scromiting
July 15, 2021 9:09 AM   Subscribe

 
It's definitely a weird feeling to have, but I'm relieved the term is a portmanteau of "screaming + vomiting" instead of "scrotum + vomiting" as I originally assumed.
posted by LionIndex at 9:18 AM on July 15, 2021 [111 favorites]


scromit, the hyperemesis muppet
posted by 20 year lurk at 9:21 AM on July 15, 2021 [58 favorites]


I appreciated the bit about how these people are using up precious medical resources. *rolls eyes*

Since September of 2019, when I had my first bout, I've had these out-of-nowhere days of absolutely the worst vomiting ever—feels nonstop, no hope of getting all the way to the bathroom when it decides to start*, a lot of that horrible thing where there is nothing more to bring up but your body just won't stop. It lasts one day, and then I spend the next 24 hours mostly sleeping, and then I'm ok.

I saw a gastroenterologist for it, and he said, "hmmm, that's odd. We only usually see this in heavy cannabis users."

Anyway, mine is called Functional Cyclic Vomiting Syndrome, which basically means, "Every now and then you throw up for no apparent reason. We don't know why, but we can give it a descriptive name."

I do now have really good anti-nausea meds, including the best kind, that goes up your butt, for when you can't keep anything down. I try to be pro-active about medicating, and I haven't had a bout since December 25, 2020.

I don't care how much pot they smoke, my heart goes out to anybody who experiences this. It's horrible.

*My partner and I have discovered that a large plastic Folgers coffee container like this one works really well as a handy vomit container—it has a wide mouth, it's easy to wash, and you never have leaks like you do when you're trying to use, say, a plastic bag. It even has an indented handle. In addition, whenever my partner has to go to the ER or has another opportunity, he steals me one or two of the hospital vomit bags that are plastic bags with hard plastic rings to go around your mouth, because he's thoughtful like that. I like the Folgers container better, because vomit is gross and I don't like to see or feel it in a plastic bag.
posted by Orlop at 9:24 AM on July 15, 2021 [71 favorites]


The ER at Parkview Medical Center in Pueblo saw only five scromiting cases in 2009. By 2018, the number had risen to more than 120

oh my goodness it's affecting 0.02% of heavy cannabis users in Colorado what a scourge
posted by ook at 9:25 AM on July 15, 2021 [48 favorites]


Like the munchies, only in reverse.

(Jokes aside this sounds truly awful. Good thing it's rare.)
posted by Nelson at 9:26 AM on July 15, 2021 [9 favorites]


(I mean, to be fair, it does sound awful for the vanishingly small number of people affected; the panicky moralizing tone of the article is just really off-putting.)
posted by ook at 9:26 AM on July 15, 2021 [43 favorites]


My sister went to the hospital with GI symptoms, and a nurse asked her if she used cannabis, and more or less dismissed her when she said yes. Seems the staff at that hospital had passed around a news article or two about it. Anyway if my sister hadn't been persistent in getting past that they would have sent her home with appendicitis.
posted by Space Coyote at 9:29 AM on July 15, 2021 [85 favorites]


This is a symptom of increased potency. Does anyone care to wager that there are zero other symptoms long term from high concentrations of all the various chemicals that are inhaled?

We are, once again, living through the "I can just sell this" -> "Oh, that's why we have the FDA" news cycle. It takes a year or two.
posted by Slackermagee at 9:30 AM on July 15, 2021 [35 favorites]


Orlop, that sounds like a nightmare. So glad you have it under control. Honestly, I'm exhausted by people who are in a helping profession but don't want to help. If you want to moralize, maybe go into religion instead.
posted by Bella Donna at 9:32 AM on July 15, 2021 [10 favorites]


If this were linked to a normal uncontroversial food or medication item, the investigation would start with what they ingested: i.e. where did they buy this weed from, what strain is it, and how was it produced, packaged, handled, etc. to see if any contaminant made it into the process of going from ground to customer.

What I'm saying is, in a state where it's legal to sell, can't medical investigation travel up the supply chain to the source? Because if it turns out there's no commonality amongst what they smoked (more than just "it's marijuana"), what we're seeing might just be that some small percentage of people who hadn't tried strong weed now have access to something that they didn't before, and are now experiencing allergic reactions.

But since it's marijuana, we're automatically getting "think of the children" reactions asking lawmakers to legislate potency and varieties of strains, I guess.
posted by The Pluto Gangsta at 9:36 AM on July 15, 2021 [64 favorites]


Had this twice before I got diagnosed. It’s awful.
posted by sixswitch at 9:37 AM on July 15, 2021 [9 favorites]


Experts say the marijuana consumed 20 years ago had levels of THC, the main psychoactive ingredient, of 2 percent to 3 percent, but cannabis products now sold in markets like Colorado can have THC levels as high as 90 percent.

90 percent. . . of? Mass? Who cares. Volume? Who cares. Absorbed content in one dose compared to previous forms? Seems really unlikely. $8 brownies that will ruin your day have been easy to get since my parents were teenagers. Just like whiskey and cigarettes. There might be an important medical story here. It's hard to tell.
posted by eotvos at 9:41 AM on July 15, 2021 [15 favorites]


So, personal story:

I've been a fairly regular weed smoker for the last, oh, 10 yrs. or so (since my early 30s). From mid-2014 to late 2018, I had several episodes of intense vomiting (sometimes with the sluice at the other end opening up as well) accompanied by severe stabbing stomach pain. Pretty much every system in my body was thrown into haywire. I'd sweat uncontrollably, my heart rate was uneven, my skin would go ghost-white, my blood pressure was jacked up, and I'd be in such pain that I could barely walk. (No screaming though, as in the cases described here and elsewhere.) Every time sent me to the emergency room, and the only thing that could stop the pain was heavy doses of morphine or something stronger, and a few saline IVs.

Time between these attacks varied from 3-4 weeks to 4-6 months. I had MRIs, CAT scans, allergy tests, had my gall bladder removed... I also changed up my diet significantly, eating less meat, etc. etc. Nothing worked, although some things seemed to alleviate the condition for longer periods. At some point, in maybe late 2015, on ER doc said that he thought it was "cannabinoid hyperemesis syndrome." I did some reading on it -- from what I could tell, it was first offered as a diagnosis somewhere in Australia. I was pretty skeptical about the idea -- how the hell could Snoop Dogg or Wiz Khalifa be alive and functioning if this was a real thing? So, kept smoking, trying various dietary solutions, kept having episodes -- maybe 25-30 total over this 4 year period. (Yes, I'm stubborn, and I like smoking weed.) After that first time, almost every doctor after gave me the same "cannabis hyperemesis syndrome" along with a heavy, heavy dose of puritan disapproval.

Fast-forward to 2018, on a whim I picked up some fiber supplements at the grocery store -- psyllium husks in little capsules. I'd taken them before in an attempt to alleviate my problem, but only like 1/5th the recommended dosage. So, I started taking the full dosage every day -- 5 capsules, 4x/day.

Reader, I never got sick again, and I still smoke weed almost everyday, 2 1/2 years later.

I've maintained most of the dietary changes -- very little meat, less cheese, less dairy (no yogurt! that was almost always a catalyst for getting sick, I think), more grains, more veggies (well, veggie smoothies) -- and I spend like $15/month on fiber capsules. They've also helped my health in general, helping to lower my cholesterol and such.

Anyway, My totally-medically-uninformed-but-based-on-extensive-personal-experience theory is that marijuana may be part of the cause of these episodes, but it is not the sole cause and something else more complicated must be going on. Maybe it has some reaction that fucks with your digestion, maybe all the crap you eat when you've got the munchies screws something up. Who the hell knows? But I think there's very little official interest in investigating beyond "marijuana is sending our children to the hospital!" because it's such a useful narrative for shaming and social control.

So, if this is happening to you, get yourself some fiber capsules.

On Preview:
Orlop: Now that I think about it, I was also initially diagnosed with "Cyclical Vomiting Syndrome." I think I was probably prescribed many of the same drugs that you're on. If you can, try those fiber pills! I'm not saying it'll be a magic bullet, but maybe they'll help!
posted by Saxon Kane at 9:54 AM on July 15, 2021 [48 favorites]


Cannabis hyperemesis syndrome is rare (and women who are heavy cannabis users tend to be more commonly affected), and sadly usually the only solution is to abstain entirely. As someone who is just starting out as a cannabis educator/coach, my curriculum definitely includes talking about about this, as well as cannabis use disorder, to potential users that way they know the risks are existent, if minimal. To have CHS if you're someone who is using for long term or acute illness (cancer, for example) would be awful.
posted by Kitteh at 9:57 AM on July 15, 2021 [11 favorites]


he steals me one or two of the hospital vomit bags that are plastic bags with hard plastic rings to go around your mouth

FYI, you can buy these cheap on Amazon or at medical supply stores. For when the best part of waking up isn't Folger's.
posted by praemunire at 10:08 AM on July 15, 2021 [8 favorites]


Experts say the marijuana consumed 20 years ago had levels of THC, the main psychoactive ingredient, of 2 percent to 3 percent, but

what!?!?

Or perhaps I should ask where? I'm from BC. Our bud has been known to be STRONG for at least thirty years now (actually forty but the strong stuff didn't really become ubiquitous until the mid-late 1980s). And though I haven't been smoking that much for the past decade or so, there was a significant chunk of time where I was definitely a "most days" smoker.

This is the first I've heard of scromiting. Not that I've been paying much attention to marijuana news, it being legal now, my not smoking it that much anyway (as mentioned). Anyway, it sounds awful and I'm in no position to suggest or deny a connection to marijuana use. What I can suggest is that I know many long term users (three decades at least) and have yet to hear any bad news from any of them.

Which gets me wondering, what do they mean when they say "heavy users"? Does this mean daily? Does this mean all day every day? Does this mean effectively chain smoking the stuff? I've only ever gone as far as being a daily user, never anything more intense than that. But pretty much always (since about 1985 anyway) pretty intense stuff.
posted by philip-random at 10:09 AM on July 15, 2021 [3 favorites]


90 percent. . . of? Mass?

Yes, in concentrates. You can get extract products that are pretty close to pure THC/cannabinoids. Not regular weed, though I think some growers claim to hit 30 percent these days.
posted by atoxyl at 10:16 AM on July 15, 2021 [5 favorites]


We are, once again, living through the "I can just sell this" -> "Oh, that's why we have the FDA"

Nope. nope. nope.

the CO growers i know (several) have a higher degree of ethical responsibility to their buyers than any pharmaceutical exec. the selling points of good weed are are consistent thc content, accurate thc/cbd ratios, and knowledgeable retailers.

there are so many good grows here, if you burn the client, they're going somewhere else. you *will* pay top dollar at a respected grow.

if you get cheap-ass weed from the cartels in pueblo or aurora, that's not a 'legal CO grow' problem.
posted by j_curiouser at 10:19 AM on July 15, 2021 [9 favorites]


Or perhaps I should ask where? I'm from BC. Our bud has been known to be STRONG for at least thirty years now

Weed was always 2-3 percent twenty years ago!

Yes obviously you are correct. I’m not really super in touch with this stuff but I doubt the peak potency for actual bud has risen more than a few percent in 15 years? I don’t know about the average. I’m from CA (the other one) so similar deal to you though - the weed I could get was by no means weak when I was younger.

Crazy concentrates are a thing now though and honestly probably a bad idea the way some people consume them - c.f. “dabbing.”
posted by atoxyl at 10:21 AM on July 15, 2021


In theory super strong weed should just mean you don’t have to smoke as much, though. I mean I can buy $20 worth legally here and it will literally last me a year as a casual smoker. The people I’ve heard of developing this kind of issue were, ahem, chronic heavy users, and then the problem is that it’s hard to understand what’s going on because they’ve been heavy users for a long time without issue and may expect weed to relieve nausea so they often get into a weird cycle of being miserable.
posted by atoxyl at 10:27 AM on July 15, 2021 [4 favorites]


Weed was always 2-3 percent twenty years ago!
Yes, exactly. What decade do these people think that it currently is RIGHT NOW!? PRESENTLY! Because they said the exact same shit 30 years ago.

I get that they sneakily compared weed to "cannabis products". I get it, they're technically correct. whatever.

I have all the sympathy in the world for the sufferers of this illness, it sounds terrible.

But the article is bad and it should feel bad.
posted by Horkus at 10:29 AM on July 15, 2021 [15 favorites]


Back when I was in high school in the early/mid 70s, I had a friend who would go into a deep, debilitating attack of...something...when he smoked weed. It wasn't paranoia, per-se, but that was definitely part of it. He would curl up in a fetal position on the floor and weep and wail. Obviously, he avoided weed. But, sometimes (rarely) he would brave it and see if he would still react that way (high school, kids, remember)

That was on the god-knows-where-and-when-it-was-grown weed that made its way to Indiana. I sometimes think about my friend trying some of today's insanely potent weed and just can't imagine the mind-breaking effects it might have.
posted by Thorzdad at 10:32 AM on July 15, 2021 [2 favorites]


Marijuana has absolutely gotten stronger in the past 20 years: see this 2016 scientific study for instance. It finds an increase in THC in marijuana from 4% to 12% from 1995 to 2014 from "DEA confiscated material". Not that it's the final word, see this industry response for some criticism.

That's for actual herb. Vape oils and edibles are all over the map. But it's definitely true that it's much easier today to get a clean very high THC oil now in the legalized states than the shitty homemade hash oil of the 90s.

the CO growers i know (several) have a higher degree of ethical responsibility to their buyers than any pharmaceutical exec

Enjoy your wonderland. Legal and semi-legal marijuana is an enormous business in America and there's definitely plenty of unethical actors in the business. Also a lot of fake science. And just sloppy science, see for instance the problems with potency testing in Oregon. (In 2018, but it seems unlikely it was a unique problem.)
posted by Nelson at 10:49 AM on July 15, 2021 [13 favorites]


I tend to think of creeping THC percentages like I used to look at high grav beer. I mean, sure it's nice to have a heavy hitter every now and then, but for everyday usage, I am not looking to be very very stoned. (I have been my own guinea pig since Canadian legalization to find the Goldliocks dosage for myself, and I have learned as a woman who likes to read about weed, it is heavily geared towards an audience who assumes you want to have face-melting experience as compared to, say, medical use.) Most LPs are really aiming for high THC when I would love to see more 1:1, 2:1 chemovars on the market.
posted by Kitteh at 10:52 AM on July 15, 2021 [13 favorites]


We are, once again, living through the "I can just sell this" -> "Oh, that's why we have the FDA" news cycle. It takes a year or two.

It's worth pointing out that the regulations around growing weed are far stricter than those around selling it, and can easily involve multiple federal agencies. Any one of them can derail what is already a long and financially-intensive process (compliance in California can cost hundreds of thousands of dollars and take months or even years) all before the first plant can go in the ground.
posted by Glegrinof the Pig-Man at 10:58 AM on July 15, 2021 [1 favorite]


We are, once again, living through the "I can just sell this" -> "Oh, that's why we have the FDA"
Nope. nope. nope.
the CO growers i know (several) have a higher degree of ethical responsibility to their buyers than any pharmaceutical exec. the selling points of good weed are are consistent thc content, accurate thc/cbd ratios, and knowledgeable retailers.
there are so many good grows here, if you burn the client, they're going somewhere else. you *will* pay top dollar at a respected grow.
if you get cheap-ass weed from the cartels in pueblo or aurora, that's not a 'legal CO grow' problem.


This is basically the libertarian argument for removing all government regulations, relying on consumers to have perfect knowledge of all options rather than having legal repercussions to not producing a safe product.
posted by LionIndex at 11:12 AM on July 15, 2021 [24 favorites]


The moralizing Reefer Madness tone of the article is unfortunate. That said, last time I smoked a pre-roll someone offered me, it was one of those keef and oil infused joints and it sent me to another dimension...soooooo not for me (but to each their own).

I'm a fan of CBD dominant strains, or just plain, organic, outdoor weed grown with tender love and care by friends.
posted by nikoniko at 11:14 AM on July 15, 2021 [1 favorite]


the term is a portmanteau of "screaming + vomiting"

I'd really like a clear explanation of this - don't understand how it's possible, simultaneously. I'm guessing the 'screaming' part isn't actually meant to be literal, more just a shorthand way to indicate 'feels so bad.'
posted by Rash at 11:21 AM on July 15, 2021 [1 favorite]


I got food poisoning once, it's literal.
posted by Greg_Ace at 11:24 AM on July 15, 2021 [7 favorites]


Experts say the marijuana consumed 20 years ago had levels of THC, the main psychoactive ingredient, of 2 percent to 3 percent

Yeah the drug warriors love to quote those experts, as they have been for over twenty years. It's true that weed potency increased, when sinsemilla farming took over, but that happened late 1980s. (It's when you kill all the males before flowering, so the female's buds don't seed and get enormous).
posted by Rash at 11:24 AM on July 15, 2021 [5 favorites]


I'm guessing the 'screaming' part isn't actually meant to be literal, more just a shorthand way to indicate 'feels so bad.'

It is very literal. People with CHS express levels 9 and 10 (of 10) pain in joints, muscles all over the body, and especially torso and gut. Combined with mental confusion, lack of calories, and frustration, there is a great deal of screaming.
posted by Revvy at 11:38 AM on July 15, 2021 [2 favorites]


I have cyclical vomiting syndrome and it sucks, because as soon as they hear I smoke weed, they go straight for this. Never mind that I had the first case 10 years before I realized what that weird smell that was sometimes in the living room on weekends was. In my case, it's part of a strange cluster of vagus nerve related issues.

If you struggle with this yourself, I'd suggest looking into the home IV places you can get for hangovers. It's not cheap but they will manage your hydration and that is key for me. You can't really get more than saline from urgent care but these services are far more generous about it.
posted by feloniousmonk at 11:50 AM on July 15, 2021 [6 favorites]


It is super sucky to vomit and have pain like this (for whatever the reason - cyclic vomiting, appendicitis, gall bladder attack, cannabis overdose or others). You have pain because it can hurt to vomit forcefully and also because your electrolytes get messed up and the cramps come and cannot stop.

However, it was well known that overdosing on cannabis causes this problem and has been known for centuries. It is well documented in old western medical texts (pre-1900), in Ayurvedic texts and Chinese Medicine texts. Also, noted in these texts: smoking cannabis will likely cause a cough and it will make coughs, bronchitis, asthma, etc worse. To treat: stop smoking and use a different method of entry. Part of using an old medicine is remember how not to use it.

Perhaps we can acknowledge that too much of anything can be rough on a human body, and different bodies have different definitions of "too much."
posted by mutt.cyberspace at 12:07 PM on July 15, 2021 [12 favorites]


Perhaps we can acknowledge that too much of anything can be rough on a human body, and different bodies have different definitions of "too much."

I had "too many" cherries the other day and my stomach was screaming and I had explosive awfulness for hours. Indeed this is basically what happens with anything when you overdo it.

I smoke a lot of really high potency marijuana, so I'm pretty glad this has never happened to me, but it also jives with the fact that I've been trying to cut back a lot and looking for more reasons to cut back. This one right here is a pretty good reason to cut back.
posted by deadaluspark at 12:25 PM on July 15, 2021 [2 favorites]


Time between these attacks varied from 3-4 weeks to 4-6 months. I had MRIs, CAT scans, allergy tests, had my gall bladder removed... I also changed up my diet significantly, eating less meat, etc. etc. Nothing worked, although some things seemed to alleviate the condition for longer periods. At some point, in maybe late 2015, on ER doc said that he thought it was "cannabinoid hyperemesis syndrome." I did some reading on it -- from what I could tell, it was first offered as a diagnosis somewhere in Australia. I was pretty skeptical about the idea -- how the hell could Snoop Dogg or Wiz Khalifa be alive and functioning if this was a real thing? So, kept smoking, trying various dietary solutions, kept having episodes -- maybe 25-30 total over this 4 year period. (Yes, I'm stubborn, and I like smoking weed.) After that first time, almost every doctor after gave me the same "cannabis hyperemesis syndrome" along with a heavy, heavy dose of puritan disapproval.

Fast-forward to 2018, on a whim I picked up some fiber supplements at the grocery store -- psyllium husks in little capsules. I'd taken them before in an attempt to alleviate my problem, but only like 1/5th the recommended dosage. So, I started taking the full dosage every day -- 5 capsules, 4x/day.

Reader, I never got sick again, and I still smoke weed almost everyday, 2 1/2 years later.


This aspect of Metafilter sometimes reduces me to helpless laughter, Saxon Kane, because I think you've just handed us the key to this whole mess.

Cannabinoids are well known to decrease intestinal motility.

And there's another and much more common hyperemesis disorder in the US, hyperemesis gravidarum, or hyperemesis of pregnancy:
Background: In the United States, hyperemesis gravidarum is the most common cause of hospitalization during the first half of pregnancy and is second only to preterm labor for hospitalizations in pregnancy overall.
And I found a citation dating all the way back to 1971 pointing out something very interesting, that intermittent intestinal obstruction simulates hyperemesis gravidarum. which implies that HG probably is the result of mechanical interference by the presence of the baby with maternal intestinal motility.

So here's how I think this has to work. Cannabis (or the baby) sharply reduces or halts intestinal motility altogether, and this sends a signal that causes forceful rejection of any further ingestion and expulsion of any ingestion that's already taken place. Which would be a highly desirable response because any more content on top of an intestinal obstruction raises the odds of intestinal torsion, which can easily be fatal.

But your experience with psyllium seems to show that if there's nothing much in the intestines in the first place, the hyperemesis reaction is much less likely.
posted by jamjam at 12:56 PM on July 15, 2021 [32 favorites]


I think if it happens to you, you don't cut back, you stop. So smoking weed more like, say, the married couple in Poltergeist, and less like the road crew for Steel Pulse, may be a more sustainable path, yeah.
posted by thelonius at 12:57 PM on July 15, 2021 [2 favorites]


Scromiting aside, I'm still hoping that an enterprising young cannabis entrepreneur will come out with a brand of decent but weak weed for old, boring people who only smoke occasionally and are looking to get no more fucked up than they might from drinking 1-2 beers with friends on a Saturday afternoon.
posted by evidenceofabsence at 1:13 PM on July 15, 2021 [21 favorites]


>> the term is a portmanteau of "screaming + vomiting"

> I'd really like a clear explanation of this - don't understand how it's possible, simultaneously. I'm guessing the 'screaming' part isn't actually meant to be literal, more just a shorthand way to indicate 'feels so bad.'


Not from weed (I'm pretty sure it was norovirus) but I've been in the state where you're so nauseated and miserable that you're continuously moaning on the verge of screaming except during the times when matter is actively exiting your digestive tract via the mouth. (Because you will continue to moan/scream if it's exiting via the other end. Speaking from experience.)

So... "uhhhhhhh OHHHHH EURRRRRGHHHH *vomit* ohhhhhhhhh somebody kill me now EURFFFFFFF"
posted by Lexica at 1:15 PM on July 15, 2021 [4 favorites]


I'm in my 60s, Maine has legal weed, and the weed at the dispensary is just too strong. 2 puffs and the space-time continuum becomes fluid, my body gets very weird; it's not pleasant at all. That one time I had 1 puff and giggled for a few hours; I want that. Have not found it yet and not that interested in the research. Meanwhile, small doses of edibles are great when I have a run of nights with very poor sleep.

orlop and others who've experienced this, deepest sympathies.
posted by theora55 at 1:19 PM on July 15, 2021 [3 favorites]


Cannabinoids are well known to decrease intestinal motility.

Not to derail, and maybe I'm hoping this is all related, but why do edibles not work like smoked weed for some people?

I've tried small edibles (like 5 mg THC at most) a few times and every time I just end up with a really dull nausea and slight stomach pain. And no effects at all.
posted by JoeZydeco at 1:24 PM on July 15, 2021


jamjam: I've actually thought of emailing the authors of the few studies of CHS that exist to say, "Hey, I maybe had this, but now I take fiber and I'm totally fine. Maybe try that in your next study?" The funny thing is, it's not like I was constipated or something before I started taking the pills. I was pretty regular -- I go maybe a few times more per week on average now than I did before going on the fiber. I was also losing a lot of weight; at one point I was nearing Christian Bale in The Machinist proportions, with my ribs clearly visible beneath my skin. Now I'm back to having a lil' manbelly. So it makes me wonder what exactly wasn't getting processed through my system to make me sick?

People with CHS express levels 9 and 10 (of 10) pain in joints, muscles all over the body, and especially torso and gut.
With me, the pain was localized 100% in my stomach, maybe 1 1/2" above my belly button. Vomiting was the only thing that temporarily alleviated the pain, but also made it hurt worse a split second later. The worst attacks were 9 or 10 on the pain scale; the mildest got up to maybe a 6 or 7.

Combined with mental confusion, lack of calories, and frustration,
I also never had any sort of mental confusion during my attacks, besides just the distraction of being in extreme pain. But never any sort of "psychotic" episode like the ones described in the article. A few times I've had the attacks while driving between towns in South Texas, so more than once I had to drive myself 45 minutes to reach an emergency room while puking into an empty gatorade bottle.

If I'm being totally honest with myself (and you, Dear Readers), it was stupid to keep smoking and put myself through all that pain and misery -- and expense! I have good health insurance, but I went through my entire $5k deductible 4 years in a row, and the few times I called an ambulance instead of driving myself or getting a friend to drive me ended up costing me hundreds of dollars. But at the time, weed was a pretty big emotional crutch for me. It's much less so now, and even though I still smoke almost daily, I smoke about 1/2 as much now as I did during that period.
posted by Saxon Kane at 1:25 PM on July 15, 2021 [4 favorites]


I have a friend who has this, and it is just the worst. At least when I had hyperemesis gravidarum, I knew it would be over in 9 months. I feel so awful for him. We commiserate over people giving you dumb anti-puke tips when they have not had hyperemesis and have NO IDEA what it's like vs. "having a stomach bug and vomiting for five days."

"And I found a citation dating all the way back to 1971 pointing out something very interesting, that intermittent intestinal obstruction simulates hyperemesis gravidarum. which implies that HG probably is the result of mechanical interference by the presence of the baby with maternal intestinal motility."

That'd be fascinating if the embryo weren't EIGHT CELLS BIG when the hyperemesis sets in. And it often IMPROVES in late pregnancy, which is when the baby is big enough to cause problems with pooping. (Moreover, tons and tons of pregnant women take fiber supplements during pregnancy and/or stool softeners and STILLLLLLL have hyperemesis.)
posted by Eyebrows McGee at 1:25 PM on July 15, 2021 [17 favorites]


evidenceofabsence - i think that's where many of the edibles excel. i recently began experimenting with CBD to relieve chronic pain, and have found it works much better if combined with a low dose of THC (my doctor told me i need to cut down on the NSAIDS). i hate smoking, and have a poor reaction to cannabis high - not as bad as Thorzdad's friend, but not really enjoyable. i've found my Goldilocks point, too and there are some great drinks available that do just what you describe. the buzz word seems to be "social". i like the stuff Cann makes.

oh and - scromiting is possible. i had a severe gallbladder attack, and yeah - you scream and vomit... until you can't. then you dry heave, and make noises like a dyin' animal. dilaudid was the only thing that could stop it.
posted by lapolla at 1:26 PM on July 15, 2021 [3 favorites]


'm in my 60s, Maine has legal weed, and the weed at the dispensary is just too strong. 2 puffs and the space-time continuum becomes fluid, my body gets very weird; it's not pleasant at all. That one time I had 1 puff and giggled for a few hours; I want that. Have not found it yet and not that interested in the research. Meanwhile, small doses of edibles are great when I have a run of nights with very poor sleep.

Well, tbh, maybe your Goldilocks point is 1 puff. And that's not a bad thing. Can I ask: when you had two puffs, were they consecutive or did you space it out?

I do what is known as dose layering for my night time routine: I take about 10 mg edible 90 minutes before bedtime, and then an hour before I swallow about 40 mgs CBD/THC oil of a 5:1 ratio (4 parts CBD to 1 part THC), and holy shit, it's like I went to the spa when I wake up.

When Canada legalized weed in 2018, all that was on offer for pre-rolled joints was 1 gram ones. That is...a lot of weed if you're cannabis naive. In past year or so, nearly every LP carries pre-rolls that equal about 0.35 grams each--dogwalkers, because it's just enough weed to smoke while you're walking your pooch--and that is my perfect joint amount. Just enough to relax, but not enough to be catatonic.
posted by Kitteh at 1:33 PM on July 15, 2021 [7 favorites]


tl;dr- too much of a good thing can be a bad thing?
posted by MrJM at 1:33 PM on July 15, 2021 [1 favorite]


TL;DR

everyone's cannabinoid system is different and even yours is not the same every day
posted by Kitteh at 1:34 PM on July 15, 2021 [9 favorites]


"everyone's cannabinoid system is different and even yours is not the same every day"

this part is worth repeating with emphasis.
posted by deadaluspark at 2:06 PM on July 15, 2021 [7 favorites]


kitteh, 2 consecutive puffs. Have tried 1 puff of different strains, but have not had the laughing reaction. That was really enjoyable. Weed high is not my preference, but maybe my dispensary's product is not what I need. They suck in other ways and will not return there.
posted by theora55 at 2:07 PM on July 15, 2021


A less drug panic version of this story from the CBC (in Canada where weed has been federally legal for a while now).
posted by Mitheral at 2:32 PM on July 15, 2021 [5 favorites]


I occasionally eat legal edibles in small amounts and years ago I used to smoke a lot of pot. So I'm not moralizing here. But I do get a queasy feeling seeing the insane potency and immediate, constant availability of intensely strong concentrates of THC that are extremely common nowadays.

I see my adult nephews and nieces with THC vape pens hanging out at family gatherings, just puffing away. Not every family gathering, but sometimes. I tried a small puff of one of theirs once and was immediately STONED in a semi-unpleasant way. And it makes me wonder how much they partake when not around family—on weekends with alcohol in the mix, etc. I wonder what that kind of impact the "instant-bake, any time, anywhere" culture is going to have in the long run.

I mean, you no longer even have to discretely step aside and light up. These are very powerful drug delivery systems in your pocket, on your person, all the time.
posted by SoberHighland at 2:35 PM on July 15, 2021 [4 favorites]


It's why I have no desire to dab. I think I have pretty low to moderate tolerance--I try to keep it that way--and I have seen videos of folks dabbing and it looks too intense for my tastes. As I said upthread, I really really don't want to be that high. I have greened out a couple of times by accident and it was deeply unpleasant.
posted by Kitteh at 2:56 PM on July 15, 2021


The experienced user rarely gets too high. Building up the tolerance is a well-known effect of heavy consumption. So daily users, like those you see vaping, aren't getting what an old chum calls "the whirlies" -- they're used to it. Just as I get pretty ripped off a small glass of beer or wine, 'cause I never drink much anymore.
posted by Rash at 3:02 PM on July 15, 2021 [2 favorites]


It's worth noting that marijuana tolerance has a very large effect. For instance, this dosage guide suggests a daily smoker may take 5-10x as much marijuana as someone with minimal tolerance to get the same effect. I can't find a similar chart for alcohol tolerance but my belief is that it's about 2x for a regular drinker vs. a non-drinker.

IMHO the marijuana tolerance thing has been a real problem in the rollout of legal weed. A lot of the medical dispensaries are making products for folks who can handle a whole lot more THC than all the new and casual users they've attracted. It helps that places have standardized on a 10mg dose for edibles (thank you, Colorado) but even that can be an awful lot for someone.
posted by Nelson at 3:22 PM on July 15, 2021 [8 favorites]


wonder what that kind of impact the "instant-bake, any time, anywhere" culture is going to have in the long run

This has already been mine and a significant chunk of others' culture for at least fifteen years. Is it having an impact upon, or is it a result of, the culture we swim in, a little bit of both, yes/no/maybe? For me the impact is being able to reasonably complete Spiderverse daily tasks such as all-at-once finishing these two pull requests, this middle eight and chorus, these audit remediations, plan how I'll support my child's homework tonight, continue seeing how I can help my older kids with their struggles with heroin and benzo addictions and grab a bite, to eat all across the backdrop of an ever more self-conscious spear of fascism and hatred. I think its impact is quite lovely and helpful. YMMV. All love.
posted by riverlife at 3:35 PM on July 15, 2021 [5 favorites]


Maybe I'm missing it because of the egregiously moralizing tone of the article, but how many of these people have died from cannabis overdoses, or from withdrawal if they quit?
posted by silentbicycle at 4:10 PM on July 15, 2021


I have enough tolerance that the 50 mg I'd need from legal edibles to notice would cost me a prohibitive $50+ up here in Canada: I will diy instead. That dosage chart scans.
posted by not_that_epiphanius at 4:13 PM on July 15, 2021


Not to derail, and maybe I'm hoping this is all related, but why do edibles not work like smoked weed for some people?

The main think about edibles is a) they take much longer to work and b) the effects are different, and more intense. This is my experience, anyway. I found the only good way to approach edibles is to treat it like a scientific experiment. Take a very small dose, start a timer. Check the effects. And WAIT. I think this is the crux of the problem, because it’s human nature to think “welp, not working, better take some more.” Which is exactly what you do with, say, alcohol. But cannabis is different, the onset is more binary: either you’re stoned, or you’re not.

So wait until you’re most certainly sober, then try a higher dose. Repeat until you achieve the desired effects. Once I made some cannabutter but didn’t know how potent it would be, so I just spread a teeny bit on a cracker as described above. Took a day or so of experimenting, but eventually I figured out how much butter it took to get a pleasant buzz without it flooring me.
posted by zardoz at 4:21 PM on July 15, 2021 [4 favorites]


Is the youth framing here because CHS mainly occurs in young people, because the author is going for a "think about the children" angle, or because underage cannabis consumption in Colorado may be mostly in the form of concentrates?
posted by silentbicycle at 4:27 PM on July 15, 2021 [2 favorites]


IMHO the marijuana tolerance thing has been a real problem in the rollout of legal weed. A lot of the medical dispensaries are making products for folks who can handle a whole lot more THC than all the new and casual users they've attracted. It helps that places have standardized on a 10mg dose for edibles (thank you, Colorado) but even that can be an awful lot for someone.

Hence, having to be my own guinea pig to figure out to make cannabis work for me. I am aiming to be the person I wish I could have found when I was starting out with weed.
posted by Kitteh at 4:31 PM on July 15, 2021


It's definitely a weird feeling to have, but I'm relieved the term is a portmanteau of "screaming + vomiting" instead of "scrotum + vomiting" as I originally assumed.

You were not alone in this immediate assumption and blessed relief.

I have never had mine vomited on, nor have I vomited on anyone else’s or, to the best of my recollection, my own. I am not sure which the portmanteau would have referred to, but every possibility seems far from pleasant.
posted by ricochet biscuit at 4:55 PM on July 15, 2021 [2 favorites]


When I was a bottle-a-night drinker I vomited painfully, shit myself, got in fights, passed out in a snow bank, and once joined the Army. Thank god marijuana wasn’t legal then.
posted by Abehammerb Lincoln at 5:03 PM on July 15, 2021 [2 favorites]


I just wish our society were this well advanced on legalizing and norming the recreational use of ‘shrooms.

Probably not in my lifetime, though.
posted by darkstar at 5:14 PM on July 15, 2021 [2 favorites]


I have a friend who has this, and it is just the worst. At least when I had hyperemesis gravidarum, I knew it would be over in 9 months. I feel so awful for him. We commiserate over people giving you dumb anti-puke tips when they have not had hyperemesis and have NO IDEA what it's like vs. "having a stomach bug and vomiting for five days."

I vomited all the way through my first pregnancy 20 years ago. Months into it, people would still be like, "Have you tried saltines? Ginger ale?"
posted by Orlop at 5:20 PM on July 15, 2021 [3 favorites]


When I was a bottle-a-night drinker I vomited painfully, shit myself, got in fights, passed out in a snow bank, and once joined the Army. Thank god marijuana wasn’t legal then.

Because you would have done none of those things if you smoked?
posted by Saxon Kane at 5:23 PM on July 15, 2021 [3 favorites]


Cotton mouth-cotton entire body. Wow.
posted by Oyéah at 5:32 PM on July 15, 2021


I've been experimenting with edibles after not being a pot user before—my new habit at 55. There is this one that, if I take half, has a really excellent and predictable arc: for the first 30 minutes, nothing happens. The next 30 minutes: a very pleasant and creative state during which I often write (I am a writer). The next 30 minutes: at some point I stop writing and am just looking around me happily or chilling with my eyes closed, like a mellow cat. And then I take a nap.
posted by Orlop at 5:35 PM on July 15, 2021 [10 favorites]


I've only tried the stuff a few times and every time it has made me feel like vomiting, so I get that this is a thing, but I chalk that up to "not for me" rather than going into hand-wringing mode about how we live in a society.
posted by turbid dahlia at 5:52 PM on July 15, 2021


Maybe I'm missing it because of the egregiously moralizing tone of the article, but how many of these people have died from cannabis overdoses, or from withdrawal if they quit?

Cannabis withdrawal is not in the same league as that from opiates or benzos, nowhere close, but, in some people, it is real; I've been told that it is related to the natural production of endocannabinoids becoming suppressed in long-term heavy users. I don't know if that is true, but, if it is, that's basically a textbook example of biological dependency. It's just a mild one. The most common problem that people report is insomnia, in my experience, although there can be others. Some people have digestive disturbances, some people feel like they have a weak flu for a couple of days. Others don't have any problems.
posted by thelonius at 6:18 PM on July 15, 2021 [2 favorites]


Don't forget the dreams.
posted by Rash at 6:47 PM on July 15, 2021 [1 favorite]


When I was a teenager, there was a guy who would drive over to use our shower sometimes, as hot as it could go, and then he’d run back home to use his shower there. Apparently his water heater was slow and we did have hot water to spare. The slang word “dabbing” came into vogue at the same time as the spike in hospital reports of pot overdoses of varying degrees, and it sure seems like that guy from my past was having the same problem teenagers are today: so much concentrated high that their body freaks out.

I have to wear a smartwatch because after a surgery I used pot for pain management to mitigate a temporary pain issue that came up a couple weeks later, when I hadn’t taken anything in a while. It actually destabilized my heart rhythm at the same time as causing one of these nausea-pain episodes. I’m super super sensitive so I didn’t get the full episode, but it was still absolutely horrifying - and reproducible. Turns out regulated opiate drugs are safer than modern pot for short-term pain management for me. This leaves me uneasy.

Apparently all modern pot vape cartridges are as concentrated as science allows. Not only did breeders 2X the THC levels of plants, the cartridge produces also 5X concentrate that further. No one’s found an LD50 for marijuana yet, but they seem dedicated to trying to find out, and it hurt me pretty badly to discover that the hard way.
posted by Callisto Prime at 7:14 PM on July 15, 2021


> nearly every LP carries pre-rolls that equal about 0.35 grams each--dogwalkers, because it's just enough weed to smoke while you're walking your pooch

One quarter of one of those is enough to make me want to stop because I don’t feel as well if I continue. They seeming a nice idea but I really, really miss the option to have a full glass of wine instead of a thimble of vodka, so to speak.
posted by Callisto Prime at 7:26 PM on July 15, 2021 [1 favorite]


"Cracking pot, Scromit." — Wallace
posted by kirkaracha at 7:27 PM on July 15, 2021 [20 favorites]


I'm certainly no stranger to the substance or the experience of vomiting when high (check my post history, yes I've been on Mefi that long) but these days my tolerance is way down and when I do indulge I want the equivalent of a light lager. But the smallest unit available at the friendly local pot shop is pretty much a six pack. Why can't I buy singles?
posted by lemur at 7:34 PM on July 15, 2021 [1 favorite]


Yeah, I've smoked a fair amount of pot, every day, for many years up until then pandemic hit. But, when my soccer bud put some dab crystals on the bowl...

I was walking around thinking... "I am really fucking high..." Like, "whoa, I am really high..." "It's cool, yeah"
posted by Windopaene at 9:59 PM on July 15, 2021


Haven't scromited yet...

That would be a bummer
posted by Windopaene at 10:01 PM on July 15, 2021


So. When legalization went down in Oregon, I had one really strong objection to how the law was written for amounts you could posess. I don't think it got much attention at the time, because ending prohibition was a big deal, rightfully so, and everyone wanted it to pass kind of no matter what. You can own like four plants, and a few ounces on you at any given time, and there are various other holding limits. All seemed really reasonable, until you get to the part about extracts.

The law was written to allow for 72 ounces of extract (which is what, like 1000ml?), with no set strength, to be legally owned by a human at any given time. that is just over TWO BIG GULPS OF EXTRACT which others have noted, can be up to 90+% THC content. I thought it was a misprint in the voting booklet.

I don't think that extracts are inherently or even necessarily a huge problem (I actually think unregulated edibles are probably an actually bigger problem, as many have mentioned that they're dosed for frequent users), but that amount that you can purchase in a day and carry on your person, is. That's like a bananas quirk of the law that I just do. not. get.

Honestly, I'm also for the legalization (not just decriminalization) of every drug because it needs to be regulated. Just like I don't think anyone should be walking around or able to get access to bananas-pants amounts of those drugs, and as a society we should get to agree to all that limit. There is a limit. There already is a limit. I just don't know why on earth the limit is what it is.

I'm more than open to the possibility that someone might be starting like a bacta tank of THC extract, but hey is that a good thing, for like, society...man?
posted by furnace.heart at 10:21 PM on July 15, 2021 [2 favorites]


I just wish our society were this well advanced on legalizing and norming the recreational use of ‘shrooms.

Oh darkstar, We're on the case.
posted by furnace.heart at 10:22 PM on July 15, 2021 [5 favorites]


Please don't let this lead to a dab ban. Some of us consume them responsibly and really enjoy them.
posted by She Vaped An Entire Sock! at 11:42 PM on July 15, 2021 [3 favorites]


Eponysterical :)
posted by Bob Regular at 5:24 AM on July 16, 2021 [2 favorites]


One quarter of one of those is enough to make me want to stop because I don’t feel as well if I continue.


This is where dry herb vaporizers come in for me. You can grind about a matchstick head's worth, place in vape, and just enough if you're a low tolerance user. (Also it's much easier on the lungs.)
posted by Kitteh at 6:41 AM on July 16, 2021 [4 favorites]


I have had this a few times. I used to smoke acres of the stuff, and 3-4 times I had these episodes that are exactly as described. Intense nausea and disorientation, vomiting all the time. I was constantly in the shower - like every towel in the house was deployed for my showers. iT was the only way to feel relief. A couple of times I went to the hospital for it, but this was years ago before this was a thing, and one time they thought it was a potassium deficiency, in which they also put me on IVs of strong painkiller which I thought was just lovely, a it was the kind of thing I enjoyed greatly then. The other time they though it might be appendicitis, but that wasn't it either. It subsided magically when I had been in hospital, forced to abstain from pot.

Anyway, it's interesting to see that's what it was. I always had a suspicion it was somehow related. I love how the shower thing is part of it too. I guess I feel validated. I don't use the stuff anymore - I've been sober for about eleven years. I just can't use the stuff and have any quality of life. If you can, more power to you, but it ain't for me.
posted by seed at 7:48 AM on July 16, 2021 [4 favorites]


I always thought scromiting was what rugby players did at the beginning of a match.
posted by Saxon Kane at 8:34 AM on July 16, 2021 [1 favorite]


Somebody actually did have the idea of selling cheap non-pedigreed weed with nostalgia for the days of cheap non-pedigreed weed. I think this is brilliant marketing, personally, because... well I have to, they scooped my idea.

I feel like that stuff is probably already plenty strong for a really casual user. I’ve had no problem with the “take two hits and go inside” approach to the good stuff but then I used to be a regular smoker so maybe I have some baseline calibration to it and ability to sense how high I’m about to be.

If you look into stuff like high CBD strains you can find some with like 5 percent THC, if you’ve ever had the fantasy of actually smoking a whole joint to yourself.
posted by atoxyl at 8:43 AM on July 16, 2021


(I don’t like and I’ve never liked edibles because one doesn’t get that quick feedback so substitute vape for smoke if you’re health-conscious.)
posted by atoxyl at 8:54 AM on July 16, 2021


I'm still hoping that an enterprising young cannabis entrepreneur will come out with a brand of decent but weak weed

The problem is, weak weed costs about the same to produce as strong weed. While it takes skill and effort to consistently make weed of a particular strength - especially at the levels of THC some growers are getting now - it also takes care to consistently make a particular level of "weak" weed.

"Just throw some seeds in the ground and apply water & light" is easy. And you get much weaker weed that way. But you don't know how strong it is; sometimes you hit the right combo for super-potent stuff even with mediocre growing conditions. And if you are marketing your weed as "casual user/just relax" instead of "blow your face off," you need to not hit the potency jackpot by accident.

So you need carefully measured growing conditions, seeds chosen from particular strains, and so on. Just like with the extra-strong stuff. So you wind up with 6% THC weed and 25% THC weed costing the same per gram...and most buyers would rather just get the 25% stuff and smoke less of it. (They can use a pipe. A small pipe.)

Better packaging for edibles would fix part of the problem - if 10mg cookies or gummies were easy to break into 2.5mg pieces, that would help some people. (However, the likely outcome of a request for this is the same sized cookies or gummies or whatever at 2.5mg for the same price. Sigh.)

Decriminalizing to allow more casual growers would help a lot with this problem. If neighborhood backyard farms were legal, they could cover the "low power but not always" niche.
posted by ErisLordFreedom at 12:01 PM on July 16, 2021 [3 favorites]


You want weak weed? Just ask for some shake at the dispensary. Mix it in with the good stuff, et voila! Take a hit of that nostalgic, old-school harshness.
posted by Rash at 3:51 PM on July 16, 2021 [1 favorite]


I’ve definitely seen 2.5mg mints and gummies. Maybe I’m still privileged to live in CA because I feel like a lot of things people in the thread are saying they’d like to see actually do exist.
posted by atoxyl at 4:17 PM on July 16, 2021 [1 favorite]


Between the teeny tiny percentage of heavy users who are affected by this condition (120 people/yr? In Colorado?? Consuming our valuable medical resources?) and urgent digressions into some correlation/causation confusion around mental illness and smoking weed, this reads like a moral panic trial balloon.
posted by tehgubner at 4:33 PM on July 16, 2021 [8 favorites]


a moral panic trial balloon

Definitely. It’s telling that the scare term “powerful” was used several times when discussing simple potency.
posted by LooseFilter at 6:40 PM on July 16, 2021 [1 favorite]


"scromiting" is such a stupid term. I wish I had some weeeeeed.
posted by thelonius at 2:22 AM on July 20, 2021 [1 favorite]


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