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Cannabinoid Hyperemesis Syndrome

SgtKiLLx

Well-Known Member

SgtKiLLx

Well-Known Member

Pennywise

Member of the Year: 2017 - Member of the Month: Mar & Oct 2017, Aug 2018, May 2019 - Plant of the Month: Aug 2017

TheFertilizer

Well-Known Member
Capsaicin rubbed on the belly aborts vomiting episodes for CHS sufferers. One of the main criteria for diagnosing it is that a patient will take chronic hot showers as it's the only way to get relief. This has lead to a working theory that THC effects parts of your brain that are also affected by temperature, and so when heat is applied to the belly it causes the pain and vomiting to stop.

It's not exactly a well-known illness. The first and only medical literature defining it came from a 2004 case study in Australia following 12 individuals. However since the legalization of cannabis, the uptick of acute intoxication being treated in Emergency Rooms has correlated in a sharp upswing in CHS diagnosis. However, that's not to say that this means that those visits are caused by CHS, and there's been much speculation that the medical community is over-diagnosing common things like a "whitey" (when someone simply smokes too much and becomes nauseated) as CHS, but also mischaracterizing other disorder known as Cyclical Vomiting Syndrome as CHS merely because of the use of cannabis. A lot of doctors are even going so far as to misappropriate CHS as being the cause of CVS.

One prevailing theory among tinfoil-hat-wearing internet super-sleuths is that it's actually a form of azadirachtin poisoning. The reason for this assumption is because azadirachtin poisoning also closely matches the symptoms of CHS, although it has a plethora of symptoms which do not manifest in CHS ( of course, the tinfoil-hat-wearers love to cherry pick). There is 1, count them 1, NIH case study of an Indian man with azadirachtin poisoning, who was orally ingesting raw neem oil. Azadirachtin is the active ingredient in neem oil when used as pesticide. Of course this lead to the suspicion that everything from neem oil to Azamax or Azatrol was causing this illness in people, and then there was even one entirely anecdotal report from a blogger who stopped using any kind of azadirachtin based product on their plants, and found their episodes of illness to completely disappear.

The problem is there are many users who smoke only pesticide free weed, and still have these types of vomiting episodes. They are typically never anti-pot in sentiment or rhetoric, but have simply come to a point where they can no longer deny it's the pot because they will cease use, and by fine for months. Then as soon as they resume use, they begin getting these episodes again.

A lot of people think that this is nothing but BS propaganda to malign pot's image after legalization. I caution people to not think like that, and to not dismiss it out of hand, if we really wish for cannabis as medicine to maintain any credibility in the medical and scientific communities. We cannot just simply dismiss and deny it out of hand because it doesn't fit our preconceived notion of this plant, and we are better served by acknowledging it is a real phenomenon and trying to proceed from there. The studies concerning THC's effect on the hypothalamus and temperature regulation are the most promising research invested in the area so far, and if we're to inscentivize the medical community into investigating how these issues can be dealt with, we can't simply dismiss their findings out of hand unless we wish them to do the same for the notion of cannabis as medicine.

There is also a lot at stake for sufferers of CVS like myself. If the medical community can not manage to more clearly differentiate between these two illnesses, many people with CVS will be misdiagnosed with CHS. The opposite is not very likely, because CVS is thought to be extremely rare, and the diagnostic criteria for it are rigorous. Basically every traceable form of illness must be ruled out before a diagnosis of CVS can be given. On the contrast with CHS, the only thing which must be present for a diagnosis is vomiting symptoms similar to what is seen in CVS, and also the presence of cannabis use. Because the criteria are so grossly over-encompassing, many CVS sufferers are told that it's actually CHS, and told to stop one of their only forms of relief. This even despite the fact that many CVS sufferers have documentation showing they've had the illness since childhood, long before they ever used cannabis. There are several forms of differential diagnostics available to determine if a patient's illness is CVS vs CHS (for example, CVS causes rapid gastric emptying while cannabis causes delayed, and CVS sufferers have a maternal history of chronic pain and/or depression), but emergency room doctors are simply looking at the presence of A ) Cyclic vomiting and B ) Cannabis use, and calling it CHS. This paper outlines the challenges Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment

Many in the medical community, as well as the cannabis culture, are questioning why the sudden uptick in these emergency room visits following legalization, and the overwhelming majority point the finger and increasing concentrations of THC. The medical community sees a correlation of these visits rising with the percentage of THC available in commonly used products rising, and they suggest a link. The cannabis community itself recognizes that things like BHO and distillates are delivering much higher doses of THC than users have previously used, and without the "entourage effect" of the other bouquet of cannabinoids that cannabis flower provides. The common suspicion among both medical professionals and cannabis enthusiasts alike, is that the gradual removal of other cannabinoids besides THC has led to a buildup of THC metabolites in cannabinoid receptors which regulate body temperature. The suspicion is that with increasing potencies, THC is then becoming available to these receptors in concentrations not seen by human use before, and with no cannabinoids like CBD to abate possible negative effects. Humans spent thousands of years smoking cannabis, not pure THC; we're entering a brave new world.

While it may be hard to accept, one of the most damning things pointing towards cannabinoids causing this illness is that it's even seen with synthetic cannabinoids. Now, those are the THC analogues that are made in China and sprayed onto plant material and sold as legal weed alternatives. The likelihood that the plant material that gets sprayed is given azadirachtin based pesticides is very low (think about the cost of pesticides versus how much they sell that crap for, and keep in mind they're not selling to a discerning market), and so it really points to the cannabinoids themselves causing this illness. Still, I've yet to see it induced with pure THC analogues (so we can't rule out the presence of pesticides), so it is still possible that it is all a result of azadirachtin poisoning, but that entire theory is based on speculation and comparing apples and oranges.

Anyway, that's about the depths of my knowledge concerning CHS and related ailments. I do believe it's a real phenomenon, and one that we're going to hear more about as the use of THC rich concentrates eclipses the use of flower in popularity. I don't say that to malign concentrates, but it may be a health risk that we did not realize would exists with ultra-concentrated THC products.
 
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GrizzWald

Plant of the Month: June 2016 - Nug of the Month: Aug 2017
Until it's proven one way or another, treat with the way you see the illness.. placebo is an effect and if it's helping with pain,nothing wrong with that..
stomach cramps, hot showers, mine coincided with commercial weed and stopped once back growing again.. oh and what I was buying, I'm sure my grown has more/stronger cannabinoids. So it's a neem free existence for my crops..
 

TerpDeDerp

Member
It was thrown around loosely back during the "k2" spice insurgence. JWH-18 was said to be such a powerhouse because it was activating CB1 and CB2 receptors. I always thought it was a great development in understanding cannabinoid uptake. My ex wife loved that garbage, she developed CHS symptoms and even went on zofran for the nausea.

Last night allergies attacked me. I felt like I was foaming from the lungs. I choked on phlegm for about 10 min. Threw up a little. Got it up! Shower was the only thing that helped. I can still feel the knot in my stomach. All in all though, comparing this to how heat feels on my back literally every night, I can understand how a hot shower could help curb symptoms. If they ultimately determine this is a real thing, then I guess that sucks. But I find it more likely to be attributed to basic physiological response. Betcha it happens if you smoke pine needles and horse turds too.
 

Nunyabiz

Well-Known Member
There is no such thing as cannabis Hyperemesis Syndrome.
It's not the cannabis causing the problem, is mostly Azamax.
This alleged Syndrome never existed until Azamax hit the market, it has the EXACT symptoms of Azaractin poisoning.

What we have is Azamax Hyperemesis Syndrome and the usual suspects trying to blame it on cannabis

 
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GrizzWald

Plant of the Month: June 2016 - Nug of the Month: Aug 2017
Shut up, what would you know.. not even making sense
 
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TheFertilizer

Well-Known Member
There is no such thing as cannabis Hyperemesis Syndrome.
It's not the cannabis causing the problem, is mostly Azamax.
This alleged Syndrome never existed until Azamax hit the market, it has the EXACT symptoms of Azaractin poisoning.

What we have is Azamax Hyperemesis Syndrome and the usual suspects trying to blame it on cannabis

That article itself disputes the possibility of it being azadirachtin poisoning. First of all, the first reported cases of CHS occured in Australia, so when Azamaz or Azatrol was approved and adopted for use in the U.S. is irrelevant to that. Secondly, it also points out how neem oil and neem based products have been in wide regulation since the 90s and used as traditional medicine long before that. It makes very little sense that only now we'd be seeing azadirachtin poisoning associated with cannabis use, and only in the U.S. Meanwhile, even in India where neem is widely used, there is only one available case study to show someone suffering from azadirachtin poisoning, with the article claiming there's only a handful more. Then we have to consider the fact that weed is used globally and so is azadirachtin based pesticides, so why is this illness only being reported in the U.S.?

The azadirachtin poisoning symptoms don't even match CHS symptoms as identically as people claim. "hepatic toxicity, metabolic acidosis, and encephalopathy." are not mutual symptoms with CHS. The only actually commonality is profuse and incessant vomiting with stomach pain.


I don't really agree with the medical community's "Stop using it and see if you get better" approach however. There are other diagnostics which could be used to determine if it is CHS without asking a patient to stop using their medicine. It's ironic that if someone has opioid induced constipation, they don't tell them to stop taking the opioid, they prescribe a laxative. However when it comes to pot, it's like "Who needs that? Just stop."

I really just think it's important to not dismiss this as propoganda, or to promote other propoganda as an answer to it. I have seen many people convinced it was merely neem oil change their pest management routine and have no more problems, BUY I have seen people who also cut out any neem and still have issues. Perhaps there actually IS some widespread azadirachtin poisoning happening, but it is happening alongside a separate phenomenon.

One of the things it's really hard to hear as a CVS sufferer, is so many people claim that I just don't want to quit smoking weed. It's really asinine to think I'd rather suffer such misery. If I knew it was weed causing it I'd stop in a second. I even gave it a try and quit smoking for 1.5 months. I never had any subsiding of episodes, and left my PTSD untreated.
However as long as there are cannabis enthusiasts so steeped in denial, it's going to make the medical community keep thinking those things about CVS sufferers, and it's going to make CVS sufferers think less and less of the cannabis community.
 

Nunyabiz

Well-Known Member
Far as I am concerned its Azamax Hyperemesis Syndrome.
It fits too perfectly for it not to be.

And there are lots of people in India that get these same symptoms from neem.

 
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SgtKiLLx

Well-Known Member
Wow, didn't expect this much feedback on the subject . Glad I put it up, learning plenty on it already.
 

TheFertilizer

Well-Known Member
Far as I am concerned its Azamax Hyperemesis Syndrome.
It fits too perfectly for it not to be.

And there are lots of people in India that get these same symptoms from neem.
Lots of people? The study directly describes one case and references 22 more. In a country with a few billion people.

What about the symptoms of azadirachtin poisoning which aren't present in CHS?

I don't know how it fits "perfectly" at all unless you deliberately pick and choose which facts to consider and which to dismiss.

The more cannabis users deny this, the more CVS sufferers trying to use cannabis for relief will be treated like lunatics by their doctors. As it stands I had to compile several sources of medical literature to convince my backwoods doctor that it was CVS, and they finally referred me to a specialist who knew more about it. How many people without that knowledge are going into their ER rooms or their family doctors office, and having nothing more to offer than some lofty theory about neem oil poisoning. You can find all the blogs you want, but no doctor is going to look at less than two dozen case reports of azadirachtin poisoning caused by direct oral ingestion, and then think that's remotely comparable to exposure from smoking crops treated with it.

Spreading the azadirachtin-poisoning propoganda is a disservice to all those who use cannabis, and especially those who need it medicinally. If that weren't the case I'd say believe what you want, but this is has more dire consequences than people reconciling differences of opinions.

Sorry if I seem like a jerk about it, but I think it's really important we put this azadirachtin poisoning theory to rest. I have already provided more than enough information, all I can is urge you to please reevaluate it, and reconsider perpetuating the azadirachtin poisoning propoganda.
 

Nunyabiz

Well-Known Member
Believe whatever you wish.

But people been smoking the hell outa cannabis and hash for 1000s of years and all of a sudden just 10 years ago a very few people get Hyperemesis Syndrome right when a certain "organic" pesticide shows up in regular use.

Is it possible that maybe 1 in a million people are allergic to cannabis and have a bad reaction? Sure, I mean hell about 100 out a million might drop dead from a peanut while everyone else on the planet gobbles them down by the handful.

I dont know how many have allegedly gotten ?HS but I bet it's very few, and most of those few got AHS.

 

TheFertilizer

Well-Known Member
Believe whatever you wish.

But people been smoking the hell outa cannabis and hash for 1000s of years and all of a sudden just 10 years ago a very few people get Hyperemesis Syndrome right when a certain "organic" pesticide shows up in regular use.

Is it possible that maybe 1 in a million people are allergic to cannabis and have a bad reaction? Sure, I mean hell about 100 out a million might drop dead from a peanut while everyone else on the planet gobbles them down by the handful.

I dont know how many have allegedly gotten ?HS but I bet it's very few, and most of those few got AHS.

Well it's true that these ER room visits spiked when Azamax/Azatrol were starting to become adopted for use in the U.S. However, you also have to consider that HS has alledgedly been seen in other countries which may not have adopted the use of those pesticides at the same time, and through all of it people have been using neem oil without issue long before the first hint of HS came about, so the association isn't really that strong between azadirachtin and HS. I believe it's merely a coincidence, and that the sudden increase in HS diagnostics is completely contributed to its introduction in medical literature in 2004, and then ER doctors in newly-decriminalized areas generalizing it as caused by an increase in use when in reality it was probably only an increase in patients disclosing cannabis use, and so all instances of Cycling Vomiting ( a wider symptom basically synonymous with how you've used HS ) then became CHS. People have been suffering Cyclical Vomiting for a long time, but as soon as doctors could make a gross assumption of the cause of it at the mere presence of cannabis use, they ran wild with it

But I don't think that means cannabis can't cause it. I do appreciate the thousands of years we've used cannabis before this, but I think there's a huge difference between cannabis that people are using now and the cannabis which has been used for traditional medicine or recreation. We have always had things like hashish, but it's very unlikely even that ever reached the concentration of THC that we're seeing in modern extracts. I have seen a lot of samples of bubble hash and dry sift analyzed, and it rarely is over 60% and the highest testing sample I saw was 80%. Most were in the 30-60% range, and so unless as a culture we forgot how to make good hash, then it would be reasonable to conclude that as a culture, regular consumption of cannabis products with a concentration of 80% and higher is relatively new. Meanwhile, the accompanying terpenes and cannabinoids besides THC are becoming gradually more diminished in consumer products, and accessibility increasing. Either way, the accumulation of THC either through heavy use of high quality cannabis or concentrates is another prime suspect which I think has much more veracity, and can also explain cases of CHS that predate the wider adoption of Aza based pesticides, and why they have increased along pace with cannabis products increasing on potency.

I also agree that the actual incidence of new CHS diagnosis are inflated. Many are misdiagnosis of much more serious illnesses, but because the diagnostic criteria for CHS is so lax, an ER doctor can diagnose as such even if all they can confirm is Cyclical Vomiting and Cannabis use. That Oregon Cannabis Connection link I posted alluded to a patient who was told they had CHS, but as it turns out it was actually a plugged bile duct. It's not likely that the original misdiagnosis of CHS was shown as incorrect in statistics tracking ER visits since the correct diagnosis never ends up being diagnosed in an ER setting.

I have spoken to people with CHS who discovered they had it far before it was even defined in 2004, but they thought it was just a "allergy" at that time. They have all heard the neem/azadirachtin theory and grew their own or sourced cannabis they knew wasn't treated with pesticides, and it still made them sick. I'll also add, that when they shared these experiences they often have backlash from other cannabis users. There is a very wide push to cast this as issue as fabricated by anti-weed crusaders, and I can understand that since doctors have been really screwing up with overdiagnosing CHS.

Anyway, thanks for taking the time to read and respond even if it doesn't change your mind or anything.
 

BeanTownFan420

Well-Known Member
From what i have read the vomiting stops with the cessation of cannabis use which means its a temporary side effect for a very few users like many other wise safe drugs.
The true dangers of drug use are in orange plastic contaners given to you by a pharmicist..PNG
 
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BeanTownFan420

Well-Known Member
There is no such thing as cannabis Hyperemesis Syndrome.
It's not the cannabis causing the problem, is mostly Azamax.
This alleged Syndrome never existed until Azamax hit the market, it has the EXACT symptoms of Azaractin poisoning.

What we have is Azamax Hyperemesis Syndrome and the usual suspects trying to blame it on cannabis

Because some idiot applied it to the cannabis which in turn gives you a good dose when said plant is consumed.
 

TerpDeDerp

Member
As for root cause, literally every single (x)HS is a toxin in terms of what the lungs are designed to mediate. To this date I've had

Cocaine Hyperemesis Syndrome (likely caused by the gasoline used to make it) BAN BP!

Wildfire Hyperemesis Sydrome (helped stop a forest fire) Ban boat trailers and metal hubs that scrape the concrete. Also ban friction for creating heat.

Knife hit Hyperemesis Syndrome (***seed induced) Ban stupid friends that think 2" paint scrapers and quarter size nugs are good knife hits!

Cockroach Hyperemesis Syndrome

DON'T DO BUGS KIDS!

Way back in the day you'd hear about this on the news. "Victims suffered from smoke inhalation!" Ever suffered from it? Holy shit, it's like 100 dabs in a row. And yes, you vomit from it. At the end of the day some schmuck doctor out there just made all sorts of waves for a few years of his career. All the while bamboozling the public with a new word for an old thing.
 

GrizzWald

Plant of the Month: June 2016 - Nug of the Month: Aug 2017
No not true about people using neem long before blah blah (no disrespect intended towards what was said,I just can't remember)... In most more than one a lot of countries,use of neem is banned for food crops.. so how is using something for ornamentals and something ingested going to have the same effects on people? It's not..
No problem with cannabis or neem being the cause, not sure why anyone does, especially those that don't have any problem, yet want to tell others how they feel and cause of it..????
 
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