Association between Δ9-tetrahydrocannabinol (cannabis, marijuana) and the cannabinoid hyperemesis syndrome

The use of medical (and recreational) cannabis in moderation, has been purported to ameliorate pain and discomfort from patients suffering from the effects of neoplastic diseases, administration of chemotherapy, neuropathy, inflammation, muscle spasticity and more [1,2]. The inordinate use of cannabis paradoxically, has been etiologically linked to patients presenting with intense gastrointestinal cramps, cyclical diarrhea, nausea, and vomiting clinically referred to as cannabinoid hyperemesis syndrome or CHS [3]. Although once considered rare, CHS has markedly increased over the last number of years. Data obtained from two urban hospital Emergency Departments for example, showed > one third of cannabis users being diagnosed with CHS [4,5]. The abuse of cannabis is not considered life threatening, although two CHS-associated mortalities due to nonspecific electrolyte imbalances have been reported [6].