Thursday, September 23, 2021

What marijuana cures in some, it causes in others

BIRMINGHAM, Ala. (WIAT) — At age 13, Leonna Davis lost her father to suicide. Davis was later forced to contemplate her own suicide by a marijuana-related disease.

Cannabinoid Hyperemesis (CHS) is a condition that results from the long-term use of marijuana. It has become more common across the country. Its symptoms — severe stomach pain and nausea, with relief coming only from scalding hot showers or heating pads — have caused increasing health care and utility bill costs, emotional and physical distress, and even, in some cases, suicidal thoughts among those who suffer from the syndrome. 

For Davis, in the wake of her father’s death, smoking marijuana helped ease her pain. It provided relief from her anxiety and PTSD. However, her life was drastically changed by the drug’s role a year later.

Leonna Davis was contemplating suicide after suffering from CHS. (Courtesy Leonna Davies)

“Every morning, I’d wake up, and I’d have to throw up. I couldn’t eat. I couldn’t sleep. It was a complete nightmare,” Davis, a Huntsville native, told CBS 42. “My episodes would last for hours at a time. In a four-hour episode, I would vomit fifteen times. I threw up for eight hours once, to the point that my throat was bleeding.”

Davis saw a doctor who performed a colonoscopy as well as an endoscopy to determine if Davis may have early-onset colon cancer. The results were normal. Doctors began to worry that Davis might be bulimic. She was not. 

“The only thing that ever helped with the nausea was scorching hot, boiling showers,” she said. “I would put hot rags on my face while I was in there. Popsicles were the only thing I could eat, and that was only while I was in my shower. I could also drink Ensure shakes. I didn’t eat solid food.”

Davis lost 85 pounds between the time she noticed her symptoms and when she started to feel better. Due to her near constant hot showers, her utility bills increased by $100 per month. After insurance, she racked up more than $1000 in hospital bills. She nearly lost her job in a dental lab because of her absences, even with doctor’s notes. 

Davis quit smoking marijuana after more than a year. Her symptoms subsided. “But I didn’t connect those dots,” she said. 

Her symptoms returned when she started smoking again at 17 years old. Davis had a second colonoscopy when she was 18. 

She would not discover that she was suffering from CHS until she reached 22. 

“I was in the hospital with extreme dehydration. I was in and out of consciousness,” she said. 

Eight months ago Davis was again admitted to the hospital. CHS could be the reason, according to a nurse. The nurse was correct. 

Davis stopped smoking immediately. Within a few weeks, all of her symptoms disappeared. 

Despite Davis’ experience, she said that she is not opposed to legalization. Instead, her message is one of education. 

“If you smoke weed,” she said, “please be informed. If you feel sick all day, especially in the mornings, and hot showers are not helping, you should seek medical advice. This could lead to your death. People that continue to smoke have lost their lives because they were so dehydrated and didn’t seek help. I was very fortunate. I was able get to the hospital on time. “

Davis is correct about the dangers of CHS. In 2019, for example, a 17-year-old in Indiana died after suffering from dehydration due to the disease, according to the coroner’s report. 

Nina Griffith’s story doesn’t match Davis’ exactly, but it rhymes.

Griffith, originally from Florida attended the University of Alabama between 2016 and 2019, before moving to Denver, Colorado. In December, she will graduate from UA and from the Colorado Film School, but for a while, she didn’t know if she’d make it.

Nina Griffith was affected by CHS. (Courtesy Nina Griffith)

Griffith felt lonely and bored at the same time as COVID-19 gripped the country, closing down businesses and forcing universities online. Although she had smoked before, the coronavirus made her a more regular smoker. She was a heavy smoker who smoked every day. The symptoms started to set in. 

“I was nauseous all morning. I lost almost 30 pounds,” she said.

Hot showers were her only relief, just like Davis.

“Hot showers were the only thing that helped me,” she explained. “I would spend up to eight hours in the shower, literally just laying there.”

Griffith began to search the Internet for answers and found information about CHS.

Griffith was suffering from symptoms for five days and had a vague suspicion about what was causing them. Griffith went to the hospital after she experienced the first symptoms. Doctors gave her fluids, and confirmed that she had the syndrome. 

Griffith gave up smoking after her hospital visit. She did smoke once more, on Valentine’s Day, but on the whole, she avoided weed. 

Griffith and her boyfriend took a three-month road trip from her Denver home to visit her family in Florida. Once they arrived, Griffith’s symptoms came back. 

“When we got there, I completely shut down,” she said. “That’s when I realized that stress and trigger foods could lead to episodes. My sickness ruined the trip.”

When it was time for the return drive across the country, Griffith didn’t think she could make it. Her boyfriend drove her back alone. Griffith would fly home a week later after her symptoms had resolved.

“I knew then how serious this disease can be,” she said. “It’s been debilitating.”

Griffith has now been sober for months, and she feels fine, but she says she doesn’t feel normal anymore.

“Something has permanently changed.”

Stories like Davis’ and Griffith’s resonate with Sue Justice, an 84-year-old who lives in Athens, Georgia. 

Justice smoked marijuana for 30 years, but for the last 15, she’s suffered from the symptoms Davis and Griffith know all too well.

“Pain and nausea, pain and nausea, all the time,” Justice said. “I’d been to the ER four times.”

Justice fainted while being sick in her bathroom, causing a laceration. Her husband came to check on her and asked what was wrong.

Sue Justice, 84, smoked cannabis for 15 years before she was diagnosed with CHS. (Courtesy Sue Justice)

“I fainted,” Justice told him, lying on the marble floor. “Just let me lay here.”

Justice was never asked whether she smoked pot. Justice received a colonoscopy as well as an endoscopy instead of a CHS diagnose. Like Davis’, the results were normal. Justice was then referred by doctors to an oncologist. 

For Justice, “cancer” wasn’t what she wanted to hear, but at least it was something she could understand.

“And I thought, you know, maybe I have cancer, but at least I’ll know. I’m so sick. Just give me an answer,” she said. 

After testing, the oncologist declared that there was no possibility. 

Justice decided to look up a place CHS patients use often: Google. Justice began to search every website she could to find the right disease for her. 

Justice discovered a Facebook group for CHS support along the route. She said that the group would save her life.

“If I hadn’t found the group,” she said, “I wouldn’t be here today. I might’ve killed myself. I didn’t want to be here anymore.”

Justice was also dealing with the stress of a husband whose Alzheimer’s disease was progressing.

“If I’d have had my choice to live or die, I’d have rather been dead,” she said. 

The symptoms started to disappear once she quit smoking. Slowly, the nausea and pain subsided. Justice was able eat normally again. She gained weight from 129 to 155. 

“Some people just don’t want to believe that it’s the pot, but it is,” she said. “It’s nothing but the pot.”

Like Davis and Griffith, though, CHS hasn’t changed Justice’s opinion on the legalization of weed, particularly for medicinal uses.

“Weed is the biggest healer on the planet when used right,” she said. “It will alleviate nausea. It’s the best thing since sliced bread, just not for us.”

Justice claimed that Justice saved her life because of the group she was referring to.

The Facebook group, called “Cannabinoid Hyperemesis Syndrome Recovery,” now has over 12,000 members.

Erica Hagler, who resides in New England, started this group about a month and a half ago. She was inspired by her own experience at CHS. 

Sue Justice saved her life by creating the logo for CHS Recovery Group. (Courtesy Erica Hagler

Hagler smoked marijuana for approximately 18 years. The symptoms began around eight years ago and became unbearable about three years later.

“It got to the point where I couldn’t go out anymore,” she told CBS 42. “I would start cancelling plans, not wanting to hang out with friends.”

Hagler began to experience fainting spells when she was a teenager, but she never believed it was due to marijuana. 

Three years ago, Hagler and her then-boyfriend travelled to Martha’s Vineyard, where he proposed. Hagler was overcome by the stress and excitement of the engagement.

“That’s when I had my first full-blown episode,” she explained. “I went to the hospital for two weeks the day after my engagement.”

Hagler, like Griffith, Justice, and Davis, would not receive a quick response from health care professionals. 

“The doctors tested me for everything they could think of,” Hagler told CBS 42. “It got to the point where they said there’s nothing else we can test you for and asked me to leave the hospital.”

Hagler lost 20 pounds in three weeks, continuing to suffer. 

“Once I had started vomiting, I could not stop,” she said. “I almost died.”

Hagler began to research CHS herself. Slowly, she stopped smoking and felt better. 

“I had been in another support group that would blame the disease on the pesticides and not the weed itself,” she said. 

So Hagler created her own support group. That group has now grown to a community of thousands — the group that Sue Justice said saved her life. 

“People have said I work for ‘big pharma,’ that I’m anti-weed,” Hagler said. “That’s not true. I’m just a person that refused to be sick anymore, and if there was any way I could stop people from feeling the way I was feeling, I was going to do it.”

Dr. Joseph Habboushe has been a part of many such stories. 

Habboushe, an assistant professor of Clinical Emergency Medicine at Weill Cornell Medical College, works in emergency rooms throughout New York City. He has conducted numerous studies on CHS.

“We started seeing more and more patients with this disease, and it was something that we knew very little about,” he said of CHS. “It’s a syndrome that has been grossly underdiagnosed.”

Dr. Joseph Habboushe, an assistant professor of clinical emergency medicine at Weill Cornell Medical College, is Dr. (Courtesy Weill-Cornell)

Habboushe was also intrigued at the paradox of CHS – that it cures some people, but causes others.

“Marijuana decreases nausea in the acute setting and here you have something paradoxical, where it’s increasing nausea and pain.”

Habboushe’s first research on the topic, though, was spurred by one of his own patients.

Habboushe had a patient he was concerned would develop severe kidney damage from severe dehydration. 

“But that doesn’t happen from one day of vomiting. That happens after significant, significant vomiting,” the doctor said. “But I had this patient with CHS who had a day or so of vomiting and had acute renal failure.”

He knew that CHS patients suffered from constant vomiting and inability of drinking water. But he thought there must have been another factor. The answer? Hot showers. Hot showers.

“A lot of CHS patients are taking showers in very hot temperatures — hotter than hot tubs, which you aren’t supposed to be in for more than 20 or 30 minutes,” he said. 

Habboushe’s second study on CHS garnered even more attention. He used survey data from an emergency department setting to find that around a third of people who smoked marijuana for more than 20 days per month had symptoms similar to those described in this story. The study found that CHS symptoms could affect as many as 2.75 million Americans, an increase likely due to marijuana laws being more relaxed. 

“Folks would call CHS rare in the medical literature, and I hated that,” Habboushe said. “I’m a scientist and you shouldn’t use a word if you don’t have evidence to back it up. They called it rare, but it wasn’t rare. We doctors were just rarely noticing what it was, and that was our bad.”

Habboushe stated that although ER doctors are becoming more familiarized with CHS, there is still room for improvement. He stated that the disease is less well-known among primary doctors. 

Ignorance of CHS, its symptoms, and its treatment — cessation of marijuana consumption — can lead to increased health care costs, like for the colonoscopies and endoscopies that those in this story were subjected to. Habboushe indicated that these costs could be reduced as CHS becomes more common and better understood.

“Now that we know CHS better,” he said, “I think we can start to avoid those costs and those workups.”

Habboushe said that while he’s apolitical when it comes to the legalization of marijuana, what those on both sides of the argument should agree on is an effort to study the effects of the drug. 

“One commonality on both sides of the argument — folks who want to legalize and those completely against it — is that they’re not arguing that we should study things,” he said. “We should study these things. We shouldn’t be shy to study it. All of us should agree that science should be involved.”

As for those who may be suffering with CHS, Habboushe said that the “cure” to their ailment is relatively simple.

“If you consume cannabis and hot showers help, the next thing should be cessation. It’s not easy, and patients may need support to stop, but quitting is the answer.”

    Leave a Reply