Cannabinoid Hyperemesis Syndrome – Genetics, Pesticides, or Both?

CANNABIS CULTURE – A DML deep dive into CHS resulting from an ongoing discussion with Dr. Ethan Russo.

“There is no evidence of what exactly is being metabolized differently, or what metabolite is causing the nausea, or by what mechanism. It may be any component of the plant or any additive that’s used in the manufacturing and production.”

• Dr. Mary Clifton, responding to an interview with Dr. Ethan Russo by Celebrity Stoner/Steve Bloom. (1)

Right off the bat I wish to extend massive props to Dr. Ethan Russo for being a pioneer in both the research areas of harms from cannabis pesticides and of Cannabinoid Hyperemesis Syndrome (among many other things). This article is in no way meant to question the intelligence or integrity of Dr. Russo. He’s really one of the only people looking into these things, and our community is fortunate to have him working on our behalf. Dr. Russo is absolutely one of the “good ones.”

But. 

When researching supposed “inherent cannabis harms” or “safe corporate products,” one must be very, very careful not to discount the possibility of sketchy corporate chemicals or materials being the cause of emerging medical problems. There are so many examples of medical problems related to synthetics, or additives, or contaminants, or proprietary medicines or other corporate products that have been hidden or dismissed by an army of ethically-flexible members of the academia who would sell their grandmothers for a nickel, that it can never be assumed that corporate greed is not a factor in these new health concerns. 

For example, there’s mounting evidence that all chemical fertilizers are radioactive, and the main cause of cigarette-related lung cancer. (2) The tobacco industry has known this since the 1980s, but refuses to do anything about it because it would be too “expensive.” (3) Regulators of tobacco and cannabis in the Canadian government cover for the tobacco and cannabis industries by claiming that heavy metal contamination is within “allowable limits” – not mentioning unless pressured that there are, in fact, no legal limits to heavy metals in either cannabis or tobacco in Canada. (4)

 

For another example, there’s the case of “elixir sulfanilamide” – a patent medicine which, in 1937, killed more than 100 people in the US and led to the 1938 Federal Food, Drug and Cosmetic Act, which mandated animal testing for all new drugs pre-approval. (5) Elixir sulfanilamide was an antibiotic created to meet a demand that was previously met by cannabis medicines – a result of natural antibiotics such as cannabis being phased out of use by a medical establishment that favoured proprietary products and stigmatized medicines that couldn’t be easily monopolized. 

There’s also the example of a medicine known as “thalidomide.” When first released back in 1957, thalidomide was promoted for anxiety, trouble sleeping, “tension”, and morning sickness. (6) In other words, it was another cannabis substitute. It was later found to cause birth defects. In spite of the manufacturers being unable to prove efficacy, it was distributed “in large quantities” in the U.S. “for testing purposes.” (7) Due to the lobbying power of the pharmaceutical industry, thalidomide is still on the market, being promoted as a treatment for leprosy, sometimes with an image of a pregnant woman inside a circle with a line crossed through it imprinted on the pill (8) – an image that could be mistaken for a symbol of an abortifacient (abortion pill) for those who can’t read English or don’t have access to the package – which is probably one of the reasons why birth defect problems from the use of thalidomide persist to this day. (9)

The elixir sulfanilamide and Thalidomide tragedies set up the current multi-million dollar safety and efficacy drug testing protocols. These protocols still don’t stop the (on average) 4,500 unsafe drugs making it to market that are later recalled off the market every year in the U.S. (10) but because of their expensiveness, they keep illegal or stigmatized herbs like cannabis from being considered “medicines” worthy of being subsidized by the Canadian health care system, or considered a medicine worthy of a legal status by the American health care establishment. 

For another example, there’s the lead that used to be found in gasoline. Tetraethyllead was first added to gasoline in 1923, as it helped prevent engine knocking. By 1965, researcher Cameron Patterson began to lobby the establishment to remove lead from gasoline, arguing that lead poisoning (11) was a thing. 

Patterson immediately ran up against the powers of his corporate rulers. These rulers saw their profits as more important than people’s health, and used the academics on their payroll to delay the removal of lead in gasoline for more than two decades: 

“Beginning in 1965, with the publication of Contaminated and Natural Lead Environments of Man, Patterson tried to draw public attention to the problem of increased lead levels in the environment and the food chain from lead from industrial sources. Perhaps partly because he was criticizing the experimental methods of other scientists, he encountered strong opposition from those then recognized as experts, such as Robert A. Kehoe. In his effort to ensure that lead was removed from gasoline (petrol), Patterson fought against the lobbying power of the Ethyl Corporation (which employed Kehoe), against the legacy of Thomas Midgley, Jr. (which included tetraethyllead and chlorofluorocarbons), and against the lead additive industry as a whole. Following Patterson’s criticism of the lead industry, he was refused contracts with many research organizations, including the supposedly-neutral United States Public Health Service. In 1971, he was excluded from a National Research Council (NRC) panel on atmospheric lead contamination, even though he was then the foremost expert on the subject. The United States mandated the use of unleaded gasoline to protect catalytic converters in all new cars starting with the 1975 model year, but Patterson’s efforts accelerated the phaseout of lead from all standard, consumer automotive gasoline in the United States by 1986.” (12)

Lead is currently found in some cannabis – as a result of 1) being a contaminant as a result of non-organic/poor farming practices and possibly 2) as an adulterant that is put in cannabis on purpose by unscrupulous dealers to increase the weight of the baggy:

“In 2007, a mass poisoning due to adulterated marijuana was uncovered in Leipzig, Germany. The 29 young adults were hospitalized with lead poisoning for several months and they all had smoked marijuana that had been tainted with small lead particles. One hypothesis of the police was that lead, with its high specific gravity, was used to increase the weight of street marijuana sold by the gram and thereby maximizing the dealers’ profits. The researchers estimated that the profit per kilogram increased by as much as $1,500 with the lead added. It is common for drugs to be cut with less-expensive substances to increase the profits of dealers or distributors (e.g., cocaine is routinely adulterated with sugars, talcum powder, magnesium salts, and even other drugs). It is thought that the adverse reactions to many of these drugs are a result of poor manufacturing rather than face-value overdoses. Besides adulteration, cannabis plants have an inherent ability to absorb heavy metals from the soil. This makes them useful for remediating contaminated sites. But this may also make cannabis dangerous for consumers who ingest it. In fact some cannabis strains have been bred specifically to remove pollutants from soil, air or water, a method known as phytoremediation. In 2022, around 40% of cannabis products sold at unlicensed storefronts in New York City were found to contain heavy metals (e.g., lead, nickel), pesticides and bacteria.” (13)

For yet another example (and, truth be told, there are endless examples to choose from) there’s the case of Teflon. Exposed to the general public as a poison in the 2019 film Dark Waters, (14) Teflon began to be used in the mid 1940s to coat valves and seals within pipes and by the mid 1950s to make pots and pans “no-stick.” (15)

By 1999, academics employed by both the chemical industry and the government attempted to cover up the ongoing poisoning of farmers near the Teflon factory by blaming the farmers themselves for their health problems: 

“In the summer of 1999, Bilott filed a federal suit against DuPont in the United States District Court for the Southern District of West Virginia. In response, DuPont advised that DuPont and the United States Environmental Protection Agency would commission a study of the farmer’s property, conducted by three veterinarians chosen by DuPont and three chosen by the Environmental Protection Agency. When the report was released, it blamed the tenants for the dying cattle claiming that poor husbandry was responsible: ‘poor nutrition, inadequate veterinary care and lack of fly control.’” (16)

In each of these five cases of poisoning – radioactive chemical fertilizers, elixir of sulfanilamide, thalidomide, lead in gasoline and Teflon – academics have facilitated the poisoning. Academics created the product. When other more ethical academics would attempt to call attention to the poisoning, they almost always ran up against an army of industry-beholden academics, government regulators and/or corporate media that would help the polluters to resist any expensive, profit-threatening regulations. 

Similar greasy academics can be found employed by big pharma, the nuclear and fossil fuel industries, the “defense” industry, and every other major corporate polluter. The world is an environmental nightmare because most academics have sold their souls to the devil. 

It is within this context that Cannabis Hyperemesis Syndrome must be investigated. 

I began my investigation with an interview with Dr. Ethan Russo, the leading researcher of CHS. It might be helpful to watch/listen to it before continuing to read. It’s only 16 or so minutes long. 

The New High Society Episode 1: Cannabinoid Hyperemesis Syndrome – A discussion with Dr. Ethan Russo 

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

The interview was supposed to have been posted months ago, but we had some technical difficulties and it was delayed until his webinar about CHS had already transpired. Here are some other links to interviews with Dr. Russo in case you would like to hear more about CHS from him. https://credo-science.com/cannabinoid-hyperemesis-syndrome-chs-webinar/

Shaping Fire Ep. 80 – Cannabis Hyperemesis Syndrome Genomic Investigation Results w/ Dr. Ethan Russo 

https://www.youtube.com/watch?v=zQS8BWClHT0

EPISODE #120 Cannabinoid Hyperemesis Syndrome with Dr. Ethan Russo, Founder of Credo Science  

https://www.youtube.com/watch?v=_S51n67nub4

https://www.celebstoner.com/news/marijuana-news/2021/07/21/cannabinoid-hyperemesis-syndrome-chs-ethan-russo-marijuana-malady/

The first thing that stood out from my interview with Dr. Russo was this exchange, which begins at 14:05 of the interview. After quickly reviewing the facts about Teflon, lead in gasoline and radioactive metals in fertilizers (and the resistance to those who would attempt to end the pollution), I said this: 

“It just makes me wonder . . . could there be a kind of a machine – big corporate influence – on academia (that could) prevent the investigation of the full effects of chemical pesticides and chemical fertilizers on cannabis growing. And could there be efforts to not fund the type of research that would prove or disprove that theory?”

“Real quickly: I mean I’ve written this article decrying heavy metal contamination . . . pesticides. Additionally, the study we just did I funded personally.”

“OK so that’s you.”

“Ethan Russo from his bank account.” (17)

I think what happened in that exchange there was that Dr. Russo argued that he funded his own investigation into contaminants in cannabis because he believed I was attacking him for being beholden to our corporate overlords. What was actually going on instead was that I was attacking the academic establishment and industry for not funding such investigations, and the fact that Dr. Russo had to fund it himself instead of the funds being supplied to him by a benevolent medical system or health-focused industry was evidence that I was right.   

I looked at the materials that Dr. Russo had shared with me on the subject:

https://ethanrusso.org/cannabinoid-hyperemesis-syndrome-survey-and-genomic-investigation/

https://ethanrusso.org/myth-busting-cannabinoid-hyperemesis-syndrome/

. . . but then got distracted by other projects. 

A few months later, Dr. Russo shared the following link about CHS with the Canadian Cannabis Coalition, a group I belonged to:

https://www.technologyreview.com/2022/07/20/1056219/weed-influencer-and-scientist-feud-over-cannabis-hyperemesis-syndrome/

I took the opportunity to engage with Dr. Russo by email and review the information he sent me. The following is our exchange: 

“Dear Dr. Russo, 

Sorry about not posting my interview of you on CHS on Cannabis Culture. I wanted to post the video recording of it but have experienced technical difficulties, and I am too busy finishing up my massive history of reefer madness to transcribe it. I do intend to publish it one day. 

I’m just wondering … if it’s true that CHS is a result of genetics, how far back does the history of records of CHS symptoms go? Have people been puking from too much pot for thousands and thousands of years, or is it a more recent phenomenon? Is it possible that the genetics that result in a puking reaction to smoking lots of pot have also developed recently? 

I’ve been reading over the anti-pot literature in the mass media over the last 140 years or so very thoroughly and I haven’t come across any mention of puking from pot until very recently. Maybe you have found stuff I missed. 

DML”

Email, July 20th, 2022, 3:32 PM

 

“Hi, David. 

Please call me Ethan (after all this time!). You’re right. This does seem to be a recent phenomenon. Perhaps this kind of thing happened among saddhus in India in the past, but when people got sick, they just had the sense to abstain. It is more doubtful that the genetics have changed. The more likely scenario is that a much greater population has access to high-potency material and technology to bombard their system with it. I appreciate your continued interest! 

Cheers, Ethan”

Email, July 20th, 2022, 3:45 PM

“Dear Ethan, 

I don’t mean to be an argumentative half-Jew conspiracist, but something strikes me as inaccurate about your explanation. 

‘The more likely scenario is that a much greater population has access to high-potency material and technology to bombard their system with it.’ 

‘High-potency material’ includes hashish, does it not? Chris Bennett argues that we’ve had that for around 1000 years. And my research leads me to believe hashish has been imported into North America by the tonne since the 1980s. 

From my upcoming book: 

Hashish is a popular item for smugglers because it is much more condensed and therefore easier to transport than cannabis flowers are. And hashish seizure photos were popular with the press, because the size of the seizures seemed to be constantly breaking records over the course of the decade. For example, there was a Montreal, Quebec, Canada seizure on October 20th, 1981, involving 500 pounds, (92) an article reporting ‘more than 12 million dollars worth of marijuana’ and 41 bales of hash worth millions of dollars, with ‘more than 50 million of hashish’ remaining in a sunken boat was printed on page one of the October 26th, 1981 edition of The Record newspaper from Hackensack, New Jersey, (93) an article in the November 5th, 1981 Gazette of Montreal featured a photo of ‘part of a three-ton haul of Lebanese hashish’ worth ‘40 million’ (94) and a November 11th, 1981 story in the Atlanta Constitution involved ‘$12 million worth of opium and hashish’. They broke it down this way; ‘… 58.62 pounds of opium and 27.84 pounds of hashish were confiscated. The opium was worth about $200,000 a pound and the hashish had a street value of $1000 a pound.’ (95) The record-breaking seizures continued. A March 25th, 1982 article in the Melbourne, Australia newspaper The Age reported on a ‘110 million’ hash bust involving ‘2.15 tonnes’ of hashish – “almost as much as all the cannabis seized in Australia in 1980’. (96) The dollar amount of this bust was inflated to $120 million in the Sidney Morning Herald’s reporting the same day. (97) A Dayton Ohio paper reported on a million dollar hash bust involving 300 pounds of blonde hashish. ‘’We’ve had bigger ones (raids) on the west coast but never in the mid-west and especially in Ohio,’ said an agent for the Federal Drug Enforcement Administration.’ (98) The Montreal Gazette reported on a bust from June 16th, 1983, involving the seizure of 72 pounds – or $750,000 dollars worth – of ‘Golden Elephant’ hashish (with a gold-leaf stamp of an elephant placed on each hashish brick to assure genuine quality). That worked out to $10,416 per pound, or about $23.25 per gram, which means that the value was calculated as if the smuggler was going to go around and sell each and every gram at maximum retail prices rather than sell it to a few different dealers for wholesale price as one would expect. It seems very likely that the police wanted to inflate the value of their seizure, to inflate their own importance. (99) On August 21st, 1983, the Orlando Sentinel reported that Dutch police found ‘more than 4 tons of Lebanese hashish in bales of rice marked as an Italian gift to Third World nations’. The ‘street value’ was estimated at ‘More than $5 million.’ (100) On February 28th, 1984, it was reported in the Philadelphia Inquirer that four people were sentenced to 10 years in prison for attempting to smuggle 29,965 pounds (about 15 tonnes) of hashish into the US. The hash was valued at up to $90 million dollars. Federal authorities said it was the third largest seizure of hashish in U.S. history. (101) In a November 27th, 1984 article entitled ‘Egypt, U.S. seize 20 tons of hashish’, the claim was made that the seizure was ‘the largest single haul of hashish ever in Egypt and possibly in the world.’ The seizure was valued at ‘$50 million, based on the Egyptian street value of about $2,500 for 2.2 points of hashish.’ (102) The seizure was reported on in both U.S. and Canadian newspapers. (103) There was more. April 26th, 1985: 1,800 pounds of hash seized in Pakistan – seizure was ‘largest in history’. (104) May 25th, 1985: 13 tonnes of hashish seized in Lockporte, Nova Scotia, with an ‘estimated street value of $238 million’ – the ‘largest ever hashish seizure in North America.’ (105) June 25th, 1987: 2,740 pounds of hashish was seized in Washtenaw County, Michigan – ‘about 28 times the amount that the Drug Enforcement Administration has confiscated nationwide this year’. The retail value is estimated at $2.2 million. (106) May 25th, 1988, 30 tons of hashish and 15 tons of marijuana with a combined value of $162 million were found beneath the deck of a barge as it slipped underneath the Golden Gate Bridge in San Francisco. (107) According to all sources, only a small fraction of the hashish that was smuggled into North America was seized, and those who now make arguments that high-potency cannabis products are a new thing in western nations are obviously talking nonsense.’ 

 

So if it’s true that, since the 1980s, tonnes and tonnes of hashish have been smuggled into North America, and all manner of hash pipes and hot knives and other modes of administration have been around to ‘bombard their system with it’, why didn’t CHS also show up in the 1980s? 

Continually interested, DML”

Email, July 20th, 2022, 4:06 PM

“It’s certainly true that high potency material has been available in the past, but the scope of availability has vastly expanded. I cannot document CHS before 1996, and no, it is not from pesticides or neem. 

Ethan”

Email, July 20th, 2022, 4:23 PM

“Your evidence that it doesn’t come from pesticides is the Journal of Emergency Medicine paper: ‘A CASE OF CANNABINOID HYPEREMESIS SYNDROME CAUSED BY SYNTHETIC CANNABINOIDS’ (2012) – correct? If I remember correctly, you argued that because synthetic cannabinoids also caused the syndrome, and there are no pesticides in synthetic cannabinoids, it must not have been pesticides. Did I get that right? 

DML”

Email, July 20th, 2022, 5:34 PM

“Yes and the fact that symptoms from pesticide toxicity don’t match those of CHS. 

E.”

Email, July 20th, 2022, 5:38 PM

“You wrote: 

‘While synthetic cannabinoids have serious attached morbidity and possible mortality due to off target toxicities [5], there is no reason to expect pesticide contamination in their manufacture.’

• E.B. Russo, Myth busting cannabinoid hyperemesis syndrome, American Journal of Emergency Medicine 

When I looked at the source of the article mentioning the synthetic cannabis/CHS link, I found this: 

‘The patient provided us with a sample of the ‘synthetic pot’ he had been smoking, which consisted of a packet of dried herbs that he had purchased at a local convenience store.’

– A CASE OF CANNABINOID HYPEREMESIS SYNDROME CAUSED BY SYNTHETIC CANNABINOIDS Christopher Y. Hopkins, MD and Brandi L. Gilchrist, MD 

According to NIDA: 

‘What are synthetic cannabinoids? Synthetic cannabinoids are human-made mind-altering chemicals that are either sprayed on dried, shredded plant material so they can be smoked or sold as liquids to be vaporized and inhaled in e-cigarettes and other devices. These products are also known as herbal or liquid incense.’

 https://nida.nih.gov/publications/drugfacts/synthetic-cannabinoids-k2spice 

Is it not possible that the dried herbs or shredded plant material used as a carrier for the synthetic cannabinoids in the case report were not grown to organic standards? Honestly, I did a gut-check on this, and I can’t for the life of me understand why people who cared so little for their customers that they would supply them with harmful, synthetic pot, would care so much as to spray it on the cleanest, organic herbs. They’re in it to make money – organic fertilizer costs five times as much as synthetic fertilizer. Isn’t that a reason to suspect pesticide contamination – not in the synthetic cannabinoids they sprayed on the plant material, but in the plant material itself? As far as I could tell, the dried herbs/shredded plant material used in the case report was not tested for pesticides. 

Still super interested in your insight but unable at this time to arrive at a comfortable conclusion, DML”

Email, July 20th, 2022, 5:52 PM

 

“You have a point, but that is not the only such case. CHS has also been seen with synthetic caps and powders. I know what pesticide toxicity looks like clinically, and am confident that it is not the cause of CHS. Plenty of CHS patients get symptoms from indoor organic cannabis. 

E.”

Email, July 20th, 2022, 5:59 PM

“’CHS has also been seen with synthetic caps and powders.’

If you can show me that the capsules and powders contained no plant material, I will admit that this particular argument has reached a dead end. But Wikipedia talks as though the synthetic material comes in liquid form: 

‘Typically, synthetic cannabinoids are sprayed onto plant matter [5] and are usually smoked,[6] although they have also been ingested as a concentrated liquid form in the US and UK since 2016.[7]’

https://en.wikipedia.org/wiki/Synthetic_cannabinoids 

To become a powder or put in a capsule, wouldn’t this liquid material have to be sprayed onto plant matter first? 

‘I know what pesticide toxicity looks like clinically, and am confident that it is not the cause of CHS.’ 

I don’t understand where that confidence comes from. 

‘While it has a relatively low toxicity level, farmers working with myclobutanil have reported the following side effects: 

Rash 

Headache 

Diarrhea 

Abdominal pain 

Vomiting 

Nosebleed 

Eye irritation’ 

https://lagunatreatment.com/drug-abuse/marijuana/pesticide-laced/ 

‘The hyperemetic phase is characterized by the full syndromal symptoms of CHS, including

persistent nausea, 

vomiting, 

abdominal pain, 

and retching.[7]’ 

https://en.wikipedia.org/wiki/Cannabinoid_hyperemesis_syndrome 

Two things come to mind: 

1) Two symptoms is quite a lot of overlap to argue there is no overlap, and 

2) The symptoms of farmer-related pesticide poisoning and smoker-related pesticide poisoning may not be exactly the same. 

‘Plenty of CHS patients get symptoms from indoor organic cannabis.’ 

And there is plenty of evidence that soil suppliers can be just as greasy as synthetic pot suppliers: 

https://www.cannabisculture.com/content/2021/11/10/lp-soil-scandal/ 

Basically, I’m faced with two theories, neither of which have been proven true or proven false beyond a shadow of a doubt. 

1) CHS is a genetically-related condition that only manifested in the 1990s because people in the 1980s who smoked hash had the good sense to stop after the onset of effects, but from the mid 1990s onwards they lost that good sense. 

2) CHS is pesticide related, and our ability as a community of researchers to understand the pervasiveness of pesticides is not as powerful as our ability to rationalize that it’s not pesticide related. 

Call me a conspiracy theorist if you must, but the elite deviance and corporate greed that I’ve seen all over the map when it comes to cannabis research and cannabis policy may have had an influence on this debate as well. 

I am willing to be proven wrong. My mind is always open to that possibility. 

Respectfully yours (and delighted to continue the conversation if you have the patience for it), DML”

Email, July 20th, 2022, 6:36 PM

“David, we’re done for now. You will draw your own conclusions.”

Email, July 20th, 2022, 6:39 PM

As a result of our dialogue, I am left with the feeling that there may be more to CHS than simply a genetic predisposition to get sick on high doses of cannabinoids. Unfortunately, it may take an academic even more curious than Dr. Russo to fund the research needed to find out the truth, because Dr. Russo seems to have lost interest – at least temporarily – in confirming his suspicions, and I very much doubt the industry – or the academic establishment – will fund the research without all kinds of public pressure. 

Who knows? Perhaps articles like this being widely circulated and discussed might help with the public pressure part of the equation. 

Citations:

1. “Dr. Ethan Russo Calls CHS, the Misunderstood Marijuana Malady, a ‘Side Effect’,” Steve Bloom September 1, 2021

https://www.celebstoner.com/news/marijuana-news/2021/07/21/cannabinoid-hyperemesis-syndrome-chs-ethan-russo-marijuana-malady/

2. “Po210 is the only component in cigarette smoke tar that has produced cancers by itself in laboratory animals as a result of inhalation exposure (Beverly S. Cohen, Ph.D. and Naomi H. Harley, Ph.D.).”

https://pot-facts.ca/chemical-fertilizers-are-radioactive-and-the-real-cause-of-tobacco-related-cancer/

3. “The recommendation of using ammonium phosphate instead of calcium phosphate is probably a valid but expensive point” – Philip Morris                                                                              https://pot-facts.ca/big-tobacco-knew-radioactive-particles-in-cigarettes-posed-cancer-risk-but-kept-quiet/

4. “When informed by CSA that its independent tests showed high levels of heavy metals in the PPS cannabis, Health Canada spokesperson Jirina Vlk stated that Health Canada’s own tests showed that heavy metal concentrations in the PPS cannabis were similar to those found in Canadian tobacco, and well within allowable limits. When pressed as to what these ‘allowable limits’ might be, she admitted that there are currently no legal limits to heavy metal content in either cannabis or tobacco in Canada. This disingenuous response is of little reassurance to the critically and chronically ill Canadians who depend on cannabis for their health and well-being.” View Magazine. 23rd October, 2003. Available at: http://www.mapinc.org/newscsa/v03/n1666/a03.html 

https://pot-facts.ca/there-are-currently-no-legal-limits-to-heavy-metal-content-in-either-cannabis-or-tobacco-in-canada/

5. https://en.wikipedia.org/wiki/Elixir_sulfanilamide

6. https://en.wikipedia.org/wiki/Thalidomide

7. Ibid.

8. Thalidomide scandal: 60-year timeline, 1 Sep 2012 https://www.theguardian.com/society/2012/sep/01/thalidomide-scandal-timeline

9. “Despite this, cases of thalidomide embryopathy continue, with at least 100 cases identified in Brazil between 2005 and 2010.” 

https://en.wikipedia.org/wiki/Thalidomide

10. https://www.drugwatch.com/fda/recalls/

11. https://en.wikipedia.org/wiki/Lead_poisoning

12. https://en.wikipedia.org/wiki/Clair_Cameron_Patterson

See also: https://en.wikipedia.org/wiki/Robert_A._Kehoe https://en.wikipedia.org/wiki/The_Clean_Room

Cosmos A Space-Time Odyssey S01 – Ep07 The Clean Room https://www.dailymotion.com/video/x6u3qd9

13. https://en.wikipedia.org/wiki/Lead_poisoning

14. https://en.wikipedia.org/wiki/Dark_Waters_(2019_film)

15. https://en.wikipedia.org/wiki/Polytetrafluoroethylene

16. https://en.wikipedia.org/wiki/Robert_Bilott

17. The New High Society Episode 1: Cannabinoid Hyperemesis Syndrome – A discussion with Dr. Ethan Russo beginning at 14:05 of the video.

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