Emergency Department Visits for Cannabinoid Hyperemesis Increased Significantly After Oklahoma Medical Legalization
ED visits for cannabinoid hyperemesis syndrome rose from 43 to 62 cases in comparable 8-month periods before and after Oklahoma's first medical cannabis sales, a statistically significant increase (P=0.026), with a prevalence far higher than previously reported in the literature.
Quick Facts
What This Study Found
CHS-related ED visits increased from 43 cases pre-legalization to 62 post-legalization (P=0.026), despite total ED visits decreasing from 30,437 to 28,362. The proportion of ED visits for CHS (220/100,000) was much higher than previously reported (13.3/100,000). No demographic differences between pre- and post-legalization groups.
Key Numbers
Pre-legalization: 43 CHS cases in 30,437 ED visits. Post-legalization: 62 cases in 28,362 visits (P=0.026). CHS proportion: 220/100,000 vs. 13.3/100,000 in prior literature.
How They Did This
Retrospective chart review comparing equivalent 8-month periods before and after the first legal medical cannabis sales in Oklahoma, at a single urban ED.
Why This Research Matters
CHS causes severe vomiting episodes that can lead to dehydration and kidney injury. The much higher prevalence found here compared to prior literature suggests CHS may be significantly underdiagnosed or that Oklahoma's medical cannabis market has unique characteristics.
The Bigger Picture
Oklahoma's medical cannabis program expanded rapidly, becoming one of the largest per capita in the US. The high CHS rate found here could reflect this rapid expansion, high THC concentrations in Oklahoma products, or increased provider awareness of the diagnosis.
What This Study Doesn't Tell Us
Single-center retrospective design. Cannot distinguish whether increase is from more CHS cases, better provider recognition, or increased cannabis use. Short comparison window (8 months). "Suspected CHS" inclusion may overestimate true cases.
Questions This Raises
- ?Is the much higher CHS prevalence due to underdiagnosis elsewhere or unique factors in Oklahoma?
- ?Do high-THC products in Oklahoma contribute to higher CHS rates?
Trust & Context
- Key Stat:
- CHS visits rose 44% after Oklahoma medical cannabis legalization
- Evidence Grade:
- Single-center retrospective chart review with significant finding, but limited by short timeframe and single location.
- Study Age:
- Published in 2023.
- Original Title:
- Cannabinoid Hyperemesis Encounters After Medical Legalization in Oklahoma.
- Published In:
- Cureus, 15(10), e46465 (2023)
- Authors:
- Riha, Randal, Winchell, Ryan, Safo, Danielle, Gentges, Joshua
- Database ID:
- RTHC-04884
Evidence Hierarchy
Frequently Asked Questions
Did medical cannabis legalization increase cannabinoid hyperemesis?
In this Oklahoma ED study, CHS visits increased significantly (P=0.026) after legalization, though whether this reflects more cases or better diagnosis is unclear.
How common is cannabinoid hyperemesis syndrome?
This study found a CHS rate of 220 per 100,000 ED visits, far higher than the 13.3/100,000 previously reported, suggesting the condition may be more common than thought.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-04884APA
Riha, Randal; Winchell, Ryan; Safo, Danielle; Gentges, Joshua. (2023). Cannabinoid Hyperemesis Encounters After Medical Legalization in Oklahoma.. Cureus, 15(10), e46465. https://doi.org/10.7759/cureus.46465
MLA
Riha, Randal, et al. "Cannabinoid Hyperemesis Encounters After Medical Legalization in Oklahoma.." Cureus, 2023. https://doi.org/10.7759/cureus.46465
RethinkTHC
RethinkTHC Research Database. "Cannabinoid Hyperemesis Encounters After Medical Legalizatio..." RTHC-04884. Retrieved from https://rethinkthc.com/research/riha-2023-cannabinoid-hyperemesis-encounters-after
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.