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Monday 23 March 2020

Cannabis and the Digestive System


 
The human digestive system is a complex mechanism that works on food from the moment it enters the mouth till the moment it leaves the body as faeces, urine and sweat. The food absorbed is converted to energy to build, and maintain the body and brain, as well as perform all its functions. Keeping this digestive system in top condition is one of the key aspects of health. Having an optimum amount of nutrition, ensuring its proper digestion and absorption, and finally eliminating the toxic waste products, on a continuous basis are some of the keys to good health.

In our times of inadequate, excessive or imbalanced nutrition, irregular consumption and elimination, it is no surprise that the diseases of the digestive system are numerous and wide spread. The interdependence of the rest of the body systems with the digestive system result in widespread diseases across the body due to a poorly functioning digestive system. We are what we eat is a scientific reality, extending to the way feel, think and behave.

In the above context, it is worth looking at the role that cannabis plays in the proper functioning of the digestive system.  Human digestive systems are some of the key locations of endo-cannabinoid receptors, indicating the evolution of man's food habits and their relation to cannabis.

For a long time now, cannabis has been known to induce appetite, improve digestion and help in the process of waste elimination through its purgative action. The Report of the Indian Hemp Drugs Commission, 1893-94, provides a lot of evidence of the use of cannabis in India for these purposes, until the end of the 19th century when its prohibition became widespread. Traditionally a glass of bhang as an appetizer before a meal, a chillum of ganja as a digestive after a meal, and a chillum of ganja in the morning as a purgative, was a part of the routine of many people in India. 
 
Regarding the use of cannabis as a appetizer, food accessory or digestive, the Commission reports that - '469. Among the beneficial effects attributed to the drugs is their effect as a food accessory or digestive. This effect is more generally attributed to bhang than to the other two forms. But there are a large number of witnesses who attribute it also to the smoking of ganja. The "cooling and refreshing" cup of bhang taken by the well-to-do, especially in the hot weather, to stimulate their energies and to create an appetite for food is frequently in evidence. There would seem to be a very general use of bhang in moderation as a stimulant and digestive by the middle classes, especially in advancing years. Some of the most intelligent and enterprising classes of the community are among those who thus use bhang. This use is generally spoken of without any marked condemnation, and often even with approval; for it is the practice of the respectable classes. But after all there seems quite equally good ground for believing that the chillum of ganja taken by the labouring man after his food with the object of allaying weariness and assisting digestion is no more harmful; and there are many witnesses whose evidence is in this sense. The use of bhang in the one case is sometimes compared to the glass of wine taken at meals by a moderate consumer of alcohol, and the use of ganja in the other case to the labouring man's glass of beer or even to his pipe of tobacco. It is possible also that the effects of hemp drugs in this respect may be to a certain extent comparable with those of tea. In connection with the most recent experiments on the subject, the action of tea is thus described by Dr. Edward Smith: "It increases the assimilation of food both of the flesh and heat forming kind, and with abundance of food must promote nutrition, whilst in the absence of sufficient food it increases the waste of the body." If there is anything in this comparison, Dr. Smith's remarks regarding tea may throw some light on the statements frequently found in the evidence regarding the necessity for sufficient or nourishing food to prevent injury to the constitution from the prolonged use of hemp drugs. 
 
Regarding its purgative properties the Commission reports that - '465. Some witnesses refer to the purgative action; it is quite possible that a chillum of ganja may act in the same way as the morning pipe does with many Europeans.' Cannabis was in inherent part of cooking, with many sweets and dishes such as majum and yakuti using it as a key ingredient.  
 
Cannabis was used for treating dysentry and diarrhoea by native physicians in many cases. In its summary on the medical uses of cannabis, the Indian Hemp Drugs Commission writes that - '461. In several diseases of the organs of digestion hemp drugs are prescribed, flatulence, diarrhœa, dyspepsia, piles, and prolapsus ani being the chief. Bhang has also been prescribed to check salivation.' There is evidence of the diuretic action of cannabis in past and recent studies. 
 
The benefits of cannabis for the urinary system are stated as follows - '461. In diseases of the urinary organs hemp preparations are used in diabetes, impotency, stricture, spermatorrhœa, hydrocele, incontinence of urine, and swellings of the testicles. In orchitis a warm bhang poultice applied on a warm fig leaf is recommended to be bandaged over the testicles, and in hydrocele a similar poultice is spread on a castor-oil leaf. In impotency and nervous debility the drug is doubtless used on account of its supposed aphrodisiac power.'  
 
In addition to this, ascetics and the poor were known to use ganja to stave off hunger for long periods of time, face adverse conditions and still remain in good health. Regarding the usage of cannabis to ward of hunger, the Commission writes that - '472. They are said to be used by the poor and on occasion by others to alleviate hunger when sufficient food is not obtainable. The alleged occasional use in this way by sepoys, who for any reason cannot devote a sufficient amount of their pay to procuring food, is interesting. One witness (Mr. E. J. Ebden, Collector of Ahmednagar) thus refers to this: "I am told on good authority that native soldiers who have gambled away their pay employ the ganja pipe as a cheap substitute for food until in funds again." Want of money from other causes might lead to the same practice; and the evidence shows that the practice is not confined to sepoys. It is especially found among wandering mendicants, and no doubt exists among other classes. The practice cannot result in permanent advantage, but the temporary relief is not to be overlooked.'
 
The multiple ways in which cannabis can be consumed helped made it a pervasive part of Indian social life, until the end of the 19th century when it started getting prohibited.

The overall medical benefits of cannabis on the digestive system are restated as follows - ' 465. The tonic, digestive, stimulant, antispasmodic, astringent, and alterative effects of the drugs are mentioned by some witnesses.'

As any cannabis smoker will tell you, its action on the human body starts within seconds of intake, if you smoke it, and within a few minutes if you eat or drink it. A person's sense of smell and taste are immediately enhanced. I almost instantly start feeling pangs of hunger if I am on an empty stomach. My stomach seems to lighten up if I've just had a heavy meal. Cannabis seems to make me conscious of every aspect of consuming food and drink, and seems to nudge me towards healthy food consumption behavior, preferring organic and wholesome food, and this too in measured quantities. In this regard, I believe that cannabis has vast protective properties for the digestive system that go way beyond what is immediately evident, based on investigations into certain diseases that arise in the digestive system.

One of the key problems that we see today, in terms of diseases that plague the digestive system, is that not only do we eat unhealthy food, at unhealthy times, we also tend to overeat, thus creating tremendous stress on our digestive systems. Obesity is one of the biggest health problems facing humans today. Cannabis was used by many among the poorest classes, including religious mendicants, to stave off hunger, and also to stay healthy despite reduced consumption of food. Many witnesses speak of this benefit of cannabis consumption. In this regard, a detailed account can be found in the Indian Hemp Commission's report of 1895. Even though this involved a rhesus macaque, the behavior of the macaque corroborated the evidence of witnesses in terms of how cannabis helped one to stay nourished, despite a reduced intake of food. The Hemp Commission writes in its summary on the effects of cannabis inhalation as follows: '483. The following interesting account of an experiment [on a rhesus macaque for eight months] on the effects of the systematic inhalation of the smoke of ganja conducted by Dr. D.D. Cunningham at the request of the Commission is extracted from his report (Vol. III Appendices)...The only permanent appreciable effect resulting from the treatment manifested itself in the form of a very considerable diminution in appetite for food, which set in shortly after the initiation of the experiment, and thereafter remained persistent throughout its entire course.' Dr. Cunningham reports that - "On laying the body open, the phenomenon which at once attracted attention, as unlike any ordinarily present in those of caged monkeys, was the great amount of fat accumulated in the omentum, the mesentery, and the visceral and parietal pericardium. This was specially noteworthy in connection with the markedly diminished ingestion of food which had characterised the subject of the experiment during the greater part of its course, and with the coincident considerable reduction in body weight which had occurred. The body generally appeared to be fairly well nourished, and a considerable amount of subcutaneous fat was present....But the only persistent symptom attending the treatment during life was a considerable diminution in appetite for food, so that, in so far as the results of a single experiment afford any ground for inference, it would appear that the most important effect of the habitual employment of inhalations of the smoke of ganja is to give rise to diminution in the normal processes of tissue-waste to such a degree that local accumulations of fat are liable to occur even in spite of the coincident and similarly originating diminution in the ingestion of food. The diminution in activity of the normal processes of tissue waste tends, on the one hand, to give rise to decreased ingestion of food, and, on the other, to local accumulation of fat in spite of this. But if the habitual practice of inhalations of the drug really do produce such effects, it is clear that, in place of being hurtful, it may be positively beneficial to people who are obliged to undergo exertions without having the means of procuring a diet fully adapted to make good the amount of tissue waste normally associated with them."

In the modern context, cannabis has been used to fight  cancers of the colon, pancreas and rectum. Cannabis has been used to treat ulcerative colitis, endometriosis, inflammatory bowel diseases, and diabetes. Cannabis is increasingly seen as a means of improving the appetite of HIV and cancer patients. Current studies demonstrates for the first time that THC attenuates SEB[Staphylococcal enterotoxin-B]-mediated ARDS[Acute Respiratory Distress Syndrome] and toxicity by altering the microbiota in the lungs and the gut as well as promoting anti-microbial and anti-inflammatory pathways. Regarding gastroparesis, NORML reports that - 'Gastroparesis patients who regularly consume cannabis require shorter lengths of hospitalization than non-users, according to data published in the journal Clinical Gastroenterology. Gastroparesis is a disease characterized by the partial paralysis of the stomach. Symptoms of the disease include: poor appetite, weight loss, chronic abdominal pain, and vomiting.'

The above are just a few of the ways in which cannabis is said to aid in the functioning and health of the digestive system. Combine this with its antibiotic properties,  taste-enhancing properties, anti-nausea properties and metabolic stabilization properties and we start to understand why historically, and increasingly in the modern world, cannabis is such an important aid to the health of the digestive system.  This is not just in humans but in a number of other animals as well.

Compare this with our recent tendencies to have a different pill, and in many cases a number of different pills, for everything from flatulance, constipation, diarrhoea, lack of appetite, nausea, pain, etc., and we can see how far we have strayed away from the time tested and sustainable natural path that life walked through all these years. Let us look at the commonly used analgesic paracetamol. Wikipedia says - 'Chronic consumption of paracetamol may result in a drop in hemoglobin level indicating possible gastrointestinal bleeding and abnormal liver function tests. There is a consistent association of increased mortality as well as cardiovascular (stroke, myocardial infarction), gastrointestinal (ulcers, bleeding) and renal adverse effects with taking higher dose of paracetamol. The drug may also increase the risk of developing hypertension.'
 
Considering that the cannabis plant is now prohibited world wide, forcing everybody to subject their digestive systems to an assault of pharmaceutical drugs,  if they can access and afford it that it, in addition to all the other unhealthy habits of food and lifestyle, is it any surprise that nature may be looking at humans now as an indigestion, and working on ways to eliminate us as toxins and waste products from her system? 

Related articles

Below are articles related to the above subject. Words in italics are my thoughts related to the above subject.
 
 
'Investigators affiliated with the New York Institute of Technology, College of Osteopathic Medicine and other universities reviewed results from 29 selected studies published between 2012 and 2022. Most studies reported “reduced clinical complications” following cannabis treatment.

“Following treatment with cannabis cigarettes, … there tends to be a better patient perception of their general health, proving statistically significant and reflecting the promising effects of using cannabinoids in addressing IBD,” the study’s authors wrote. “Simultaneous improvements … suggest that the use of cannabinoids yields notable improvements in IBD patients’ social functioning, as well as improvements in the parameters of depression, body pain, and the ability to work.”

They concluded: “[C]annabis … yields promising outcomes. … It is recommended that in the future, more and more in vivo and in vitro studies are conducted … to foster a better understanding of the extent to which cannabinoids could play a protective role in IBD patients.”'

https://norml.org/news/2023/04/20/literature-review-cannabis-promising-in-treating-symptoms-of-inflammatory-bowel-diseases/

 
'A team of investigators from Puerto Rico and the United States surveyed 162 IBD patients regarding their attitudes toward cannabis.

Twenty-three percent of respondents said that they consumed cannabis products specifically to address symptoms of IBD, such as pain, decreased appetite, insomnia, and anxiety. Over 85 percent of respondents who consumed cannabis for therapeutic purposes said that it improved their symptoms.

The findings are consistent with those of other surveys showing that a significant percentage of IBD patients acknowledged using cannabis and gaining relief from it.

“The use of medical cannabis to relieve symptoms is frequent in patients with IBD, although knowledge about cannabis among patients and physicians is limited,” the study’s authors concluded. “Our study supports the need for more investigation in this area, as well as an increase in educational programs for patients and physicians.”'

https://norml.org/news/2023/04/06/survey-ibd-patients-frequently-report-using-medical-cannabis-for-symptom-relief/

 
'Study participants reported that their use of cannabis was effective at mitigating endometriosis-related pain and gastrointestinal issues. Respondents also reported improvements in mood following marijuana consumption.

“With emerging evidence internationally demonstrating that women are utilizing illicit cannabis as a self-management strategy for the pain and the associated symptoms of endometriosis, this paper demonstrates that Canadian women are also utilizing legally obtained and quality-assured products to manage endometriosis symptoms across domains such as pelvic pain, gastrointestinal symptoms and mood,” authors concluded. “Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.”'

https://norml.org/news/2021/10/28/study-endometriosis-patients-report-successfully-managing-symptoms-with-cannabis


'Abstract
Given the abundancy of angiotensin converting enzyme 2 (ACE-2) receptors density, beyond the lung, the intestine is considered as an alternative site of infection and replication for severe acute respiratory syndrome by coronavirus type 2 (SARS-CoV-2). Cannabidiol (CBD) has recently been proposed in the management of coronavirus disease 2019 (COVID-19) respiratory symptoms because of its anti-inflammatory and immunomodulatory activity exerted in the lung. In this study, we demonstrated the in vitro PPAR-?-dependent efficacy of CBD (10-9-10-7 M) in preventing epithelial damage and hyperinflammatory response triggered by SARS-CoV-2 spike protein (SP) in a Caco-2 cells. Immunoblot analysis revealed that CBD was able to reduce all the analyzed proinflammatory markers triggered by SP incubation, such as tool-like receptor 4 (TLR-4), ACE-2, family members of Ras homologues A-GTPase (RhoA-GTPase), inflammasome complex (NLRP3), and Caspase-1. CBD caused a parallel inhibition of interleukin 1 beta (IL-1ß), IL-6, tumor necrosis factor alpha (TNF-a), and IL-18 by enzyme-linked immunosorbent assay (ELISA) assay. By immunofluorescence analysis, we observed increased expression of tight-junction proteins and restoration of transepithelial electrical resistance (TEER) following CBD treatment, as well as the rescue of fluorescein isothiocyanate (FITC)–dextran permeability induced by SP. Our data indicate, in conclusion, that CBD is a powerful inhibitor of SP protein enterotoxicity in vitro.'

https://onlinelibrary.wiley.com/doi/full/10.1002/ptr.7302


'The relevance and incidence of intestinal bowel diseases (IBD) have been increasing over the last 50 years and the current therapies are characterized by severe side effects, making essential the development of new strategies that combine efficacy and safety in the management of human IBD. Herbal products are highly considered in research aimed at discovering new approaches for IBD therapy and, among others, Cannabis sativa L. has been traditionally used for centuries as an analgesic and anti-inflammatory remedy also in different gastrointestinal disorders. This study aims to investigate the effects of different C. sativa isolated compounds in an in vitro model of intestinal epithelium. The ability of treatments to modulate markers of intestinal dysfunctions was tested on Caco-2 intestinal cell monolayers. Our results, obtained by evaluation of ROS production, TEER and paracellular permeability measurements and tight junctions evaluation show Cannabidiol as the most promising compound against intestinal inflammatory condition. Cannabidiol is able to inhibit ROS production and restore epithelial permeability during inflammatory and oxidative stress conditions, suggesting its possible application as adjuvant in IBD management.'

https://www.frontiersin.org/articles/10.3389/fphar.2021.641210/full


NSAIDs for inflammation such as aspirin, ibuprofen, naproxen increase risk of a range of gastrointestinal (GI) problems, kidney disease and adverse cardiovascular events. Large doses of NSAIDs significantly suppress the production of immune cells. By inhibiting physiological COX activity, all NSAIDs increase the risk of kidney disease and through a related mechanism, heart attack.

Higher doses of analgesics like paracetamol may lead to toxicity, including liver failure. Paracetamol poisoning is the foremost cause of acute liver failure in the Western world, and accounts for most drug overdoses in the United States, the United Kingdom, Australia, and New Zealand. There is a consistent association of increased mortality as well as cardiovascular (stroke, myocardial infarction), gastrointestinal (ulcers, bleeding) and renal adverse effects with taking higher dose. 
 
Acetaminophen(paracetamol) treats pain mainly by blocking COX-2 and inhibiting endocannabinoid reuptake almost exclusively within the brain, but not much in the rest of the body.

Besides this, prolonged use of all opioids and NSAIDs cause multi-organ failure.
 
Source Wikipedia


'We found that the majority of individuals from all groups used cannabis to address pain and improve quality of sleep. While PwMS reported lower baseline levels across all five outcomes, we found that the reported effects of cannabis were largely comparable across the groups. We also found that cannabis benefitted persons with sleep and digestive issues regardless of condition, whereas persons who used opioids in addition to cannabis were less likely to experience an improvement in any of the outcomes. This comparative evaluation suggests that cannabis’ effects are not specific to MS, arthritis, or cancer as much as they impact processes common among these distinct conditions. We also found evidence that cannabis may be a viable alternative to opioids for those with these conditions and experiencing pain.'

https://www.mdpi.com/2076-3425/11/5/532


Chronic consumption of paracetamol may result in a drop in hemoglobin level indicating possible gastrointestinal bleeding and abnormal liver function tests. There is a consistent association of increased mortality as well as cardiovascular (stroke, myocardial infarction), gastrointestinal (ulcers, bleeding) and renal adverse effects with taking higher dose of paracetamol. The drug may also increase the risk of developing hypertension.

The recommended maximum daily dose for an adult is three to four grams. Higher doses may lead to toxicity, including liver failure. Paracetamol poisoning is the foremost cause of acute liver failure in the Western world, and accounts for most drug overdoses in the United States, the United Kingdom, Australia, and New Zealand.

Source Wikipedia


'Gastroparesis patients who regularly consume cannabis require shorter lengths of hospitalization than non-users, according to data published in the journal Clinical Gastroenterology.

Gastroparesis is a disease characterized by the partial paralysis of the stomach. Symptoms of the disease include: poor appetite, weight loss, chronic abdominal pain, and vomiting.'

https://norml.org/news/2021/04/01/study-gastroparesis-patients-who-use-cannabis-possess-better-hospitalization-outcomes


'Short term treatment with THC rich cannabis induced clinical remission and improved quality of life in patients with mild to moderately active ulcerative colitis. However, these beneficial clinical effects were not associated with significant anti-inflammatory improvement in the Mayo endoscopic score or laboratory markers for inflammation.'

https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0246871


'Key results
While SEB [Staphylococcal enterotoxin-B] triggered ARDS [Acute Respiratory Distress Syndrome] and 100% mortality in mice, THC protected the mice from fatality effects. Pyrosequencing analysis revealed that THC caused significant and similar alterations in microbiota in the lungs and gut of mice exposed to SEB. THC significantly increased the abundance of beneficial bacterial species, Ruminococcus gnavus, but decreased pathogenic microbiota, Akkermansia muciniphila. FMT confirmed that THC-mediated reversal of microbial dysbiosis played crucial role in attenuation of SEB-mediated ARDS. THC treatment also led to increase in SCFA, of which propionic acid was found to inhibit the inflammatory response. Transcriptome array showed that THC up-regulated several genes like lysozyme-1&2, ß-defensin-2, claudin, zonula-1, occludin-1, Mucin2 and Muc5b while downregulating ß-defensin-1.

Conclusions
Current study demonstrates for the first time that THC attenuates SEB-mediated ARDS and toxicity by altering the microbiota in the lungs and the gut as well as promoting anti-microbial and anti-inflammatory pathways.'

https://bpspubs.onlinelibrary.wiley.com/doi/abs/10.1111/bph.15226


'This system, however - deliberately poisoning our food, then policing the result - is too reminiscent of Lewis Carroll's White Knight who thought of 'a plan to dye one's whiskers green, and always use so large a fan that they could not be seen.' The ultimate answer is to use less toxic chemicals so that the public hazard from their misuse is greatly reduced.' - Silent Spring, Rachel Carson, 1962


'In 1937, weed was placed under the Harrison Narcotics Act. Narcotics authorities claim it is a habit-forming drug, that its use is injurious to mind and body, and that it causes the people who use it to commit crimes. Here are the facts: Weed is positively not habit forming. You can smoke weed for years and you will experience no discomfort if your supply is cut off. I have seen tea heads in jail and none of them showed withdrawal symptoms. I have smoked weed myself off and on for fifteen years, and never missed it when I ran out. There is less habit to weed than there is to tobacco. Weed does not harm the general health. In fact. most users claim it gives you an appetite and acts as a tonic to the system. I do not know of any other agent that gives as definite a boot to the appetite. I can smoke a stick of tea and enjoy a glass of California sherry and a hash house meal.' - Junky, William S Burroughs, 1977, originally published in 1953


'I once kicked a junk habit with weed. The second day off junk I sat down and ate a full meal. Ordinarily, I can't eat for eight days after kicking a habit.' - Junky, William S Burroughs, 1977, originally published in 1953


'The stereotypical image of a cannabis smoker is someone who sprawls on the sofa for hours surrounded by a haze of smoke and half-eaten snacks. The scene is played up for laughs in films, but social psychologist Angela Bryan thought it could be cause for concern. After all, cannabis is known to increase appetite and aid relaxation, which might put people at risk of health conditions such as obesity, says Bryan, who is at the University of Colorado Boulder.

But digging into health trends revealed the opposite. Nationwide US studies report that, compared to non-users, cannabis users actually have a lower prevalence of obesity.'
https://www.nature.com/articles/d41586-019-02529-0


'Investigators from the John Hopkins School of Public Health in Baltimore and the Digestive Disease Institute in Cleveland compared the prevalence of UC complications during hospitalization in cannabis users versus matched controls. Researchers reported that cannabis users, on average, had shorter hospital stays compared to non-users and were far less likely to require either a partial or a total colectomy (a surgery to remove part or all of the colon). '
https://norml.org/news/2019/08/29/study-cannabis-use-associated-with-fewer-complications-in-patients-with-ulcerative-colitis


'Authors concluded: "This paper reports a fortuitous discovery of positive cannabinoid effects on CIPO (chronic intestinal pseudo-obstruction) symptoms in a patient, leading to significant relief of GI complaints. Although further observations are required to consolidate these findings, this case may be helpful for some patients with the same condition."'
https://norml.org/news/2020/05/07/case-report-oral-thc-improves-gastrointestinal-symptoms


'Inflammatory bowel diseases (IBD) are characterized by a chronic and recurrent gastrointestinal condition, including mainly ulcerative colitis (UC) and Crohn’s disease (CD). Cannabis sativa (CS) is widely used for medicinal, recreational, and religious purposes. The most studied compound of CS is tetrahydrocannabinol (THC) and cannabidiol (CBD). Besides many relevant therapeutic roles such as anti-inflammatory and antioxidant properties, there is still much controversy about the consumption of this plant since the misuse can lead to serious health problems. Because of these reasons, the aim of this review is to investigate the effects of CS on the treatment of UC and CD. The literature search was performed in PubMed/Medline, PMC, EMBASE, and Cochrane databases. The use of CS leads to the improvement of UC and CD scores and quality of life'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215817/


'They reported that IBS patients with a history of cannabis use were less likely than non-users to undergo endoscopic procedures, averaged shorter lengths of stay, and averaged lower costs associated with their hospitalization.

“Our study is the first nationwide cohort study to evaluate the association between cannabis use and healthcare utilization in patients with IBS,” authors concluded. “Our study provides evidence to suggest that cannabis use may decrease healthcare utilization and costs among hospitalized patients with IBS. These findings are likely attributable to the effects of cannabis’ active compound, THC, on gastrointestinal motility and colonic compliance.”'
https://norml.org/news/2020/06/18/study-ibs-patients-with-a-history-of-cannabis-use-have-fewer-hospitalization-costs


'Results
One hundred and fifty-three patients completed the survey. The mean efficacy score of all anti-nausea treatments evaluated was 1.73. After adjustment, three treatments had scores statically higher than the mean, including marijuana (2.75, p < 0.0001), ondansetron (2.64, p < 0.0001), and promethazine (2.46, p < 0.0001). Several treatments, including many neuromodulators, complementary and alternative treatments, erythromycin, and diphenhydramine had scores statistically below average. Patients with more severe nausea responded better to marijuana (p = 0.036) and diphenhydramine (p < 0.001) and less so to metoclopramide (p = 0.020). There was otherwise no significant differential response by age, gender, nausea localization, underlying gastrointestinal cause of nausea, and GCSI.'

https://link.springer.com/article/10.1007/s10620-020-06195-5 



'There was a raw ache in my lungs. People vary in the way junk sickness affects them. Some suffer mostly from vomitting and diarrhea. The asthmatic type, with narrow and deep chest, is liable to violent fits of sneezing, watering at eyes and nose, in some cases spasms of the bronchial tubes that shut off the breathing. In my case, the worst thing is lowering of blood pressure with consequent loss of body fluid, and extreme weakness, as in shock. It is a feeling as if the life energy has been shut off so that all the cells in the body are suffocating. As I lay there on the bench, I felt like as if I was subsiding into a pile of bones.' - Junky, William S Burroughs, 1977, originally published in 1953


'Withdrawal symptoms are allergic symptoms: sneezing, coughing, running at the eyes and nose, vomiting, diarrhea, hive-like conditions of the skin. Severe withdrawal symptoms are shock symptoms: lowered blood pressure, loss of body fluid and shrinking of the organism as in the death process, weakness, involuntary orgasms, death through collapse of the circulatory system. If an addict dies from junk withdrawal, he dies of allergic shock.'
- Junky, William S Burroughs, 1977, originally published in 1953


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