- To vomit or not to vomit, that is the question.
(heartbeats)
Cannabis, is it safe, is there a darker side to using it,
can you overdose from it,
and what are the complications, if any, associated with it?
I see a ton of patients every day
who come into the ER with serious complications,
and when I ask if they do any drugs,
the most common response is marijuana.
Hi, I'm Dr. Jordan Wagner.
I'm a board-certified emergency physician.
My mission is to make videos
that answer your urgent medical questions
and clear myths about various diseases and illnesses.
Is weed just a gateway drug with no positives
or does cannabis have medical benefits?
It's a big question on everyone's mind,
and it certainly seems so.
I mean, there's plenty of information out there
describing the potential medical benefits
of using cannabis.
Even GW Pharmaceuticals, who owns Bayer Aspirin,
for instances, has a prescription called Sativex,
which is approved in Canada and the UK
to relieve the symptoms of MS.
We also, in the US, use Marinol,
a liquid synthetic form of THC
to help with the side effects of chemo treatment
in cancer patients.
And there are plenty of other anecdotal case studies
where people will say some form of cannabis use
has changed their lives for the better.
However, those are not the folks
that come visit me in the ER.
Sadly, as relates to my work in the emergency department,
I often see the negative or the dark side of cannabis use.
Every single day, I see patients who come to the ER
with serious complications and symptoms
from using cannabis, feeling like they're going to die.
When you hear the word overdosing,
it doesn't necessarily mean death.
An overdose is any biological response
to when the human body receives
too much of a substance or a mix of substances,
and it could be accidental or intentional.
Just like with federally-approved medications,
we often react differently to it.
It seems the same with the varieties of cannabis.
When you typically hear of someone overdosing
from a drug or a medication in the ER,
usually, as a physician,
we worry about breathing problems or organ failures,
and with most drugs, we have antidotes
to combat these complications.
With marijuana or cannabis, that's not the case.
We don't have an antidote in the emergency department.
So, what kind of cannabis complications
are we talking about?
I could tell you a ton of crazy and cool stories
as it pertains to patients
who come in with weed complications,
but that would be a HIPAA violation.
But generally speaking,
the types of sick patients I see
come into the ER with their issues,
like they've used some sort of tainted weed
with mold or fungus,
they have reactionary sick like vomiting,
overdosing from eating too much edibles
or smoking too much weed with high potency,
overdosing from patients who have unknowingly
used synthetic or chemically altered weed.
Symptoms, symptoms range from paranoia to anxiety,
the palpitations, to being stoned,
where the patient is actually quite sedate
and sort of out of it.
The length of time it lasts is extremely variable,
hours to days, meaning the patient
likely will be hospitalized.
To vomit or not to vomit, that is the question.
There are plenty of stories of patients
who use cannabis often to help with nausea
for a broad spectrum of reasons,
including stopping the nausea feeling
from chemotherapy.
But on the other side of the coin, more recently,
a new medical diagnosis as come out
called cannabinoid hyperemesis syndrome.
This is the diagnosis for cannabis use
that actually causes vomiting.
Yes, although for some people,
it helps with the vomiting side effects,
in other patients that I often see,
we have to admit into the hospital,
having severe bowels of vomiting and dehydration
caused by cannabis use.
It is rare and occurs typically
in a daily long-term user of cannabis.
Cannabis has very complex
and wide-ranging effects on the body.
Is it too strong of weed?
Has the cannabis been tainted?
Is your body reacting as some people's bodies react
when they're having allergic reaction
to certain foods or medications?
Doctors and experts are still trying to learn exactly
how it causes cannabinoid hyperemesis syndrome
in some people.
Have you ever thrown up after cannabis?
You may have this syndrome
if you have all of these following:
long-term weekly and daily cannabis use,
unexplained abdominal pain,
severe repeated nausea and vomiting,
and you feel so much better after taking a hot shower.
There's no single test that confirms this diagnosis,
but these patients do see a great improvement
after quitting cannabis use.
Okay, other general cases physicians see in the ER.
Psychosis is a severe mental disorder
in which thought and emotions are so impaired
that contact is lost with the external reality.
I have had patients who say that have only used cannabis
have severe psychotic breaks
that require police involvement, physical restraints,
spit mask, and antipsychotic medications
to help these patients get through their psychotic episode.
So, the question that still needs to be answered is
does cannabis increase your risk
of a psychotic break randomly,
or does it accelerate someone
who might be predisposed to mental illness
or can cannabis be laced with a chemical
that we can't detect, causing such issues?
Some studies reported that people
who use cannabis on a daily basis
were three times more likely
to have a first-time diagnosis of psychosis
and five times more likely
if they used high potency marijuana every day.
Another issue I see often in the ER
with patients who claim
that they've only used cannabis products is heart problems,
especially in younger patients.
These problems are things like
sinus tachycardia, atrial fibrillation,
ventricular fibrillation, or in other words,
an irregular fast heart rhythm.
There have been retrospective papers written
that have tried to link dangerous heart rhythms
to young patients using cannabis,
which include atrial fibrillation
and ventricular fibrillation,
but more research is needed
to define any correlation.
I do often see it in the ER, though,
and for those types of patient researched
for the cause for the heart rate being so fast
as well as treat it with fluids
and likely antiarrythmics.
Another question I get a lot,
can smoking marijuana cause cancer?
As of now, cannabis has not been shown to cause cancer.
But, as I've said before with smoking anything,
there's always a risk to the lungs,
not just to cancer, but since this isn't regulated,
you may not know all the components
in what you are smoking.
Just like when we were kids
and our parents said, don't take candy from strangers,
be aware of what you're using
and where you're getting it from.
Also, plenty of lung injuries
still associated with vaping products,
and the American Medical Association
has called for a total ban on all vaping products
due to serious lung injury.
All right, so what do you do now?
Ask yourself, how is your cannabis use
affecting your health?
If it is negatively, speak with your doctor.
We may not be able to give recommendations
on which weed variety is right for you,
but we can discuss cannabis use
as it relates to your health.
My general rule is
the only thing going in your lungs should be air,
but as we know, with any medication,
drug, food, vitamin use,
every patient is unique and different.
So, while some people may have positive outcomes
and benefits like seizure reduction,
reduction of anxiety, etc.,
others that I see in the ER do not.
Currently, most of what we know is anecdotal
or based on a person or a patient's unofficial accounts
because, in the US, cannabis is still considered
a Schedule 1 drug, which under federal law,
means that there is no medical benefits.
Perhaps, over time, as the law is changed,
we will see a system in the future
where we actually have proper dosaging and antidotes,
we will see less overdosing cases
and adversely affected patients come into the ER
and much more of the medical benefits
as it becomes more widely used and studied.
All right, that's been your five minutes
on a few of the worries of cannabis use
with me, Dr. Wagner,
and I hope I cleared up some questions
you may have had surrounding reasons
why people come to the ER after the use of cannabis.
If you have more questions or concerns,
please leave me a comment,
or if you'd like me to do a video
on the alleged positive effects of the cannabis use,
let me know that, too.
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Thank you so much for watching
and stay healthy, my friends.