TheFertilizer
Well-Known Member
Yeah, CHS is a pretty flimsily documented illness. It's really closely similar to Cyclical Vomiting Syndrome, and in fact so much so that a lot of CVS patients are being misdiagnosed as suffering from CHS merely because they use cannabis.
But CVS is far from just puking a lot. It's literally non-stop, 24/7 for weeks at a time. People can die from it because of the extreme dehydration and circulatory stress it can cause, not to mention deaths from aspiration as people have vomited in their sleep. It's a lot more serious than having a weak stomach and nearly puking when you brush your teeth.
The reason barbituates and opiates are used for the treatment is because there's literally no way to stop the vomiting once it starts. It doesn't respond to anti-emetics of any kind (cannabis or otherwise) so once a sufferer is in the midst of a vomiting episode, sedating the nervous system is the only way to get them to stop.
CVS is thought to be really rare, and it's been known about since the even of the 19th century, though only recently (i.e. since about the 1970s) has it been accepted as an illness in adults. It use to be thought of as primarily a pediatric illness. The statistical rarity is actually probably down to the fact that getting a CVS diagnosis means ruling out every single other thing that it could possibly be. This means getting ultra sounds, colonoscopies, endoscopies, ct scans, you name it. If a doctor thinks that the problem could be attributed to a "traceable" illness, they will test for it. Only until they have ruled out all of these traceable illnesses does someone get a diagnosis of CVS. Basically, the actual incidence rate of CVS might be a lot higher than the statistics show.
So what that means is that, say someone goes in with CVS, they're stomach is cramping, they can't stop throwing up, etc. The ER doctor might say, "Well it's your galbladder, we're going to have you go see a specialist." They may ultra sound it, find that you have galstones, and remove it. So case closed it was your galdbladder right? No, not necessarily, because people can have both CVS and a bad galbladder so when the doctor thought they were treating the cause they were just treating an entirely separate but coinciding illness.
Now on the other end of the spectrum is CHS. Doctors don't need to perform any of the same rigorous testing to rule out other illnesses. If you present "Cyclical Vomiting" ( as a symptom ) and you also use cannabis, then the E.R. doctors will automatically diagnose it as CHS and move on from there. Meanwhile, the standard treatments for CVS tend to work the same because they're not really addressing nausea, but the nervous system of the patient. All those drugs are doing is sedating a person to keep them from throwing up. Long story short, it's the opposite of CVS, where the statistics incidence probably eclipses the actual real-world incidence because of how lax the diagnostic criteria are. In other words, for every 10 CHS diagnosis, 1 of them probably actually has it, and the other 9 probably have anything from acid reflux, gallstones, to CVS. The fact that they can diagnose CHS for such a broad spectrum of illnesses is damn near malpractice.
When I first heard about CHS I was extremely skeptical myself and thought it was just bullshit as well. But after doing a lot of research into it, there's too much compelling evidence that shows there might actually be something to it. When given large doses of THC, it has a "paradoxical" effect where it can cause nausea instead of being an anti-emetic. Now, I still believe that a good portion of CHS cases which have been diagnosed in an E.R. setting are so laughably flimsy that they could be attributed to any number of other ailments including CVS, but I've also seen case studies of individuals presenting what doctors attributed as CHS being treated with capsaicin cream and finding relief. That is significant because the capsaicin cream binds with cannabinoid receptors and acts as a blocker, which indicates that something is binding to those receptors too much, and causing issues with the hypothalamus. Since THC binds with those receptors, it's a prime suspect. Does azadirachtin bind to those? I don't know, nobody has studied that.
So why not azadirachtin? Because azadirachtin poisoning is so infinitesimally small in occurrence compared with the number of people worldwide using neem based products which contain it. It's used by so many people, for so many different ailments, and yet the actual instances of azadirachtin poisoning cases can be counted on your fingers and toes. Think about this for a second: In India, a country with well over a billion people, and traditions using neem for centuries, you can still only find less than two dozen instances of azadirachtin poisoning. Meanwhile, what about the fact that growers have been using neem oil on cannabis for many decades now, way before any murmur of CHS? If it's really azadirachtin poisoning, then why haven't people been getting sick from it now with such high exposure? The only possibility there is that these synthetic forms of it like Azamax or Azatrol have something to do with it, but once again, those neem derivatives have been approved for use on crops since 1990... So where has the complications due to exposure been until now? I suppose it's possible we've all just been accumulating stores since then, but again, where's the studies to show that? It's all 100% speculation at this point.
Finally, probably the biggest problem with the azadirachtin theory is that synthetic analogues of THC are shown to induce the Cyclical Vomiting symptoms. If it truly is just the pesticides that are causing this in people, then why is it that people who are using synthesized forms of THC, without any azadirachtin present, are still getting these symptoms? There's a lot of case studies of people consuming legal weed alternatives and getting the same cyclical vomiting symptoms, as well as studies showing pure THC having the same effect. I think the legal weed alternatives are a little less of a "nail in the coffin" because we can't rule out that the plant material the analogues are infused with aren't also treated with some kind of pesticide. If someone were to do a study with pure THC that could put this issue to bed.
Anecdotally speaking, I have talked with a lot of people who believe they suffer from CHS who have grown their own without pesticides, and still end up getting sick. However, I've also heard the opposite anecdote from people who stopped using pesticides, and stopped getting sick. We could throw opinion and conjecture at this until we're blue in the face, but the only way we're ever really going to do is to do some actual experiments.
Because the poison view is just so flimsy, and might cause more undo suffering for people if they believe, "Oh all I have to do is stop using pesticides on it," and then continue to use cannabis. If it's the cannabis that's causing them to be sick like this, they will continue to suffer under that advice. Nobody that has to suffer cyclical vomiting wants to continue to use cannabis if they think it's the cause. But the problem is doctors insist that we're all just too stupid to know better, and that people's "preconceptions about it being used to treat nausea make them unwilling to admit the possibility it might cause it." I mean, I'm sure you'd agree with me the medical community is full of a bunch of jackasses; but they'd just as quickly say the same thing about us.
On the other hand, if you consider it as this CHS illness, then you have two avenues: 1. Quit smoking and see if that helps 2. Getting a second opinion and a diagnosis of CVS. With the diagnosis of CVS, a person could continue using cannabis for other ailments they may need it for, but also receive medical treatment for the Cyclical Vomiting. If they're told to just "cease use and see if that helps" and don't have any other ailments they need cannabis to treat, then it shouldn't be as big a deal. However, what if someone needs cannabis to treat a medical condition, they're basically being forced to go without treating that illness, or forced to use less ideal medications. Unlike doctors, I don't view people as too stupid for their own good, and if someone tells me, "No, pot doesn't make it worse, it actually helps," I tend to believe them. They need to know how to convince the medical professionals in charge of their healthcare of that too.
I would like it if doctors would stop giving out "CHS' diagnosis at all, and would prefer they list cannabis as a possible trigger to CVS. But that's not going to happen, at least not soon, because a lot of doctors still just want to hold on to anything they can to demonize the plant thanks to the stigma involved. What I worry the most about, because I've seen it happening, is that doctors will gather around blogsites targeted to emergency room staff, and talk about how "Cyclical Vomiting suffers are really just potheads," and crazily prejudicial stuff like that. I have seen it, and let me tell you, when someone comes in and talks about "Oh it's actually pesticides causing it!" and can't show a credible source for that claim to save their life, it only reinforces their idea that we're all just a bunch of stupid potheads. However, when someone comes in, and they show these quacks legitimate, peer-reviewed information, they're forced to actually stop and reconsider their position, or at least offer you a 2nd opinion from someone who is not a prejudicial quack. The more that happens, the more medical researchers say, "Hey, you know there may be something about this worth looking into," and find avenues of treatment that actually explain something like the capsaicin treatment did.
Basically, long story short... If we keep pushing the idea it's all just pesticides, doctors will not listen to us, and we're just going to continue seeing CHS diagnosed over and over again. If we keep an open mind, and say, "Listen doctors, we know cannabis might cause this, but have you considered this?" then they will actually be forced to do new research on the topic. I mean, the doctor who tested whether capsaicin was an effective treatment for example, do you think he would have done that research if he'd said, "Well it's pesticides, case closed." If he had come out swinging, "CHS is bullshit!" do you think they would have even funded his research? Instead, he played with the ball in their court, and showed there were viable alternative treatments than cessation.
Anyway, as you guys can see I'm pretty incapable of saying anything short and sweet on this topic. Really a better way to state my position is to say that I don't really believe CHS and CVS are that distinct, I'm dubious about cannabis really being a cause, but less dubious about it being the cause than pesticides. Meanwhile, what's the phrase, "You win more bees with honey," or something like that... Well if we just persist in alienating the medical community, telling them they're full of shit, that CHS is made up and it's actually pesticides, then we're really never going to find out what's actually going on. They will just stick to their story about it being caused by cannabis, CHS diagnosis will continue to rise (and will be used to malign cannabis and stall legalization efforts ), no clearer understanding of CVS vs CHS will be gained (causing undue suffering), the pesticide theory (as currently evidenced) will never be accepted by any medical professional, and we will all lose.
I could be completely wrong as well. It really might be caused by azadirachtin poisoning, or increasing THC levels, but that's predicating a lot on the idea that there even is a real increase in people getting sick. I'm still not convinced that there are actually are more people getting sick, and it's not just that doctors are more able to call it CHS now. CHS cases probably aren't actually increasing across the board, many of them were just more likely to be diagnosed as GERD, IBS, gallstones or CVS before.
