19-year-old, Julia Unger, of Denver, Colorado never thought that her efforts to promote her mental health would leave her even sicker than before. Since high school, she had been self-medicating with cannabis in an effort to relieve anxiety and depression. Unger had gotten into the habit of smoking as often as 5 times every day in an effort to manage her mood. But in 2018, she began to develop severe nausea, stomach pains, and vomiting, which seemed to only get worse.
“Almost every morning I’d wake up with the pain. It was hard for me because I wasn’t knowing what was going on with me and I was very confused about why my body was doing this.” Unger told KHOU news. “I would be throwing up for hours on end.”
Unger visited the emergency room frequently, but it was months before a physician referred her to a digestive system specialist.
“They initially sent me to a gastroenterologist. They told me that they see a lot of this with people who smoke marijuana,” Unger said. Her specialist thought she had cannabinoid hyperemesis syndrome.
“I’m like, that’s ridiculous. This could never happen to me. I just kept smoking. I totally ignored the fact that she told me that’s what was wrong with me.”
Finally, the young woman did some digging on her own to find out more about the diagnosis that she had dismissed as ridiculous. She looked into cannabinoid hyperemesis syndrome online and realized that her specialist had been right. Every symptom described her own experience.
“It just hit me and I was like, ‘Okay. I’m stopping today.’ Ever since August 28th, I haven’t touched anything and I’ve been feeling amazing,” she said.
Unger’s specialist was certainly on to something, and their timely insight might have come from a certain research study on the subject, which was published only a month prior to Unger’s initial diagnosis 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 patients flagged as under the influence of cannabis.
Of those 9,973 cases, 2,567 hospital visits 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 what 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. Participants who restarted their use of marijuana were soon battling their symptoms again within months. (3)w where it in your inbox
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 research 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.
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