EVALI, CHS, and Other Weird Weed Side Effects You Should Be Aware of

The only cannabis news that seems to make it into the mainstream tends to border on the sensational—Maureen Dowd “overdosing” on edibles; police departments issuing warnings about the “threat” of cannabis-infused Halloween treats. Enthusiasts are quick to dismiss this news as mere sensationalism; remnants, perhaps, of the century-long campaign to vilify the drug. But even weed’s biggest advocates admit there are some instances in which consuming cannabis is not the right choice, for reasons involving both health and safety.

Yes, weed is largely safe to use in numerous medical and recreational situations. Still, there are some need-to-knows actually worth knowing about that go beyond headline- grabbing clickbait from naysayers.

Remembering that whole “vaping disease” thing?

Before COVID eclipsed all other health concerns, the media was doing backflips over what was dubbed a vaping crisis—a rash of instances of lung damage in patients who reported using THC-filled cartridges, often from unregulated sources. These products caused lipid pneumonia and lung damage, as oily particles within them were inhaled and stuck to people’s pulmonary tissue and, in many cases, led to their deaths. The condition was dubbed EVALI—e-cigarette or vaping use-associated lung injury.

According to the CDC, there have been 68 deaths and almost 3000 hospitalizations due to EVALI, which they attribute the primarily to DIY vapes containing the additive Vitamin E acetate. “Vitamin E acetate is strongly linked to the EVALI outbreak,” notes a CDC report. “[It] has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states.”

Cases of EVALI are still occurring, even if the acute peak has passed. As Melissa Pandika wrote this past spring in Mic, “The vaping crisis hasn’t gone anywhere…Vaping still causes lung injury, even if it doesn’t result in hospitalization, and will probably give rise to more sinister, slower-burning diseases that take decades to surface.”

While these lung injuries aren’t specifically a danger posed by constituents of the cannabis plant itself, there have still been far too many recalls of even lab-tested products due to contamination to consider vaping cannabis truly “risk-free.” On the other hand, there’s no question that the increasing regulation of cannabis products due to legalization will help make products safer, at least.

Those stories about uncontrollable barfing aren’t just a myth

Advocates of cannabis legalization sometimes feel conflicted when talking about potential harms of the drug—they are, it seems, the tidbits that often suck up all the news coverage and provoke outrage. Those who have experienced issues arising from their weed habits are often attacked by members of the cannabis community, even if they remain pro-ouid overall.

One of those people is Alice Moon, a publicist and canna-influencer who has been abstinent from the plant for three years due to her experience with Cannabis Hyperemesis Syndrome, which is, to put it bluntly, uncontrollable cannabis-induced vomiting. It was while working as a budtender in 2016 that Moon first started experiencing seemingly inexplicable bouts of intense nausea.

“After throwing up off and on for two years and having a plethora of tests done, I was diagnosed by a GI specialist in 2018,” she told Lifehacker via email. “I saw numerous doctors over the two years I was sick, and finally [saw] one knew about CHS and suggested I had it.”

Cannabis Hyperemesis Syndrome presents like other cyclical vomiting issues — there’s a period of pre-attack, where nausea or abdominal pain might start up; a period of uncontrollable vomiting, called emesis; and an intermission, a period recovery before the next episode. It’s not pleasant, as you can imagine. Sufferers are completely non-functioning during an attack, and complications can arise as the episodes intensify or happen more frequently.

“CHS is a rare but serious condition. There have been at least 5 known deaths attributed to CHS, due to the constant throwing up causing dehydration and organ failure,” Moon said.

People with CHS are reluctant to talk about it, lest their experience be wielded against easing access—an unfair aspect of the continuing taboos surrounding cannabis. But according to Moon, “This syndrome should be talked about, as we will continue to see more and more people experience CHS as more states legalize.”

Sufferers like Moon want consumers to know about CHS, but not to worry about it. “CHS is a rare condition, so it is unlikely most consumers will develop it. That being said, if you start to experience any of the symptoms, which include nausea, vomiting, and/or abdominal pain, I suggest taking a cannabis break for three months to eliminate [it as a possible cause] for the symptoms. Don’t be afraid to talk to your doctor honestly about your cannabis use, but make sure you advocate for yourself by suggesting that they run tests on you to eliminate other possible causes.”

CHS and EVALI are just two of the potential issues that can arise from cannabis use, and some of these cautionary tales stem primarily from how much cannabis you are using. It’s unlikely that you will contract an illness from one puff, a first try, or otherwise. Safe access and moderation are your first defenses against such concerns.

Know your risk of mental health disorders

One scenario where avoiding cannabis even in small doses is a good idea is if you are prone to mental health issues that can induce psychosis. Hallucinations, paranoia, and other brain misfires are scary, and can be indicators of an underlying condition. And while the science is still incomplete, there are competing theories that tie cannabis use disorder (that is, using cannabis to the point of addiction) to schizoaffective disorders and potentially schizophrenia itself, though others that rule it out.

We spoke with a cannabis recruiting expert who deals with some scary psychological symptoms after smoking weed; she asked to remain anonymous to avoid backlash from weed advocates.

“It takes about 20-30 minutes after cannabis use and side effects start kicking in,” she told us. “I have a bad/negative thought, [then] I hear a crowd ‘boo-ing’ as if I’m on a stage and there are many people listening to my thoughts. When I have a positive and uplifting/encouraging thought I still hear a crowd around me that cheers and says ‘yay.’ Every single thought I have comes with a boo or cheer from a large crowd – the crowd is not physically there and it’s a rollercoaster of emotions for each thought.”

Because of this, the recruiter abstains from consumption. “I have discussed it with my therapists and they are not surprised cannabis has this effect on my brain,” she said. “As someone who has a family member with schizophrenia, it is extremely possible cannabis triggers schizophrenia [in] myself.”

Some studies claim that the link is strong while others seem to disagree, but anyone experiencing such adverse outcomes should simply not consume cannabis.

Reports of adverse effects shouldn’t derail support for legalization

Both women I spoke to are still on the front lines of the fight to normalize cannabis use and the cannabis industry as a viable career path— and their advocacy is unconditional.

The recruiter believes in the medical potential of cannabis, even if it isn’t for her “I am an advocate because I believe it can truly be medically beneficial for patients,” she said. “Although it’s not my personal experience, it doesn’t mean that I don’t believe it to be true.”

Moon, meanwhile. wants research to meet the moment, so it can demystify the functions of the human endocannabinoid system and, perhaps, allow her to enjoy the herb once again.

“I recognize that even though cannabis doesn’t work for me, it works for millions of people for a plethora of reasons,” Moon said. “My previous work as a budtender gave me a firsthand look into how cannabis positively affects the lives of people of all walks of life. I want everyone to have safe access to cannabis. And I hope one day there is a cure for CHS so I can go back to using my medicine.”

Unclean product is a root cause of some issues

Tainted, moldy, and otherwise contaminated products make it to market in both the underground and sanctioned supply streams, but only one of those has a recall process that could prevent you from consuming it.

Since cannabis is an agricultural product, it will always be able to be grown outside the sanctioned supply chain, and unscrupulous actors will always adulterate products to stretch them—especially where cannabis remains both profitable and illegal.

While nobody wants the corporatization of cannabis except the corporations themselves, everyone wants clean, safe, and affordable access to products that won’t literally poison them. Federal legalization can hit the sweet spot of allowing people to grow their own cannabis, opening the market up to eager smaller entrepreneurs, and mandating processes for keeping the shelves empty of drugs containing pesticides, fungi, bacteria, and yes, even bird poop.

Just because something is generally safe doesn’t mean it doesn’t carry risks for you. All bodies are different, and cannabis remains a scientific enigma; we don’t yet know every chemical component of the plant or how it functions in the body. Until we have the whole thing mapped out and understand on a physiological level why each element does what it does and with which bodies it does so—which is going to take a lot more research—there’s an element of mystery to overcome, and risks and cautions to keep in mind before you partake.

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