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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.

Marijuana and heart health: What you need to know

Access to marijuana is growing, but marijuana benefits and its risks have not been carefully studied.

Image: © UrosPoteko/Thinkstock

In many states in this country, you can legally use marijuana for a range of health benefits, including the treatment of chronic pain, anxiety, and nausea. Smoking is the fastest way to feel the effects of marijuana, which is derived from the Cannabis sativa plant. Yet marijuana smoke contains many of the same toxins, irritants, and carcinogens found in cigarette smoke — a known contributor to heart disease as well as cancer.

Marijuana cultivation and use dates back some 6,000 years. However, the cardiovascular and other health effects of cannabis aren’t well studied. That’s partly because under federal law, cannabis is a Schedule I substance, meaning it has “no currently accepted medical use and a high potential for abuse.” That designation places numerous restrictions on researchers, making it difficult to carry out rigorous research on marijuana.

“As a result, everything we’re told about what marijuana does or doesn’t do should be viewed with a certain amount of caution. This holds equally true for the risks as well as the benefits,” says Dr. Kenneth Mukamal, associate professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center.

Pot and pain

Some of the strongest evidence supporting the medical use of marijuana is marijuana’s benefits for managing chronic pain. Cannabinoid compounds (see “Cannabis 101”) interact with receptors in nerve cells to slow down pain impulses and ease discomfort. Cannabinoids also have been shown to be effective in quelling nausea and vomiting. In addition, marijuana is a powerful appetite inducer. The combination of these attributes makes marijuana a therapeutic option for people coping with the side effects of chemotherapy and others who are in danger of unintended weight loss. However, in conditions where gaining extra weight might exacerbate existing health problems, such as diabetes, appetite stimulation would be counterproductive.

Cardiovascular effects

One of the few things scientists know for sure about marijuana and cardiovascular health is that people with established heart disease who are under stress develop chest pain more quickly if they have been smoking marijuana than they would have otherwise. This is because of complex effects cannabinoids have on the cardiovascular system, including raising resting heart rate, dilating blood vessels, and making the heart pump harder. Research suggests that the risk of heart attack is several times higher in the hour after smoking marijuana than it would be normally. While this does not pose a significant threat to people who have minimal cardiovascular risk, it should be a red flag for anyone with a history of heart disease. Although the evidence is weaker, there are also links to a higher risk of atrial fibrillation or ischemic stroke immediately following marijuana use. Consistent with these links, studies by Dr. Mukamal and colleagues also suggest that marijuana smoking may increase the long-term death rate among heart attack survivors.

Questions remain on marijuana’s benefits and risks

Most of the evidence linking marijuana to heart attack and stroke is based on reports from people who smoked it. So it’s hard to separate the effects of cannabinoid compounds on the cardiovascular system from the hazards posed by the irritants and carcinogens contained in the smoke. Because cannabis smoke is known to cause airway inflammation, wheezing, and chest tightness, people with lung diseases should not smoke it. Other people who should just say no to marijuana include those who may be vulnerable to developing schizophrenia or addiction.

Cannabis 101

The cannabis plant contains more than 100 unique chemical components classified as cannabinoids. These are the active ingredients that bind to specific receptors in the brain and other parts of the body. The two most prevalent types are tetrahydrocannabinol (THC), which is primarily responsible for the mind-altering properties sought out by recreational users, and cannabidiol (CBD), which has no psychoactive effect. Cannabidiol may actually work to offset the psychoactive properties of THC.

The magnitude of marijuana’s psychoactive effect depends on the THC level in the particular strain of plant, which parts of the plant are used, and the route through which the drug enters the body. Legalization in some states has led to the breeding of strains that are three to seven times more potent than those available three decades ago.

The impact of smoked or inhaled marijuana is generally felt within a few minutes and lasts two to four hours. Marijuana ingested in food or beverages kicks in more slowly and lasts longer.

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