The dark side: How some users could be risking serious illness

By Reid Southwick

When he arrived at a southern Ontario hospital emergency room, Cody Morin was dehydrated and vomiting blood. He was rushed into quarantine; doctors worried he was infected with the Ebola virus.

His father wasn’t allowed at his bedside without a hazmat suit.

Hours before, Morin was at his fiancée’s Whitby, Ont. home after work, where he smoked a bowl of pot, a daily routine for the drywaller accustomed to smoking at least four joints a day. He was overwhelmed by cold sweats, dizziness and nausea. He vomited uncontrollably for about two hours before his fiancée took him to the hospital.

Morin had been in and out of hospital for years with similar bouts of being violently ill, which lasted for six hours at times. Doctors told him he suffered from stomach ulcers. He took medication and changed his diet, but it did nothing to stop the overwhelming spells that churned his stomach.

“You instantly feel light-headed, like you’re going to pass out, and your stomach starts spinning like crazy,” Morin said. “I was so dehydrated … they couldn’t stick an IV in my arm because my veins kept collapsing.”

As Morin lay in isolation in late 2014, doctors brought in a stomach specialist who gave him the diagnosis that would ultimately relieve his misery — he had cannabinoid hyperemesis syndrome. The condition has been detected in some chronic pot smokers who face the same periodic bouts of violent vomiting.


Scientists don’t know for sure what causes the condition, but they believe that avoiding marijuana is the only cure, said Dr. Andrew Monte, an assistant professor at the University of Colorado’s school of medicine who has studied the syndrome.

Morin initially balked at the diagnosis, having smoked for well over a decade, but he watched his symptoms disappear after he stayed off marijuana. Now, he has discovered other pot smokers who suffered through similar torment.

Researchers haven’t identified how widespread the condition is across Canada, given that the syndrome is newly identified and not well understood, said Dr. John Foote, an emergency physician at Mount Sinai Hospital in Toronto who has written about cannabinoid hyperemesis.

He has seen roughly one case every month in the past two years, but says those who end up at emergency departments likely represent the tip of the iceberg.

Emergency rooms at two Colorado hospitals have seen a doubling in the rate of patients with cyclical vomiting syndromes like cannabinoid hyperemesis, said Monte, who believes the spike is largely due to the state’s recent legalization of marijuana. Hospitals across Colorado now see several new cases every week.

The growing prevalence of the debilitating condition was among several unexpected health effects of legalizing pot for medicinal and, later, recreational use, Monte said.

In a two-year period, his hospital alone reported 31 admissions for marijuana-related burns, most of them caused by extracting Tetrahydrocannabinol, the active ingredient in marijuana known as THC, from plants using butane as a solvent. Twenty-one cases required skin grafting. Some burns covered 70 per cent of the patients’ bodies.

Monte said the most concerning unexpected health effects have involved children who consume marijuana, mostly in edible products, by accident. Pot is often sold in chocolates, candies and other goodies that look attractive to kids who know nothing of the intoxicating contents. In the five years before medicinal pot was legalized, the Children’s Hospital Colorado had not treated any youngsters for mistakenly ingesting marijuana. In the second year of medical legalization, there were 14 cases.


Across the state, the rate of children younger than nine being hospitalized for possible marijuana exposure has increased dramatically, according to a public health committee that has been measuring the impact of legalization in Colorado.


There was roughly one case for every 100,000 hospitalizations in Colorado from 2001 to 2009, the initial period of medical legalization. The rate spiked to 13 cases per every 100,000 in 2014 through to June 2015, the first year and a half of retail legalization.

Children who eat marijuana candy bars or cookies can develop pneumonia from a depressed central nervous system. Their heart rate can double normal levels to 200 beats per minute. They can become comatose.

“A hundred milligrams in an adult may cause some hallucinations, may cause their heart rate to go very fast, which may be a risk, but it’s a risk in a subset of patients,” Monte said. “Every single paediatric patient shouldn’t have 100 milligrams, and that’s really only one cookie.”

Monte said edible products should not be sold in retail pot shops, given the health risks. According to his research, edibles are responsible for most health care visits due to marijuana intoxication, for patients of all ages.

Concentrations of THC in these products can vary wildly, while the effects can take hours to fully kick in. Users who don’t feel high shortly after eating a cookie may eat more, intensifying the effects when they peak. Overconsumption can lead to increased anxiety, rapid heart rates, high blood pressure and vomiting.

In 2010, about 330 patients across Colorado were hospitalized with ailments where marijuana was believed to be a contributing factor, according to data published by the public health committee studying the effects of legalization. In the first six months of 2015, there were nearly 600 cases, according to the committee.

“The problems outweigh the benefits in the recreational realm with edibles,” says Monte.

In Washington state, where retailers began selling recreational pot in July 2014, calls to the poison centre for marijuana exposure have been on the rise, from about 160 a year before legalization to 270 in 2015. Nearly half the calls, 126 of them, involved patients younger than 19.

Still, these calls account for a small percentage of the 63,000 total calls the poison centre receives each year.

The number of pot-related calls is escalating, in part, because parents are not as worried about child protective services getting involved now that recreational use is legal, said Alexander Garrard, clinical managing director at Washington Poison Center.

The public health committee measuring the effects of legalization in Colorado found adolescent and young adult users are at higher risk of developing psychotic symptoms or disorders in adulthood.

The same committee also found substantial evidence that pot smoke contains many of the carcinogens that are in tobacco smoke, and that heavy pot smoking is linked to bronchitis, including chronic coughs and wheezing.


In Canada, those advocating legalization argue public health officials have a better chance of reducing these ill effects by legalizing and regulating marijuana than by keeping it in the illicit market.


“We’ll know what’s in it and how it’s grown, what the strength is, and the product will be labelled. We’ll know who made it, who sold it,” said Dr. Mark Lysyshyn, medical health officer at Vancouver Coastal Health.

He said regulations should also include childproof packaging and other steps to keep pot away from children.

“If there are problematic products out there, then we’ll have them withdrawn off the market. People used to go blind from drinking moonshine; that doesn’t happen anymore. We have to get safe products out there that people can use safely.”

At Vancouver’s annual 4/20 pot rally, which draws thousands of users, health officials typically deal with dozens of patients who ingested too much pot. Lysyshyn said these users have usually eaten products without knowing the concentrations or how much to eat. Under a legalized regime, he said, there should be labels on THC contents, and users will become more used to edibles.

Reports of pot-related hospitalizations linked to pot use are often met with disbelief on web forums for marijuana users, but the adverse effects are real, said Allan Bays, the grow manager at a pot dispensary in Denver who has been diagnosed with cannabinoid hyperemesis syndrome.

Bays continues to smoke, despite his crippling condition, because he loves it and finds relief from migraines. He believes he has been able to control his symptoms by maintaining a healthy diet and exercising, although he still suffers through bouts of vomiting every couple of months or so.

“I believe in facts and truth, not in misinformation. The harmful effects of marijuana are well-documented,” he said. “I’m in big favour of marijuana becoming legalized nationwide, but you have to be aware of those effects.”