Could years of smoking weed cause you to throw up? How serious is vaping? Can alcohol cause your gut to leak? This week, we covers some of the long-term implications from substance use.
Could years of smoking weed cause you to throw up? How serious is vaping? Can alcohol cause your gut to leak? This week, we covers some of the long-term implications from substance use.
Marissa: So, welcome back to the podcast! On today's episode, we're going to talk about some of the long term implications from substance use. As a disclaimer, we understand that a lot of this might not feel applicable right now. It's hard to visualize what we're doing next weekend. Let alone 20 or 30 years from now, but you don't typically wake up and try out cirrhosis of the liver or, organ inflammation, or throwing up every morning because of your weed use, and this episode’s not meant to be a scare tactic, but rather a friendly reminder to examine some of our behaviors now to try to prevent negative experiences later.
Sarah: So the 1st thing we're going to talk about is alcohol and liver disease. This is probably one of the most common things that you hear about kind of, throughout, you know, high school health class and that if you drink enough, your liver is going to shrivel up and die. And while that can happen, I'm going to hit you with some facts about that. So, basically cirrhosis is when your liver is scarred and permanently damaged, and your liver can't work the way that it should. So, unfortunately, once you get to that point, this damage is permanent and nothing can cure it. You can help it from getting worse by stopping drinking and stopping things that are going to continue to cause permanent damage. So some ways that cirrhosis is diagnosed are by an exam blood tests, imaging testss and biopsies. So, this is really interesting because the National Institutes on health estimates that about 1 in 200 adults in the U. S. have cirrhosis and then it's the most common in adult age 45 to 54. But they also say that this number is probably a lot higher due to people who have it, but haven't been diagnosed or who don't want to be diagnosed.
I would be curious to see if they talked to those people, how much did they say that they drank or, you know, for how many years they did they say they drank, you know, to, to get to that point.
So, some risk factors are people who have abused alcohol for a long time, those who are type 2 diabetic, men, which I thought was really interesting. And then people aged 50 and up.
What are some things that come with cirrhosis? So again, this episode isn't meant to be one big scare tactic after another, but I think it's important to just kind of know that if you do drink heavily, you know, these are some things that could come with it in large veins that could cause internal bleeding swelling in the legs fee and ankles, which is called the edema a fluid can build up in your abdomen.
So there can also be this condition called hepatic encephalopathy, which is confusion in your brain that comes as a result of your body's inability to read itself of toxins.
Marissa: And oftentimes, when there is an illness of the liver, a transplant is the best option for somebody. And if someone has alcohol use disorder, they're not necessarily at the top of the organ transplant list.
Sarah: Yeah, that's really interesting too. Um, so, you know, um.
Marissa: Yeah, and speaking of liver, let's kind of move to other organs in the area with alcohol, is somebody's gut health. So, the gut, the intestines and, you know, your stomach all of that and alcohol causes inflammation in the intestines by disrupting someone's bacterial balance.
The intestines actually contained between 30 and 500 bacterial species and 4,000 square feet of surface area - that's huge. And the body needs a balance of this bacteria in order to function properly. So, alcohol causes cell death, which can lead to ulcers and erosion of the gut.
And it's not just our stomachs! Alcohol, especially when it's consumed chronically and in larger amounts, causes inflammation throughout the body, just like you said. So, this inflammation is often associated with an increased risk of inflammatory bowel disease and gastrointestinal cancers in the esophagus, stomach, and colon. This is super important for people with gluten intolerance, because your body could be having an allergic reaction to alcohol, and nothing screams a good time to me, like inflammatory bowel disease.
So, now that we're talking a little bit about alcohol, let's switch for a second to maybe the 1st drug we're all introduced to… soda!
So soda poses a risk to our gut health. The Journal of internal medicine found that men and women who drink 2 or more glasses of sugary-sweetened soda or soft drinks had a higher risk of dying from digestive disorders. And just like alcohol, evidence suggests that high sugar intake can impair the gut barrier. So, this may lead to something that sounds really appealing called “leaky gut,” which is intestinal inflammation. Gut microbiota is also altered, which leads to an increased risk of gut infections and digestive diseases. So if we made that sound really appealing, let's switch to the lungs!
Sarah: Wow Marissa, you sure do you know how to have a good time!
Marissa: Yeah, I'm really fun at parties.
Sarah: So, it's funny, I thought you were going to say tobacco and you said soda. So, tobacco is sometimes the, the first abused drug that many people tend to start using at a young age.
So a lot of this data that I'm going to say is from the Centers for Disease Control. So everyone knows that cigarettes are bad, but I think it's really important just to not only talk about cigarettes, but to cover vaping as well. Because that's kind of the newer topic that not a lot of people think is harmful or dangerous. So let's start with cigarettes.
So as I was looking up this information, 80 to 90% of lung cancer deaths are linked to cigarette smoking. So, a huge thing that could be prevented. So, if you can cut down that big risk factor for potentially getting lung cancer, I think it's something to consider.
Obviously lung cancer can occur in those who don't smoke, but it's good to know that quitting can instantly reduce your risk. So, even if you've smoked for years, you can reduce your reduce your risk by quitting today. That's huge. Like, you talked about Mariss, you know what you said about the alcohol causing other conditions… smoking cigarettes doesn't just cause lung cancer.
It can also lead to different types of cancer, including throat, voice box, trachea, kidney, bladder cervix, and mouth cancer.
So, the next thing that I think is probably one of the saddest things about smoking is second hand smoke. So you're exposing other people that aren't making the choice to smoke cigarettes to smoke, and potentially putting them at risk.
So the next thing that I wanted to just briefly touch on is e-cigarettes. So it's really interesting because vaping is now able to be tied to certain types of lung injury, which is called EVALI, or vaping product use associated lung injury so kind of a mouthful. But since 2019, they've been able to pull and coordinate some pretty good data on it. And I think this is really interesting because a lot of people think as vapes as the lesser of the 2 evils between, you know, cigarettes and vapes.
And I've also heard a lot of people say that, you know, they turn to vaping because they want to cut down or cut back on cigarettes. And it was really interesting to see this data. And it had said that with this, a lot of the time people will turn not to quitting use, but actually turn to what's called dual use and that means using both things instead of just one or the other. So, instead of just cigarettes or a vape, they'll start using both. So, that was really interesting.
And so the really the important thing to know about this as that 78% of reported EVALI cases came from cartridges that were obtained from an illicit source that didn't come from a dispensary, and most of those cartridges contained vitamin E acetate. So this is the substance that's most linked to the outbreak starting in 2019.
The scariest part of all this Mariss is that these were in seemingly healthy young people. So, 66% of these cases were males, 15% were under 18, 37% were 18 to 24, 24% were 25 to 34, and 24% of the patients were 35 are older.
So, when you think about kind of risk, and people who have been smoking for long periods of time, if you're under 18, you know, how long have you been using a VI pen for? You don't really think of yourself in an, at risk population.
Marissa: And something to make a little note of as you're reading the statistics - the dates for this. So, this was as of February 18th, 2020. What happened right around this time, or a little bit after? COVID.
So I'm curious how those numbers, if they're even higher, but due to COVID statistics coming in, that shifted the priority. Or people came in presenting with COVID symptoms that could have been EVALI symptoms.
Sarah: Yeah, and that's a really great point Mariss and so interesting. Like, I wonder how much of this research was paused or stopped because of the COVID pandemic, and they didn't even consider these things.
So, on to cannabis and fertility.
Marissa: Probably not something we're thinking about at 18, 19, and 20 years old is, “You know, when can I get pregnant?” But there is some mixed data about cannabis and fertility and how cannabis is scheduled really impacts the research that can be done, but the majority of data shows that cannabis does have a negative impact on fertility. More data is needed, but here's some of the things that we do know.
For both men and women, there's a reduction in libido and sexual performance. Hard to get pregnant if you don't feel like having sex, and when you do, it's bad sex.
So the National Institute of Health studied cisgender women, ages 18 to 40, who are trying to conceive. Women who used cannabis in the weeks before pregnancy were around 40% less likely to conceive than cisgender women who did not use cannabis.
Why is this? Cannabis has an impact on your hormones and delays ovulation cycle.
In cisgender men, this reduces sperm count and sperm concentration. So it changes sperm motility or movement, and the morphology, which is the size and shape. So bottom line: it changes how your sperm moves and books, it also changes hormones and reduces the sperm viability.
So, like we said, in the beginning of this, it might not feel like this is a problem you're concerned about right now, but with repeated, prolonged cannabis use, this could be important in the future if you decide someday that you'd like to have children.
Sarah: So the last one – cannabinoid hyperemesis syndrome, or CHS actually comes from chronic use of cannabis, which is really interesting. So it's where users feel sick to their stomachs. They have puking, vomiting, stomach, pain. And the only thing that lessens their pain is when they're taking a hot shower or a hot bath.
Marissa: And with CHS, and with the only thing that makes it go away is to essentially stop consuming and using cannabis altogether. This is new, and is quite rare from what the data is showing. Tt's from people that are daily, long term cannabis users. So not necessarily “I've smoked weed for 3 days straight, and now all I'm doing is throwing up,” but for someone who may be smoking cannabis for 3 or 13 or 30 years straight, they might fall prey to this.
Typically, this is an earlier middle aged adults. Like we said, who have been using cannabis since adolescence and that information comes from the National Institute of health.
Sarah: In some of the articles that we're talking about, people who had been diagnosed, had talked about how they'd gone to so many different doctors with all these stomach symptoms and crazy gastro symptoms, but they couldn't find answers when they went to the doctor. They were put on all these different types of medications and nothing helped. And then finally, when I don't know if it was doctors that became more aware, they would just became more comfortable with diagnosing were able to kind of link it to cannabis use.
Marissa: And it's not a surprise that maybe people aren't very forthcoming about their cannabis used, depending on what state you live in, depending on the legal status of cannabis, depending on the stigmas around cannabis use. So people may withhold information from their medical practitioner so the diagnosis is a little bit harder to, you know, put their finger on.
For so long in the research that's out there cannabis is an antiemetic meaning it helps people with nausea. So the very thing that people are using cannabis for sometimes is what's ending up, making them sick also why it's so hard to pinpoint. Typically, relief is found within 10 days of cannabis cessation but it might even take a few months for somebody who is a heavy chronic user.
Sarah: So any final thoughts on anything that we've talked about today?
Marissa: Yeah, one final thought and we, we started off that this wasn't meant to be a scare tactic, but I really want to reiterate that to people that are listening. Because we approach this from a harm reduction standpoint, we understand that completely abstaining from all substance use might be a tall order. But at the same time, having all of this information, and knowing what some of the long term impacts could be, can really set you up to make better choices now or long term better choices.
Sarah: You know, just because you don't want to do these things today. It doesn't mean that they won't impact your house long term.
Marissa: Yeah, so thank you so much for joining us. We have a very special next week – we’re going to be talking about psychedelics and mental health, so be sure to tune into that next time.
Sarah: Bye!