Physicians’ ability to guide their patients on the use of medical cannabis can vary widely and is often shaped by their training, experiences, and the regulations and policies of their state. The goal of this qualitative study is to understand how prepared physicians are to certify and advise their patients to use medical cannabis. A secondary goal is to explore how physicians integrate certification into their clinical practices, and what factors shape their decisions and behaviors around certification.Using semi-structured interviews with 24 physicians authorized to certify patients to use medical cannabis in Pennsylvania, a state with a medical access only program, we explored how physi- cians are trained and set up their practices. Interviews were analyzed using a blend of directed and conventional, and summative content analysis.
Cannabis use is becoming more common globally, making it important for physicians to be aware of cannabinoid hyperemesis syndrome (CHS). CHS presents in chronic cannabis users, typically under the age of 50, and entails a severe cyclic nausea and vomiting pattern with abdominal pain but normal bowel habits. Symptoms typically predominate in the morning, are relieved by hot baths or showers, and resolve with discontinuation of cannabis use. This report details a case of a 32-year-old woman who presented to the emergency department at a large Canadian hospital with severe nausea, vomiting and a history of regular use of marijuana cigarettes. In an attempt to alleviate her symptoms she reported taking frequent hot baths and using as many as five marijuana cigarettes per day. The patient’s clinical presentation, chronic daily use of marijuana and relief of symptoms with hot baths led to the diagnosis of CHS. The antiemetic properties of cannabis are widely known in the community, meaning patients may not associate marijuana use with their symptoms. Additionally, cyclic vomiting syndrome is present in many different conditions, making physician awareness of this syndrome crucial. Recognition and diagnosis of this condition can prevent unnecessary, costly diagnostic tests, and provide an opportunity to initiate counselling on cessation.
Authors: Marieka V. DeVuono, Linda A. Parker Published in Mary Ann Liebert, Inc Publishers June 2020 Abstract Introduction Cannabinoids have long been known for their ability to treat nausea and vomiting….
Psychiatria Danubina, September 2019
BACKGROUND: Cannabinoid Hyperemesis Syndrome (CHS) is characterized by cyclic vomiting and compulsive need to take hot showers in the context of chronic cannabis use. Physicians’ lack of knowledge of CHS often results in a diagnostic delay of several years. The purpose of this…
Neurogastroenterology and Motility, June 2019
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…
Journal of the American Academy of Physician Assistants, April 2019
Cannabis has long been used for medical and recreational purposes because of its antiemetic, analgesic, and mood effects. Ironically, chronic use of cannabis can result in paradoxical effects, including a condition known as cannabinoid hyperemesis syndrome. Patients with this …
Current Drug Abuse Reviews, December 2011
Coinciding with the increasing rates of cannabis abuse has been the recognition of a new clinical condition known as Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting, and frequen…
The Journal of Emergency Medicine, April 2011
BACKGROUND: Cannabinoid use is prevalent in the United States, with recent reports of increased usage among younger Americans. Traditionally, cannabinoids have been used recreationally or as antiemetics; however, recent reports suggest that chronic abuse can result in the para…
World Journal of Gastroenterology, 14 March 2009
Cannabis is a common drug of abuse that is associated with various long-term and short-term adverse effects. The nature of its association with vomiting after chronic abuse is obscure and is underrecognised by clinicians. In some patients this vomiting can take on a pattern si…
Gut, November 2004
BACKGROUND AND AIMS: To explore the association between chronic cannabis abuse and a cyclical vomiting illness that presented in a series of cases in South Australia. METHODS: Nineteen patients were identified with chronic cannabis abuse and a cyclical vomiting illness. For le…