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>relief.....end is near > >"Just like anything, the dose makes the poison.” > >https://currently.att.yahoo.com/news/loved-weed-then-vomiting-began-184850933.html > >U.S. >He loved weed. Then the vomiting began. Months later, he died >USA TODAY >USA TODAYSeptember 20, 2019, 4:00 PM EDT > 0:55 1:25 > NYC climate march joins global call for action >The doctors told Regina Denney and her son Brian Smith Jr. >what was causing his severe vomiting and abdominal pain. > >Neither the teenager nor his mother believed what they said: >smoking weed. > >Smoking marijuana, the two knew, was recommended to cancer >patients to spur the appetite. How could it lead to Brian's >condition? > >As the months went by and the pounds slipped off Brian’s >once healthy frame, it was clear that whatever was causing his >stomach troubles had just the opposite effect. > >Brian kept smoking. The symptoms continued on and off. > >Last October, after another severe bout of vomiting, the >teenager died. He was 17 years old. > >Five months later, as Denney pored over a coroner’s report >for answers, she finally accepted that marijuana played a >pivotal role in her son’s death. The autopsy report, which >Denney received in March, attributed her son's death to >dehydration due to cannabinoid hyperemesis syndrome. > >"We had never heard about this, had never heard about >marijuana causing any vomiting. He and I were like, 'Yeah, I >think it’s something else,' ” Denney said. “Brian did >not believe that was what it was because of everything we had >ever been told about marijuana. … It didn’t make any >sense.” > >Cannabinoid hyperemesis syndrome, also known as CHS, can arise >in response to long-term cannabis use. The syndrome consists >of vomiting, nausea and abdominal pain, which can often be >alleviated by taking hot showers. > >Doctors say CHS is on the rise, but they are not certain why. >Marijuana is more available than in years past, and it is more >potent. > >Rarely does CHS result in death. > >'Basically, they smoked weed' > >Denney didn’t like the fact that her teen son started >smoking at 13, but she figured the situation could be worse. >Brian and she had a strong relationship, and he always had >been honest with her about his use of marijuana. > >For the most part, Brian was a good kid who had a tightknit >group of friends who called themselves the GBS, Gimber Block >Savages, after the south side street where many of them lived. >Although they called themselves a gang, Denney said, they >never caused any trouble. > >“Basically, they smoked weed,” she said. > >About two years after Brian started smoking, he began using a >lot more, perhaps to help deal with depression, Denney said. >He dropped out of school after ninth grade and started working >full-time with an uncle who had a tree-trimming business. >Brian helped clear brush. > >The job provided enough money to support his marijuana habit, >another reason Denney felt there was no reason for her to >intervene. After all, many of Brian’s peers were using >heroin or methamphetamine. > >“I thought, 'OK, if that’s all he’s doing, smoking >marijuana, pick and choose your battles,' ” she said. “If >this is the worst thing he’s doing, I’m OK. He’s not in >any trouble legally. He’s not playing with guns, robbing >people and stealing things. He’s supporting his own habit. I >thought, 'OK, this is what it is.' ” > >Denney had no reason to be concerned about cannabinoid >hyperemesis syndrome. She, like many others, had never heard >of it. > >'A totally underdiagnosed entity' > >A few years ago, many doctors had no idea this condition >existed. First described 15 years ago, CHS symptoms follow >heavy cannabis use and include intense stomach pain, bouts of >vomiting and debilitating nausea. > >A study published last year in the journal Basic & Clinical >Pharmacology & Toxicology surveyed urban emergency room >patients who smoked marijuana 20 or more days a month. Of the >155 who said yes, almost a third experienced CHS symptoms. > >“A lot of papers prior to mine would say it’s very >rare,” said Joseph Habboushe, one of the study’s authors >and a clinical associate professor of emergency medicine at >NYU Langone Health in New York City, who saw his first case >five or six years ago. “Emergency room doctors on the >front-line lines, we know that it’s a totally underdiagnosed >entity.” > >On the other side of the country, Dr. Jeff Lapoint and his >colleagues saw an influx of patients with CHS symptoms about >six years ago. Lapoint is the director of the division of >medical toxicology at Kaiser Permanente Southern California >and practices in San Diego, which he said is home to both >craft beer and craft marijuana. > >Many of Lapoint's patients returned time after time when the >next bout hit, seeking relief from their stomach woes. > >“We would see lots of it. We would see an alarming amount of >it,” Lapoint said. “People were coming in all the time, >and physicians didn’t know what to do with them.” > >Op-ed: Vaping deaths and booming black market: Pot experiment >will fail without better oversight > >Lapoint said he and his colleagues have seen fewer such cases >lately. > >Habboushe concluded in his study that as many as 2.75 million >regular cannabis users may suffer from symptoms of CHS, though >many of them may be mild. Mild symptoms can serve as a warning >to discontinue cannabis use to avoid more severe distress down >the line, Habboushe said. > >A study this year in the Journal of Forensic Science described >two people in Canada who died from CHS and a third for whom >the condition contributed to death. > >'It makes no sense' > >Brian was Denney’s baby, her boy after two girls. From the >time he was a child, he suffered from acid reflux and often >took medicine to ease the symptoms. > >Brian, who loved sports and the movie “Twilight,” was >close to his family and called himself his mother’s >“snuggle bunny.” He was beloved uncle BubBub to his >toddler nephew, Zayden. He was a loyal friend, once giving up >his bed so a buddy who was homeless had a place to sleep. As a >teen, he split time between Denney’s home and that of his >father. > >In April 2018, Brian felt ill. At first everyone, including >his pediatrician, thought his acid reflux was acting up. He >lost 40 pounds and frequently complained of nausea that led >him to avoid food. > >A few days into the illness, he called his mother and told her >he couldn’t stop vomiting. Denney drove to his father’s >house to take him to the hospital. On the way to Franciscan >St. Francis Health, Denney had to stop multiple times for >Brian to vomit. > >The 1st tied to a weed shop: Another death is linked to >vaping. This time, it's in Oregon > >Brian complained of tingling in his face. When they got to the >hospital, half his face was numb, the muscles in his hands and >legs constricted and froze, and he projectile vomited. > >Denney assumed he was having a stroke. > >Within a few minutes, he was hooked up to oxygen and a heart >monitor. Medical staff placed IVs in each arm. Tests revealed >his kidneys were failing, and many of his other lab values >were abnormal. No one could tell what was behind the attack, >though they knew the frequent vomiting left him dehydrated. > >Another emergency room doctor poked her head in the door and >asked two questions: Do you smoke marijuana often? Do you take >frequent hot showers? > >Yes, Brian said. Yes. > >You have CHS, the doctor said. > >The following day, Brian was discharged with an appointment to >follow up with a gastroenterologist in July. > >Although neither Denney nor Brian accepted the diagnosis >completely, she urged him to consider not smoking as a process >of elimination. He agreed, but he struggled with nausea and >was too sick to work. > >The GI doctor took a tube of blood, did no further testing and >confirmed the earlier diagnosis: CHS. > >Denney remained unconvinced, thinking the specialist was too >quick to accept the emergency room doctor’s diagnosis >without doing any confirmatory testing. > >“Going to the GI doctor, I thought we’re going to finally >get an answer. We’re going to finally know what we need to >do to make him better,” she said. “Then when they didn’t >run any other tests, it was like, 'OK, so why are we not doing >them?' It makes no sense.” > >After that visit, Brian returned to his dad – and started >smoking again. > >He told Denney he had symptoms the whole time he wasn’t >smoking, so what was the point of quitting? > >'The dose makes the poison' > >Experts aren’t 100% sure what’s behind the relatively >sudden advent of this condition. They suspect that more potent >cannabis may be to blame, along with several states’ >decision to legalize the drug for medicinal purposes or >altogether. > >In the 1970s, THC concentration in most marijuana would be >about 7%, Lapoint said. The mean concentration has risen to >15% to 30%, and it’s possible to make extracts with 99% >THC. > >“Marijuana was the joke of the toxicology world when it was >7%,” Lapoint said. “People never got sick. … But now if >you make the concentration 99%, it’s just like if a >17-year-old kid goes to a frat party and has a beer. That’s >a lot different than drinking shots of Everclear 151. Just >like anything, the dose makes the poison.” > >Vaping lung illness:: What we know about the recent spate of >cases and deaths > >The best treatment for CHS is to stop using cannabis entirely, >Habboushe said. > >Once a person develops the condition, he or she has probably >done something permanent. Further exposure to cannabis highly >increases risk of recurrence. Persuading patients to accept >this can be difficult, Habboushe said. > >“There’s a lot of denial,” he said. “A lot of patients >are really heavy marijuana smokers, and they really don’t >want to believe that it’s related to cannabis and hard for >them to believe because they have been using cannabis >forever.” > >'Don't give up' > >In July Brian moved back in with Denney. She knew he was not >going to give up smoking, but she thought being around his >nephew would encourage him to smoke less. > >A few months passed. Brian did not put back the weight, but he >seemed to be a bit better. > >Then came Oct. 7. Brian started feeling ill again. Denney and >her daughters had concert tickets, so she went to buy him >Gatorade and popsicles to stem the nausea and asked his father >to come and stay with him. > >When they returned from the concert, he started vomiting >nonstop. They rushed to the St. Francis emergency room, where >doctors transferred him to Riley Hospital for Children. Once >more, Brian was rehydrated. > >Denney said her son cut back on smoking, but a few weeks >later, he went to visit his cousins. “I know they smoked,” >Denney said. “That’s just what he did.” > >When she picked him up Oct. 21, he felt a little nauseated but >had not been vomiting. > >Three days later, Denney woke up around 5 a.m. to find her son >sitting in the living room and clutching his stomach. > >He told her it was his acid reflux but he was fine. Then he >started vomiting again. > >“He was throwing up so much,” Denney said. “I was taking >the bucket in there and holding it for him because he didn’t >have the energy to hold it.” > >For the first time, Brian told her he was going to quit >smoking. > >He grabbed his lower back, saying it hurt bad. > >Remembering his kidneys had suffered in his previous attacks, >Denney called 911. > >Before the paramedics arrived, she found her son lying on his >side. > >She rolled him over. He was not breathing. > >Denney screamed. She started doing chest compressions. Her >daughter’s boyfriend ran across the street to get their >neighbor, a Navy veteran. > >“I kept telling him, 'Fight, B, fight. I need you. Don’t >give up.' I begged God to take me instead," Denney said. > >The paramedics arrived and worked on Brian for about 45 >minutes to no avail. On Oct. 24, Brian died. > >Because he died at home, detectives had to investigate, and >the coroner prepared a report. It took five months for Denney >to receive a copy. It arrived on her birthday in early March. > >Soon after Brian’s death, Denney found edibles in his >backpack. > >She asked herself again and again what she should have done. >Should she have forced him to go to rehab? > >Denney devoted herself to helping raise awareness about CHS. >She started a Facebook group in Brian’s name. She talks >about Brian and CHS every chance she gets. She keeps Brian >close to her, wherever she is. > >Photos of her son hang on the walls in her bedroom. On her >dresser sits a dark urn emblazoned with a gold marijuana leaf >that contain's Brian's ashes. His sister chose it. She knew >her brother would have liked it. > >Follow Shari Rudavsky on Twitter: @srudavsky > >This article originally appeared on Indianapolis Star: Indiana >boy, 17, died from smoking weed. CHS is to blame. What is >CHS?
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