The late music legend — who scored such classic movies as “In the Heat of the Night,” “In Cold Blood” and “The Color Purple” — was honored four months after his death at 91 in November. “It’s rare, but it’s becoming more and more prevalent yearly — like, numbers alcohol rehab are doubling every year,” he shared with us at the Cinema Society screening of “Riff Raff” on Wednesday. “It’s rare, but it’s becoming more and more prevalent yearly — like, numbers are doubling every year,” Krumholtz shared during a Cinema Society screening of Riff Raff on Wednesday, February 26. David Krumholtz claims he “almost died a couple of times” due to a reaction from smoking weed.

Complications Secondary to CHS

• In a study in Spain, a questionnaire was sent out to all patients over 18 years of age who attended a single outpatient marijuana rehabilitation center in 2014; of the 22 respondents, 18.2% reported symptoms suggestive of CHS 71.
• Topical capsaicin has been advocated for use as a diagnostic tool for CHS to differentiate it from other vomiting syndromes 36.
• In the ED, the physician treated him with IV propranolol 1 mg as this had been effective in cases of CVS.
• Drugs with an anticholinergic effect may likewise block medullary mediated vomiting, though they may have minimal impact on visceral stimulation, including the crippling abdominal cramping pain that patients with CHS experience.

In both cases, topical capsaicin provided symptomatic relief in about 30 min. Both patients reported a burning sensation where the capsaicin was applied but were satisfied with the results 97. Oncology patients may be advised to use cannabinoids to relieve chemotherapy-induced nausea and vomiting, only to develop CHS over time. The belief in marijuana as a therapeutic and benign agent is so pervasive among some patients and certain healthcare personnel that they will persist in using cannabinoids, even if they are educated about the role of marijuana as a potential proemetic 1, 13. In some case reports in the literature, a few patients rejected the notion that marijuana might in some way be the cause of their symptoms and refused to give it up even to see if it might relieve their symptoms 1. The literature reports on global clinical experience with CHS to date in the form of case studies, case reports, and case series.

Deterrence and Patient Education

The official cause of death was dehydration due to cannabinoid hyperemesis syndrome. It’s important to be honest about your marijuana use if you have symptoms of CHS. Without knowing this background, providers often misdiagnose CHS as other conditions, like cyclic vomiting syndrome (CVS).

Patient Education

• After 3 days in the hospital (and no marijuana use), his symptoms resolved 94.
• The only known treatment to permanently get rid of CHS is to stop cannabis use completely.
• However, the gastroenterologist agreed with the CHS diagnosis and ordered more blood work.
• To assess the burden of disease, Meltzer and his colleagues conducted a survey of 1,052 people who report suffering from cannabinoid hyperemesis syndrome.
• Other cannabinoids have been implicated in the pathogenesis of CHS, such as CBD and cannabigerol (CBG).

The New York Times estimated last year that 6 million Americans may have CHS symptoms from using marijuana. The syndrome’s rates have risen as more Americans consume higher-potency cannabis with greater frequency. Over recent decades breeding has dramatically increased THC content in the plant itself, while purified THC products are now ubiquitous.

What are the risk factors for cannabinoid hyperemesis syndrome?

If these results are applied to the general population of regular marijuana users in the US, it is possible that 2.75 million Americans (range 2.13–3.38 million) suffer from CHS 72. It is likely many are not even aware that their symptoms relate to their cannabinoid use. Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which a long-term cannabis user suffers an episode of intractable vomiting that may last days separated by longer asymptomatic periods of weeks or months. Cannabinoids are often utilized for their antiemetic properties, so CHS can be a puzzling condition, and chs symptoms and signs the diagnosis of CHS may be disputed by patients.