Cyclic vomiting hospitalizations jumped 46% in Colorado as cannabis use rose with legalization | Research

The takeaway

Cyclic vomiting syndrome hospitalizations in Colorado increased 46% from 2010 to 2014, alongside rising cannabis use after recreational legalization, with CVS patients having 8-10 times higher cannabis use rates than other hospitalized patients.

Emergency physicians, gastroenterologists, health policy researchers, and legislators evaluating cannabis legalization impacts.

46% increase in CVS admissions

What the researchers found

CVS hospitalizations increased 46% from 806 (2010) to 1,180 (2014). Cannabis use prevalence in CVS patients (13-17%) was dramatically higher than in non-CVS hospitalizations (1.7%). Cannabis use increased in both groups following recreational legalization in 2012.

Why it matters

This provides population-level evidence linking cannabis legalization to increased cyclic vomiting hospitalizations, a relationship with significant healthcare cost implications as more states legalize.

The numbers in context

CVS hospitalizations up 46%: 806 (2010) to 1,180 (2014). Cannabis use in CVS: 13% (primary diagnosis) to 17% (all-listed). Non-CVS cannabis use: 1.7%. Cannabis use increased dramatically in both groups after 2012 legalization.

How the study worked

Retrospective analysis of the Colorado State Inpatient Database covering all hospital admissions from 2010-2014. Five-year trends in CVS hospitalizations and cannabis use analyzed. Multivariate logistic regression for predictors of cannabis use in CVS.

What this study cannot tell us

Observational study cannot prove causation between legalization and CVS increases. ICD coding for CVS may have changed over time (increased awareness = more diagnoses). Cannot distinguish cannabinoid hyperemesis from other CVS causes in administrative data.

How to read the evidence

Rated moderate because this uses comprehensive state hospital data over 5 years, though the observational design and potential coding changes limit causal inference.

When this study was published

Published in 2019 covering 2010-2014 data, the earliest years of Colorado recreational legalization.

The bigger picture

As cannabis legalization spreads, the healthcare system impact from cannabinoid hyperemesis and related vomiting syndromes may grow. This Colorado data, from one of the first states to legalize recreationally, provides an early signal of what other states might expect.

Questions still open

How much of the CVS increase reflects true incidence versus better recognition? Will other legalizing states see similar patterns? What proportion of CVS cases are actually cannabinoid hyperemesis?

Common questions

Did legalizing cannabis increase vomiting hospitalizations?

CVS hospitalizations in Colorado increased 46% between 2010 and 2014, concurrent with rising cannabis use after recreational legalization. However, the study cannot prove legalization directly caused the increase.

How common is cannabis use among people hospitalized for vomiting?

Cannabis use was found in 13-17% of CVS patients, compared to only 1.7% of other hospitalized patients, suggesting a strong association.

Read the original research

Recent trends in cyclic vomiting syndrome-associated hospitalisations with liberalisation of cannabis use in the state of Colorado.

Internal medicine journal, 49(5), 649-655

View on PubMed ↗Publisher’s paper ↗

Citation

Bhandari, Sanjay; Jha, Pinky; Lisdahl, Krista M; Hillard, Cecilia J; Venkatesan, Thangam. (2019). Recent trends in cyclic vomiting syndrome-associated hospitalisations with liberalisation of cannabis use in the state of Colorado.. Internal medicine journal, 49(5), 649-655. https://doi.org/10.1111/imj.14164