Common marijuana-related cases encountered in the emergency department

Heard, Kennon; Marlin, Michael; Nappe, Thomas M.; Hoyte, Christopher

doi:10.2146/ajhp160715

Cited by 16 publications

(12 citation statements)

References 28 publications

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“…Our review of the literature identified a total of 25 case series (n = 271) and 105 individual case reports of patients identified with CHS (Table ) . Most of the reported case series and case studies predated the publication of Rome IV criteria for CHS.…”

Section: Resultsmentioning

confidence: 99%

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Venkatesan

Levinthal

et al. 2019

Neurogastroenterology Motil

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Cannabis is commonly used in cyclic vomiting syndrome (CVS) due to its antiemetic and anxiolytic properties. Paradoxically, chronic cannabis use in the context of cyclic vomiting has led to the recognition of a putative new disorder called cannabinoid hyperemesis syndrome (CHS). Since its first description in 2004, numerous case series and case reports have emerged describing this phenomenon. Although not pathognomonic, a patient behavior called “compulsive hot water bathing” has been associated with CHS. There is considerable controversy about how CHS is defined. Most of the data remain heterogenous with limited follow‐up, making it difficult to ascertain whether chronic cannabis use is causal, merely a clinical association with CVS, or unmasks or triggers symptoms in patients inherently predisposed to develop CVS. This article will discuss the role of cannabis in the regulation of nausea and vomiting, specifically focusing on both CVS and CHS, in order to address controversies in this context. To this objective, we have collated and analyzed published case series and case reports on CHS in order to determine the number of reported cases that meet current Rome IV criteria for CHS. We have also identified limitations in the existing diagnostic framework and propose revised criteria to diagnose CHS. Future research in this area should improve our understanding of the role of cannabis use in cyclic vomiting and help us better understand and manage this disorder.

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Section: Resultsmentioning

confidence: 99%

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Venkatesan

Levinthal

et al. 2019

Neurogastroenterology Motil

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“…A Survey on Cannabis in Homes with Children to preventable emergency department (ED) visits, invasive workups, and hospital admissions. 3,4 Despite the institution of safe storage guidelines in Colorado, a recent study found continuing suboptimal storage practices in that state. 5 This trend was mirrored in the use of medical marijuana, as oncology patients and their caregivers reported suboptimal storage practices and had received little storage education from healthcare providers.…”

Section: Gimelli Et Almentioning

confidence: 99%

Cannabis in Homes with Children: A Survey on Use, Storage, and Attitudes

Gimelli

Deshpande

Magaña

et al. 2021

WestJEM

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Introduction: The recent legalization of cannabis in California has the potential to affect cannabis prevalence in households with children. This eventuality, combined with suboptimal cannabis storage practices, could lead to adverse effects such as unintentional pediatric ingestion, which occurred in Colorado after legalization. Our objective was to assess prevalence and storage practices of cannabis in households with children, and attitudes on use and storage education in a state that has legalized cannabis. Methods: We administered electronic surveys to 401 adults in a pediatric emergency department in California. Participants were excluded if they were not English- or Spanish-speaking or did not live in a household with children <18 years old. They answered questions regarding cannabis use, storage, and attitudes on cannabis storage education. We used convenience sampling and analyzed data using descriptive statistics. Results: Research assistants approached 558 participants of whom 401 completed the survey. Three participants did not respond regarding past or current cannabis use, and 14.5% (58/401) reported cannabis use in their home in the prior six months. Both users and non-users rated safe storage of high importance in homes with children. Only 44.8% of home users (26/58) reported that their cannabis was both locked and hidden. Among home users, the most common source of storage advice was friends and family (21/58, 36.2%), and 45% of home users (26/58) received no storage information whatsoever. Most cannabis users (53/67, 79.1%) and non-users (241/330, 73%) reported that they would feel comfortable receiving cannabis education from their primary care provider. Conclusion: Cannabis is used and stored in homes with children; however, safe storage is not clearly defined in California, and storage education is lacking. Healthcare providers in primary care and the emergency department may play an important role in educating the public about cannabis use and safe storage.

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“…In Colorado, hospital visits after marijuana exposure use have significantly increased since legalization of recreational marijuana [15]. This increase includes a rise in pediatric ingestions, acute intoxications, hyperemesis, and withdrawal [16].…”

Section: Negative Effects Of Marijuana Usementioning

confidence: 99%

Cannabis conundrum

Berliner

Collins

Coker

2018

Spinal Cord Ser Cases

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As there is a high prevalence of cannabis use in the population of people with spinal cord injury (SCI), it is important for clinicians to understand the positive and negative consequences of cannabis use in order to have educated and constructive discussions with their patients. The recent National Academies of Sciences, Engineering, and Medicine (NASEM) report provided an excellent summary of current cannabis research and touted clinical efficacy for cannabis for neuropathic pain and spasticity, two common secondary conditions after SCI. However, it is important to consider the limitations of the studies examined and the shortcomings of the meta-analysis methodology. We will discuss the fallacies in evidence supporting cannabis use by identifying limitations of current cannabis research that lead to limited generalizeability of the results, including short duration of the studies, small sample sizes, lack of statistical significance, inability to conduct blinded trials, non-standardization of delivery systems and lack of defined dosing, and small clinical benefits. The number of negative side effects associated with cannabis use, including risk of injury, overdose injuries, impairment of cognition, and increased risk of depression and suicide, are a strong argument for more rigorous studies of the efficacy of cannabis, especially in an already vulnerable population.

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Common marijuana-related cases encountered in the emergency department

Cited by 16 publications

References 28 publications

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Cannabis in Homes with Children: A Survey on Use, Storage, and Attitudes

Cannabis conundrum

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