Proposed mechanisms of cannabinoid hyperemesis syndrome—how can cannabinoid pathways both relieve and cause vomiting?

Sharkey, Keith A.

doi:10.1016/b978-0-12-821597-5.00003-4

Cited by 1 publication

(2 citation statements)

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“…Conversely, a questionnaire‐based study from North America and the UK suggests that CHS is uncommon when strict Rome IV criteria are used 14 . The pathophysiology of CHS is likely due to dysregulation of stress responses mediated by the hypothalamic–pituitary–adrenal (HPA) axis, with a possible contribution of genetic polymorphisms 11,15,16 . During acute attacks of CHS, patients often present to the emergency department (ED) for treatment, which can lead to prolonged stays as well as multiple further investigations 17 .…”

Section: Introductionmentioning

confidence: 99%

“…14 The pathophysiology of CHS is likely due to dysregulation of stress responses mediated by the hypothalamicpituitary-adrenal (HPA) axis, with a possible contribution of genetic polymorphisms. 11,15,16 During acute attacks of CHS, patients often present to the emergency department (ED) for treatment, which can lead to prolonged stays as well as multiple further investigations. 17 This, in combination with its relapsing nature, makes CHS a significant health care burden.…”

Section: Introductionmentioning

confidence: 99%

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Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence

Andrews

Rehak

Woo

et al. 2022

Aliment Pharmacol Ther

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Summary Background Cannabinoid hyperemesis syndrome (CHS) is a poorly understood vomiting disorder associated with chronic cannabis use. Aims To characterise patients experiencing CHS in North America and to obtain a population‐based estimate of CHS treatment prevalence in Canada before and during the Covid‐19 pandemic Methods Internet survey of 157 CHS sufferers in Canada and the United States. Administrative health databases for the province of Alberta (population 5 million) were accessed to measure emergency department (ED) visits for vomiting, with a concurrent diagnostic code for cannabis use. Three time periods of 1 year were assessed: prior to recreational cannabis legalisation (2017–2018), after recreational legalisation (2018–2019) and during the first year of the Covid‐19 pandemic (2020–2021). Results Problematic cannabis use (defined as a CUDIT‐R score ≥8) was universal among the survey cohort, and 59% and 68% screening for moderate or worse anxiety or depression, respectively. The overall treatment prevalence of CHS across all ages increased from 15 ED visits per 100,000 population (95% CI, 14–17) prior to legalisation, to 21 (95% CI, 20–23) after legalisation, to 32 (95% CI, 31–35) during the beginning of the Covid‐19 pandemic (p < 0.001). Treatment prevalence among chronic cannabis users was as high as 6 per 1000 in the 16–24 age group. Conclusion Survey data suggest patients with CHS almost universally suffer from a cannabis use disorder, which has significant treatment implications. Treatment prevalence in the ED has increased substantially over a very short time period, with the highest rates seen during the Covid‐19 pandemic.

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Section: Introductionmentioning

confidence: 99%