Effect Measure

The dangers of weed

I know families that if you visited them and found them laughing, confused, dizzy, thirsty and vomiting and apparently hallucinating you would think, “everything’s normal.” On a July night in suburban Maryland, however, an after dinner social call by a relative didn’t think it was normal at all and EMTs were called and six adults were headed for the hospital, five to the intensive care unit. Attention immediately focused on what they all had in common, a meal of stew and bread an hour earlier:

On admission to the emergency department, two of the six patients were unconscious. The other four were awake and had altered mental status; complete history of meal preparation and food exposures could not be obtained. Physical examinations revealed tachycardia and dilated, sluggishly reactive pupils in five of the six patients. Temperatures ranged from 98.0ºF (36.7ºC) to 99.4ºF (37.4ºC). Respirations ranged from 17 to 22 breaths per minute.

During the next 6 hours in the emergency department, the six patients continued to experience tachycardia, mydriasis, and altered mental status. One remained unconscious. The others demonstrated confusion, aggression, agitation, disorganized speech, incoherence, and hallucinations. All six were admitted to the hospital, five to the intensive-care unit. The unaffected relative reported to providers that pesticides had been sprayed on mint leaves that might have been incorporated into the stew. However, a treating physician consulted the poison control center hotline and established that the illnesses were not consistent with cholinergic poisoning, as would be expected with ingestion of organophosphate pesticides, but were consistent with anticholinergic poisoning. (CDC, Morbidity and Mortality Weekly Reports)

Organophosphate pesticides enhance the actions of a neurotransmitter, acetyl choline, causing continued nerve stimulation. But the symptoms of these patients were just the opposite one would expect from a cholinergic effect. They were an anti-cholinergic effect, more typical of drugs like atropine (often used to counter the effects of pesticide-like nerve agents) or scopolamine. How did these things find their way into the stew? Foul play?

After she regained her faculties, epidemiologists were able to question the cook who said the stew was mainly potatoes, but also had garlic, onion, tomato, curry powder, and leaves from two plants growing in the yard. One of the plants was definitely mint, but the other one was only identified as something that grew wild in the yard. It turned out the “other plant” was jimsonweed (aka thorn apple, angel’s trumpet, and Jamestown weed), sometimes used infused as a tea by callow youth in the never ending search for a good high. Cut jimsonweed was found in the yard and in leftover stew, which also contained atropine, scopolamine and a couple of other anti-cholinergic glycoalkaloids.

It’s likely that this episode was due to the jimsonweed but the CDC and Maryland investigators did consider one other possibility: the potatoes. Potatoes? It turns out that potatoes are members of the deadly nightshade family and also contain anticholinergics, but only in significant amounts when they are green or sprouting. No samples of the potatoes were available, however, and it is likely the toxic agent was the jimsonweed.

I’m all for eating healthy foods, and the stew recipe sounded tasty. But you can’t just throw stuff in there, even if it looks like Nature’s Bounty, and not run some risks. Still, jimsonweed poisoning is hard to diagnose and pretty uncommon. So if you drop in on friends and relatives tonight after their Superbowl Party and find them laughing, confused, hallucinating and vomiting, it probably isn’t from jimsonweed. At least not the jimson part.

Comments

  1. #1 Comrade PhysioProf
    February 7, 2010

    Dude, when I read the title of this post in my feed reader, I first thought it was by DoucheMonkey. I knew a dirty fucking hippie like you wouldn’t harsh my buzz!

  2. #2 Onkel Bob
    February 7, 2010

    Better than the mushrooms the Asian immigrants to California often incorporate in their meal plan. Apparently Amanita Phalloides resembles a mushroom found in the home country; and invariably someone ends up on the liver transplant list after the first rains of November appear.

  3. #3 Matthew Platte
    February 7, 2010

    Jimson weed used to grow in the lane to the pasture. One day while walking I managed to swing my arm in such a way that a spike from a still-green seed pod punctured then broke off in my knuckle. A little while later my finger was numb.

  4. #4 revere
    February 7, 2010

    Matthew: Yes, the concentration of alkaloid is highest in the seed. Interesting story, though.

  5. #5 Alex
    February 8, 2010

    Revere, this isn’t some kind of rant against getting high right? I mean most weed is pretty harmless. And we may be callow youth but we sure have lots of fun.

  6. #6 Big Ugly Jim
    February 8, 2010

    I’ve been arguing with my parents, two confirmed woo-flingers on the highest order about the idea that natural does not mean safe. Last week I wrote in my blog about how this thinking is bad. I got a real giggle out of this post. Thanks for the good work, Revere!

  7. #7 DrA
    February 8, 2010

    Jimson weed”, short for Jamestown weed, got its common name for an accidental poisoning of British troops garrisoned there during the Revolutionary war. Cook wanted some “pot herbs” and got Datura instead (a genus derived from an ancient name for poison, dhatura). A little botanical knowledge is a dangerous thing. I guessed the secret ingredient correctly, but it could have been worse. Kids who heard you could get “high” from the seeds of jimson weed killed themselves. So people like Alex can go for it; the Darwin award needs some nominations.

  8. #8 Alex
    February 8, 2010

    @DrA: I guess I didn’t make my point clearly enough, so the mistake is mine. I didn’t say that ALL weed is pretty harmless. I was refering to Revere’s title for the article: “The dangers of weed”, which seems to put all weed on the same boat. Obviously, I posted my comment after having read the article and thus understand that Jimson Weed doesn’t fit into “most weed”. Here is a very interesting debunking of myths about “normal weed” (with studies cited):

    http://www.drugpolicy.org/marijuana/factsmyths/

    Pay special attention to this paragraph:

    “Fact: In 1972, after reviewing the scientific evidence, the National Commission on Marihuana and Drug Abuse concluded that while marijuana was not entirely safe, its dangers had been grossly overstated. Since then, researchers have conducted thousands of studies of humans, animals, and cell cultures. None reveal any findings dramatically different from those described by the National Commission in 1972. In 1995, based on thirty years of scientific research editors of the British medical journal Lancet concluded that “the smoking of cannabis, even long term, is not harmful to health.” ”

    It’s also an interesting fact that weed has medicinal value.

    That said, it’s very easier to make ad hominem attacks about having someone remove himself from the gene pool.

  9. #9 phytosleuth
    February 9, 2010

    I have some similar stories from students and colleagues, but from our local hallucinogen, henbane (Hyoscyamus niger). Like the ranch cook from California in Montana who stir-fried some in garlic and butter. Crawled into the kitchen next morning and the cowboys just shook their heads at him. Dude. Definitely. But an all too common mistake and sad that people don’t know the plants all around them. Big Disconnect.

    My favorite story though is the one where people new to the area stuff their Thanksgiving turkey with sage. ROFL! Wrong sage folks!

    (Hint: mint family is not daisy family and common names will steer you very wrong)

  10. #10 skeptic
    February 9, 2010

    Marijuana sees enough demonization and doesnt need oblique references like the title given here. A reader has to get at least half way through the post to realize it is about a common toxic hallucinogenic plant that is one of many. Having “weed” in the title is disingenuous and weak.

  11. #11 Alex
    February 9, 2010

    @skeptic: Exactly!

  12. #12 Anne
    February 9, 2010

    One of my favourite parts of the local botanical garden is the “poisonous plants” section. There they have examples, with nameplates and descriptions of all sorts of poisonous plants, including most of the ones that grow locally. So they have jimsonweed, foxglove, and deadly nightshade, but also potatoes, rhubarb, poison ivy, and ragweed. A nice way to learn what to watch out for, even if it does seem like an alarming temptation – if you wanted to commit murder, you could just go harvest some poison.

  13. #13 Charles
    February 10, 2010

    Ragweed!

    The things you learn reading blogs! LOL

    I’ve always thought the worst ragweed could do to me was make my lungs fill up with crud. Which it once did with ridiculous ease, back when I lived in one of the least well appreciated allergy hellholes in the country, Tucson.

  14. #14 Anne
    February 10, 2010

    @Charles: actually, that’s exactly why ragweed is there, because it causes allergies. Personally I think it’s kind of a marginal inclusion, but then I don’t suffer from allergies. And I suppose something that causes mild problems for a very large number of people is as important as something that causes severe problems for a few.

  15. #15 Charles
    February 11, 2010

    *chuckle*

    I guess a fair number of fairly well qualified people agree with that assessment, Anne.

    When I read the Wikipedia page for ragweed, about 2/3 of the content concerned its history as a allergen par excellance.

    I wouldn’t quarrel with it myself. Considering the sheer number of allergy-drive infections I’ve had to work through, in other climes than the one I now enjoy.

    Not to mention “medications” like Tedral. The only reason anyone remotely sane would touch that ghastly stuff is that the alternative was even worse.

Current ye@r *