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.

Mahmad, Abdul I et al.·Toxicology reports·2015·Preliminary EvidenceCase Report
RTHC-01006Case ReportPreliminary Evidence2015RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Case Report
Evidence
Preliminary Evidence
Sample
Not reported

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

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal StudyOne case or non-human subjects
This study

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.

Read More on RethinkTHC

Cite This Study

RTHC-01006·https://rethinkthc.com/research/RTHC-01006

APA

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.