Case Report: Cannabinoid Hyperemesis Treated with Lorazepam and Hot Showers
A 32-year-old man with 19 years of daily cannabis use presented with five days of severe nausea, vomiting, and abdominal pain that improved with benzodiazepines and hot showers.
Quick Facts
What This Study Found
A 32-year-old man with no significant medical history arrived at the emergency department with five days of nausea, vomiting, and diffuse abdominal pain. He reported that hot showers alleviated his symptoms.
His vital signs and lab work were normal except for a positive urine THC screen. He was diagnosed with cannabinoid hyperemesis syndrome based on his 19-year history of daily cannabis use and the classic symptom pattern.
Treatment with lorazepam and access to hot showers improved his nausea, and he was discharged the next day in stable condition.
Key Numbers
32-year-old male; 19 years of daily cannabis use; 5 days of symptoms; normal CBC and CMP; positive THC screen; discharged next day
How They Did This
Single case report describing clinical presentation, workup, and management of one patient with cannabinoid hyperemesis syndrome.
Why This Research Matters
This case adds to the growing body of reports documenting cannabinoid hyperemesis syndrome and highlights the importance of taking a thorough substance use history in patients with unexplained cyclic vomiting, potentially avoiding expensive and unnecessary diagnostic workups.
The Bigger Picture
As cannabis use becomes more widespread and potency increases, clinicians are likely to encounter more cases of cannabinoid hyperemesis. Recognition of the hot shower relief pattern and association with chronic cannabis use can expedite diagnosis.
What This Study Doesn't Tell Us
Single case report provides the lowest level of clinical evidence. No follow-up data on whether the patient ceased cannabis use or had recurrent episodes.
Questions This Raises
- ?Why do some daily cannabis users develop hyperemesis while others do not?
- ?What is the mechanism by which lorazepam helps?
- ?Would the symptoms have resolved without treatment if cannabis use stopped?
Trust & Context
- Key Stat:
- 19 years of daily cannabis use before symptom onset
- Evidence Grade:
- Single case report. Illustrates a clinical entity but cannot establish prevalence, risk factors, or optimal treatment.
- Study Age:
- Published in 2015. Cannabinoid hyperemesis syndrome is now much more widely recognized in emergency medicine.
- Original Title:
- Cannabis hyperemesis syndrome: A case report review of treatment.
- Published In:
- Toxicology reports, 2, 889-890 (2015)
- Database ID:
- RTHC-01006
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
What is cannabinoid hyperemesis syndrome?
It is a condition where chronic, heavy cannabis use paradoxically causes severe episodes of nausea, vomiting, and abdominal pain. A hallmark feature is that hot showers or baths temporarily relieve symptoms. The only definitive treatment is stopping cannabis use.
How common is cannabinoid hyperemesis syndrome?
The true prevalence is unknown. It appears to occur primarily in people with years of daily or near-daily heavy cannabis use, but not all heavy users develop it. Increasing recognition by clinicians is leading to more diagnoses.
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Cite This Study
https://rethinkthc.com/research/RTHC-01006APA
Mahmad, Abdul I; Jehangir, Waqas; Littlefield, Jay M; John, Sujith; Yousif, Abdalla. (2015). Cannabis hyperemesis syndrome: A case report review of treatment.. Toxicology reports, 2, 889-890. https://doi.org/10.1016/j.toxrep.2015.05.015
MLA
Mahmad, Abdul I, et al. "Cannabis hyperemesis syndrome: A case report review of treatment.." Toxicology reports, 2015. https://doi.org/10.1016/j.toxrep.2015.05.015
RethinkTHC
RethinkTHC Research Database. "Cannabis hyperemesis syndrome: A case report review of treat..." RTHC-01006. Retrieved from https://rethinkthc.com/research/mahmad-2015-cannabis-hyperemesis-syndrome-a
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.