In my experience scromiting is induced not by high potency weed but by watching Republican primary debates.
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I saw this earlier today and 100% assumed this was a bit
wait, the substack IS a bit? I can’t tell anymore. Eve simmons definitely isn’t doing a bit,
or maybe?
It’s not that rare at all. It’s not an allergy either. It’s a dose dependent reaction that happens to people who smoke a shit ton.
It’s also a subset of the most annoying patients I see as they’re all convinced that there’s NO WAY marijuanna is causing their 15 ER visits per month. They’re commonly super dramatic and the main stay of treatment is basically a hot pepper cream and an antipsychotic.
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This is the best use of this meme I’ve ever seen.
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Thanks I made it myself!
(But I stole the idea off a twitter post I saw and couldn’t find again.)
The best is when some dumbass gives them morphine or dilaudid 4-5 times and they return to the ER like a stray cat that was fed once.
One of the most challenging cases I’ve ever had in my career was a 70ish man who came in completely obtunded and no one knew why. GCS was 3 initially. Did a massive workup including a pan scan of his head, chest, and abdomen, all the lab tests, a lumbar puncture. I ordered a urine tox screen too, but I generally find them useless. Literally the only abnormality that came back was THC.
Turned out his grandson had gotten some black market THC edible thing where they make it look like a real product. Forget what it was exactly, it was some sort of real food type thing that confused the guy. Took him 24 hours to wake up. I almost intubated him when I didn’t know what was going on.
See a fair number of kids who get into a gummy or whatever. It’s hard when you don’t know from the beginning that’s what happened. On the other hand, high toddlers are fucking hilarious and they do well so long as you know what it is so you don’t end up doing what I did to that older guy.
It seems to be a bit more complicated than this (like some people are susceptible to it and some are not) but yeah obviously risk increases with heavy use.
I’m all for cannabis decriminalisation but I’m not sure “let’s just hand it over to the free market and see what kind of insanely potent shit they can compete to create, yolo” was an amazing idea either.
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Hot pepper cream? Really? What does that do?
Anti-inflamatory?
Yeah capsaicin cream on the belly. It stops them from vomiting. There’s some weakly supported mechanism but know one really knows.
Hot showers work too.
Weird. If it were a pothead telling me about this one weird trick to get you to stop vomiting if you smoke too much instead of an MD, I would 100% not believe him.
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There’s a receptor called TRPV1 which is activated by both high temperatures and capsaicin and I believe is responsible for the “heat” sensation of capsaicin. The receptor is also activated by various cannabinoids, including endocannabinoids. So the details are unclear but that seems to be how the mechanism is mediated.
People seeking relief from nausea by taking very hot showers is characteristic of cannabinoid hyperemesis syndrome, like almost a defining feature.
It really is amazing what is happening here. Somehow we went straight from sending people to prison by the truckload for selling weed to peddling THC candy at the corner store. Anything to shift the tax burdon to the working class I guess. In New York they legaluzed it over a year ago but still don’t have any headway on a regulatory structure for recreational sales. So here in the Bronx every other block has some guy selling chocolate bars dipped in vape juice out of a truck. Great job all around.
Remember like two years ago when everyone went completely apeshit with fireworks? That was one of the oddest phoenomena ever.