last 17 years, nobody paid attention to the situation, when natural substances turn into poison. The Center for Injury Research and Policy and the Ohio State University College of Medicine, both in Columbus, OH conducted a study. The researchers looked at the use of natural substances from 2000 to 2017. They noted that during this time marijuana had increased by 150% and there was a 64% increase of nutmeg use. Nutmeg contains the hallucinogenic substance myristicin, a potent mind-altering substance. There was a 4949% increase of kratom use, which comes from the leaves of a South American tree which have powerful mind-altering substances. The original study of the researchers was published here.

More hallucinogenic substances

Other natural substances came from Jimson weed, where the leaves and seeds contain natural substances that cause hallucinations and euphoria. It contains the chemicals atropine, hyoscyamine, and scopolamine. These interfere with the normal messenger molecule acetylcholine in the brain and in nerves. 21% of all toxic reactions between 2000 and 2107 were due to Jimson weed. Besides those, 16% of all toxic reactions came from magic mushrooms. There are other natural substances which are similar. They come from a shrub that grows in East Africa and southern Arabia. Khat contains the alkaloid cathinone, which is a stimulant. It causes excitement, loss of appetite, and euphoria.

More details about the different natural substances and their actions

Marijuana

Marijuana includes dried leaves, the stem, seeds and flowers of the Cannabis sativa or Cannabis indica plant. The mind-altering THC compounds are what people are seeking out. When a person smokes marijuana, the THC enters the blood through the lungs. The THC reaches the brain and causes a “high”. This can be associated with seeing brighter colors, get an altered sense of time, have hallucinations, delusions and in severe cases a psychosis. Marijuana peaks at different times depending on whether it is smoked or taken in as an edible. When smoked, the effect of marijuana is felt by the user within a few minutes. Ingested as edibles will take 30 minutes to one hour to show an effect, but it lasts a lot longer (3 to 4 hours). This is important to know, particularly if other agents including alcohol are combined with marijuana.

Nutmeg

Nutmeg is used in small amounts as a spice, typically ¼ to ½ teaspoon in a family dinner. However, when a person consumes 2 teaspoons or more of nutmeg, such as more than 10 mg, toxic symptoms occur. Symptoms from myristicin, the active substance in nutmeg, can be hallucinations, dizziness, confusion and seizures.

Kratom

Kratom is a tropical tree (Mitragyna speciosa), which is native in Southeast Asia. The leaves contain mind-altering compounds. At this time kratom is freely available on the Internet. There is no restriction in the US. But there are health concerns. Kratom has both opioid and stimulant effects on the brain. It produces sensations of pleasure, sedation and decreased pain. In small amounts people experience increased energy, sociability and alertness. There are a number of side effects: nausea, sweating, itchiness, dry mouth, increased urination, constipation, loss of appetite, hallucination and seizures. Kratom caused 8 of the 42 deaths reported by the Ohio State University College of Medicine, Columbus, OH study.

Jimson weed

The leaves and the seeds of Jimson weed are used by drug-seeking individuals. It causes hallucinations and euphoria, a heightened sense of well-being. It contains the chemicals atropine, hyoscyamine, and scopolamine. These interfere with acetylcholine, one of the major hormones in the brain and nerves. 15-100 grams of leaf and 15-25 grams of the seeds can be lethal. Children are more sensitive, so the lethal dose is much smaller for them. Jimson weed slows down the stomach emptying and also the activities of the large intestine leading to severe constipation. It can cause glaucoma and also rapid heartbeat. Urinary retention is also common.

Khat

Khat is a drug found in the wild East African shrub called Catha edulis. It contains a central nervous system stimulant, called cathinone. People living on the Arabian Peninsula are chewing the leaves of this plant. It is illegal in Canada and the US. In Ethiopia 30% of adolescent girls and 70% of the adolescent boys chew khat. The effect of khat is similar to the effect of a strong coffee. It has a stimulant effect like the coca plant that is used to make cocaine. It increases respirations, elevates blood pressure and leads to gum disease. This results in tooth decay. Ulcers and constipation occur more often. People on khat become more talkative, elated and euphoric. Some say that they have more imagination and are able to associate things better. From a medical point of view Khat causes constipation, hemorrhoids and impotence. Other symptoms are blurred vision, headaches and dizziness.

Kava kava

Piper methysticum, a plant native to the western Pacific Islands is from which kava kava is made. Kava kava relaxes you, but it has caused liver damage and is even responsible for a few deaths. It has been banned from many European countries and Canada. It is still available in the US. Some people take kava kava for sleeping problems, anxiety and restlessness. There are many more claims that kava kava is effective for other diseases, but research could not confirm those claims. Kava kava is detoxified in the liver, but in doing so there are profound interactions with other drugs that get detoxified in the liver. This liver toxicity has led to irreversible liver damage requiring a liver transplant. Several people have died because of liver failure.

Magic mushroom

Wild mushrooms, namely magic mushrooms that contain psilocybin are a popular way to get a high. Psilocybin is psychoactive and hallucinogenic. Psilocybin is classified as a Schedule I drug in the US, meaning that it is highly addictive, but has no currently accepted medical use for treating any medical condition. Magic mushrooms cause nausea, yawning, drowsiness, nervousness, panic, paranoia, hallucinations and psychosis.

Toxic side effects of natural substances reported to Poison Control

There were 67,369 calls to poison control centers in the United States between January 1, 2000 and December 31, 2017 regarding natural substances. This is when natural substances turn into poison. There were 41.4% from calls regarding older than 19-year-old individuals. 34.8% of calls to the poison control center was regarding the age group between 13- and 19-year olds. 46.9% of cases were due to marijuana, 21.1% of the calls to the poison control centers were due to anticholinergic plants, 15.6% were due to hallucinogenic mushrooms. In the age group of 3-19 years 47.8% called because of marihuana overdoses. Above the age of 19 it was 53.0% who overdosed on marijuana. In children less than 6 years of age 44.4% of toxic overdoses came from anticholinergic plants.

Deaths reported in the study

The study reported 42 deaths from 2000 to 2017. 8 deaths were due to kratom. 7 deaths among the 42 deaths occurred in people under the age of 18. 5 of the 42 deaths occurred in teenagers aged 13 to 19. Two of the deaths occurred in children under the age of 12. These were due to marijuana.   

Discussion

When reviewing the research of natural substances with the potential to cause addiction, it is important to see things in the right perspective.

Natural substances can be poisonous for you

Many people think that a natural substance, like a leaf from nature, should be trustworthy. But it is the chemicals that people swallow, inhale or chew that matter. Opium also comes from a “harmless” poppy seed. But opium is a powerful and addictive substance. All of the natural substances reviewed above contain potent mind-altering agents. This means that the natural substances are not safe.

Using SPECT scan to measure brain activity

None of the above-mentioned natural substances are harmless. They all attack the brain and interfere with the action of the natural brain hormones in the brain. This may be reversible for a few weeks, but eventually it leads to a chemical burn with permanent damage to the brain. This is when natural substances turn into poison. Dr. Daniel Amen, a psychiatrist has developed a scan that will depict changes in the brain in addicted persons. It is called the Single Photon Emission Computed Tomography or SPECT scan. This nuclear medicine scan measures blood circulation of the brain and brain activity. With prolonged use all of the natural substances show a decreased brain activity pattern on the SPECT scan.

Missing toxicity studies about natural substances

Armed with the SPECT scan as a tool and the knowledge that all of the reviewed “natural” substances have toxic effects on the brain makes one wonder how US citizens could willingly consume these substances for the past 17 years. It was probably a mix of curiosity, peer pressure and the fact that these natural substances were readily available, which made many people try them. There is very little research about toxicity in this field. This is only starting now. To my way of thinking this is another warning sign that people should stop their love-affair with mind-altering natural substances.

When Natural Substances Turn Into Poison

When Natural Substances Turn Into Poison

Conclusion

I have reviewed the thorny issue of natural substances and how they can turn into poisons. All of the substances reviewed affect brain function. This is why people experience hallucinations, elations and euphoria. But this is not real. It is due to the toxic effect of chemicals on the brain.Advertisements promote kava kava as a relaxing substance. But it can damage the liver and as a result several people have died. It is unknown to a large extent how these natural substances interact with other illicit drugs or with alcohol.

It is best to avoid consuming any of these natural substances. Anybody who consumes them is knowingly consuming a poison, and it means that the user will get into health problems…naturally!

Oct
19
2019

How Marijuana Affects Your Reproductive Health

The latest edition of the British Columbia Medical Journal contains an article on how marijuana affects your reproductive health.

Dr. Dunne is an assistant professor in the Department of Obstetrics and Gynecology at the University of British Columbia. She is the author of the linked review above.

Products of the Cannabis sativa plant like marijuana and hashish are most popular in North America. Since October 2018 smoking recreational marijuana is legal in Canada.

The medical community has some concerns, as we do not fully know the long-term effects of smoking marijuana. In the following I will summarize the effects on the male and female reproduction based on Dr. Caitlin Dunne’s report.

Consumption of marijuana

Marijuana contains over 500 compounds, of which 100 are cannabinoids. The ingredient that produces the high a user gets is due to tetrahydrocannabinol (THC). Cannabis is available in different forms. It can be smoked (raw leaves or extract), but it can also be converted into edibles. Ingestion of cannabis creates a longer-lasting experience. The reason for this is that the liver metabolizes cannabis into more psychoactive forms by the liver enzyme, cytochrome P-450. Smoking marijuana can irritate the airways; oral consumption of cannabis products can lead to vomiting, nausea and disorientation.

Contaminants in cannabis such as pesticides, microbial toxins and metals can also be harmful to recreational marijuana users.

Endocannabinoid system

Researchers found endogenous cannabinoids in the brain that function as messenger molecules. They need to activate their targets, the cannabinoid receptors, called CB1 and CB2. CB1 receptors are found mainly in the central nervous system. CB2 receptors are located mainly in the immune system. Reproductive organs have their own cannabinoid receptors. The lining of the uterus contains only CB1 receptors. Ovaries and testicles both use CB1 and CB2 receptors. THC from smoking or ingesting marijuana can stimulate these cannabinoid receptors also. But compared to the body’s own cannabinoids THC is much stronger. This leads to more pronounced effects that concern many physicians.

How marijuana affects your reproductive health: female fertility

The normal functioning of the body requires that the hypothalamus send gonadotropin-releasing hormone (GnRH) to the pituitary to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). The FSH release happens mainly in the first two weeks of the menstrual cycle. LH is released in the 3rd and 4th week of the menstrual cycle. Only when the female hormone rhythm works can a follicle in the ovary mature and ovulate normally. After ovulation the corpus luteum needs further LH stimulation to start prednisone production, which helps with embryo implantation and with sustaining the pregnancy.

THC from cannabis consumption interferes at all the levels of these hormone actions. Cannabinoids suppress GnRH, FSH and LH release.

This is the reason why moderate to heavy users of marijuana have infertility problems. If a woman is a moderate to heavy consumer of marijuana she cannot ovulate normally, and hence she has difficulties getting pregnant.

How marijuana affects your reproductive health: pregnancy

THC from cannabis use can cross the placental barrier. Levels in cord blood are three to six times lower than the mother’ blood level, as the placenta attempts to detoxify THC.

Prenatal exposure to cannabis can interfere with fetal growth and alter neurodevelopment. These children can have permanent effects regarding academic achievement and intellectual capacity. Other risks are hyperactivity, attention-deficit disorder, and impulsivity, but also future substance abuse.

CB1 receptors seem to regulate mitochondria, the energy packages of cells and cellular adenyl cyclase.

The end results are mitochondrial dysfunction and oxidative stress.

Clinical studies regarding cannabis use in pregnancy

Recently a BC study followed 243,140 pregnant women. Over an 8-year period cannabis use rose from 2.2% to 3.3%. Closer analysis of the pregnant cannabis group showed an increased risk of poor perinatal outcomes. 47% had smaller babies than expected (“small for gestational age” is the medical term). 27% were born prematurely, there was a risk of 2.4-fold that the baby died in the womb (“intrapartum stillbirth”). Women who used cannabis often used other illicit drugs as well. They also often had a history of mental illness. The authors relied on self-reporting, which means the cannabis use likely was underreported.

An American study

An American study from 2016 identified 7,851 pregnant patients who used cannabis. Like the BC study they showed a low-birth weight and preterm deliveries. But when the authors controlled for confounding factors, namely mainly tobacco use, statistical significance disappeared.

Often marijuana users are also tobacco users. Tobacco has long been proven to lead to prematurely born babies and babies that are too small for their age. The BC study had controlled for tobacco use and thee results were only due to smoking or consuming marijuana.

How marijuana affects your reproductive health: male fertility

Males on cannabis also contribute to infertility of the couple. The hypothalamic/pituitary/testicle hormone axis needs to also be intact for proper sperm cell maturation to take place. In medical language sperm cells are spermatozoa. The hypothalamus generated gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to release FSH and LH. LH stimulates testosterone production in the Leydig cells of the testicles. FSH stimulates spermatogenesis (production of sperm cells) from the so-called Sertoli cells. Testosterone, along with FSH provides a stimulatory effect on spermatogenesis. Whenever a system is that complicated, much can go wrong. Sperm cells contain both CB1 and CB2 receptors. When the man uses marijuana regularly, THC exposure can significantly interfere with CB1 and CB2 receptors.

Effects of THC on sperm motility, sperm concentrations and DNA

This leads to sperm cell mobility reduction. In an experiment where THC was added to sperm from 78 men in vitro (Petri dishes) researchers simulated high marijuana users and moderate marijuana users.

They found that lower THC concentrations caused 28% sperm motility reduction, high TCH caused 56% sperm motility reduction. Many other publications exist that documented similar results and correlated these findings with infertility of couples.

Studies on sperm cell motility and marijuana use are inconsistent. In 2019 a study came out from the Chan Scholl of Public Health where researchers analyzed 1143 semen samples and 317 blood samples.

They found no difference in terms of findings among men who smoked marijuana versus men who never smoked Marijuana. They looked at sperm concentrations, DNA aberrations of sperm cells.

This leaves many questions open regarding marijuana toxicity.

How Marijuana Affects Your Reproductive Health

How Marijuana Affects Your Reproductive Health

Conclusion

Marijuana affects the reproductive organs, but it is easier to document in women than in men. In women marijuana has an effect on fertility and on pregnancy, which is measurable. However, in men the results of investigations have been conflicting. Here is a statement of the Society of Obstetricians and Gynecologists of Canada. They believe “there is sufficient evidence of harm to advise women to avoid cannabis when pregnant”. Use of marijuana is also not advisable for women who are breastfeeding. At this point a similar clear suggestion regarding reproductive health cannot be made to men, but the in vitro study with TCH suggests that it is wise to refrain from marijuana when a man tries to father a child. Further studies will likely clarify these outlines.