Cannabinoid Hyperemesis Syndrome

"Among the more common adverse effects is the cannabinoid hyperemesis syndrome (CHS), first reported in 2004 [6]. CHS is a syndrome of cyclic vomiting in the setting of chronic, high-dose cannabis use that is frequently associated with compulsive hot baths/showers, used in attempt to control symptoms.

"Patients with CHS present frequently to various health care settings with intractable nausea and vomiting. These patients often undergo expensive medical testing, may require hospital admission for symptom management, and often experience significant delays in diagnosis [7]. CHS is under-recognized due to a combination of factors including the paradoxical use for treatment of nausea and vomiting, the stigma associated with cannabis use, and the illegal status of cannabis in many regions leading to under-reporting of use. The frequency of emergency department visits and high rates of hospital admission for CHS exemplify the difficulty in symptom management. The lack of knowledge and treatment recommendations regarding CHS compounds this issue. Subsequently, CHS is a costly illness to manage. In an observational study of CHS patients followed over 2 years, the median charge for ED visits and hospital admissions was $95,023 (IQR = $62,420–$268,110) [7]."

Source

Sorensen, C. J., DeSanto, K., Borgelt, L., Phillips, K. T., & Monte, A. A. (2017). Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 13(1), 71–87. doi.org/10.1007/s13181-016-0595-z.