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Investigating Cannabinoid Hyperemesis Syndrome

Nurses Article   (60,806 Views 25 Comments 804 Words)
by Brenda F. Johnson Brenda F. Johnson (Member) Writer Verified

Brenda F. Johnson has 25 years experience and works as a RN at Gi Lab.

17 Likes; 5 Followers; 70 Articles; 103,431 Visitors; 244 Posts

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Not too long ago, I took care of an 18 year old young man. He was admitted under a diagnosis that I had never seen before, “Cannabinoid Hyperemesis Syndrome”. I was fascinated and wanted to learn more about this syndrome. So we will learn together exactly what defines this syndrome, the causes, and what the treatments are. You are reading page 2 of Investigating Cannabinoid Hyperemesis Syndrome. If you want to start from the beginning Go to First Page.

That Guy has 6 years experience and works as a RN.

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"But im allergic to capsaicin, haldol....etc etc" These patients really bug me some days.

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Brenda F. Johnson has 25 years experience and works as a RN at Gi Lab.

17 Likes; 5 Followers; 70 Articles; 103,431 Visitors; 244 Posts

My brother-in-law suffers from this and refuses to quit smoking. He believes it is made up and that the marijuana is actually helping him. He was tested for autoimmune disorders and it came back that he is sensitive to gluten. However, he tells everyone that he has Celiac disease and that's what causes this.

The showers, let me tell you - that was the giveaway. He showers so much that he runs out of hot water and then goes over to my in-law's house and runs down their hot water heater. He moans and groans and screams out in pain. Two of the local ERs will see him when he's having an episode (obviously) but they won't give him any pain medication or antiemetics. He's a nurse's worst nightmare when he goes there with this.

He's been confronted on the issue and is unwilling to accept it. I remember finding one of the original articles that was written on it about two years ago and that's when I started putting the pieces of the puzzle together. He can't work "normal" jobs because he misses work when he has one of his vomiting spells. It has made things very tense in our family, to say the least.

Wow, thanks for sharing. I know this has to have an extreme effect on the family.

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280 Visitors; 5 Posts

Interesting. I looked after someone who'd 'self diagnosed' as having this syndrome a few years ago in the UK. I initially thought it was a 'Post Kate middleton' made up syndrome until I heard that the patient spent weeks in a bath trying to resolve her symptoms. Great to read international comments

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Brenda F. Johnson has 25 years experience and works as a RN at Gi Lab.

17 Likes; 5 Followers; 70 Articles; 103,431 Visitors; 244 Posts

Interesting topic & article, are your sources for this information available?

The inflorescence ("flowers" or "buds") are the drug-containing portion of the cannabis sativa plant, while the leaves contain significantly less psychoactive chemicals and the seeds have no significant drug content. The chemicals are primarily cannabinoids, i.e. THC, and bind to human CB-1 and CB-2 G-protein coupled receptors, as does endogenous anandamide. These receptors help regulate nausea/appetite, pain, and inflammatory response. There are also many additional compounds in cannabis that are purported to provide a synergistic and/or additive effect to the cannabinoids.

Whether or not plant-based cannabinoid or synthetic cannabinoid mimetics are useful as medications is not yet the issue. The extensive anecdotal evidence as well as the rare clinical evidence warrants further study of these compounds and receptor systems. So many users (patients?) chronically consuming something we (clinically/scientifically) know very little about!

The reference is at the end of the article

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missmollie has 4 years experience as a ADN, BSN and works as a RN.

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Learn something new everyday. I had not heard about this, but this article was informative and interesting. Thanks for writing it!

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114 Likes; 16,502 Visitors; 1,489 Posts

My brother-in-law suffers from this and refuses to quit smoking. He believes it is made up and that the marijuana is actually helping him. He was tested for autoimmune disorders and it came back that he is sensitive to gluten. However, he tells everyone that he has Celiac disease and that's what causes this.

The showers, let me tell you - that was the giveaway. He showers so much that he runs out of hot water and then goes over to my in-law's house and runs down their hot water heater. He moans and groans and screams out in pain. Two of the local ERs will see him when he's having an episode (obviously) but they won't give him any pain medication or antiemetics. He's a nurse's worst nightmare when he goes there with this.

He's been confronted on the issue and is unwilling to accept it. I remember finding one of the original articles that was written on it about two years ago and that's when I started putting the pieces of the puzzle together. He can't work "normal" jobs because he misses work when he has one of his vomiting spells. It has made things very tense in our family, to say the least.

It seems like part of this syndrome is actually denial. It's as though weed is a gift from god that could never harm anybody.

It really must suck. To make things worse, it really is hard to muster a huge amount of sympathy for these folks, even though they are truly miserable.

I am sure plenty of pot smokers end up with hyperemesis and quit smoking, and get better. Of course, as an ER nurse I never meet them.

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I've never heard of this condition but glad to be aware of it. Another to watch out for is marijuana induced vaso-vagal syncope, usually seen in young women but I've also seen it with older men. Alcohol is usually involved.

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DowntheRiver has 5 years experience and works as a Registered Nurse.

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It seems like part of this syndrome is actually denial. It's as though weed is a gift from god that could never harm anybody.

It really must suck. To make things worse, it really is hard to muster a huge amount of sympathy for these folks, even though they are truly miserable.

A HUGE part of it is denial. Definitely some substance abuse and mental health issues there as well that go untreated. It broke up his marriage as well, unfortunately. Just glad there weren't any children involved.

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alucas75 has 1 years experience.

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Hi I have been a nurse for almost 13 years in the OR. I have a son who was diagnosed with this just this week. I would just like to say that I never heard of this before his diagnosis but I KNEW something was wrong related to his abuse of marijuana. I even took him to his primary doctor and told him "I think he has an allergy to marijuana". We were told it was more likely a food allergy or intolerance. His doctor didn't ask him much about his consumption and did not ask about showers. It took an ER visit almost a year after to get a diagnosis and him to to be told its marijuana, and your mom is not crazy. With the push for legalization there is a ton of misinformation that marijuana is harmless so young people tend to use it and use in excess and there are a ton of highly concentrated products out there. So it does not take as long to build up a threshhold level to cause this paradox. I did not approve or condone his use. I don't care if you pass judgement on me as a parent or my kid as an abuser, all I ask is that you spread the word of its existence especially if you work in a primary care setting. Ask patients about showers and bathing in addition to marijuana use. They may lie about the weed but not the bathing.

Edited by alucas75
Needed to add details.

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alucas75 has 1 years experience.

22 Visitors; 4 Posts

Hi I have been a nurse for almost 13 years in the OR. I have a son who was diagnosed with this just this week. I would just like to say that I never heard of this before his diagnosis but I KNEW something was wrong related to his abuse of marijuana. I even took him to his primary doctor and told him "I think he has an allergy to marijuana". We were told it was more likely a food allergy or intolerance. It took an ER visit to get a diagnosis and him to stop using marijuana. I don't care if you pass judgement on me as a parent or my kid as an abuser, all I ask is that you spread the word of its existence especially if you work in a primary care setting. Ask patients about showers and bathing in addition to marijuana use. They may lie about the weed but not the bathing.

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Nipper48 has 35 years experience.

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What would the lab drug screen show and is this used to confirm the diagnosis? I am thinking of the patient unwilling to disclose the extent of their use.....

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