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Weed Turns Some Users Green in the Gills

“Weed is really amazing for a ton of people, but really dangerous for some,” Kristen Mort says. Her 18-year old son was hospitalized earlier this year for a condition called “cannabinoid hyperemesis syndrome” after she says he had writhing convulsions, excruciating abdominal pain and nonstop vomiting. 

While not all patients develop the condition so severely — Mort says her son experienced metabolic acidosis, and was going into kidney failure from the vomiting — Dr. Hans Notenboom, medical director for emergency medicine for PeaceHealth Sacred Heart Medical Center, says the marijuana-induced vomiting syndrome is treated frequently in the ER.

Notenboom points out that thousands of people in the community smoke pot with no vomiting, and the ER doesn’t care if you smoke pot or not. But if you do partake, then telling your doctor will aid in diagnosis. 

The doctor says that most people who come in with the cyclical vomiting are easily treated, but the diagnosis is trial and error, and for frequent smokers, many of whom use marijuana to control nausea, the fact that weed is the cause of their problem is not what they want to hear.

For Mort’s son, who requested not to be named as  he is under legal age for smoking pot in Oregon, that was a part of the issue. 

He was using pot to control anxiety and, after more than a year of frequent use, began to experience nausea, then used marijuana to control the nausea. He began to lose weight and soon found he could only eat if he smoked, he tells EW

A 2011 study on the National Institutes of Health website, says that “despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and central nervous system” and calls cannabinoid hyperemesis a “plausible diagnosis” in patients with “recurrent intractable vomiting and strong history of cannabis abuse.”

Mort says tests done at Genelex in Seattle revealed that her son lacked the enzymes needed to process the THC in the marijuana over time. 

She says after he became sick, a gastroenterologist asked her son about his pot smoking, but cannabinoid hyperemesis was at first ruled out because one of the treatments — taking a hot shower — had no effect on the symptoms. Notenboom says hot showers alleviate the vomiting in many patients. 

Notenboom says the condition can be hard to diagnose, and diagnosis is usually done through a primary care provider and not in the ER itself. Not all cases are textbook in their presentation and the cause has to be ruled out over time. Other cyclical vomiting syndromes can be food allergy related or one theory is that they can be caused by abdominal migraines, he says.

Mort’s son, who is a glassblower, says when he has tried to talk about his experience people were resistant to the idea that marijuana could cause any medical issues.

But in response to those who say cannabinoid hyperemesis syndrome is a conspiracy theory dreamed up by Big Pharma to attack legal weed, Notenboom says that’s not what the ER is about. “We are the frontline trying to help people out in the acute phase,” he says. 

He says it’s hard to say if the syndrome is seen more often due to the rise of legal weed or if it was present all along but not recognized.

The weed-induced cyclical vomiting is real, Notenboom says, though it probably happens to a minority of smokers, cannabinoid hyperemesis “is a thing,” just like opioid addiction is a thing.

In a 2014 story on cannabinoid hyperemesis the magazine High Times writes, “This should not, by any means, hurt marijuana’s reputation for being the safest recreational drug around, but people need to be aware of the syndrome’s existence.”

Both Mort and her son caution that they think people under 21 in particular should avoid long-term regular use.

Mort likens the syndrome to gluten intolerance, “If you believe you have problems with gluten, you can believe some people have problems with THC.”