Recreational marijuana was legalized on January 1, 2020, making Illinois the 11th state in the country to do so. Purchasers of marijuana must be 21 years old and can buy marijuana with or without a medical card. At this time, only dispensaries equipped to sell medical marijuana are allowed to sell recreational marijuana. It is legal to smoke marijuana in one’s home, but prohibited in public areas, in the car, near others who are under age 21, and near someone in law enforcement or public service (firefighter, school bus driver, etc.)
There is a plethora of evidence that cannabis can help with a variety of conditions. We have discussed it with many patients who have tried and failed mainstream FDA approved treatments using the Medical Cannabis Patient Program (MCPP) and the Opioid Alternative Pilot Program (OAPP). Some of the conditions cannabis can potentially be used for include neuropathic pain, osteoarthritis, migraine headaches, chronic pain syndromes, inflammatory bowel disease like ulcerative colitis, and cancer-related pain.
Cannabis is used by approximately 147 million people according to the World Health Organization.1 One cannot overdose on marijuana 2 and it is not considered an addictive substance. There are, however, side effects of marijuana that one can experience that can be unpleasant. These side effects include but are not limited to anxiety, paranoia, hallucinations, panic, hypertension, impaired memory, and psychosis.3
Despite individuals using marijuana for its anti-emetic properties, cannabis can cause a unique condition called Cannabinoid Hyperemesis Syndrome, or CHS. It is typically seen in chronic marijuana users, but with many cannabis/marijuana naïve users trying it for the first time, it has been seen with acute use.
There are typically three phases for cannabinoid hyperemesis syndrome:4
- The Prodromal phase, or time between initial symptoms and the full development of vomiting
- Hyperemetic phase, or phase where intense vomiting occurs. It usually stops around 48 hours, and this is the phase where treatment with intravenous fluids and anti-nausea medication can significantly benefit.
- Recovery phase
- Cannabinoid Hyperemesis Syndrome is becoming a much more prevalent condition that is debilitating for patients and difficult to diagnose and treat for healthcare providers.5
A comprehensive review of Cannabinoid Hyperemesis Syndrome was done in Colorado in 20176. The major characteristics of this condition were the following:
- History of cannabis for any duration of time
- Cyclical nausea and vomiting
- Resolution of symptoms after stopping cannabis use
- Bathing in hot water for symptomatic relief
- Male > Female prevalence
- Abdominal pain
A case series review was done at Albert Einstein College of Medicine in 2012. The authors concluded that Cannabinoid Hyperemesis Syndrome should be strongly considered in the differential diagnosis of patients with intractable vomiting and or compulsive hot water bathing.7 There is even a case report of CHS during pregnancy, and its similarity to Hyperemesis Gravidarum (a cyclical vomiting syndrome during pregnancy, especially during the first trimester of the first pregnancy.)