Wednesday, March 22, 2023

Student presentation exploring "Cannabinoid Hyperemesis Syndrome"

CHS-1024x459As regular readers know, students in my Marijuana Law, Policy & Reform seminar are now in the midst of "taking over" my class through presentations on the research topics of their choice.  Before their presentations, students are expected to provide in this space some background on their topic and links to some readings or relevant materials.  The first of our presentations for next week will be looking at "Cannabinoid Hyperemesis Syndrome".  Here is how my student has described his topic along with background readings he has provided for his classmates (and the rest of us):

As more American states end cannabis prohibition, regulators and lawmakers are faced with the difficult task of implementing rules to govern the growth, sale, and use of a plant that we still seem to know very little about.  Empirically and anecdotally, moderate cannabis use looks to be less harmful than use of other legal regulated substances like alcohol and tobacco.  As with nearly all substances, however, excessive chronic use of cannabis can have negative health effects.  One such side effect is Cannabinoid Hyperemesis Syndrome (CHS), a relatively rare syndrome which was first reported in Australia in 2004 and is characterized by cyclical vomiting and nausea paired with compulsive hot bathing in heavy cannabis users.  Despite being first described nearly two decades ago, many questions remain as to the actual prevalence and exact causes of the syndrome. 

This paper will discuss current data surrounding CHS and the implications this condition has for the ever-growing post-prohibition world of cannabis.  More studies are certainly necessary to determine how to prevent and treat CHS so that we can form a responsible and common-sense cannabis policy.  There is a significant possibility that current data and studies about CHS will be used to argue for continued prohibition in states that have not yet legalized the plant.  However, based on what we currently know about the syndrome, the existence of CHS is not a reason to continue prohibition.  While extremely heavy high-THC cannabis users should be concerned with developing the adverse symptoms of CHS, moderate and infrequent users do not generally develop the condition.  Furthermore, CHS is relatively rare and, if diagnosed early, has a simple cure — upon ceasing cannabis use, symptoms recede quickly and do not return until the afflicted user re-ingests cannabinoids. 

After a review of the data, the discussion will turn to possible responses to CHS rates such as THC limits, education of cannabis users, and proactive moves the cannabis industry can make to lessen the likelihood that CHS is used as a scare tactic to continue prohibition. Rather than perpetuate a misguided prohibition scheme that unfairly punishes users of cannabis, a substance empirically less harmful than legal substances such as alcohol or tobacco, we should continue to study CHS, determine with relative certainty what causes it, and educate the public on harm-reduction methods that will prevent CHS.  

Background reading

From Leafy, "Is "scromiting" from smoking weed a thing?"

From Forbes, "Science Reveals The Cannabis Industry’s Greatest Lie: You’re Buying Weed Wrong (And So Is Everyone Else)"

From JAMA Open Network, "Changes in Emergency Department Visits for Cannabis Hyperemesis Syndrome Following Recreational Cannabis Legalization and Subsequent Commercialization in Ontario, Canada"

Assembled readings on specific topics, Medical community perspectives, Recreational Marijuana Commentary and Debate | Permalink


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