Cannabis hyperemesis syndrome is characterized by three typical features: chronic cannabis use, severe cyclical nausea and emesis, and frequent hot bathing. Although the hot bathing feature is common, it is a learn self-palliative behavior and may not be present in all instances. This syndrome was first report in the literature in 2004.
A large gap exists between the growing interest in cannabis base medicine for palliative care and the dearth of literature to guide clinicians in appropriate use of this medication to alleviate symptoms, as well as presentation of adverse effects relate to cannabis use in patients with advance disease or disability.
The Medical marijuana
The medical use of cannabis is growing. Medical marijuana may improve symptoms including pain and anorexia. While it may improve nausea and vomiting, it can rarely cause a hyperemesis syndrome with chronic use. Because this is a rare syndrome, case reports are important.
A new case study has surprisingly shown that stopping cannabis use may not be necessary to alleviate cannabis hyperemesis syndrome. The case study and a review of the current literature on cannabis hyperemesis syndrome are publish in Journal of Palliative Medicine, a peer review journal from Mary Ann Liebert, Inc., publishers.
Ileana Howard, MD, University of Washington and VA Puget Sound, Seattle, WA, presents the unique example of a patient with amyotrophic lateral sclerosis (ALS) receiving palliative care who was able to overcome the effects of nausea and vomiting link to chronic cannabis use by markedly decreasing, but not discontinuing the use of cannabis.
Concentrate cannabis extracts
In the article entitled “Cannabis Hyperemesis Syndrome in Palliative Care: A Case Study and Narrative Review,” Dr. Howard report that the patient stop using inhale concentrate cannabis extracts; but continue to use oral whole plant base edible cannabis; which eliminate the cannabis hyperemesis syndrome; so while sustaining the beneficial effects on other symptoms.
This paper and the comprehensive literature review illustrate the challenges in diagnosis, assessment; also management of these patients by clinicians. Charles F. von Gunten, MD, PhD, Editor-in-Chief of Journal of Palliative Medicine and Vice President, Medical Affairs, Hospice and Palliative Medicine for the OhioHealth system, states: This case study adds to our clinical ability to respond to rare adverse effects of medical cannabis use.
Given the meteoric rise in the medical use of marijuana across the U.S. and around the world; so it is essential to disseminate these clinical observations. This case highlights both the importance of monitoring quantity; so of medical cannabis use by palliative care patients for symptom management; hence as well as remaining vigilant for adverse reactions relate to the use of cannabis; so in this population, so that they may be rapidly addressed and rectified.