Blood cannabinoid profiles differed between symptomatic and asymptomatic periods in suspected CHS patients | Research

The takeaway

Emergency department patients with suspected cannabinoid hyperemesis syndrome showed detailed cannabis use patterns and different whole-blood cannabinoid profiles during symptomatic versus asymptomatic episodes.

Emergency medicine physicians, gastroenterologists, clinical toxicologists, and heavy cannabis users experiencing recurrent vomiting.

Blood cannabinoid profiles differed between CHS symptomatic and asymptomatic periods

What the researchers found

Whole-blood cannabinoid profiles differed between symptomatic and asymptomatic periods in patients with suspected CHS, providing biological data to complement clinical diagnosis. Detailed cannabis use patterns (frequency, mode, product type) were characterized.

Why it matters

CHS diagnosis relies on clinical criteria, and blood cannabinoid data could improve diagnostic accuracy. Understanding which use patterns and cannabinoid profiles are associated with symptoms helps identify at-risk users.

The numbers in context

ED patients with symptomatic cyclic vomiting after chronic cannabis use enrolled. Whole-blood cannabinoid profiles measured during both symptomatic and asymptomatic periods. Cannabis use patterns including frequency, mode, and product type characterized.

How the study worked

Prospective observational cohort study recruiting ED patients during symptomatic CHS episodes. Characterized detailed cannabis use patterns and measured whole-blood cannabinoid profiles during symptomatic and asymptomatic periods.

What this study cannot tell us

Small prospective cohort from ED recruitment. Suspected CHS diagnosis (not always confirmed). Blood draws during symptomatic episodes may be affected by recent cannabis cessation or reduced intake. Cannabinoid profiles are complex and not standardized for CHS diagnosis.

How to read the evidence

Small prospective cohort with objective biological measurement. Preliminary data requiring validation in larger samples.

When this study was published

Published 2023.

The bigger picture

CHS is increasingly recognized in emergency departments as cannabis potency and use frequency rise. Objective blood markers could help distinguish CHS from other causes of cyclic vomiting and improve care.

Questions still open

Could blood cannabinoid profiles be developed into a diagnostic test for CHS? Do specific cannabinoid metabolite ratios predict who will develop CHS among heavy users?

Common questions

What is cannabinoid hyperemesis syndrome?

CHS is a condition in heavy, chronic cannabis users characterized by episodes of severe nausea and vomiting that typically resolve with cannabis cessation. Hot baths or showers often provide temporary relief. It is diagnosed clinically, though this study explores whether blood cannabinoid measurements could aid diagnosis.

Why do some heavy users get CHS and others don't?

This is not yet understood. This study found differences in blood cannabinoid profiles during symptomatic vs. asymptomatic periods, suggesting biological factors may explain individual susceptibility. Use patterns (frequency, product type, mode of consumption) may also play a role.

Read the original research

Cannabis Use Patterns and Whole-Blood Cannabinoid Profiles of Emergency Department Patients With Suspected Cannabinoid Hyperemesis Syndrome.

Annals of emergency medicine, 82(2), 121-130

View on PubMed ↗Publisher’s paper ↗

Citation

Wightman, Rachel S; Metrik, Jane; Lin, Timmy R; Li, Yu; Badea, Adina; Almeida, Robert; Collins, Alexandra B; Beaudoin, Francesca L. (2023). Cannabis Use Patterns and Whole-Blood Cannabinoid Profiles of Emergency Department Patients With Suspected Cannabinoid Hyperemesis Syndrome.. Annals of emergency medicine, 82(2), 121-130. https://doi.org/10.1016/j.annemergmed.2023.03.005