Cannabinoid hyperemesis syndrome

[Krazy]

Interesting topic indeed. I'm still playing catchup on this thread.

My sister has a very violent reaction to even small amounts of smoked/vaped meds. Some of this is strain specific as sativa is worse for her as well as anything with pine or lemon terps. Edibles she is completely tolerant of; no bad reaction at all.

 

[Garysfriend]

Steams, I dont' know if I have CHS, I don't vomit and showers do little for me. However, based on what I've read on the subject, there are apparently 3 phases (and I'm summarizing here), and I'm thinking I may be in the first phase:

-morning nausea, loss of appetite, mild stomach pain

-puking your brains out for hours to days at a time, sweating, intense thirst, hot showers, intense pain

-recovery where things appear to be "normal" again.

Then the cycle repeats. I wonder if I'm in the first phase and just never go past that, because of the amount I use, and the fact that realize something is off and I stop.

I've enjoyed the herb near daily for 10+ years. But not heavy. Almost always less than .1g a day, vaped. Always in the evening.

Currently, if I vape, I have issues the next day. If I don't vape, within a few days everything is fine again. I'm currently experiencing this for the 2nd time. My first time was 7 months ago. At that time I took a 6 week break and then resumed as described above. I was fine until a week or two ago and things started up again.

Of course, this could not be the issue at all. Cannabis can mess with your head, and with the stigma, "horror stories" all over Reddit and the rest of the web, and this condition itself, I realize it could be something else and I'm just being paranoid. I am rather certain though that somehow... either directly or indirectly, cannabis has something to do with it.

 

[chris 71]

Well , i have went the last few days not having any cannabis till after 4 pm and today i had one of my spells without any cannabis involved . so im thinking in my case its probably not this .

I also think there are really to many unknowens to really diagnose anybody with this . to call it CHS is really streaching it , till we have more scientific data showing that cannabiniods can really effect somone like this . how can we know that it is not something eles . possibly the chemical nutrients used to grow the plant . or maybe exposure to something eles related to the prodution , or even chlorophyll from improper curing or heck maybe even harvesting imature plants or something . could the cannabis flower need to be ripened simalar to ripined fruits as in if you eat to much unripened strawberries or water melon ect ect might make us sick ?

Seems these days everybody is after the highest thc numbers maybe people are chopping the plants too soon , maybe for a propper ripened flower , its best to have some degregation and harvest after the peak levels are reached . in a simalar way to fruits tasting beter and not making us sick wen properly ripened

 

[ginolicious]

This is way too wild. I can't believe this is even a thing. I've never experienced such a thing before. I hope I never do. I've been sick for about a week. Naseous and weak. But I've never thrown up. Worst part is by the evening I feel as if nothing is wrong.

Back on topic here, if this is really a thing what are we suppose to do? Stop vaping?

 

[Krazy]

I don't know enough to answer the question; could this be a Terpenes issue?

EDIT:

Crap, don't mind me, I already mentioned Terps. Also as mentioned before: krazy person with TBI, PTSD, and other.

 

[ginolicious]

I would assume for someone to be affected by such a thing they would need to be vaping at least a gram a day no?

 

[Glass004]

did any of you guys who have experienced this remember if there were some signs leading up to the first time you got sick ? did you notice a change in the effects of your usage before hand ? i mean like maybe feeling sick after using for a while before you had the full blown puking ?

The first time I got it 15 years ago, I had been smoking vast quantities of really bad dope cuz back then it was all we could get. A significant combustion history is usual, sudden increases of chronic smoking can start your body's CHS process. Greater quantities of toxic cannabinoids produced with smoking are the primary cause. However there will be many triggers from stress to fatty foods that affect an individuals CHS onset.
It comes on out of the blue like food
Poisoning, usually first thing in the morning You will wake up feeling really off. Maybe have a poop, then nausea slams you.
Stop smoking. Vaping and edibles are the safest way to consume herb.
My son just had his first attack after smoking a lot of DAB. I think the potency of cannabinoids smoked have a role in the onset of CHS as well. Now really potent medical herb is common, there is more CHS. My son is sucking on an old Iolite vap now, he is convinced.
One more thing, once your body starts reacting to combusted cannabinoids, it only gets more sensitive to them.

 

[BD9]

Just thinking out loud........

I wonder if this could be a chemical reaction from heated parts of the materials from which vapes are made. No matter how safe these materials are considered, off gassing may be a possibility. Maybe?
Whether it's bleach or what ever chemicals are used in rolling papers to oil used in manufacturing vapes, or off gassing from warmed/heated metals, plastics and even wood in the vape are toxic when inhaled.
Even if these materials are separated from the air path is it 100% separation?
Could it be pesticides or mold in the cannabis?

As I've gotten older I seem to have more allergies and more severe histamine responses to things I've been in contact with for years that have never bothered me before.
I feel there are too many variables and further research should be done this this syndrome.

I do wish the best to all of you that are suffering from this.

 

[syrupy]

Just thinking out loud........

I wonder if this could be a chemical reaction from heated parts of the materials from which vapes are made. No matter how safe these materials are considered, off gassing may be a possibility. Maybe?
Whether it's bleach or what ever chemicals are used in rolling papers to oil used in manufacturing vapes, or off gassing from warmed/heated metals, plastics and even wood in the vape are toxic when inhaled.
Even if these materials are separated from the air path is it 100% separation?
Could it be pesticides or mold in the cannabis?

As I've gotten older I seem to have more allergies and more severe histamine responses to things I've been in contact with for years that have never bothered me before.
I feel there are too many variables and further research should be done this this syndrome.

I do wish the best to all of you that are suffering from this.

I doubt it's from heated material? There is so much diversity in materials for the different vapes, it seems that all sufferers of CHS would be exposed to the exact same chemicals. Now, if everybody with CHS used Volcanos...then I'd be in on the theory. Also, people have been combusting for a long time in devices made of glass, various woods and metals. Why'd it take this long for CHS to appear? I have no answer, your guess it as good as mine!

I think the people in this thread are doing the right thing-- experiment by isolating various factors (one at a time) and observe the outcomes. Sounds like reducing/eliminating vaping and dietary changes are helping some.

 

[herbivore21]

Just thinking out loud........

I wonder if this could be a chemical reaction from heated parts of the materials from which vapes are made. No matter how safe these materials are considered, off gassing may be a possibility. Maybe?
Whether it's bleach or what ever chemicals are used in rolling papers to oil used in manufacturing vapes, or off gassing from warmed/heated metals, plastics and even wood in the vape are toxic when inhaled.
Even if these materials are separated from the air path is it 100% separation?
Could it be pesticides or mold in the cannabis?

As I've gotten older I seem to have more allergies and more severe histamine responses to things I've been in contact with for years that have never bothered me before.
I feel there are too many variables and further research should be done this this syndrome.

I do wish the best to all of you that are suffering from this.

This is very interesting. I did notice reclaim inside a dab rig once hanging off of the inside of the titanium e-nail base got some rock solid black residue building up in it. It was hard like shatter, but when dabbed on a hot nail - DID NOT READILY MELT!

It very slowly partially melted but this suspected polymerization byproduct gave me the most intense headache even though it barely produced vapor and stayed mostly in the same form/color when superheated on a nail. It also made me feel quite nauseous but did not cause vomiting because I noticed it was weird stuff and stopped inhaling after a second when it didn't melt (I just thought it was typical reclaim originally, it looked sorta like it but it felt much more solid than reclaim usually does).

I wonder if Hyperemesis may emerge as a side effect of exposure to similar polymerization byproducts from cannabis smoke/vapor over time?

 

[invertedisdead]

I wonder if Hyperemesis may emerge as a side effect of exposure to similar polymerization byproducts from cannabis smoke/vapor over time?

Vape pen coil atomizers certainly come to mind.

 

[Glass004]

Hey folks, when most of the posts begin with I wonder, it confuses me that when people give you the answer in a silver platter you ignore it and go on making uneducated guesses.
Go on down the polymer road.
This forum is named fuck combustion. Get a clue people, stop smoking. Eat edibles or get a vaporizer and keep temps below combustion. The volcano set on high is combusting your grass.
If you aren't in love with hot showers, find another forum regarding your health. This is the CHS crowd. Hot showers define us!!!

I would assume for someone to be affected by such a thing they would need to be vaping at least a gram a day no?

Never heard of a vaper having CHS. Only smokers are being affected. The quantity and potency of herb smoked diffinately affect CHS

This is way too wild. I can't believe this is even a thing. I've never experienced such a thing before. I hope I never do. I've been sick for about a week. Naseous and weak. But I've never thrown up. Worst part is by the evening I feel as if nothing is wrong.

Back on topic here, if this is really a thing what are we suppose to do? Stop vaping?

Stop smoking. Vaping pot does not produce the same taxi cannabinoids as does the chemical reaction of combustion.
No true CHS sufferer I know if has linked CHS to vaping. Where are you guys getting the info to make this bad supposition of vaping causes CHS???

 

[ginolicious]

Stop smoking. Vaping pot does not produce the same taxi cannabinoids as does the chemical reaction of combustion.
No true CHS sufferer I know if has linked CHS to vaping. Where are you guys getting the info to make this bad supposition of vaping causes CHS???

I don't smoke brother. I only Vape and have been for 2 years now. I also never said I had CHS or thought I did. When I read this thread it made me question the sickness I have been experiencing which rather differs from CHS, let alone i have been vaping more than usual which is a .2-.3 oppose to the .1. But that's besides the point.

 

[herbivore21]

Hey folks, when most of the posts begin with I wonder, it confuses me that when people give you the answer in a silver platter you ignore it and go on making uneducated guesses.
Go on down the polymer road.
This forum is named fuck combustion. Get a clue people, stop smoking. Eat edibles or get a vaporizer and keep temps below combustion. The volcano set on high is combusting your grass.
If you aren't in love with hot showers, find another forum regarding your health. This is the CHS crowd. Hot showers define us!!!

If you are referring to my post here, I was suggesting one single possibility that may lead to aspects of this syndrome, I never suggested that this was the only possible cause or definitely a cause. The data does not exist to my knowledge to support any such claim.

If you are suggesting that someone has conclusively explained the nature, mechanisms and causes of cannabis hyperemesis, I would be very surprised!

At present, the scholarly literature is far from conclusive when discussing much about this condition. The prevalence in recorded medical literature is negligible and only pre-clinical research, almost exclusively from individual case reports (this has no usefulness for extrapolation to other cases, the datasets are far too small).

As to other kinds of sources, I've also seen one study that considered cases of increases in numbers in various cyclical vomiting presentations in Colorado hospitals before and after legalization and trying to use this to argue that the numerical difference were cases of cannabis hyperemesis. This is very sloppy, superficial reasoning. As with all large datasets the increase could be explained by infinite variables, something as simple as overall population growth for one basic example could lead to a rapid increase in presentations in a given condition over that period of time! To avoid conflating this kind of correlation with a causal explanation is one of the biggest things to be avoided, this is basic scientific method 101.

Given the lack of large-scale and representative data, scientists and laypeople alike simply don't know enough about this syndrome yet to do more than take a guess as to possible causes. There isn't enough systematically recorded data on this phenomenon to pretend that we can come up with a full scientific explanation yet. Medical science has very high standards for evidence requiring large-scale, repeatable evidence before we can presume to be able to explain a health condition. Eventually that will come.

Until now, there is no sense in being frustrated by folks taking guesses. After all, the claims that we test as hypotheses in early scientific research into new topics like this are usually educated guesses - and often turn out wrong! It is only by narrowing the possible explanations down in this way that we get closer to knowing what the causes are. This is the hypothetico-deductive method which characterizes today's science.

BTW I have heard isolated reports (which are all there is on the topic of cannabis hyperemesis so far when we look at the literature internationally!) of people who dab heavily getting cannabis hyperemesis. That is vaping, not smoking!

 

[Krazy]

Just read another Refer Madness article on this. Full of doctors are noticing, potential causation, numbers in Colorado almost doubling, etc.. Study sited has no real causation lol. I have no doubt that this is a real thing affecting a small number of people and is horrible to experience. But boy is it being pimped by the "It's the Devils Weed!" crowd. The "study" is actually a review of ER visits targeted and cherry picked to generate a result as far as I can see. Articles are full of words like; might, could, seems, etc..

This is the "study" all the scare mongers keep siting.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469074/

https://www.merryjane.com/health/heavy-marijuana-use-may-lead-to-kidney-failure

According to reports, there were 41 cases of CHS in Colorado in 2009, which increased to 87 after the passing of Amendment 64.

“It is certainly something that, before legalization, we almost never saw,” Heard told CBS News. “Now we are seeing it quite frequently.”

So 41 cases is "we almost never saw" And 87 cases is “Now we are seeing it quite frequently.”


Thanks to herbivore21: The above edit occurred while you were posting the info below.

 

[herbivore21]

Just read another Refer Madness article on this. Full of doctors are noticing, potential causation, numbers in Colorado almost doubling, etc.. No studies, links, or hard data, lol.

Oh the doubling of numbers in Colorado was relating to all cases of cyclical vomiting by ICD9/Rome III criteria. This includes much more than CHS (also that study does not provide compelling evidence to suggest the increase is related to CHS)!!!

That is one of the studies I mentioned above which is problematic science to put it diplomatically.

Here's the study:

http://onlinelibrary.wiley.com/doi/10.1111/acem.12655/full

 

[Detonator]

I haven't had a CHS attack since the last time I check in months ago... Still vaping and dabbing as much as usuall... Little less stress in my life lately and I think that has something to do with it, maybe?
I don't like to talk about it but I do like to keep a record here,,,lately I'm good...

 

[Glass004]

DAB on a very hot surface (common administration) is most times causing combustion. Anything hotter than say 450 F is burning the material. Not many people DAB ing this way are going to reduce and measure the temp of their heat spike to avoid combustion.
Again, if you not hooked on hot showers, you're not talking about CHS. The definition of combustion is not derived from using a lighter, it us determined by the temperature of the substances at which the chemical process of combustion occurs for that substance ( above 450F for cannabinoids.
Your discussions about vaping causing CHS don't hold up the scrutiny of someone who figured it out 5 years ago. No attacks unless combustion involved.
No studies relating to this topic, but having suffered from CHS for decades, having smoked grass for over a half century, and a as trained health care scientist, the info I analyzed points to toxic cannabinoids produced combustion alone that have a toxic effect on the hypothalamus.
Seeing people post uneducated guesses makes me sad for the poor sufferers of CHS that believe them. If you ain't in the hot shower with us, there is no way you should be propagating theories with no scientific basis. You are causing more harm than good for the CHS sufferers, and we don't need anymore suffering from misinformation.

 

[herbivore21]

I never argued that vaping can cause CHS, I have never met or known of anybody IRL who has suffered from this. I do not know what causes it. All I said is that somebody else on FC mentioned a colleague who was dabbing heavily and got CHS from that. That is one isolated anecdote and does not mean that everybody will experience CHS from vaping. Yours is another isolated anecdote suggesting that in your case, smoking leads to CHS symptoms but not vaping.

I do not personally hold any firm beliefs as to whether CHS can only occur with smoking or vaping and we have only got anecdotes which in this case are contradictory to work with.

The only cases of CHS I know of are from the scholarly literature or the small handful of FC members here. I only refer to those cases.

I have not propagated any 'theories' here. I have suggested one possible cause of one possible aspect of this rare and complex presentation of symptoms. I did not say it was a conclusive or strongly supported claim. I have been very clear that it may be inaccurate and is only a guess. I have only referred to anecdotes here - no scientific 'theories', anecdotal reports are all that there is available on CHS at the moment (as you concede, there are negligible studies!).

As I said above, cases of CHS are rare anecdotes, statistically speaking. I do not put much stock in these cases for having extrapolative potential. THIS DOES NOT IN ANY WAY DIMINISH OR RENDER THE SUFFERING OF THOSE WHO EXPERIENCE IT TO BE ANY LESS REAL!!!

It is simply not reasonable to say that after considering the anecdotal information available, that you have some scientifically compelling explanation for CHS that is generalizable to other cases. You do not have a statistically representative sample to draw upon and so you cannot possibly argue that you have an argument that can be used to generalize to other cases. This is the crux of my post above and you have not responded to this. How do you propose to understand CHS in a way that can be extrapolated to others when you concede only having access to isolated anecdotes? Surely you understand why I would raise this if you worked/work in the health sciences?

Again, I am not saying that CHS experiences as described in the anecdotes are not real! I am simply saying that it is far from well understood and that the required data is simply not there to have anything approaching a scientific understanding.

Also man if you think that dabbing concentrates on an e-nail typically involves combustion, you don't understand concentrate use/vaporization very well. The understanding that you have about temperatures for combustion is not appropriate when we consider dabbing, the data is relevant to consumption of flowers, not extracts. When you change the composition of the thing you are heating in the first place, it behaves differently (this should come as no surprise!).

Flowers subjected to temps like you say will combust. However, high quality extracts contain a comparatively small portion of the original constituents of those flowers - the resin (varying portions/fractions depending on the kind of extract of course). This is not flammable/combustible/subject to thermal decomposition at the same temperatures/in the same ways, as the components of the plant which do combust more readily are not found in these extracts!

The temperatures that are read on the dial of an e-nail controller are absolutely not the temps at the dish where contact is made with the concentrate btw. In my experience, the difference between the temp on the PID controller as determined at the heater coil thermocouple can reach >150f! The temp on the dial of an e-nail is always hotter than the temp on the dabbing surface. This is especially true of nails that use inserts and do not get direct contact with the dabbing surface.

If an e-nail controller says you have 600f, then what you have on your dish may actually be as low as 450f. Now consider that most of us dabbing on SiC and Sapphire use temps often less than 600f (I use 500-550f as read from the d-nail controller with my Sapphire halo!). This is not necessarily even exceeding the combustion temps for flowers you mention in some low temp enail configurations.

Now consider that the substances that we dab have been rendered devoid of the vast majority of anything that will smoulder and combust in cannabis flowers. Now you can see why the resulting vapor is actually much more pleasant smelling and tasting (also much less harsh on the throat) to use than vaping flowers and will have less thermal decomposition byproducts than flowers vaped at the higher range of flower vaping temps (of course data on the actual temps that flower is subjected to in the various flower vapes is not reliable either - being arbitrarily measured temps taken at various points of radically different airpaths!).

There is less shit in the extract that is susceptible to thermal decomposition and combustion in the first place! The composition of flowers vs concentrates is incomparable and greatly influences the behavior of either substance when heated.

In low-temp dabbing of high quality extracts (low temp dabbing is what most people are doing these days, I certainly know of fewer and fewer people who dab at anything but low temps), we are boiling the resin into a vapor phase and inhaling it. This requires higher temps as we are boiling a blob of oil, rather than unevenly distributed deposits of the same resin spread amongst a higher proportion of dried and MUCH MORE FLAMMABLE plant material (as with vaping flowers).

Which info did you analyze by the way? Do you mean that you read some online articles (please share your sources!)? Or is this a scientific analysis of some kind which is published somewhere that we can read?

 

[Detonator]

I been taking notes on my symptoms and useage here for several years, sense the start of it.... so either one of you two scientist want to go back and make a chart based on my findings, see if you can come to any conclusions? , I encourage you do do so.... lol I'd like to see it...... I'm dabbin some SD on the Sublimator now.... good luck making a chart from my OMG CHS is killing me ramblings from the past... Glad I'm OK now,,,knock on wood... carry on... ps I like bar graphs and pie charts

 

[herbivore21]

I been taking notes on my symptoms and useage here for several years, sense the start of it.... so either one of you two scientist want to go back and make a chart based on my findings, see if you can come to any conclusions? , I encourage you do do so.... lol I'd like to see it...... I'm dabbin some SD on the Sublimator now.... good luck making a chart from my OMG CHS is killing me ramblings from the past... Glad I'm OK now,,,knock on wood... carry on

If I find some free time before my vacation ends (this is doubtful), I'll be happy to look at your posts

I hope more importantly that you have spoken to your relevant clinicians/doctors about this too. It is important to seek medical attention when you experience sustained vomiting and some other symptoms relevant here.

We need to keep in mind that anything we gleam from your anecdotes will only be relevant to managing your own case. We must also take into account that we could no doubt fill many football fields with potentially relevant context about your lifestyle/biology etc that I am unaware of lol - I couldn't pretend to give you any advice that is likely to be very useful.

Still, if there are any questions that I can answer, I'm happy to help!

 

[grokit]

This is very interesting. I did notice reclaim inside a dab rig once hanging off of the inside of the titanium e-nail base got some rock solid black residue building up in it. It was hard like shatter, but when dabbed on a hot nail - DID NOT READILY MELT!

It very slowly partially melted but this suspected polymerization byproduct gave me the most intense headache even though it barely produced vapor and stayed mostly in the same form/color when superheated on a nail. It also made me feel quite nauseous but did not cause vomiting because I noticed it was weird stuff and stopped inhaling after a second when it didn't melt (I just thought it was typical reclaim originally, it looked sorta like it but it felt much more solid than reclaim usually does).

It sounds like more of a carbonized tar thing imo.
Good thing you only did this once, as you may have dabbed a bit of creosote

 

[herbivore21]

It sounds like more of a carbonized tar thing imo.
Good thing you only did this once, as you may have dabbed a bit of creosote

Oh man I cringed again when I read the mention of creosote lol (mind you that is ruled out, any comparable creosote that I know of has a boiling point that would have seen the stuff vaporize quickly when dabbed)! That dab was fucked up. I seriously thought my e-nail was turned off when the stuff wouldn't melt for a few seconds and barely changed sitting on the dish lol

Man any number of possible decompositon byproduct could have been the culprit here, the part of the e-nail that the build-up was found within was left on for a long period accidentally and as it was a backup unit, didn't get noticed for a month (this was not apparent at the time and the realization occured when I noticed how strange this material was)! The buildup was inside the vapor path extremely close to the heater coil and would have been subjected to the same temps as the dish of the nail!

Ever since then, I have never attempted to recover reclaim from the metal components of my e-nails. It is not worth dabbing something that has been subjected to nail temps for such a long time. That temp for the duration of the hit when you dab is one thing, but sustained for weeks or longer is likely to be awful!

 

[grokit]

Yeah I been there with my sub atomizer "reclaim".
Not all sublimate is created equal

 

[herbivore21]

Yeah I been there with my sub atomizer "reclaim".
Not all sublimate is created equal

Oh shit man I have seen sublimators that have reclaim so oxidized that it actually resembled rust! Needless to say, I turned down a hit off of any such unit lol

Reclaim definitely needs to collect away from hot components of the rig/vape setup IME, otherwise it is not worth saving