Cannabis Hyperemesis Syndrome

Treating Cannabinoid Hyperemesis Syndrome with Benzodiazepines

Resolution of cannabinoid hyperemesis syndrome with benzodiazepines- a case series

In summary

A recent series of case studies has revealed the possible benefits of utilizing benzodiazepines to treat cannabinoid hyperemesis syndrome. Cannabis hyperemesis syndrome (CHS) is characterized by nausea, cyclic vomiting, and intense abdominal pain due to chronic cannabis consumption. Although CHS is now gaining recognition for how under-recognized the condition is, many patients suffering from CHS still suffer for long periods of time and have difficulty responding to traditional anti-emetics. Benzodiazepines, a common sleeping medication, were distributed to the four featured patients and appeared to provide rapid relief. Further research should focus on the development of a benzodiazepine-like substance that provides the same antiemetic effects while minimizing side effects. 

Benzodiazepines and benzodiazepine-like medications, such as Ambien (zolpidem tartrate), are known to have unsavory side-effects that can negate its benefits. Ambien specifically has been featured heavily in popular media due to the dangerous activities of patients utilizing Ambien for insomnia as some have caused serious accidents and even attempted murder. Considering the dangerous side-effects of such medications, those who report cannabis use or are screened and found to test positive for cannabis use should be advised to immediately cease all cannabis use and general anti-emetics should be attempted before benzodiazepines.

The study is available for review or download here

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Benjamin Caplan, MDTreating Cannabinoid Hyperemesis Syndrome with Benzodiazepines
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Methods to Improve the Diagnosis of Cannabinoid Hyperemesis Syndrome

Improving the diagnosis of cannabinoid hyperemesis syndrome 

In Summary

A recent op-ed has recommended a method to diagnose cannabinoid hyperemesis syndrome (CHS) accurately and quickly. Although awareness of CHS is quickly growing parallel to the legalization and public approval of cannabis use, patients continue to receive a late diagnosis. Cannabis use should always be questioned in patients who suffer from chronic vomiting and intestinal pain where the origin of the pain is uncertain. A urinalysis panel should also be conducted when CHS is interrogated, even in patients who previously denied cannabis use. Adding these steps into common emergency room practices should improve the accuracy and timing of CHS diagnosis. 

 This article highlights the growing field of synthetic cannabinoids and how that affects the general public. Online shops have increased the ease and availability of synthetic cannabinoids and cannabis seedlings which has led many to cultivate the crops at home. The increase in at home cultivation has led to a higher number of occurrences of CHS which has led to the development of better treatment but now needs to include the development of better diagnostic techniques. Those cultivating at home or increasing their use should be mindful of developing CHS.

Benjamin Caplan, MDMethods to Improve the Diagnosis of Cannabinoid Hyperemesis Syndrome
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Dr Caplan’s response to Surgeon General advisory statement

Last week’s statement by the US Surgeon General

https://www.hhs.gov/surgeongeneral/reports-and-publications/addiction-and-substance-misuse/advisory-on-marijuana-use-and-developing-brain/index.html

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This review is also stored here:    http://bit.ly/34KRgEm     inside the CED Foundation Archive

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Benjamin Caplan, MDDr Caplan’s response to Surgeon General advisory statement
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Standardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome

Title: Cyclic vomiting syndrome- Pathophysiology, comorbidities, and future research directions

A recent article has called for the establishment of a multicenter registry in order to learn more about cyclic vomiting syndrome and related disorders. Creating such a registry would provide a database of patients for clinical trial recruitment, research on patient outcomes across different treatment methods, the underlying mechanism for the disorder, and the ability to identify potential biomarkers for the disorder. The registry would expand our understanding of the disorder, on all fronts, and hopefully, reveal the most effective treatment method. 


Could such a registry be created while still safeguarding patient privacy?


Highlighted in this article is the similarity of cyclic vomiting syndrome and cannabinoid hyperemesis syndrome (CHS). CHS is often misdiagnosed or goes undiagnosed for an exorbitant amount of time. By creating this registry for cyclic vomiting syndrome and related disorders, including CHS, the same information about genetics, underlying mechanisms, and effective treatments could also be determined.

Finding a genetic basis for cannabinoid hyperemesis syndrome would support patients looking into cannabis-based medicine to decide if cannabis would even be an effective treatment, by allowing them to discover possible side effects to which they might be more susceptible.

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This paper is also stored here:     http://bit.ly/2JtDAFm    inside the CED Foundation Archive


See the full available literature on Cannabinoid Hyperemesis Syndrome here: http://bit.ly/2XHfdrI


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Benjamin Caplan, MDStandardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome
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Neem Oil vs Cannabinoid Hyperemesis Syndrome

Some people are concerned that Cannabinoid Hyperemesis Syndrome (CHS,) a rare condition involving cyclical vomiting, may be caused by neem oil or pesticides. However, symptoms are more consistent with an overload of CB1 receptors, circumstances that occur primarily with habitual, large-volume consumers. Here, an interesting review of the ongoing public conversation: http://bit.ly/2LepwAV

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Benjamin Caplan, MDNeem Oil vs Cannabinoid Hyperemesis Syndrome
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Case Studies Expose Under Recognition of Cannabis Hyperemesis Syndrome

“Cannabis hyperemesis syndrome: still under-recognized after all these years

After two years of chronic vomiting and pain and dozens of trips to emergency rooms a 23-year-old woman was found to have cannabis hyperemesis syndrome (CHS). Physicians are still unable to recognize the early symptoms of CHS as cannabis use is still in a legal gray area in much of the country. A lack of research, recognition, and trust often prevents a quick diagnosis when an illness is related to cannabis, leading to multiple referrals and invasive tests.

CHS was first described 15 years ago yet it is not frequently recognized in patients. The case study featured in this blog post highlights patients and physicians’ outcry for tolerance and support so that cannabis-related illnesses can be efficiently and effectively engaged.

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This paper is also stored here:    http://bit.ly/2IxMxNx     inside the CED Foundation Archive

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Benjamin Caplan, MDCase Studies Expose Under Recognition of Cannabis Hyperemesis Syndrome
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Capsaicin Cream Treats Cannabinoid Hyperemesis Syndrome in Adolescents

Capsaicin Cream for Treatment of CHS adolescent

Researchers have found that capsaicin cream is an effective and safe method of treating cannabinoid hyperemesis syndrome (CHS) in adolescents. Capsaicin cream has previously been shown to be effective at treating CHS in adults but adolescents have previously been treated with haloperidol, a drug known to have serious side effects. Capsaicin cream offers a much safer and more cost-effective method of treatment for adolescents.

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This paper is also stored here:   http://bit.ly/2F8Gtcc      inside the CED Foundation Archive

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Benjamin Caplan, MDCapsaicin Cream Treats Cannabinoid Hyperemesis Syndrome in Adolescents
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Cannabinoid Hyperemesis Syndrome is Frequently Misdiagnosed as Cyclic Vomiting Syndrome

Association of Marijuana Use and Cyclic Vomiting Syndrome

A recent study has found that a subset of patients diagnosed with Cyclic Vomiting Syndrome actually suffers from Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is a rare condition that primarily occurs in daily, long-term users of cannabis, more common among males than females. Chronic cannabis consumers should inform their physicians of any illicit drug use, as well as any cannabis consumption, during routine check-ups and/or emergency room visits, to ensure accurate diagnoses can be made.

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2F9YS8u      inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDCannabinoid Hyperemesis Syndrome is Frequently Misdiagnosed as Cyclic Vomiting Syndrome
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