A few months later, I came in for my yearly medical marijuana evaluation. After going over my current dosing levels, how my symptoms were being affected with the medicine, and a physical exam, the doctor asked me if I had ever heard of something called Cannabinoid Hyperemesis Syndrome. At this point, I had familiarized myself somewhat, but wanted a doctor’s opinion on the subject. He told me the same story of intense nausea, vomiting, stomach pains and patients unable to leave their bathrooms in the mornings from the discomfort. I remembered those days, lying on the bathroom floor, in so much hurt; but those days were mostly gone now that I was using cannabis.
I told my doctor I did notice a kind of “hangover” of sorts when I had smoked cannabis from certain dispensaries. While I’m not sure of the similarities they might have had in common at the time, I did notice that certain grow’s bud would leave me feeling less than keen, sometimes even headache-y, or a tad nauseous. These symptoms were not consistent however, even in times of excessive use. I agreed to monitor my symptoms and communicate if things got worse. Being the inquisitive stoner that I am, I went home and googled accordingly. This syndrome was gaining traction among medical professionals, and I wanted to know why.
Some states are showing increased rates of CHS diagnoses, and it’s really no wonder that these are also states who are also sporting legal weed. When something is no longer criminal, people feel more inclined to talk about it, and even admit to using it, on a pretty regular basis apparently. A lot of doctors (especially in states where cannabis is still a crime) are still unfamiliar with cannabis’s varying effects on the body, and CHS seems like an opportune go-to when they are unsure of other possible scenarios.
We are certainly still learning about what’s safe and appropriate for agriculture meant for combustion, not just consumption. Growers here in Colorado have had their share of pesticide safety and awareness issues. The Eagle20 scare spawned by Livwell’s angry patients brought the community’s attention to a detail that had long been overlooked.
Using approved pesticides responsibly and correctly is something the cannabis industry is still working through. And one that kept coming up in my research of this CHS issue was something called azadirachtin.
Azadirachtin is a derivative of neem oil that is present in a lot of natural pesticides and is currently used in tons of industrial grows here in Colorado. While neem has been used for centuries for a variety of reasons, it is also being used in a way that, long term, we still do not know the effects. Another idea about neem is that while it might seem the safer, more natural option, a lot of growers may not take into consideration the half life is likely very different in indoor lighting versus natural light, needing more time to be flushed from the plant than something grown in a greenhouse or outdoor garden.
How many other completely organic pesticides could come up against this battle of science and possibly compounding mycotoxins? As word of CHS continues to spread, it’s important to consider other possible opportunities for causation of these troubling symptoms before being so quick to jump on the buzz word diagnoses. It brings to light the importance of grow standards, and doing more research on what is appropriate for this new chapter in industrial agriculture.
Numbers of legitimate cases of CHS are still incredibly low, (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538402/) and states could use this growing concern as a way to reinvent “reefer madness” so to speak, scaring people away from a game-changing medicine because of lack of information.
Appropriate application of these natural pesticides is key, as well. When growers drench the roots of a plant, those pesticides absorb into the roots; doing this will keep pesticides in your plant longer, and contaminates the soil for later cultivation use. Neem is broken down through microbes in the soil, so use with a hydroponics system can almost guarantee it stays with the plant in some effect. Even spraying neem oil on plants is still something that should be done early enough in the grow cycle to allow for proper flushing. There is still a lot of misinformation and differing opinions of appropriate grow techniques, and the science behind it is constantly evolving. It’s no wonder the general public, as well as the medical community are struggling to keep up.
As a medical cannabis patient, I try to be mindful about where my medicine comes from and how it is cared for. Monitoring your own symptoms and seeing what strains work is integral to finding the right cannabis wellness plan. However, being vigilant and aware of what is helping or hurting can be difficult to identify when you’re in those stoney clouds. So I did a little study to see if I thought azadirachtin might be having some effect on me. I took a few days smoking strains with azadirachtin on the label, and noticed I had to medicate more heavily the mornings after to counter my usual mild nausea. My stomach pains are chronic and exacerbated by stress; I noticed these azadirachtin friendly strains were not as beneficial in relieving pain, but thought this could be due to a variety of reasons. When I switched to azadirachtin-free bud for a few days, I noticed my appetite came back quicker, I slept better, and my stomach felt better overall. I suffered from fewer random headaches, and was able to medicate less often. While some may blame the placebo effect, I think there is some credibility to the idea that not just neem, but organic pesticides in general have different effects when combusted; and some people, especially those with autoimmune deficiencies could be more sensitive to pesticides, especially when compounded or not properly flushed. My gut feeling is to be cautious placing blame on any particular pesticide, but to strongly encourage more community discussion, awareness, and demystification of this strange and uncomfortable diagnosis that is cannabinoid hyperemesis syndrome.