Mysterious illness tied to marijuana use on the rise

Daily News Article   —   Posted on March 2, 2017

(by Jonathan LaPook, CBS News) December 28, 2016 – For more than two years, Lance Crowder was having severe abdominal pain and vomiting, and no local doctor could figure out why. Finally, an emergency room physician in Indianapolis had an idea.

“The first question he asked was if I was taking hot showers to find relief. When he asked me that question, I basically fell into tears because I knew he had an answer,” Crowder said.

The answer was cannabinoid hyperemesis syndrome, or CHS. It’s caused by heavy, long-term use of various forms of marijuana. For unclear reasons, the nausea and vomiting are relieved by hot showers or baths.

“They’ll often present to the emergency department three, four, five different times before we can sort this out,” said Dr. Kennon Heard, an emergency room physician at the University of Colorado Hospital in Aurora, Colorado.

He co-authored a study showing that since 2009, when medical marijuana became widely available, emergency room visits diagnoses for CHS in two Colorado hospitals nearly doubled. In 2012, the state legalized recreational marijuana.

“It is certainly something that, before legalization, we almost never saw,” Heard said. “Now we are seeing it quite frequently.”

Outside of Colorado, when patients do end up in an emergency room, the diagnosis is often missed. Partly because doctors don’t know about CHS, and partly because patients don’t want to admit to using a substance that’s illegal.

CHS can lead to dehydration and kidney failure, but usually resolves within days of stopping drug use. That’s what happened with Crowder, who has been off all forms of marijuana for seven months.

“Now all kinds of ambition has come back. I desire so much more in life and, at 37 years old, it’s a little late to do it, but better now than never,”he said.

CHS has only been recognized for about the past decade, and nobody knows exactly how many people suffer from it. But as more states move towards the legalization of marijuana, emergency room physicians like Dr. Heard are eager to make sure both doctors and patients have CHS on their radar.

First published at CBS on Dec. 28, 2016. (KRON San Francisco published a follow up article on Feb. 21, 2017.) Reprinted here for educational purposes only. May not be reproduced on other websites without permission from CBSNews. Visit the website at cbsnews .com.

Background

Cannabinoid hyperemesis syndrome (CHS): 

• Cannabinoid hyperemesis syndrome is characterized by recurrent nausea, vomiting and crampy abdominal pain.
• These symptoms have been reported to be improved temporarily by taking a hot shower or bath or:
  More fully by stopping the use of cannabis.
• The syndrome was described by Allen and colleagues (2004), and Sontineni and colleagues (2009) who offer simplified clinical diagnostic criteria.
• A subsequent, larger study reported a case series of 98 subjects with cannabinoid hyperemesis syndrome, confirming the earlier reported findings.
• The long-term and short-term effects of cannabis use are associated with behavioural effects leading to a wide variety of effects on the body systems and physiologic states.
• Acute episodes of cannabinoid hyperemesis typically last for 24–48 hours and the problem often resolves with long term stopping of cannabis use. Improvement can take one to three months to occur.
• Relapses are common, and this is thought to be possibly secondary to a lack of education as many people use or increase their use of cannabis due to their symptoms of nausea and vomiting. (from wikipedia)