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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.

Hypoglycemia

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.

Indigestion

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.

Panic Attacks

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.

Marijuana Psychosis

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.

5 things you may not know about marijuana

Not many people make a doctor’s appointment to talk about the pros and cons of smoking joints vs. vaping, the effects of the cannabis gummy bears they nibbled last weekend or whether it’s OK to mix Mary Jane with merlot. But maybe more of us should.

“There’s a perception that marijuana is like water and it has no harms associated with it, and it’s totally safe because it’s so common,” says Natasha Bhuyan, a One Medical doctor in Phoenix . “But that’s not true.”

Medical and recreational marijuana have become legal in a growing number of states, and use more than doubled between 2003 and 2013, according to researchers at Columbia University. One Medical providers are seeing all sorts of people using it: from college students and professionals in their 50s to recent immigrants and conservative-looking older folks.

“The most common scenario is your mid-30s software engineer who comes home from a long day at work and vapes as they’re eating takeout and watching TV or playing video games to relax,” says Mark Berman, a San Francisco lifestyle MD who counsels patients on weight loss and anxiety.

And more marijuana use means more marijuana problems — in fact, 30 percent of regular pot users have related health problems .

While using is an individual choice, we talked to some of our providers for the 411 on the possible pros and cons of marijuana and how to use it most safely.

Should I smoke it, eat it or vape it?

Visit a medical marijuana dispensary and you’ll find choices far beyond joints and brownies. There are vapor e-cigarettes, cannabis lotions and edibles like cannabis-laced watermelon lollipops, cheese puffs and chocolate chip cookies.

“I tell my patients I’d rather have them eat it because studies are clear (smoking) it does cause lung problems,” says Michelle Rhee, an MD in San Francisco , referring to coughs and asthma that some people develop.

And though there haven’t been long-term studies, vaping is easier on the lungs than smoking an old-school joint, and may be the safest way to get high. Vaporizers deliver the drug without the high temperature of smoke from a pipe or joint.

Since it’s hard to know the dose in a cookie or candy, it’s important to eat a tiny amount and wait at least an hour or two to see what the full effect will be. Otherwise, it’s easy to get a more potent dose of THC ( tetrahydrocannabinol) than intended. “I’ve had people tell me they actually hallucinated on edibles,” Rhee says.

Is there anyone who shouldn’t use marijuana?

The most serious side effects are for adolescents and young adults, because their developing brains are more susceptible to the effects of marijuana, and pregnant women.

A Duke University study that tracked 1,000 subjects for 25 years linked marijuana use to a drop in IQ. But further research showed that the subjects with lower IQ also had other issues like unstable families, depression and behavioral problems. They also found that smoking cigarettes was a better predictor of lower IQ than marijuana. Researchers now theorize that having a low IQ may make it more likely that someone will experiment with marijuana at a young age. Other studies have shown that people who start using marijuana before age 15 have an increased risk of a psychosis later in life, and that the drug can be a trigger for people who already have a family history of schizophrenia.

A 2015 study in the British Medical Journal found that women who use marijuana before or during pregnancy have a higher risk of anemia and miscarriage. And when those women carried to full term, their babies were smaller and more likely to spend time in neonatal intensive care.

Why are people using marijuana?

Most patients say they’re enjoying pot recreationally. But others are seeking relief from conditions including anxiety, insomnia, glaucoma, chronic pain , nausea from chemotherapy, and epilepsy, says Rhee. Studies show marijuana can improve muscle control in people with multiple sclerosis , so those patients are curious about it.

But does it help?

It depends. Rhee says some people seem to benefit from it, but others don’t.

“I’m cautious … because it can make some people extremely anxious and paranoid,” says Rhee. Some stressed patients who tried marijuana had more anxiety while other patients who used it for insomnia became anxious after they stopped using it, as can happen with the sleep medication Ambien.

Staff at larger dispensaries and websites like High Times and 420 Magazine can help people figure out the strains to try to feel energized or mellow, and what formulations will achieve the desired effect.

Many people self-treat with marijuana, and Bhuyan points out that so-called “medical marijuana” isn’t FDA-approved so there’s a lot of guesswork involved. She encourages her patients to talk about what they’re trying so they can make sure it’s not causing any other issues.

What are some other side effects of using marijuana?

A 2013 study in the UK found that long-term users produce less dopamine , the brain chemical linked to motivation and reward. It explains the “slacker syndrome” often associated with chronic users. Researchers found that people who started using younger had the lowest levels of dopamine.

If you’ve seen Pineapple Express or Up in Smoke , you know short-term side effects include slow thinking, and difficulty with paying attention, learning and remembering.

And marijuana also gives people the munchies, though overall, regular marijuana users are likely to weigh less than nonusers, according to a study in the American Journal of Epidemiology.

“They’re not munching on carrot sticks and broccoli,” Berman says. “What they’re eating is pizza and fries and burgers and popcorn and basically foods they don’t need if they’re struggling with their weight.”

Berman says he generally discourages marijuana use, since it often seems to solve one problem while creating another. He says other medications and behavioral changes are better solutions.

“There are a lot of gaps in marijuana research,” says Bhuyan. “As providers, the best thing we can do for our patients is advocate for more research.”

Not many people make a doctor’s appointment to talk about the pros and cons of smoking joints vs. vaping, the effects of the cannabis gummy bears they nibbled last weekend or whether it’s OK to mix Mary Jane with merlot. But maybe more of us should. “There’s a perception that marijuana is like water and it has no harms associated with it, and it’s totally safe because it’s so common,” says Natasha Bhuyan, a One Medical doctor in Phoenix. “But that’s not true.” Medical and recreational marijuana have become legal in a growing number of states, and use more than doubled between 2003 and 2013, according to researchers at Columbia University. One Medical providers are seeing all sorts of people using it: from college students and professionals in their 50s to recent immigrants and conservative-looking older folks. “The most common scenario is your mid-30s software engineer who comes home from a long day at work and vapes as they’re eating takeout and watching TV or playing video games to relax,” says Mark Berman, a San Francisco lifestyle MD who counsels patients on weight loss and anxiety. And more marijuana use means more marijuana problems — in fact, 30 percent of regular pot users have related health problems. While using is an individual choice, we talked to some of our providers for the 411 on the possible pros and cons of marijuana and how to use it most safely.