On the Season 2 finale of 'Cannabis & Main,' host Ricardo Baca sat down with cannabis influencer Alice Moon to talk about cannabinoid hyperemesis syndrome (CHS). CHS is a little understood medical condition that causes severe nausea and vomiting in some people who consume large amounts of cannabis over long periods of time. It's something Alice knows about first hand, having suffered from the condition herself. Now she's trying to raise awareness about the issue and help people recognize when they may be suffering from CHS their self.
This season 'Cannabis & Main' is brought to you in part by Fluent Cannabis.
Ricardo Baca: Hello, hello, and welcome to 'Cannabis & Main,' a Civilized podcast where we extract one element from today's cannabis-scape and go deep. I'm your host, Ricardo Baca, founder of Grasslands, a journalism minded agency, and it's so great to be here with you today. You can learn more about this show alongside the marijuana news and cannabis lifestyle coverage your crave from Civilized found on the world wide web at civilized.life.
Now, this week, we're going to dive deep into cannabis and cannabinoid hyperemesis syndrome with a guest who is a long time marijuana consumer and advocate who now suffers from cannabinoid hyperemesis syndrome. Now, because CHS is so rare and still so new, let's first dive into what it is. According to Cedars-Sinai, "Cannabinoid hyperemesis syndrome, or CHS, is a condition that leads to repeated and severe bouts of vomiting. It is rare and only occurs in daily long term users in marijuana. The symptoms include ongoing nausea, repeated episodes of vomiting, belly pain, decreased food intake, and weight loss, symptoms of fluid loss, which is basically dehydration."
I remember first learning about CHS from a physician friend of mine. He was telling me about the occasional patient coming into the emergency room, struggling to keep food down, struggling in general, feeling like garbage and telling him and his colleagues that the only thing that made them feel better was oddly, a hot shower. Generally, the feeling of how to stop CHS is to completely halt your cannabis consumption. Sure enough, Cedars-Sinai backed up this odd treatment saying, "Most people self treat using hot showers to reduce their symptoms."
Like almost everything else in these early days of legal marijuana, CHS is also mired in controversy, complicating matters even further.
Dr. Todd Dorfma (clip): The problem in these cases because of the lack of awareness, many people who get this syndrome tend to continue to use marijuana to treat the nausea and vomiting. So it's a vicious cycle and then the symptoms persist.
Ricardo: So cannabis and cannabinoid hyperemesis syndrome. Let's talk about it, right here on 'Cannabis & Main.' Alice Moon is director of communications for Blunt Talks and an account coordinator for RRPR Creative.
Alice, thank you so much for joining us on 'Cannabis & Main' today.
Alice Moon: Thank you so much for having me. It is an honor to be here. I'm very grateful that you're giving me this platform to talk about CHS.
Ricardo: It's great to see you. I, myself, am thrilled to learn about it. I very much feel like this is such a vastly misunderstood aspect now that we're entering legalization, commercialization, normalization. We need to know about this.
Alice: Absolutely. Absolutely. It's very important for people to know about it because I don't want anyone to have the experience that I had.
Ricardo: Oh, jeez, dude. We're going to get into that, but before we do, I started the episode talking about how Cedars-Sinai writes about this. I'm sure you've been on their web materials and read through that. Was that accurate from your knowledge of CHS, but also from your experience?
Alice: Absolutely. It is accurate. Hot baths and capsaicin cream on the stomach are the only things that will stop the nausea and the vomiting. It's temporary. It's only when you're experiencing the heat. So when you're not in the bathtub, you're vomiting. In the bathtub, no vomiting.
Ricardo: My, God, dude. So this says, this only affects daily long term users of marijuana. Was that you?
Alice: Yes. I was consuming daily for years before I started experiencing symptoms. I was an edible reviewer. So I was consuming a small amount of edibles everyday, around 5–20 milligrams a day. I haven't talked to anyone that this has happened to where they just started using. It's all long time users.
Ricardo: How long had you been consuming before your first introduction to CHS?
Alice: I've been consuming for six years before I started experiencing symptoms.
Ricardo: That's baffling, is it not, that something could take that long to manifest?
Alice: It is extremely baffling. It just popped up out of nowhere. I just randomly started throwing up, every now and then, every few months until it got more and more severe.
Ricardo: Let's talk about cannabis. You are an advocate for this plant, Alice. I know you. We've hung out before, and of course, follow each other on Instagram. You're a fan and an advocate for this plant, why?
Alice: Cannabis helps so many people with so many different things. I joined this industry because I'm so passionate about helping people, and I see the wide variety of people that benefit from it. There's just so many different uses and I love to see the positive effects from it.
Ricardo: Me too, 100 percent. I love learning daily things that I didn't know before that, especially because there was so much misinformation surrounding this area. So let's fast forward from your introduction to it, you're falling in love with it, now to your first vomiting episode. I imagine you must have been confounded, like, "What the hell is going on? Why can't I stop throwing up?" Where were you and what was going on?
Alice: So, I was throwing up randomly for about two years. It was every few months I would just puke, and doctors said that it was acid reflux. So change my diet. It didn't get better. Then a year into it, I quit drinking thinking maybe alcohol had something to do with it. I didn't get better and I started throwing up more and more. In early 2018, I saw a specialist who told me it was cannabis and I was like, "Eh, I don't know if I want to believe that." She said, "Quit for three months."
So I said, "I'm going to go have one last hurrah." Civilized was throwing an amazing dinner in Malibu Hills. So I went and had a five course infused meal with the best chef ever, Chef Holden and Canndescent, which is an amazing flower. That triggered my first severe episode. I threw up all day, everyday, for 14 days. Let me clarify. Civilized threw an epic party and it was so great for me to have that as my last meal. This episode was going to happen regardless if I went to that event or not.
So 14 days, non-stop throwing up. There wasn't a lot of information available to me. I wasn't even really sure when this was going to end. The hot bath thing was something I was doing subconsciously. I was just staying in the bath and didn't know until I started really researching this. Then I found out about the capsaicin cream. At 1:30 in the morning, my roommate went and got it for me. I rubbed it all over my stomach. Didn't really understand what capsaicin cream was. It is a cayenne pepper based cream. So my skin was then on fire and I was in excruciating pain because of it.
Temporarily wasn't throwing up, but I was in so much pain I was in tears. So I lost, I think, 12 pounds during that episode. Went to urgent care twice. On the second time, the doctor said, "We need to just get a whole bunch of tests done." So he called an emergency order to my doctor because the doctor I saw had a three-month wait to even see them. I got a whole bunch of tests done and I was otherwise healthy.
So we narrowed it down to, yes, it was the cannabis. They made sure that it was absolutely nothing else. I've passed out in my front yard one day because I could no longer hug my toilet to throw up. So I was in my front yard throwing up and a neighbor came by and was like, "Can I help you?" I just started crying because I was like, "I don't know how you can help me. I wish I knew how." It's literally a sip of water and I was throwing up.
I was sleeping in my bathroom on the floor because I was rotating between the bathtub and puking. The second I'd get out of the hot bath, I'd be vomiting excessively. It was a really scary situation, not only for me, but everyone around me because I looked like I was dying. My roommate would come home and check on me on the bathroom floor like, "Are you okay?"
It was extremely scary and that was my first episode of three.
Ricardo: That was 14 days. I'm guessing you were not consuming during that time. So you ceased use.
Alice: I ceased use.
Ricardo: And it still lasted 14 days.
Alice: 14 days. Yep. It was just everyday, I'm like, "When am I going to stop throwing up? When am I going to be better? Can someone give me answers? Is there any information anywhere?" No, not really. While I'm so sick, I'm starting to study about the CB1 and CB2 receptors trying to figure all of this out. Ultimately found the information about the TRPV1 receptor, which regulates digestion.
Yeah, so they think that too much cannabis shuts off the TRPV 1 receptor, and high amounts of heat turns that receptor back on.
Ricardo: Hold that thought. We're going to take a very quick break, but in the meantime, hit that subscribe button, and if you'd be so kind to leave us a review, we'd really appreciate it. Thanks.
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Let's hear about your second episode. How much farther after your first episode was it, and was also triggered from use?
Alice: Yeah, so I quit cannabis for three months. Then I started consuming again. I was using pesticide-free weed because people blame this on pesticides. So I was like, "Okay, well, I'm going to use pesticide-free weed. Let's see how it goes." So I had another episode and that one lasted only four days. So, better. Four days versus 14, but still not great.
So after that one, I quit THC completely and went the CBD route, hemp-derived CBD. Then a few months into that, I had my most severe episode. It started December 22nd. So I missed Christmas and New Years, and it was 16 days. I had two urgent care visits, an at home nurse visit, and ultimately landed in the ER. I was hospitalized for four days. I got two ulcers, a hernia, and a bacterial infection from all the throwing up.
I was down to, I believe, 108 pounds, and I'm proud to say right now I'm 127 pounds since January. So I've put on a lot of weight since, then, which is wonderful. I already have a thin frame. So to get that skinny is really like, it just feels like I was about to die, really. The whole experience, it's just, it's a nightmare.
Ricardo: Where are you at now with your cannabis intake?
Alice: No cannabis, no CBD, no THC. Now I'm so sensitive to it that I can't inhale second hand smoke. So now that it's completely changed my lifestyle, I can't go to all the events that I used to go to. In 2017, I went to close to 200 events.
Ricardo: Yeah, you're something of a socialite, Alice.
Alice: I am, yeah. It makes me so happy to meet people and connect people. That's what I love to do. Now, unfortunately, most events are consumption events. So I'll throw up from second hand smoke. So I'm that sensitive to it now because I kept putting my body through it over and over. People want me to try like, "Oh, what about CBN, CBG?" I'm like, "No, I'm not going to test out anything anymore."
Me trying hemp-derived CBD was me trying out just CBD to see. I've kind of been a guinea pig for this situation. I won't touch cannabis again until there's some facts behind it. I don't want the hearsay anymore. I can't put my body through that.
Ricardo: This is probably a pretty common question that you get when you're educating people about this and telling them about your just awful experience. My God, I'm sorry you've been through this, dude. Why do we not know more about this? Is it just because we're only now entering a legal era and it wasn't as readily available and perhaps people weren't as open about their use with their physician? I mean, why don't we know more about this? It seems like we should.
Alice: Yeah. Multiple reasons. That's one of them. People weren't telling their doctors about their cannabis use, and now in states that are legalizing, people are more comfortable telling their doctors. Then also, doctors don't know about this, and so they're misdiagnosing people. I talked to two people who had their gallbladders removed because they were misdiagnosed.
Literally, organs being removed because doctors don't know about this. People also don't want to accept this is real. So anyone who is saying that they think they might have it is being shut down. The cannabis community is saying, "No, this isn't real." So the push saying, "No, this isn't real," is keeping people from believing it and wanting to learn more and to talk about it, you know?
Alice: The cannabis community is who is resistant to this. I think medical community is intrigued but also not motivated enough to push it. You know, when I was in the hospital, my doctor didn't know the difference between CBD and THC. I was like, "Okay, I'm not in the place to school you on this right now, but please study this. Please learn about the endocannabinoid system. Please, please look into this."
In cannabis, we're all students. We are all students. Nobody knows everything. We're discovering things all the time. I'm just so determined to figure this out because I want to smoke weed again. Honestly, I want to smoke weed again. So I am just like, "We have to figure this out. I'm so, so determined."
Canada just announced that they are putting money toward researching CHS. So I started crying when I heard that news. I was like, "This is phenomenal. Somebody is going to study this now."
Ricardo: So what do we know? We know this is rare. Do we have any idea of the percentage of cannabis consumers, daily cannabis consumers, who this affects?
Alice: No. Nobody is tracking this. That's the unfortunate part, there's no data being collected. So I started a Facebook group. I have a Google Form for people to fill out so that way I can try to piece together information. I'm trying to see if there's any commonality between people who have this. I have yet to find anything that we all have in common except that we've all been using cannabis for an extended period of time. I get a message every other day from someone who just discovered they have it. Every other day.
I get so many messages now, and I think a lot more people have it than we realize, and I've talked to two other influencers in the space that have it, but they're afraid to speak out. They don't want to announce that they have it because it can ruin your career. It's, in a way, anti-cannabis. Though I'm not anti-cannabis, but people see it that way. So it's unfortunate that I'm the face, I'm the poster child for this, you know? I guess someone had to do it so that way people become more aware and don't deny it.
Ricardo: You really have taken it up on yourself to speak out about this, to educate. I saw that you were…was that as Business Insider article?
Alice: Business Insider just put out a huge feature about me and CHS. So I'm very grateful that they took the time to write all of that. It did come with a lot of negative backlash as well, but yeah, I am trying to be as vocal about this as I can be because I don't want anyone to throw up for 16 days. I mean, it's a Goddamn nightmare.
Ricardo: Let's jump into this aspect of the cannabis community being resistant to this. To me, from an outside perspective, you are a reputable human being, a quality person, and you have no reason to lie to me or anybody else, especially about something so out of left field. Why would anybody not believe you when you're telling them what's happening?
Alice: People don't want to believe that there is any negative to cannabis. They think that if there is a negative, then it will affect legalization. They think it will move us backward and not forwards. And it's an ignorant way to think. Cannabis does have negative side effects. We can have too much water. So why do you think that you can't have too much cannabis, you know?
I've been accused of working for the government. Oh, yeah.
Ricardo: Nark? Alice Moon, the nark?
Alice: I know. I received so much online hate. It's really emotionally taxing and exhausting, from people within the community, within the cannabis community, and outside of the cannabis community as well that believe I am somehow anti. Even some of my peers that have known me for years said, "No, this isn't true. I don't believe you." That really sucks, you know, when people are like, "No, we don't believe you," and I'm like, "You've known me for years. You know how much I love cannabis. I've reviewed your products before and I've talked positively. Now you don't believe me when I'm going through this terrible, terrible thing?"
People just don't want to believe it. I understand because when I first heard of this, I didn't want to believe it either. We don't want it to be real, but it is.
Ricardo: You know, I've written a couple columns for, I believe, MG and Cannabis Now, specifically about how dangerous a position it is for the industry to spread misinformation because of course, we've been victims of misinformation for decades, 80 plus years, from the prohibitionist perspective. We as a responsible industry, it is our responsibility to listen to what is known and parrot that quality information and not spread any misinformation, even when it shines poorly upon the plant.
For example, it is generally agreed by addiction specialists that while cannabis isn't nearly as addictive as alcohol, tobacco, opiates, you name it, generally 7–8 percent of adults who come into contact with cannabis develop some sort of dependence on it. Because these medical professionals and addiction specialists say that, that's what I say, too, when I'm talking about it or writing about it. Then the flood of hate mail comes, and it's like, "No, cannabis isn't addictive. Fuck you, dude."
Do you know best or does this addiction specialist at Yale know best? I'm going with Yale, you know? So I think it's our responsibility to spread quality information, and it seems like even though we don't have a wealth of quality information about CHS, it exists. These medical professionals are telling us it exists. Those who are suffering from it recognize that the only way to make it stop is to cease use for right now. So why would we not just embrace this information, and instead of victimizing the victim, welcoming them into our circles and surrounding them with love and hoping for more information in the future.
Alice, I'm so sorry that this afflicts you. This is just something that we clearly need to understand better, but I have no doubt that your activism on this point is only elevating the profile and the need for this. So keep it up.
Alice: Thank you, and you know, I feel like this happened to me so that way there could be a voice for this, a credible voice, somebody who has the street cred that I have, that I've been in the industry for so long. So it's unfortunate that it happened to me, but I think it happening to me is going to save a lot of people.
Ricardo: Alice Moon, thanks so much for coming on 'Cannabis & Main' today.
Alice: Thank you so much for having me. Greatly appreciate it.
Ricardo: You're listening to 'Cannabis & Main,' a Civilized podcast.