When cannabis makes you vomit

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As the legalization of marijuana has boosted use of the drug across the country, doctors are seeing a rise in cases of cannabis, or cannabinoid, hyperemesis syndrome (CHS), experts said. MedPage Today.

Earlier this month the New York Times reported at CHS as well as other damage of marijuana that doctors are increasingly confronted with.

Tucker Woods, DO, chairman of emergency medicine at Lenox Health Greenwich Village in New York, shared MedPage Today that he rarely saw CHS twenty years ago. Now he sees it “almost every day in our emergency department.”

Although cannabis is often used as an anti-emetic, it can sometimes have the opposite effect, resulting in repeated bouts of nausea, vomiting and abdominal pain after use.

Woods said people who develop CHS tend to have an initial phase of nausea, followed by a second phase of cyclical vomiting that can last 48 hours, after which they begin to recover in the third phase.

It can also cause severe pain, he said, noting that some patients experience what Woods calls “scrominating,” in which a patient screams and vomits at the same time.

CHS usually occurs in people who have been taking it for at least six months, but it can also affect people who have been taking it for much longer — even more than a decade, Helen Senderovich, MD, of the University of Toronto, told IPS. MedPage Today in an email. It is known to occur in older people and also in those with multiple comorbidities, she said.

Woods points to the increased use and potency of cannabis as likely culprits for the increase in CHS cases. One estimate showed that the potency of cannabis, defined by the average delta-9-THC concentration, increased from 9.75% in 2009 to 13.88% in 2019.

“This is not your grandparents’ marijuana anymore, and there is a reduced perception of harm,” Woods said. “As it becomes legal, people assume legal is safe.”

Stopping use of marijuana or cannabinoids “is the first line of treatment” for CHS, Senderovich said. In one systematic reviewshe and her colleagues found that several other treatments alleviated symptoms of CHS, including haloperidol, droperidol, benzodiazepines, propranolol, and aprepitant. Hot showers and topical capsaicin cream rubbed on the abdomen can also be effective, she said.

Woods said it can be especially challenging to diagnose CHS because many conditions cause nausea and vomiting. Still, he encouraged doctors to keep the diagnosis in mind because there have been “horror stories” where patients with CHS have been wrongly diagnosed. their gallbladder removed.

Woods added that some patients with CHS can be identified using a urinalysis, but he cautioned that some synthetic cannabis products do not appear in those studies.

“I think the most important thing is to bring awareness to the community because many people really think that marijuana is largely non-addictive and that it is safe,” he said, “but for some users, these assumptions are dangerously wrong.”