Why more Canadians are landing in emergency departments with cannabis-induced vomiting
Emergency departments are seeing a spike in visits owing to a once unusual, highly unpleasant and, in rare cases, potentially life-threatening side effect of chronic cannabis use: severe bouts of vomiting lasting hours, even days.
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As pot becomes more potent and more convenient to purchase, emergency doctors are reporting more cases of cannabis hyperemesis syndrome, or CHS, a gastrointestinal condition that can affect people who use cannabis frequently (several times a week, if not daily) over months or years.
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In addition to 'cyclical' vomiting, other signs include morning nausea, intense abdominal pain and 'relief through compulsive hot showers or baths,' Western University researchers recently wrote. It's increasingly affecting teens and young adults, they report. 'Yet few people — including many clinicians — know it exists.'
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Emergency department visits for CHS increased 13-fold in Ontario after the legalization of recreational cannabis in 2018, one study found. While weed's legalization wasn't associated with a sudden or gradual change in cases, pot's commercialization — unlimited number of stores, more products — overlapping with the COVID-19 pandemic, was associated with an immediate bump in rates.
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The potency of THC, or tetrahydrocannabinol, the main psychoactive compound in cannabis, is also off the charts, said Western's Jamie Seabrook, rising from about three per cent in dried cannabis in the 1980s to, according to Health Canada, 15 per cent in 2023. Some strains have as high as 30 per cent THC.
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'When I talk to youth, they can easily access strains that are upwards of 25 per cent. And that's huge,' said Seabrook, a professor in the department of epidemiology and biostatistics, and the department of pediatrics. The human brain continues to develop up to around age 25, he said. THC exposure over this period has been linked with problems with attention, memory and learning, as well as increased risks of paranoia, psychosis and, more recently, schizophrenia.
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Nine of the 10 'displayed an abnormal washing behaviour during episodes of active illness.'
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The Ontario study documented 12,866 emergency department visits by 8,140 individuals between January 2014 and June 2021, or pre- and post-legalization. About 35 per cent were aged 19 to 24. Nearly 10 per cent of visits led to hospital admissions. Monthly rates of CHS emergency visits increased from 0.26 per 100,000 population in January 2014, to 3.43 visits per 100,000 population in 2021.
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