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museiamcalliope · 1 year

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Cannabinoid Hyperemesis Syndrome

Hello to all, and welcome to my life with CHS. I made this account, so I can share my story and be there for others who are suffering from CHS, as well as to educate those who may be experiencing this and not be aware of the condition or cant come to terms with the fact that cannabis is making you ill.

Cannabinoid Hyperemesis Syndrome is a condition in which the effected person suffers a very wide variety of symptoms ranging from tolerable to extreme. Here are my symptoms in order of severity; extreme nausea and stomach pain, scromiting (scream vomiting), Dehydration, loss of appetite, anxiety night sweats, restlessness. With this condition, your symptoms will only go away if you permanently stop using cannabis. It is believed by some that this condition only effects long term users, but even if you are new to using, if you “green out” often, this could be your first sign that you are starting in on a trail of suffering.

I had been using for 5 years and I had my first battle with CHS this summer, 2022. At first, I didn't want to believe that it was the cannabis that was making me sick because I liked using. The first bout I had my symptoms lasted 10 days with the first 5-6 days being the most severe, then gradually I got better and the symptoms stopped. And I had stopped using during the 10 days. I went to urgent care on day 3, where the Dr thought it could be many things causing my extreme discomfort. After lots of questions and working together to get to the bottom of this the Dr asked me if I used cannabis to which I answered “yes” and then he said it's possibly CHS, stop using and see if this comes back. I did stop using for the whole time I was sick and then when I got better I decided to try using again. I was okay for a few months with occasional morning sickness, but I thought if tat was the extent of it than I might as well continue.

I continued smoking for the next five months, which brings us to now. And let me tell you, the second time around this has been so awful, and scary and not to mention strenuous to my mental health. I had all the symptoms as the first time, but when compared, this time is literal hell. I can't count how many times I told my SO that I thought I was going to die. I had to go to the ER because after 5 days of constant vomiting, I was so dehydrated that I could feel my heart beat in my kidneys. At the ER they were able to replenish my hydration through IV and they had also administered nausea medicine and pain medicine through the IV which only gave me relief for what felt like 15 minutes, but I have only thrown up once since my treatment, even though I'm still queasy. This started on the 5th with throwing up in the am and going down hill for what felt like weeks but in reality was just two days, going to the ER the night of the 8th. Finally coming to terms with the fact that it was indeed the use of cannabis causing this condition, I completely stopped using on the 6th of this month and I will never use again.

If you think you might be suffering from CHS or are experiencing any of these symptoms, no matter how severe, you should definitely ask your Dr about CHS.

You are not alone! Please reach out if you would like my additional support/input as a sufferer of CHS. Also feel free to leave any questions in the comments below.

#cannacommunity #health #awareness

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grad703designresearchblog · 2 years

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Key Words

- Cannabinoid Hyperemesis Syndrome (CHS)

- Addiction

- Marijuana

- Mental Health

- Relapse

- Recovery

- Dependency

- Sickness

- Withdrawals

- Lifestyle

- Smoking

- Young People

- Awareness Campaign

- Addict

- High

- Support

- Help

- Distractions

- Therapy

- THC

- CBD

- Vomiting

- Sweats

- Insomnia

- Self Medicating

- Coping Mechanism

- Effects

- Publication

- Illustration

- Weed

- Pot

- Stoner

- Loser

- Cones

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robbialy · 3 years

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From • @davidkrumholtz Be careful. This is real. And it is not worth it. NOTE: I am not slamming marijuana. This is a rare condition. I am bringing awareness to something that has affected me 4 times. It is BRUTAL. Please refrain from mocking this post. People are suffering. Cannabinoid Hyperemesis Syndrome https://www.instagram.com/p/CM_nKqYJ1CwIj_3ZGpP8i2Ij3VfEaPcCBT3zww0/?igshid=7myidt6cb2pj

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laceyspencer · 5 years

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Juniper Publishers-Cannabinoid Hyperemesis Syndrome; A Growing Concern for New Mexico

Introduction

Marijuana is the most commonly used illicit drug in the United States (22.2 million people have used it in the past month) according to the 2015 National Survey on Drug Use and Health [1]. Marijuana use is more prevalent among males compared to females and more likely to be used by adolescents and young adults. [2]. The overall prevalence of marijuana use has remained stable in the United States at 4%, but the prevalence of cannabis related disorders has continued to increase [3]. As of December 2016, more than half of all states in the United States have a law legalizing marijuana for recreational or medical use. [4]. In 2007, New Mexico became the 12th state to allow the use of cannabis for medical use with the Lynn and Erin Compassionate Use Act.Cannabinoid Hyperemesis Syndrome (CHS) was first described in 2004 by Allen and colleagues [5], and is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting, and the learned behavior of hot bathing [5,6]. Several case reports have described patients with chronic marijuana use presenting to healthcare facilities with abdominal pain, cyclic vomiting, and compulsive showering [7-15], but there are few epidemiologic studies that have analyzed the association between marijuana use and CHS.In this analysis, emergency department data from 2010-2015 was analyzed for CHS cases. The primary objective of this study was to describe the prevalence of CHS over a 6-year period in New Mexico. A secondary objective was to compare any CHS trends observed in New Mexico to national estimates.

Materials and Methods

Study Sample and Variables

This study is a retrospective analysis of emergency department (ED) data from hospitals across the state of New Mexico. This data consists of ED visits from 36 non-federal hospitals. Data elements included in this dataset include patient characteristics including age, sex, and patient residence information as well as visit characteristics including +/- 20 diagnosis fields, +/- 6 procedures codes (2015 only) and visit and discharge information (dates and times).Six years of New Mexico ED data were analyzed (2010-2015) with an average of 765,000 visits per year. For this analysis, the following ICD-9-CM and ICD-10-CM codes were used: Cannabis Related Diagnosis Codes [ICD-9-CM: 304.3, 304.30, 304.31, 305.20, 305.21; ICD-10-CM: F12.10, F12.2, F12.20, F12.9, F12.90] and Persistent Vomiting [ICD-9-CM: 536.2; ICD-10-CM: R11.10]. A CHS case was defined as an ED visit with a cannabis related diagnosis code and a persistent vomiting diagnosis code.

National Study Sample

For national estimates of ED visits, five years of emergency department data were analyzed (2010-2014) using the Nationwide Emergency Department Sample (NEDS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. (Healthcare Cost and Utilization Project (HCUP), 2017) The NEDS dataset contains ED data from 30 states with approximately 30 million ED visits each year. The NEDS dataset can be weighted to yield national estimates [16].

Results

The annual number of total ED visits increased by 24.2% from 2010 to 2015 in New Mexico. During this six-year period, the annual number of ED visits for cannabis increased by 172.8% and 585.7% for CHS visits (Table 1). On the national level, total estimated ED visits increased 6.9% from 2010 to 2014 (same period in New Mexico saw a 23.6% increase). National estimates for cannabis ED visits increased 71.9% and CHS increased 423.3%.

In New Mexico, a higher percentage of CHS visits were among males, between the age of 18-29 years, who resided in the Northeast region of the state. A higher percentage of visits for cannabis were male, between the age of 30-64 years, who resided in the Northeast region of the state. For every year of ED analysis, all four age groups (0-17, 18-29, 30-64, and 65+ years) had an increase in the number of visits for cannabis. On a national level, a higher percentage of CHS visits were male and between the age of 30-64 years. Visits for cannabis followed a similar pattern.The number of visits for cannabis have been steadily increasing from 2010-2015, with a very large increase from 2014-2015 (Figure 1). A similar trend was observed for CHS visits. Visits for vomiting decreased in 2012, but then increased from 2013-2015, with a similar large increase from 2014-2015 as observed for both cannabis and CHS visits. The number of patients admitted for CHS increased with each year (Table 1). On average, each patient visited 1.5 times for CHS. Evaluating CHS and cannabis only visits together, patients visited roughly 2 times per year (the range was 0-5 additional visits).

Discussion

Key Findings

In this analysis, we found that the number of ED visits for patients presenting with CHS symptoms has increased from 2010 to 2015. Both the number of patients per year and the number of visits has increased, with an average of 1.5 annual visits per patient. A higher percentage of patients presenting with CHS symptoms were male and between the age of 18-29 years. New Mexico CHS patients differ from national CHS patients as New Mexico patients are younger in age.The New Mexico Medical Cannabis program (MCP) has grown substantially. In 2012, the number of active patients in the MCP was 8,059 New Mexico residents. At the end of 2015, the number of active, purchasing members grew to 41,419 New Mexico residents (https://nmhealth.org/about/mcp/svcs/pdb/). A lot of the growth in MCP members is due to increased efficiency in processing MCP registrations, additional health conditions added to the list of qualifying conditions, and increased supply of cannabis due to the addition of more licensed producers.

In an analysis of ED visits from two large Colorado hospitals from 2008-2011, Kim et. al [17], found that the prevalence of cyclic vomiting ED visits doubled after marijuana liberalization in the state. Of the patients admitted for cyclic vomiting, marijuana use was more likely documented after medical cannabis use legislation went into effect (October 19, 2009). Cyclic vomiting and CHS are very similar syndromes with the main difference being a history of cannabis use among CHS patients [18].

The increase in the number of visits for CHS is concerning as this may just be the tip of the iceberg regarding ED visit numbers. Studies have shown that there is a delay in the onset of vomiting illness in chronic cannabis users. The delay could be 1-2 years before a CHS patient experiences heavy nausea, vomiting, and abdominal pain. Hot showering or bathing can bring temporary relief to CHS patients, but only cessation of cannabis use will cure the patient [18,19]. Those patients that return to chronic cannabis use after a period of cessation have the potential for relapse. Not all chronic users of cannabis will develop CHS [19].

Most likely the national estimate is an underestimate of the number of visits for both cannabis and CHS. Of the 30 states that participate in NEDS, Colorado and Washington are not included. Both states have recreational marijuana laws that went into effect in 2012. Of the 9 jurisdictions that have recreational marijuana laws (Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, Washington, and Washington D.C) only Colorado and Washington had laws that were enacted prior to 2015. Of the 29 jurisdictions that have medical marijuana laws, only 16 are included in the NEDS dataset and had laws enacted prior to 2015. Key states are missing from the NEDS dataset that would be influential in estimating the national prevalence of CHS.

Limitations

There are a few limitations for this study. First, this is a retrospective study of emergency department data. The data was not collected for analyzing CHS prevalence. Second, CHS cases were identified by ICD-9-CM codes alone, and there is not a specific ICD- 9-CM code that identifies CHS. Other studies have used medical records and doctor’s notes to identify CHS patients; access to these data sources was not available for this analysis. Third, other factors, in addition to the legalization of medical marijuana, could play a role in the observed increase in CHS over time. Fourth, a greater awareness of CHS by physicians’ over time could explain some of the observed increase in CHS. Lastly, the collection of emergency department data started in 2010, therefore it is not possible to analyze CHS prior to or directly after legalization of medical cannabis in New Mexico.

Conclusion

Currently cannabis is only available to individuals with a medical need in New Mexico, but Colorado permits New Mexico residents to purchase cannabis in Colorado. Several states are moving to recreational use of cannabis and more states could adopt recreational use legislation. With the increasing availability and potential relaxing of legal restrictions on cannabis, recognition of CHS patients by healthcare staff is paramount to reducing healthcare costs. Diagnosing CHS can be hard as persistent vomiting with no clear cause necessitates multiple expensive and invasive medical procedures. Education of healthcare personnel will assist with identifying and treating CHS patients, which will ultimately lower healthcare costs.

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kayla1993-world · 4 years

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'It's torture': Is a mysterious marijuana-related illness underdiagnosed in Canada?

Regina Denney's 17-year-old son Brian called her in a panic; he couldn't stop throwing up.

It was April 7, 2018, and the Indianapolis teen asked her to take him to the emergency room — but doctors there couldn't figure out what was wrong.

He was critically thirsty and constantly vomiting.

"As we're sitting there talking, another doctor happens to walk by our room and she pokes her head in and she says, 'Do you smoke marijuana?'" Denney said.

"And he said yes. And she said, 'Does it get better with hot showers or hot baths?' And he said yes."

Brian Smith Jr. was told he had a disease, a rare condition called cannabinoid hyperemesis disease (CHS).

When his lab results came back, his mother said the teen's organs were shutting down and his liver wasn't functioning properly.

"It was just crazy," Denney said. "They were able to rehydrate him. And [the results] improved. So they released him the next day, but didn't give us any information about what CHS was, what causes it, what to look for."

He was a heavy marijuana smoker and his mother convinced him to stop, at least until they could see a gastroenterologist 45 days later.

Denney said he still had marks leading up to that appointment and thought if they were related to his marijuana use, he would have been marked free. So he started smoking again.

What they didn't know was CHS can present indications weeks or months after stopping marijuana use.

By October, Denney said her son had lost more than 40 pounds.

"You could see his bones. He looked sick," she said. "It's torture."

On the morning of Oct. 24, 2018, she woke up at 5 a.m. to find her son sitting on the couch in the family's home, grabbing his stomach.

He promised to his mother he was fine and told her to return to bed.

"So I went back to bed, got up later on in the morning, and he had said he was nauseated and then he started vomiting. I held the bucket for him, I got a washcloth, I fixed his pillows, I brought him drinks," she said.

"At one point Brian walked out of the room to go the bathroom and he said 'Mom, I can't do this anymore. I'm going to quit smoking.' and he laid back down and he grabbed his back."

Denney suspected organ damage, so she called 911.

"They said they were on their way. So I came back in and he looked at me and he said, 'Mom, I can't breathe.'" she said. "And I rolled him over and he had quit breathing."

Denney and a neighbour performed CPR until paramedics arrived, and they tried to restore him for 30 minutes.

"I said, 'Please just try a little longer. He's 17, just please try a little longer.' They tried for 45 minutes, there was nothing they could do," she said.

"So at 6:43 a.m. on Oct. 24, I lost my 17-year-old son. I didn't know what caused it."

Little is known about the exact cause of the condition or why it affects some heavy marijuana users and not others.

Health Canada says it's usually found in daily marijuana users who have signs of critical nausea, intestinal pain and episodes of constant vomiting that can last for hours or days and are relieved by hot showers.

Typical anti-nausea medicines like Gravol have little effect, and treatment recommendations include rehydration, stopping marijuana use completely and affective counselling.

Haldol, a mental drug that is used to decrease excitement in the brain, can have a positive effect, as can capsaicin lotion, which is taken from chilli peppers and can copy the hot shower effect.

One hypothesis on the cause of CHS relates to cannabinoid receptors in the brain, which could probably become overloaded due to heavy marijuana use causing them to fail.

"Marijuana does have some effect on nausea and so we know it has an effect on those receptors in the brain," said Dr. Atul Kapur, an Ottawa-based emergency room doctor and co-chair of the Canadian Association of Emergency Doctors' (CAEP) public affairs organization.

"So we think that's where this is transpiring, but the exact way of why it's having this effect I'm not aware of."

Dr. Taylor Lougheed, Ottawa family practitioner who works in sports, emergency and cannabinoid medicine, said there appears to be a link to marijuana strains with high levels of tetrahydrocannabinol (THC) but not cannabidiol (CBD).

"One of the hypotheses is that there could be an addition of THC in the body's fat," he said.

"So it's possible that during periods of stress, or during periods of relative non-eating, individually in the morning when someone's waking up, that they might feel nauseated because as we go through a period of noneating, our body starts to use some fat stores as a form of energy and so that could release the THC chemical."

Another approach is a common bug-killing chemical called neem oil, which could probably be used in the growing of marijuana.

"If you overdose with it, it can cause nausea and vomiting," said Dr. Ian Mitchell, an emergency surgeon and medicine-based helper professor at the University of British Columbia in Vancouver.

"But there's no sign that neem oil poisoning is related to having to take hot showers."

Reports in the Canadian Medical Association Journal and the Boston Globe this week thought whether CHS is underdiagnosed in Canada and the U.S., but a lack of data on the condition prevents a clear picture of how extensive it is.

Of the more determined 5.3 million Canadians who used marijuana this year, six per cent of those surveyed used it daily, according to the latest data from Statistics Canada.

Forty per cent of the 23,410 hospital stays for "harm caused by drug use" in 2017-18 were related to marijuana, according to the Canadian Institute for Health Information (CIHI), but special data for CHS is unavailable.

"It's a regular experience to be treating marijuana hyperemesis in our emergency department," said Dr. Eddy Lang, an ER surgeon and head of emergency medicine in Calgary.

"They come to us because they have continuous, nonstop vomiting going on for hours and hours. And that's very terrifying for patients."

Lang said of the 800 to 1,000 patients seen in Calgary emergency departments per day, it wouldn't surprise him if they were treating upwards of five to 10 cases of CHS.

"So it's small overall, it's under one per cent," he said. "But it's not irrelevant."

Kapur said ERs across the country saw an increase in the condition a few years ago, but it is much weaker than the harms from other drugs.

"People are recognizing this and it's remarkable. And we're glad that the word is getting out there," he said.

"But this is not our main problem, it's the pain-relieving drugs, it's the crystal meth, especially out west."

But for Denney, CHS is a very real threat.

"Yes, it's rare that death does transpire, but it happened and one person losing their life to this is too many," she said.

"And if there's some way that I can get this out there, and it saves another person, then Brian's memory continues to live on."

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