Cannabinoid Hyperemesis Syndrome from K2 Synthetic Cannabis: A Case Report
A 38-year-old man with a history of cannabis use developed cannabinoid hyperemesis syndrome from K2 (synthetic cannabinoid), highlighting that CHS can occur with synthetic cannabinoids and be missed with standard drug testing.
Quick Facts
What This Study Found
A 38-year-old man with a 10-year history of cannabis use and 1-year history of K2 (synthetic cannabinoid) use presented with episodic nausea, vomiting of clear fluids, and epigastric discomfort for one week. His symptoms were relieved only by hot showers, a hallmark of cannabinoid hyperemesis syndrome.
Extensive workup including laboratory tests, imaging, and endoscopy was unrevealing. The diagnosis of CHS was ultimately made based on clinical criteria. The case highlights two important issues: synthetic cannabinoids can cause CHS just like natural cannabis, and conventional urine drug screens do not detect synthetic cannabinoids, leading to potentially expensive and unnecessary workups.
The authors note that CHS diagnosis can take up to 9 years, suggesting widespread underrecognition of this condition.
Key Numbers
Patient age: 38. Cannabis history: 10 years. K2 history: 1 year. Symptom duration: 1 week. Diagnostic delay for CHS: up to 9 years in the literature.
How They Did This
This is a single case report with a review of relevant literature. The patient was evaluated with standard clinical workup. Diagnosis was based on proposed diagnostic criteria for CHS.
Why This Research Matters
This case extends the recognition of CHS beyond natural cannabis to synthetic cannabinoids, which are increasingly prevalent. Since K2/Spice is not detected on standard urine drug screens, clinicians need to consider CHS even when drug tests are negative, especially in patients with cyclic vomiting relieved by hot showers.
The Bigger Picture
CHS is increasingly recognized as emergency departments see more cases. This case demonstrates that the syndrome is caused by cannabinoid receptor activation generally, not just by natural cannabis. As synthetic cannabinoids continue to evolve and evade detection, clinicians need a high index of suspicion based on clinical presentation.
What This Study Doesn't Tell Us
This is a single case report and cannot establish prevalence or risk factors. The patient used both natural cannabis and K2, making it difficult to attribute CHS specifically to the synthetic cannabinoid. The specific K2 product and its active compound were not identified.
Questions This Raises
- ?Are synthetic cannabinoids more or less likely to cause CHS than natural cannabis?
- ?Does the higher receptor efficacy of synthetic cannabinoids affect CHS severity?
- ?Would CHS from synthetic cannabinoids respond to the same treatments as CHS from natural cannabis?
Trust & Context
- Key Stat:
- CHS diagnosis can take up to 9 years; standard drug tests miss synthetic cannabinoids
- Evidence Grade:
- This is a single case report. It documents CHS from synthetic cannabinoids but cannot establish prevalence or causation.
- Study Age:
- Published in 2014. CHS from both natural and synthetic cannabinoids is now more widely recognized.
- Original Title:
- A Gut Gone to Pot: A Case of Cannabinoid Hyperemesis Syndrome due to K2, a Synthetic Cannabinoid.
- Published In:
- Case reports in emergency medicine, 2014, 167098 (2014)
- Authors:
- Ukaigwe, Anene, Karmacharya, Paras, Donato, Anthony
- Database ID:
- RTHC-00882
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
What is K2/Spice?
K2 and Spice are brand names for synthetic cannabinoid products. They contain laboratory-made chemicals sprayed on plant material and sold as "herbal incense." They are not detected by standard urine drug screens and are often more potent than natural cannabis.
Why does hot water relieve CHS symptoms?
The mechanism is not fully understood, but it may involve activation of TRPV1 receptors (heat-sensing receptors) in the gut and skin that interact with the endocannabinoid system. Hot water may temporarily redirect blood flow or activate competing sensory pathways that reduce nausea.
Read More on RethinkTHC
- THC-purity-potency-label-meaning
- dab-concentrate-addiction-withdrawal
- delta-8-addiction-withdrawal
- edible-addiction-withdrawal-different
- edibles-psychosis-emergency-room
- healthiest-way-to-consume-cannabis
- how-cannabis-products-made-concentrates-edibles
- laced-weed-fentanyl-contaminated-vape
- legal-weed-vs-street-weed-quality-safety
- quitting-dabs-withdrawal
- quitting-edibles-withdrawal
- sativa-vs-indica-difference-myth
- weed-potency-withdrawal
- why-does-weed-make-eyes-red-blood-vessel
Cite This Study
https://rethinkthc.com/research/RTHC-00882APA
Ukaigwe, Anene; Karmacharya, Paras; Donato, Anthony. (2014). A Gut Gone to Pot: A Case of Cannabinoid Hyperemesis Syndrome due to K2, a Synthetic Cannabinoid.. Case reports in emergency medicine, 2014, 167098. https://doi.org/10.1155/2014/167098
MLA
Ukaigwe, Anene, et al. "A Gut Gone to Pot: A Case of Cannabinoid Hyperemesis Syndrome due to K2, a Synthetic Cannabinoid.." Case reports in emergency medicine, 2014. https://doi.org/10.1155/2014/167098
RethinkTHC
RethinkTHC Research Database. "A Gut Gone to Pot: A Case of Cannabinoid Hyperemesis Syndrom..." RTHC-00882. Retrieved from https://rethinkthc.com/research/ukaigwe-2014-a-gut-gone-to
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.