Cannabinoid Hyperemesis

Pergolizzi Jr., Joseph V.; LeQuang, Jo Ann; Bisney, John F.

doi:10.1159/000494992

Cited by 19 publications

(22 citation statements)

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“…Cyclic vomiting and nausea associated with cannabinoid use has been linked to EVALI (Spoons et al 2021) and raises important questions about the intersection of Cannabinoid Hyperemesis and other vaping related illnesses. While the pathophysiology of Cannabinoid Hyperemesis is yet to be determined and there have been no cases explicitly associated with acetate products, there has been an association with heavy THC use, typical of dabbing (Pergolizzi Jr. et al 2018), and it remains to be seen whether Ketene is implicated as a toxin that potentially contributes to this ailment (DeVuono & Parker 2020) Discussion: From our analysis of social media images, we believe that green chemists have played an important role in influencing the evolution of semi-synthetic cannabinoids. The way language about these substances, product form factors, and packaging has developed since the passage of the 2018 Farm Bill reflects the scope and nature of this influence as it extends to the THC-O-Acetate.…”

Section: Discussionmentioning

confidence: 99%

New Kinds of [Hash]tags

et al. 2022

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The rise of distinct subcultures of cannabinoid users and the proliferation of new psychoactive substances derived from the hemp plant reflects a dynamic relationship between the development of new cannabis products and the growth of the markets for these goods. This research combines social science and analytical chemistry framework to explore the historical, linguistic, and chemical developments of cannabis acetates and related products over time Understanding the multiplicity of contexts that have influenced the trajectory of moieties like THC-O-Acetate is an attempt at detecting and identifying other new psychoactive substances with structural or functional similarities to Δ⁹-THC through an interdisciplinary lens. The article concludes with a discussion on the potential implications of this kind of multidisciplinary research on new psychoactive substance research and regulation.

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Section: Discussionmentioning

confidence: 99%

New Kinds of [Hash]tags

et al. 2022

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“…In addition to potential risks to vulnerable populations, there remains significant concern over the potential for some cannabis products to cause hyperemesis. Although research has shown that feelings of nausea are among the least common side effects of using whole natural Cannabis flower,41 case studies and surveys have documented cannabinoid hyperemesis syndrome (CHS), a putative new, yet poorly understood gastrointestinal disorder 30,31. Extrapolations from survey data suggest CHS could potentially affect as many as 2.75 million Americans 30.…”

Section: Discussionmentioning

confidence: 99%

“…No epidemiologic studies have been conducted to evaluate whether azadirachtin is safe to inhale. Azadirachtin toxicity and CHS may exhibit similar symptomology, such as the association with vomiting, cardiac conditions, and renal complications 30,46,47. Interestingly, it has been reported that 2 long-term cannabis users diagnosed with CHS had their symptoms resolve after substituting their brands of cannabis products 43.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Common Cannabis Products for Treatment of Nausea

Stith

Orozco³

et al. 2021

Journal of Clinical Gastroenterology

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Goals: We measure for the first time how a wide range of cannabis products affect nausea intensity in actual time. Background: Even though the Cannabis plant has been used to treat nausea for millennia, few studies have measured real-time effects of common and commercially available cannabis-based products. Study: Using the Releaf App, 886 people completed 2220 cannabis self-administration sessions intended to treat nausea between June 6, 2016 and July 8, 2019. They recorded the characteristics of self-administered cannabis products and baseline symptom intensity levels before tracking real-time changes in the intensity of their nausea. Results: By 1 hour postconsumption, 96.4% of people had experienced symptom relief with an average symptom intensity reduction of −3.85 points on a 0 to 10 visual analog scale (SD=2.45, d=1.85, P<0.001). Symptom relief was statistically significant at 5 minutes and increased with time. Among product characteristics, flower and concentrates yielded the strongest, yet similar results; products labeled as Cannabis indica underperformed those labeled as Cannabis sativa or hybrid; and joints were associated with greater symptom relief than pipes or vaporizers. In sessions using flower, higher tetrahydrocannbinol and lower cannabidiol were generally associated with greater symptom relief (eg, within 5 min). Conclusions: The findings suggest that the vast majority of patients self-selecting into cannabis use for treatment of nausea likely experience relief within a relative short duration of time, but the level of antiemetic effect varies with the characteristics of the cannabis products consumed in vivo. Future research should focus on longer term symptom relief, including nausea-free intervals and dosing frequency; the risks of consumption of medical cannabis, especially among high-risk populations, such as pregnant women and children; and potential interactions between cannabis, conventional antiemetics, other medications, food, tobacco, alcohol, and street drugs among specific patient populations.

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“…Former use was defined as lifetime cannabis use but not in the 30 days prior to attending MEC, whereas use at least once in the past 30 days defined recent use. Frequency of recent use was determined by creating tertiles for the number of days of cannabis use and categorised into infrequent (1-2), occasional (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and frequent use (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Recent GIT illness was defined as having a stomach or intestinal illness with vomiting or diarrhoea that started in the 30 days prior to attending the MEC.…”

Section: Methodsmentioning

confidence: 99%

“…Despite its antiemetic properties, the clinical literature now includes several reports of cannabinoid hyperemesis syndrome (CHS), a condition characterised by intractable NV in heavy cannabis users that resolves with abstinence [8]. Although the exact mechanism is unknown, CB1 receptor downregulation, altered thermoregulation and gastric motility changes have been suggested as potential pathways via which cannabis use induces CHS [9].…”

Section: Introductionmentioning

confidence: 99%

Cannabis use and gastrointestinal tract illnesses: The National Health and Nutrition Examination Surveys, 2005–2018

Vanderziel

Alshaarawy

2023

Drug and Alcohol Review

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Introduction The antiemetic properties of cannabis have motivated its use in the management of chemotherapy‐induced nausea and vomiting. Conversely, case reports of intractable vomiting among heavy cannabis users have increasingly appeared in the literature. Studies on cannabis and gastrointestinal tract (GIT) health are scare. Here, we use data for the National Health and Nutrition Examination Surveys (NHANES, 2005–2018) to estimate the association between cannabis use and GIT illness. Methods The study sample included non‐pregnant adult NHANES participants (20–59 years) without history of cancer or HIV (n = 18,753). Cannabis use was categorised into never, former (0 day in the past 30 days), infrequent (1–2 days), occasional (3–19 days) and frequent (20–30 days) use. Recent GIT illness was defined as experiencing GIT illness with vomiting or diarrhoea that started in the 30 days prior to NHANES. Logistic regression was used to regress GIT illness on cannabis use, adjusting for potential confounders. Results Compared to never use, frequent cannabis use was associated with higher odds of GIT illness (OR = 1.4; 95% confidence interval 1.04, 1.9). There were no associations between former, infrequent or occasional cannabis use and GIT illness. Discussion and Conclusions Frequent cannabis use is associated with GIT illnesses in a large cross‐sectional study of US residents. It is possible that frequent cannabis use adversely affects GIT health, consistent with clinical case reports. Alternatively, patients with GIT illness might self‐medicate with cannabis given its antiemetic properties. Prospective studies are needed to understand the effects of cannabis use on GIT health.

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Cannabinoid Hyperemesis

Cited by 19 publications

References 154 publications

New Kinds of [Hash]tags

New Kinds of [Hash]tags

The Effectiveness of Common Cannabis Products for Treatment of Nausea

Cannabis use and gastrointestinal tract illnesses: The National Health and Nutrition Examination Surveys, 2005–2018

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