Posted on: April 2, 2019 at 10:41 am
Last updated: June 14, 2020 at 2:22 pm

Recreational marijuana use has been legal in Colorado since 2012, and its sale has been legal since 2014. Since then, more U.S. states have loosened their grip on cannabis use, and Canada has joined Uruguay in legalizing marijuana nationwide.


Not surprisingly, there are still camps that strongly oppose marijuana legalization of any kind, including for medical use. Cannabis-opposers just got some more fuel for their fire in a research study published on March 26, 2019, in the Annals of Internal Medicine.

Colorado Emergency Room Records: What Do They Say about Marijuana?

Dr. Andrew A. Monte and his team of researchers from the University of Colorado School of Medicine studied the hospital records of Colorado emergency room visits within the first four years of marijuana legalization (January 1st, 2012 to December 31st, 2016). Here’s what they found:


There were 9,973 emergency room visits in those four years involving someone hospital staff flagged as under the use of cannabis. Of those 9,973 cases, 2567 were actually related to cannabis use, at least partially (about 1 in 4). The other 75% of emergency room visits involving people under the influence of cannabis weren’t related in any way to the use of marijuana. (1)

Cannabinoid Hyperemesis Syndrome

Most of the emergency room visits caused by inhaled cannabis were for cannabinoid hyperemesis syndrome (about 1 in 5). The condition tends to develop among long-time chronic cannabis users and causes nausea, morning sickness, vomiting, abdominal pain, and (oddly) feeling the need to take long, hot baths or showers. (2)

“To see that this was a leading reason for people coming to the ER, that was pretty striking. We have to do a better job of educating users on the fact that this phenomenon exists,” Dr. Monte said in an interview with Business Insider.

Cannabinoid hyperemesis syndrome was barely a blip on doctors’ radars until a 2004 Australian research study outlined 9 cases of the condition. Lead researcher, Dr. J. H. Allen of Mt Barker Hospital, argues that was once called “psychogenic vomiting” had clear associations with chronic cannabis use. When the clinical team followed 9 people with the condition, they found that the only permanent relief was quitting cannabis use. Participants who restarted their use of marijuana were soon battling their symptoms again within months. (3)


It was this study that accidentally picked up on the odd habit of compulsive bathing. The researchers noted that most participants were almost entirely preoccupied with taking long, hot showers, even waking up in the middle of the night to do so. Upon further inquiry, they realized that the hot temperatures seemed to be the only thing the patients had found to provide temporary relief for their nausea and vomiting. Unfortunately, a couple of the patients had actually scalded their skin in efforts to find relief. (3)

A Caution for Edible Cannabis Products

The second most noteworthy finding from Colorado’s Dr. Monte’s findings has to do with edibles. Most of the emergency room visits caused by edible marijuana products were for acute psychiatric symptoms(about 1 in 5), intoxication (almost half), and cardiovascular symptoms (less than 1 in 10). Dr. Monte and his team noticed that sales of edible cannabis products only represented roughly 0.32% of marijuana sales in Colorado, but led to a disproportionately high rate of hospital visits. (1)

This may be attributed to the fact that ingested cannabis products have a much slower response time compared to inhaled products. First-time users who fail to exercise caution may consume far too much and not feel the effects until a few hours have passed. (4) The Alaska Department of Health and Social Services warns marijuana users to help avoid marijuana intoxication by carefully reading the label of edible products and to be aware that effects can last up to 10 hours and take several hours to begin. They also advise never to drive while under the influence of cannabis. (4)

A Note on Funding: (5)

  • Dr. Monte is a member of the  Colorado Retail Marijuana Public Health Advisory Committee and received funding for this study from Colorado Department of Public Health and Environment research grants.
  • The editorial staff of Annals of Internal Medicine have disclosed that they or their spouses have stock holdings in pharmaceutical and wellness corporations including Proctor & Gamble, Pfizer, Johnson & Johnson, and Eli Lilly.

Get Educated on Marijuana Use

Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.

Maria Sykes
Team Writer
Marie Sykes is an Ontario based writer with a background in research and a love for holistic wellness. She's especially interested in boosting awareness for women's health issues. Once a shunner of gyms, Marie has found an appreciation for weight training and HIIT circuits. She enjoys trying cuisine from all over the world, and she also enjoys not caring two cents what other people think her body should look like.

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