My Overdose

MY OVERDOSE: ANECDOTAL EFFECTS OF EDIBLE THC

The Kiva Confections website is professionally produced, sophisticated, and clean. They sell exclusive edibles for the medicinal crowd. You have to be 18 to enter and use the website, and age is verified by checking a pop-up box that first appears when you go to Kivaschocolates.com. This seems an elegant, yet foolish solution to keeping drugs out of the hands of minors. Keeping drugs out of the hands of the inexperienced is yet another problem.

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Each chocolate coated coffee bean-like morsel contains 5 milligrams of THC or Cannabis extract, far less than the equivalent of one joint[1]. And, eating or consuming the drug is much less effective than inhaling it in terms of getting high. The candy-like product is delicious, desirable, yet dangerous, much like anti-freeze to a thirsty dog, or peanuts to those with anaphylaxis.

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I had a headache, nothing major, likely due to equal parts fatigue, mild dehydration, and time stress. It was Saturday, October 10, and I was in L.A. visiting my adult sons. It was an unusually hot day, and a smog ring already had settled into the Los Angeles basin, exacerbated by a lack of breeze and the heavy weekend traffic. We were headed to the Getty Villa, due there by 11 am, but we had only just left their apartment in Koreatown at noon. I hate being late for anything, but my older son and his girlfriend explained that the free entrance ‘ticket’ to the Getty was for any time after that time. “You got any Tylenol or Ibuprofen or aspirin?” I asked my son. “No, but . . .” A quiet conversation between him and his girlfriend ensued. “Maybe we could  give you one of our pills?” “What’s in it?” I asked. “Caffeine” was the response. “Oh, I have Excedrin with caffeine in it at home.” But no little white plastic bottle was produced. When we parked the car at the Getty Villa, my son turned to offer me a tin of what looked like fancy gourmet chocolate with the Kiva label – they told me they were merely caffeine, and ‘only take one.’ I thought he said this because they were an expensive luxury item for him. Disregarding his advice, I took two. They were slightly bitter, but tasty. I was given a bottle of water, and then we began our tour of the Getty Villa, replete with thousands of rare Greco-Roman antiquities.

IMG_0996[1]            In a gallery with a large sarcophagus of a man and woman of royal bearing, with a frieze design depicting one of the scenes from the Iliad — Achilles defeat of Hector and his tying that now dead Trojan’s ankles to a cart to drag him around Troy in gory gloating – I sat down on a bench to contemplate the beautifully rendered scene. There was a copy of Richmond Lattimore’s famous translation of the Iliad that you could use to read about the Achilles/Hector violence. My vision started to telescope. My hearing began to dim. I knew I was going to faint, or worse. I told my son to get me out of there quick, “before I cause a scene.” My immediate thought, while I was still in compos mentis, was that I was having a reaction to the so-called caffeine chocolate candy pills, which I had taken on a half empty stomach, having also had a strong cup of Tom’n’Tom’s coffee a few hours earlier. That must be it, too much caffeine, not enough food nor sleep the night before.

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My son and his girlfriend took me out to a bench in the courtyard. The Getty Villa is a replica of an Italian villa at Herculaneum, so it has a large inner portico. It was shady and would be a good place to rest while the effects of heat and coffee wore off. But they didn’t. Because it wasn’t the heat, the caffeine, or as my son kept saying “a panic attack.” It was an overdose of THC.

I laid my head down on the cool stone bench, I took my hat off and laid on my side. I began to sweat profusely. I thought maybe I was having a heart attack, yet I felt like I fell asleep, I could not hear anything and everything was dark and quiet. Then my right hand began to tremble, just a little, not noticeable I guessed, but I could feel it from faraway, starting to build, inexorably, like the anticipation of a labor contraction. My hand began to shake harder, causing me to slide my hand up and down on the bench, my hat underneath like a felt coaster. The repetitive sawing motion spread to my arms and legs, which began shaking and striding in place, my brown shoes bumbling uncontrollably. This seizure lasted probably two minutes, after which I sighed heavily and passed out. In the next iteration, the shaking and involuntary whole body shuddering were more intense, sharper jabbing with my arms and legs, escalating to out of control breathing. Again I lapsed into an unresponsive stupor.

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The next seizure resulted in head banging and convulsing so terrible that my son and his girlfriend had to try to hold my head and limbs still so I would not hurt myself. By this time, they must have figured out that I was not okay, but yet I could hear them, as if under water, keep saying ‘it’s just a panic attack.’ In the next seizure, my breathing came out in a crazy articulation of ‘phoof phoof phoof,’ and ‘bah bah bah’ and other uncontrolled nonsense. I knew something was really wrong with me, and I wanted to express that to anyone who would listen, because apparently my son and his girlfriend were not sufficiently horrified enough to get medical attention for me. What were they waiting for? A priest to exorcise what must have looked outwardly like a possession? I don’t know for sure, but as we were in a public place, the scene must have been noticed by the many other visitors to the Getty Villa, and presumably by their security personnel.

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I kept hoping that maybe a medical doctor or a nurse would also be visiting the Getty Villa that day, and would immediately take charge and stab me with an EPIPEN, or that other version of an epipen-like administered drug that they use for heroin overdose, called EVZIO, naloxone. As a teacher, I had had enough Red Cross First Aid classes to know that something could and should be done for any person in my condition.

              epipen    noloxone

Eventually, after a few more episodes of convulsive twitching and jerking and passing out, including one period of unresponsiveness where I thought I might have died, I saw myself below myself, and felt a nothingness and a whiteness. I thought it might be good to die at the Getty. I heard my son say, “She’s okay, she’s still breathing.” Then several people lifted me onto something and the next thing I knew I was in the back of an LAFD ambulance. It was here that I heard that I had likely overdosed, unknowingly taking a double dose of edible marijuana, thinking it was just chocolate covered coffee beans. The convulsions still thrashed through my body while strapped to the gurney, but they were abating, and I was briefly able to tell the EMS officer “two chocolate pills!” I tried to tell him it was not a panic attack.

He checked my vitals, and although my blood pressure was high at 129 over 75, he said it was within normal, same with a four-lead e/k/g: normal. Yet I did not feel in anyway normal, I felt exhausted, sore, confused, and still very much under the influence. I kept asking, “Where, where, where?” the feeling of disorientation was complete. My son and his girlfriend convinced the EMS folks that I did not need to go to the emergency room, and/or that they would drive me there. They got me out of the ambulance and into their car, and as we drove along the Pacific Coast Highway south towards Santa Monica, I could see the ocean full of swimmers and surfers. “People, people, people!” I exclaimed. And when I saw the many oceanfront homes and buildings, I said, “Something, something, something!” I could only pronounce one word at a time, and that was repeated as if I could endow it with meaning by multiplying it.

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In her own encounter with edibles, New York Times columnist Maureen Dowd had a similar experience, although she was safely in a hotel room and not in the public sphere. In 2014, Dowd traveled to Colorado to cover that state’s historical legalization of recreational marijuana. And as any good reporter would do, she thought she “should try a taste of legal, edible pot from a local shop. What could go wrong with a bite or two? Everything, as it turned out” (Dowd A-23). The effects were not immediate, as was my case: “For an hour, I felt nothing. I figured I’d order dinner from room service and return to my more mundane drugs of choice, chardonnay and mediocre-movies-on-demand,” Dowd writes.

“But then I felt a scary shudder go through my body and brain. I barely made it from the desk to the bed, where I lay curled up in a hallucinatory state for the next eight hours. I was thirsty but couldn’t move to get water. Or even turn off the lights. I was panting and    paranoid . . . I strained to remember where I was or even what I was wearing, touching my green corduroy jeans and staring at the exposed-brick wall. As my paranoia  deepened, I became convinced that I had died and no one was telling me” (Dowd A-23).

Maureen Down is not a drug user. She’s a highly educated, middle-aged, successful professional woman. Like me, she had no prior experience with taking pot, with the exception in my case of inhaling a few hits from an improvised bong that my younger cousin Karen hooked up in her basement one summer. We were supposed to be doing the family laundry; she was 15, I was 16. I am now in my 50’s, and the only self-medication I employ is light beer and Tylenol. I don’t smoke, I don’t drink the hard stuff, I exercise twice a day, I weigh about 110 pounds and am 5’2.” As Dowd reasons, “I reckoned that the fact that I was not a regular marijuana smoker made me more vulnerable, and that I should have known better. But it turns out, five months in, that some kinks need to be ironed out [in Colorado]. . .” (A-23). Indeed, “In April, a Denver man ate pot-infused Karma Kandy and began talking like it was the end of the world, scaring his wife and three kids. Then he retrieved a handgun from a safe and killed his wife while she was on the phone with an emergency dispatcher” (Dowd A-23).

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In another report on the legalization of recreational marijuana, Jack Healy writes, “Many of Colorado’s starkest problems with legal marijuana stem from pot-infused cookies, chocolates and other surprisingly potent edible treats. . .” (A-14). School children have been inadvertently dealing drugs on the playground, exchanging their parent’s stash as they would trade a bologna sandwich for tuna fish, or chips for pretzels. Indeed, “So far this year [2014], nine children have ended up at Children’s Hospital Colorado in Aurora after consuming marijuana, six of whom got critically sick. In all of 2013, the hospital treated only eight such cases” (Healy A-14). And then in March 2014,

“[T]he state logged what appeared to be its first death directly tied to legal recreational       marijuana when a 19-year-old African exchange student, Levy Thamba Pongi, plunged to his death in Denver. He and three other students had driven from their college in Wyoming to sample Colorado’s newly legal wares. Pongi ate marijuana-infused cookies [with 65 mg of THC], began acting wildly, and leapt from a hotel balcony . . . the medical examiner’s office said marijuana intoxication had made a ‘significant’ contribution to the accident” (Healy A-14).

https://www.youtube.com/watch?v=t1RIfs7UyAY

Yet even if the State of Colorado and other recreational pot friendly states regulate the packaging of edibles as “a single-serving size of 10 milligrams,” there will still be accidental overdoses, in older people like myself and Maureen Dowd, and in children and teenagers. A single “correct dosing” standard may seem like an inconvenience to pot growers and edible makers, but the use of Marijuana oil extract can render “5 times as much THC in the bloodstream” as smoking a joint (“Extraction” par. 3).

According to NHTSA.gov in regard to purity, potency, and dose, “THC is the major psychoactive constituent of cannabis. Potency is dependent on THC concentration and is usually expressed as %THC per dry weight of material” (“Cannabis” par. 6). And in regard to Pharmacodynamics, NHTSA explains that, “THC binds to cannabinoid receptors and interferes with important . . . neurotransmitter systems. Correspondingly, THC produces alterations in motor behavior, perception, cognition, memory, learning, endocrine function, food intake, and regulation of body temperature” (par. 8). Even though the average person might not have had the overdose reaction that I did to the 10 mg of THC I ingested, I certainly experienced the full effects of interference in motor behavior in the seizure-like convulsions; and the effects of altered perception, cognition, memory, and body temperature.

According to ‘novel’ drug (drugs that are packaged as ‘novelty’ items, like candy necklaces or skull lollipops) researchers at the UK, “There are now wide ranges of synthetic cannabinoids that have been found sold as legal highs . . . although their psychopharmacological characteristics remain to be fully delineated. In general, it appears that synthetic cannabinoids act as would be expected from their affinity to CB1 receptors. . . [yet] new analogues with higher potency have a 10-fold stronger binding to the CB1 receptor than its precursor” (Baumeister et al. 105). Edibles may or may not contain synthetic cannibis, but in processing the drug into food products, there is an a priori synthesis of THC with typical baking and candy making ingredients that could contraindicate or react with the drug in unintended ways. Maybe chocolate (cocoa) and THC in some recipes is reactive?

Moreover, the confectionary and bakery concoctions that are being created and sold at dispensaries in states where Marijuana is legal for medical or recreational proposes are not precisely dosed, nor are their explicit warnings on the packaging about consuming such THC laced products. The old-school consumption of pot by smoking ironically seems to be the better choice for lovers of the weed. According to the website MedHead, the dosage debate is taken seriously in the cannabis community:

“If I tell you that [an edible] has 15mg of THC in it, do you know how that will affect      you? Based on what I’ve heard from most people the answer is no. Most people know how much dry herb to smoke to get the desired effects that works for their body. Not only         that, but smoked cannabis takes effect almost immediately, so it’s easy to stop as soon as    you need or want to. It’s different with edibles though. When cannabis is ingested it takes    1-2 hours for the effects to be felt. With such a large time gap, you can’t wait until you feel the medicine in order to stop” (“Dosage Guide” par. 2).

The writer goes on to do the math:

“Now let’s say it takes you ½ of a joint to get the effects you desire. Based on the             averages we can calculate an estimate of how many mg of THC that would be.  ½ of a joint would be about 500 mg of cannabis. 500mg of dry herb x 15% potency = 75mg total    THC. Because of the nature of smoking, about 25% of that is actually consumed by the        body. So 75mg x 25% = avg. 18.75 mg of THC is ingested from this scenario” (par. 4).

So, there are about 19 mg of THC in half a joint according to this calculation; approximately 40 mg of TNC in a full joint. But as expressed, the effects of smoking are immediate; with edibles, this is not the case, as Maureen Dowd shared, and as I experienced as well – it took about half an hour before the overdose event presented its malicious, body-rattling, traumatic effects.

And now that I have had time to reflect and research, the night before my overdose, I shared a late dinner and drinks with my younger adult son, so it’s possible that there was still latent alcohol in my bloodstream when I ingested the edible THC. In studies conducted to test impairment while driving due to both THC and alcohol, researchers have discovered what you might expect, that moderate doses of THC alone or alcohol alone (to a .04 level) “significantly impaired the subjects’ performances in both driving tests. . . [but] combining THC with alcohol dramatically impaired driving performance” (Ramaekers et al., 551). Marijuana’s effects are intensified by alcohol.

I am not suggesting that we go back to prohibition of this drug in whatever form, but I am suggesting that we un-fun and un-gastronomie its chocolate, candy, cookie, brownie versions. These deserve every bit of the same sober product information that other commercially sold foods require. If I can get fat and have high cholesterol and heart disease from eating fast food and junk food, at least I have been warned by the required nutritional information. Edible confections like Kiva’s seem innocuous, luxurious, and thus in need of dosage labeling, up to and including a warning for first time, legal users: Beware of use! Do not use if unsure of tolerance to THC extract! Dosage not exact per amount consumed!

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On the ride home, my son and his girlfriend decided to drive us past the Peterson Auto Museum on Wilshire at Fairfax in Los Angeles. He lives near there, and admires that building, so I guess he wanted to show me the progress of the museum’s million dollar renovation, including the radical change to the exterior. Maybe he thought I would recognize it and it would calm me. But being on the unpredictable drug THC, it of course had the opposite effect. They paused to park along the curb at Fairfax, “Look, mom. It’s the new Peterson.” I saw something different than the molded, stylized, gigantic chrome ribbons. I saw the frame of the dreaded wooden roller coaster at Cedar Pointe, the Mean Streak. As you might guess, I am not the biggest fan of coasters, and so seeing what I thought to be the Mean Streak, and then thinking it meant we were at Cedar Pointe, threw into true panic.

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I freaked out and began crying, “No! No! Please! No!” (This episode followed a brief period of hilarity in the car, where I apparently thought everything was funny and I could speak lucidly. Apparently, I made an ontological connection between Siri, Drake, and Peter Frampton that laughed my son and his girlfriend to tears.)  But just like a real roller coaster, my mood, actions, words, and perceptions were debilitatingly altered by further stimuli in a matter of seconds.

No more jokes about what did the hippies bring to the bake sale, this stuff is a powerful stimulant and hallucinogen. It does not always make everybody a mellow mushroom. People have killed and died on THC overdose. People have been hurt and changed. People have been lulled into thinking that edible versions of pot are somehow more acceptable, cute even. But there’s nothing attractive about having an overdose in a public space.

Works Cited

Baumeister, David, Luis M. Tojo, and Derek K. Tracy. “Legal highs: staying on top of the flood of novel psychoactive substances.” Therapeutic Advances in Psychopharmacology 5.2 (2015): 97-132). SAGE Journals. Web. 18 Oct. 2015.

“Cannabis/Marijuana.” Drugs and Human Performance Fact Sheets. National Highway Traffic Safety Administration. N.d. Web. 18 Oct. 2015. http://www.nhtsa.gov/PEOPLE/INJURY/research/job185drugs/cannabis.htm

Dowd, Maureen. “Don’t Harsh Our Mellow, Dude.” The New York Times (3 June 2014): A 23. Web. 17 Oct. 2015. http://www.nytimes.com/2014/06/04/opinion/dowd-dont-harsh-our-mellow-dude.html

“Dosage Guide.” MedHead.com. 9 May 2015. Web. 18 Oct. 2015. http://mimedhead.com

“Extraction of THC Oil from Cannabis.” Kind Green Buds. 2015. Web. 18 Oct. 2015. http://www.kindgreenbuds.com/marijuana-articles/thc-oil-extraction/

Healy, Jack. “After 5 Months of Sales, Colorado Sees the Downside of a Legal High.” The New York Times (31 May 2014): A 14. Web. 18 Oct. 2015. http://www.nytimes.com/2014/06/01/us/after-5-months-of-sales-colorado-sees-the-downside-of-a-legal-high.html

Ramaekers, J. G., Robbe, H. W. J., and J. F. O’Hanlon. “Marijuana, alcohol and actual driving performance.” Human Psychopharmacology: Clinical and Experimental 15. 7 (October 2000): 551–558. Wiley Online Library. Web. 29 Nov. 2015.

[1] The average joint contains 40 mg THC.

 

 

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