“Cannabis hyperemesis syndrome: still under-recognized after all these years“
After two years of chronic vomiting and pain and dozens of trips to emergency rooms a 23-year-old woman was found to have cannabis hyperemesis syndrome (CHS). Physicians are still unable to recognize the early symptoms of CHS as cannabis use is still in a legal gray area in much of the country. A lack of research, recognition, and trust often prevents a quick diagnosis when an illness is related to cannabis, leading to multiple referrals and invasive tests.
CHS was first described 15 years ago yet it is not frequently recognized in patients. The case study featured in this blog post highlights patients and physicians’ outcry for tolerance and support so that cannabis-related illnesses can be efficiently and effectively engaged.
Researchers have found that capsaicin cream is an effective and safe method of treating cannabinoid hyperemesis syndrome (CHS) in adolescents. Capsaicin cream has previously been shown to be effective at treating CHS in adults but adolescents have previously been treated with haloperidol, a drug known to have serious side effects. Capsaicin cream offers a much safer and more cost-effective method of treatment for adolescents.
Here, an excellent example of how valuable it is for scientific literature to be read critically and thoughtfully. When reporters read, or extract, or convey only partial conclusions, it is all-too-easy for consumers to absorb an incomplete, undigested message. As consumers of journalism, the public deserves a more knowledgeable understanding. Here (http://bit.ly/2KV0jeG), Forbes (Mike Adams) conveys an unfortunate lack of deep consideration in the reporting. Thankfully, a brief quote is conveyed by Dr. Koturbash, who “was quick to point out that the CBD products coming to market may not pose this particular risk” – but this stone-throw of even-handedness falls short to appropriately balance an article already dripping with misgivings and incomplete evaluation of the material at hand.
For a more layered view of the science, the word “gavage,” as was applied to the mice in the study, describes force-feeding animals with a tube down their throats, often taped to mouths which are then kept gaping open. This is meant to simulate the biological processes of eating (different from giving meds IV, for example.) There is no regard to the stress that this process causes the animals, as they are treated as though they are biological CBD-processing machines. In the days where many people are taking 10mg pills of CBD per day, the amounts of CBD that were force-fed to these animals in this study, if translated to humans, would be 4,305mg, 12,915mg, and 43,050mg over 10 days, or 17,220mg, 51,660mg, and 172,200mg in one-shot doses.) For reference, these days, most dispensaries sell CBD in doses of 10mg, 20mg, up to 2-300mg.)
In the study, the authors suggest that they allow animals to eat “ad libitum,” as if to convey that they are treated with a buffet. And yet, the animals being stuffed with 43,050mg (human equivalent) of CBD still lost weight, while others (given 172,200mg (human equivalent) had uneven weight distribution.) To any reader considering these values critically, it must seem absurd to make conclusions about the actions of CBD as what is causing these effects, as if the fact of over-stuffing itself has no impact at all.
An analogy to this study: If you add 17,000 cars (or 172,000!) to a tunnel on the way to the airport, and stuff each car full of way too many people, there might be problematic levels of concern inside that tunnel.
Let’s hope to see more even-handed consideration and reporting from Forbes, in the future.
Here, another study that shows very different results. Instead of overstuffing mice w/ unrealistic amounts, if one administers CBD at sensible doses in the same population of mice, it turns out that CBD could directly reduce alcohol drinking, improve healthy processes in the liver, and alcohol-related brain damage…
“CBD reduces alcohol-related steatosis & fibrosis in the liver by reducing lipid accumulation, stimulating autophagy, modulating inflammation, reducing oxidative stress, & by inducing death of activated hepatic stellate cells” This new study:
Association of Marijuana Use and Cyclic Vomiting Syndrome
A recent study has found that a subset of patients diagnosed with Cyclic Vomiting Syndrome actually suffers from Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is a rare condition that primarily occurs in daily, long-term users of cannabis, more common among males than females. Chronic cannabis consumers should inform their physicians of any illicit drug use, as well as any cannabis consumption, during routine check-ups and/or emergency room visits, to ensure accurate diagnoses can be made.
Effects of Drug Abuse, Smoking and Alcohol on Donor Hearts and Lungs
A review article that discusses how drug use can affect donor organs has revealed that receiving organs, such as a heart or lungs, from a donor who has used cannabis does not add risk to the procedure. A careful assessment of any donor organ should still be conducted, but having a history of cannabis use does not prevent someone from safely donating.
Guanfacine decreases symptoms of cannabis withdrawal in daily cannabis smokers
A study performed on daily cannabis users with cannabis use disorder (CUD) found evidence for Guanfacine to reduce the irritability and disturbances to sleep, characteristic of cannabis withdrawal. It is potentially a viable, improved alternative to Lofexidine, another treatment for CUD which happens to result in some adverse effects, including drowsiness, dizziness, and altered food intake. However, beyond these effects, while Lofexidine reduced cannabis self-administration following abstinence, Guanfacine did not in this study. Regardless, further research on the therapeutic effects of Guanfacine may be worthwhile and could help reduce cannabis cravings following withdrawal.