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Guest post by John Hughes
Critical Decisions in Emergency Medicine is a publication endorsed by the American College of Emergency Physicians (ACEP). ACEP is an organization with over 40,000 members; the majority of Emergency Physicians in the US are members. In the latest edition, Dr LoVecchio published research findings that showed evidence that rubbing Capsaicin cream on the abdominal wall at regular intervals can decrease vomiting in Cannabinoid hyperemesis syndrome, otherwise known as cyclical vomiting. Anecdotal evidence from my physician colleagues treating patients confirms that this could be a worthwhile treatment.
On the surface, it seems like a harmless publication of treatment for marijuana induced vomiting. Despite many medical authorities describing it as a rare condition (perhaps downplaying complications of marijuana), as an emergency physician I see it quite frequently in patients. Young adults with nonstop vomiting and abdominal pain who make sounds like a dog dry heaving frequently end up with a diagnosis of cyclical vomiting after a sometimes lengthy and expensive workup to exclude other possible causes and after hours of iv fluids and treatments for nausea and pain. In addition to vomiting, I frequently see marijuana users present with chest pain, anxiety, high heart rate, and several other well known symptoms and admit them to hospitals for further treatment. Again, nothing out of the ordinary for a medical colleague advocating an off the shelf treatment for a complication of a medical condition (marijuana overuse) that is well known to acute care physicians.
In 2019, ACEP published the following organizational policy on medical cannabis that has not been updated: “The American College of Emergency Physicians (ACEP) believes that scientifically valid and well-controlled clinical trials conducted under federal investigational new drug applications are necessary to assess the safety and effectiveness of all new drugs, including cannabis and cannabis derivative products, for medical use. Currently, in many states, cannabis and related cannabinoids are being recommended for patient use by physicians when little evidence has been provided regarding appropriate indications, efficacy, dosages, and precautions of these drugs.” This article is not intended to be for or against cannabis. Instead, the purpose is to highlight that with more states approving medical marijuana and society at large increasing usage, it is frightening that government and medical organizations have not done the proper research showing risk/benefit of cannabis. Worse, there are few if any warnings of cannabis dangers in advertising on tv, billboards, mass media, social media, or any other medium. Marijuana and CBD are dispensed by nonmedical personnel (where legal) with little if any warnings to buyers of side effects and complications. Most patients I see with marijuana toxicity had no idea that marijuana/CBD could cause harm. I have seen elder patients develop life threatening high blood pressure and heart attacks after use. The patients only knew about the ‘benefits.’
Patients with marijuana toxicity cost the US billions in health care expenses and take up valuable space in ER beds. There seems to be no concern within government or the medical community at large. Instead, both seem focus on increasing availability through legalization as quickly as possible. Quietly it seems the ACEP community has come around to recognition of marijuana complications. Up until recently, physicians who spoke up about the ill effects of marijuana faced rebukes from colleagues who seemed fixated on the merits and popularity of the new drug. This perhaps mirrors the left leaning bias of the emergency physician community.
Circling back, ACEP is saying that not much is known about cannabis complications, more research needs to be done, but they allow independent research and dialogue now on treatments. ACEP has also not pushed to educate the US population on the dangers of marijuana/CBD use and has not called for ‘fact checking’ proponents of Marijuana and CBD. Interesting, as this approach is decidedly different in its approach to Covid. With Covid, ACEP supported the CDC and Dr Fauci to early on forbid off the shelf treatments, censor discussions amongst colleagues about Covid management, limit discussions the origins of Covid (to prevent future outbreaks), and even after the pandemic ended, continued to censor physicians to do its part in the war against what it still calls ‘misinformation.’ ACEP never questioned the policies and treatments of Covid that frequently were wrong and harmful to patients. It’s literature is entirely pro vaccine, pro big pharmaceutical treatment, and anti-free speech amongst health professionals.
Medical cannabis is yet one more example of rising left wing bias in large medical organizations. Leaders don’t want to question the actions and motives of the political party they support and quietly publish treatments such as capsaicin cream to make it safer and more enjoyable for people to use and abuse marijuana. Marijuana legalization likely means more young voters for the left and more support for their agenda. This mentality is the reason why over 100,000 opiate deaths occurred in the US last year. The medical community wants to focus on Narcan distribution to make it safer to OD without trying to stop drug use in the first place.
Medical organizations seem to be doing their part to keep patients (and physicians to a degree) ignorant, compliant, happy, high, and controllable to further the bidding of the left-wing politicians who are thrusting a Marxist agenda on the US.
John Hughes, MD
USMA Class of 1996 (#1 graduate)
3rd Generation West Pointer
4 combat tours of duty in Iraq and Afghanistan
LoVecchio, Frank. “Capsaicin for CHS.” Critical Decisions in Emergency Medicine. June 2022. Volume 36, No 6.