Health
Cannabinoid hyperemesis syndrome | Drug use and addiction medicine | JAMA
Cannabinoid hyperemesis syndrome (CHS) is a gastrointestinal disease associated with frequent and long-term use of cannabis (marijuana).
CHS has an acute onset, causing severe nausea, paroxysmal vomiting, and recurrent episodes of severe abdominal pain lasting less than a week. Symptoms usually start suddenly within 24 hours of the last cannabis use. People with CHS often report temporary relief from symptoms when taking hot showers or baths, which can lead to compulsive bathing.1,2
How common is CHS and what are its risk factors?
Although the exact number of patients with CHS is unknown, it is estimated that approximately 2.75 million people in the United States develop CHS each year, based on emergency department surveys. From 2017 to 2021, CHS emergency department visits doubled in the U.S. and Canada, most commonly among men aged 16 to 34. The increase in CHS has coincided with the legalization of recreational cannabis and an increase in delta-9-tetrahydrocannabinol (THC) concentrations in cannabis products.
Risk factors for CHS include heavy cannabis use (usually daily or multiple times a day) for more than a year. Higher rates of CHS have been reported in people younger than 16 years who use cannabis, have other substance use disorders, and/or smoke tobacco.
A diagnosis of CHS can be made in people who have nausea, vomiting, or abdominal pain that lasts less than a week three or more times a year, who have used cannabis four or more days a week for more than a year, and who: Masu. Symptoms disappear after discontinuing cannabis for at least 6 months.
What are the complications of CHS?
Frequent vomiting due to CHS can cause erosion of tooth enamel and result in tooth loss. CHS can cause dehydration, acute kidney injury, and decreased blood chloride, potassium, sodium, and bicarbonate levels, which may require emergency department visits and hospitalization. Rare and serious complications of CHS include abnormal heartbeats, kidney failure, seizures, and death.
Patients who present to the emergency department with dehydration from CHS are usually given intravenous fluids and anti-nausea medication. Capsaicin (0.1%) cream applied topically to the upper abdomen may reduce nausea. Some patients may also benefit from the acute and short-term use of benzodiazepines (anxiolytics) and haloperidol (antipsychotics).
Complete cessation of cannabis use is the most effective long-term treatment for CHS. However, advising CHS patients to stop cannabis use immediately may result in cannabis withdrawal symptoms and higher relapse rates. Counseling to achieve cannabis cessation and tricyclic antidepressants (such as amitriptyline) are recommended for long-term management of CHS. People with CHS whose symptoms do not improve with these treatments may benefit from seeing a psychologist or psychiatrist.
Published online: October 10, 2024. doi:10.1001/jama.2024.9716
Conflict of interest disclosure: There were no reports.
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Sources 2/ https://jamanetwork.com/journals/jama/fullarticle/2824833 The mention sources can contact us to remove/changing this article |
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