Hospitalizations for intractable vomiting with cannabis use disorder rose significantly over five years, with 41% of patients also having tobacco dependence and rising rates of anxiety.
Emergency physicians, gastroenterologists, cannabis users, and health economists.
9,601 hospitalizations in 5 years
What the researchers found
Hospitalizations for intractable vomiting with CUD showed a significant increasing trend from 2010-2014 (N=9,601 total). Anxiety disorders increased from 20.8% to 30.8% as a comorbidity, while depression decreased from 19.2% to 16.4%. Concomitant tobacco abuse/dependence was present in 41.2% of patients.
Why it matters
As cannabis use increases, so do its paradoxical gastrointestinal side effects. The rising hospitalization trend predated widespread legalization, suggesting the problem may have worsened further since this data was collected.
The numbers in context
9,601 hospitalizations total (2010-2014); significant increasing trend; anxiety comorbidity rose from 20.8% to 30.8%; depression fell from 19.2% to 16.4%; tobacco co-use 41.2%.
How the study worked
Retrospective cohort study using the Nationwide Inpatient Sample (2010-2014), identifying patients aged 16-50 with primary diagnosis of intractable vomiting and cannabis use disorder.
What this study cannot tell us
Administrative database study relying on discharge codes. CHS may be underdiagnosed and coded inconsistently. Cannot determine cannabis potency, frequency, or product type from billing data.
How to read the evidence
Moderate: large national database but reliant on administrative coding.
When this study was published
Published in 2019.
The bigger picture
CHS hospitalizations represent a growing and underappreciated cost of cannabis use. The association with increasing anxiety comorbidity suggests that mental health factors may influence who develops this syndrome.
Questions still open
- Has the trend accelerated post-legalization? Does higher-potency cannabis correlate with higher CHS rates? Why is anxiety increasing while depression is decreasing as a comorbidity?
Common questions
Are CHS hospitalizations increasing?
What other conditions do CHS patients have?
Read the original research
Burden of Comorbidities in Hospitalizations for Cannabis Use-associated Intractable Vomiting during Post-legalization Period.
Cureus, 11(8), e5502
Citation
Madireddy, Sowmya; Patel, Rikinkumar S; Ravat, Virendrasinh; Ajibawo, Temitope; Lal, Anthony; Patel, Jenil; Patel, Riddhi; Goyal, Hemant. (2019). Burden of Comorbidities in Hospitalizations for Cannabis Use-associated Intractable Vomiting during Post-legalization Period.. Cureus, 11(8), e5502. https://doi.org/10.7759/cureus.5502
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