Rise in syndrome linked to pot use worries doctors
Condition related to heavy, chronic cannabis use causes nausea, vomiting
Growing numbers of patients have been showing up at Ontario emergency departments in recent months with a syndrome related to heavy, chronic cannabis use, the head of the Ontario Medical Association said Tuesday.
Dr. Nadia Alam said she has heard reports of cases of the relatively unknown syndrome while travelling the province to meet with doctors.
She is in Ottawa this week. “I have been hearing more and more about it over the past few months. Physicians have been seeing more of it in emergency departments,” she said.
Cannabinoid hyperemesis syndrome, as it is known, is marked by severe nausea and vomiting, as well as abdominal pain.
It was first reported in 2004, according to the British Columbia Pharmacy Association, and often shows up in users after one to five years of daily or at least weekly use. It comes in waves of severe vomiting. Hot showers provide relief.
Ontario doctors are viewing the legalization of cannabis this week with some concern, Alam said. “They are watching Wednesday approach and wondering what will happen.”
Among the concerns, she said, is that better access will increase use, especially among the young, and that THC — the active chemical ingredient in cannabis that makes people high — is significantly higher than it once was (about three times higher than 40 years ago, according to one study). Young people up to age 25 are at particular risk from cannabis use, according to research, in part because the human brain develops until age 25.
Physicians are also concerned about the connection between heavy cannabis use in the young and mental-health issues, including psychosis, as well as the fallout from impaired driving related to cannabis use.
Alam said the OMA is encouraging the Ontario government to carefully track cannabis use and related health issues.
The province has put effort into public health campaigns around cannabis legalization.
Alam said public health education requires tracking the impact of legalization to better understand it.
“We want the government to spend more time researching, tracking and understanding usage patterns,” she said.
Alam said she hopes there will also be positive outcomes from legalization, including more public information and discussions about the use of cannabis.
She said patients might be more likely to talk to their doctors about their usage, which is crucial.
Alam said as an anesthesiologist it is important she knows when a patient is a regular cannabis user in order to get proper dosages. Among other things, patients might have a higher tolerance for sedatives and might go into withdrawal while anesthetized.
The Canadian Medical Association Journal published a tough editorial this week saying any increase in cannabis use as a result of its legalization “should be viewed as a failure.”
“Fundamentally, the federal government needs to take responsibility for the consequences of this controversial legislation. To that end, it must provide adequate funding for robust monitoring of cannabis use among all segments of society, especially among youth and other populations at particular risk.”
Alam said the OMA takes a “harm reduction” approach to the legalization of cannabis.
“Decriminalization is associated with healthier, safer communities. It brings it out of the shadows so it can be treated like any other substance,” she noted.
Alam said the job of the Ontario Medical Association and physicians “is to educate the public so they make safe decisions.”
I have been hearing more and more about it over the past few months. Physicians have been seeing more of it ...