6 Conditions That Marijuana Can Mimic
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Marijuana is touted as the safest of all recreational drugs. There is considerable debate about that, but the good news is that deaths from marijuana only are rarely reported. Marijuana used in conjunction with other drugs, however, is a much bigger problem. Even alcohol potentiates the effects of weed significantly. After hearing how mellow marijuana is supposed to be, many folks who try it for the first time are surprised by their reactions.
As drugs go, especially naturally occurring drugs, marijuana is one of the most complicated. Made from the cannabis plant, it contains more than 113 active ingredients, called cannabinoids. These cannabinoids all affect the body in some way, and not always in the same way. Those who are well versed in the different choices have the ability to choose the sort of high they want.
Those who are new to the scene, however, can be surprised by the reaction they feel. There are plenty of stories of folks trying weed for the first time—or more precisely, the first time since college—and discovering that the high isn’t exactly what they expected. A quick internet search will find a bevy of 911 calls from people who didn’t quite enjoy the high they were feeling.
More Harsh Than Mellow
Some people go to the hospital thinking they’ve had a medical emergency.
The various psychoactive substances in marijuana are likely to create all sorts of different reactions to its consumption and even the way the drug is consumed makes a difference.
Eating a marijuana brownie metabolizes the weed differently than smoking a joint, which means the same bud could have different effects when eaten than it does when smoked. It also takes longer to feel the effects after ingesting the drug than it does after smoking it, which often leads newcomers to eat too much, thinking they aren’t getting anywhere. When the weed starts kicking in, it comes on all at once.
The two most well-known cannabinoids in pot are tetrahydrocannibinol (THC) and cannabidiol (CBD). Medical authorities aren’t entirely sure how each works exactly, but it’s generally believed that the paranoia and anxiety produced by THC are partly offset by the anti-anxiety properties of CBD. Some people are using CBD extract medicinally for things like seizure control and anxiety reduction with some success. Other folks go for the most extreme concentrations of THC they can find, which leads to a high that looks more like that of a stimulant than the sedative most people expect marijuana to be.
To meet the demand, modern marijuana farmers are very good at improving their yields. The same advances in agriculture that have increased food production per acre—and even per plant—around the world have also increased the concentration of THC in weed. THC in confiscated cannabis samples increased from 3.4% in 1993 to 8.8% in 2008. On top of that, there are other forms of marijuana besides the usual bud. Hash oil, sometimes called butane honey oil or BHO, is known for being extremely potent, up to 80% THC. The more THC in the product, the more anxiety, and stimulant-like reaction can be expected.
Not only is there great agricultural advances pushing the limits of farming efficiency, but there are also synthetic copies of marijuana. K2 or Spice are examples of synthetic cannabinoid compounds that mimic the effects of natural weed and act on the same cannabinoid receptors in the body. It sounds great to say we can make weed instead of growing it, but the reality is that you really don’t know what you’re getting. Beyond the fact that weed can mimic certain medical conditions, synthetic cannabinoids might have other drugs either as part of their chemical make-up or can be laced with other drugs to enhance their effects.
Can Weed Feel Like a Heart Attack?
With well over a hundred more cannabinoids in the marijuana compound besides THC and CBD, there’s a whole lot we don’t know about how weed affects the body. Because of the fact that it gets you high, scientists have focused on the effects of marijuana on the brain and central nervous system. But, evidence shows that weed also affects the heart.
There are several documented cases of marijuana causing heart rhythm disturbances and even one death through a fatal arrhythmia. It’s very possible these people could have had pre-existing cardiac conditions, even if they didn’t know it, but the weed certainly affected the way their hearts were functioning while they were high. In at least one case of atrial fibrillation, the effect persisted after the high wore off.
With the cardiac effects of marijuana largely still not well understood, the fact that some folks may feel as if they are having a heart attack after consuming weed is not to be ignored. Marijuana dulls pain; in fact, it’s one of the many benefits touted for medicinal use. So, even if the weed is affecting the heart in a negative way that could lead to chest pain when sober, people might not feel the pain. You can’t ignore feelings of distress, including palpitations or chest pressure, when taking marijuana. The fact is, it might not be mimicking a heart attack so much as causing one.
Weed slows down your mental processes. It’s one of the main parts of marijuana that users remember (well, if you can remember anything). It’s that slow, gentle, absentmindedness that is the butt of so many pot jokes.
Imagine a person with diabetes smoking a little weed and having someone visit. The slow, halting movements and difficulty finding words are exactly what you’d expect to see during a bout of low blood sugar. Just don’t reach for the pot brownies to help fix the problem.
Is All That Vomiting From Pot or Gastroenteritis?
Pot makes some folks vomit. It even has a name: cannabinoid hyperemesis. Typically associated more with chronic marijuana use, cannabinoid hyperemesis leads to severe, uncontrollable vomiting. Some people have discovered that hot showers can reduce nausea temporarily, but the only surefire way to completely stop the condition is to stop smoking weed.
Not a lot is known about cannabinoid hyperemesis. While it is known to affect chronic tokers, uncontrollable vomiting has been documented in other examples of folks who simply took a lot of marijuana. There is a debate about whether or not you can actually overdose on weed, but the medical community generally agrees there is such a thing as marijuana poisoning. Vomiting is one of the effects that gets mentioned often.
For folks who start vomiting after smoking marijuana, the presence of vomiting while high could be easily mistaken for some infection or gastroenteritis. It’s very important to be honest about the use of cannabis. Those around the patient are going to have a really hard time identifying the cause of nausea unless they are aware of the patient’s marijuana consumption. This is particularly bad news for the folks who started smoking weed to treat their nausea, common use by chemotherapy patients.
Besides vomiting, pot is also known for causing a fair amount of heartburn among those who use it the most. There are a few options that chronic users can take to try to calm their indigestion, but the only guaranteed cure is to stop smoking.
While most panic attacks are psychiatric in nature, weed can definitely push the panic button. It’s not unheard of to see patients hyperventilating and scared of nothing in particular when high. Unfortunately, like many other adverse reactions of marijuana, time is the only cure. There isn’t an antidote on the market that will reverse the effects of marijuana. Indeed, for those who are susceptible to the panicky feelings that weed might produce, abstinence is the only option.
THC’s anxiety-inducing properties are notorious. Even in the past, when the amount of THC in a joint was nowhere near as potent as today, some folks didn’t like the way weed made them feel as if the police were coming any minute. The anxiety felt by consuming a drug that was unequivocally illegal was probably worse than in today’s more tolerant environment. Whatever the barriers to marijuana use that have been removed, however, are probably offset by the potency of the product.
One step beyond panic is paranoia. It’s a fine line, but when weed takes you there, it might not bring you back. Psychosis that is induced by marijuana doesn’t always subside when the pot is all metabolized in some vulnerable individuals. In most cases of THC-induced psychosis, cessation of use is the eventual cure, but there are examples of marijuana being the trigger of longer-term psychotic symptoms.
This is one reason to definitely stay away from the highest concentrations of THC. Whether you choose to use or not, pushing the THC limit can be a dangerous game.
Marijuana is a complicated drug with lots of different faces. We don't yet know everything that it can do or all of its dangers.
Marijuana for GERD and Other Pressing Q’s, Answered!
Could marijuana smoking be the cause of GERD?
The effect of marijuana on the symptoms of gastroesophageal reflux disease is controversial. A study in 2002 showed that animals given a synthetic marijuana-like substance had an 80% reduction in transient relaxations of the lower esophageal sphincter, which is felt to be a significant cause of reflux. By reducing these relaxation episodes, symptoms of reflux should actually improve. Other smaller studies have shown that use of marijuana can actually worsen symptoms of gastroesophageal reflux disease by decreasing resting pressures of the lower esophageal sphincter.
I recently saw my gastroenterologist as my GERD symptoms have been worse. He has now recommended surgery. I had heard bad things about surgery in the past. Is this an acceptable option?
A very recent report out of Massachusetts General Hospital surveyed 200 patients that had underwent laparascopic anti-reflux surgery over a 10 year period. The results were almost universal near-normal quality of life scores, as well as considerable satisfaction with long-term results. The authors concluded that while some recent reports in the medical literature have questioned whether the long-term benefits of surgical repair outweigh the risks present in any sort of surgery, their surveys results indicate that, in appropriate selected patients, antireflux surgery is an excellent treatment alternative that provides very good results for patient quality of life. You should certainly speak with a surgeon to see if he feels that you would benefit from surgery.
Whenever I put on a few pounds, it seems like I experience more reflux symptoms. Am I just imagining this?
Recent research supports the link between obesity and gastroesophageal reflux disease. The risk markedly increases the larger the body mass. The mechanism is an increase in the pressure in the abdominal cavity forcing stomach contents to head towards the esophagus. This is similar to one of the ways that pregnancy causes worsening of gastroesophageal reflux. Patients that are overweight and suffer gastroesophageal reflux disease will frequently have relief of symptoms upon losing weight. Weight loss is an important behavorial modification that can lead to resolution of symptoms of gastroesophageal reflux disease.
I suffer from GERD. What types of food should I stay away from?
There are basically three ways that foods can worsen gastroesophageal reflux disease. Caffeine and alcohol can stimulate acid secretion. If there is more acid produced by the stomach, there is a greater chance of acid refluxing into the esophagus. Fatty foods tend to slow down contractions of the stomach. This also leads to acid being present in the stomach for a longer period of time, making it more likely to reflux into the esophagus. Finally, caffeine, chocolate and peppermints lower the pressure of the sphincter between the esophagus and stomach, allowing acid from the stomach to more readily reflux into the esophagus. A lot of patients with gastroesophageal reflux disease will be able to avoid medications if they stay away from the foods that tend to increase acid production and promote reflux.
I frequently wake up in the morning with a cough, and have seen a pulmonologist who finds nothing wrong. A friend suggested I take Prilosec and things have improved. Do I need to have any tests, or can I just assume the cough is from GERD?
If your cough has improved upon instituting Prilosec, it is likely related to gastroesophageal reflux disease. One of the drawbacks of having strong medications such as Prilosec available over the counter is that patients can take medications that might improve their condition, while masking a possible serious disorder. You should see a gastroenterologist and discuss your symptoms. Most likely, if you have been experiencing symptoms of gastroesophageal reflux disease for a period of time, he will want to do an endoscopy to rule out Barrett’s esophagus, a pre-cursor of esophageal cancer
Could marijuana smoking be the cause of GERD? The effect of marijuana on the symptoms of gastroesophageal reflux disease is controversial. A study in 2002 showed that animals given a synthetic marijua