A Perplexing Marijuana Side Effect Relieved by Hot Showers

By the time Thomas Hodorowski made the connection between his marijuana habit and the bouts of pain and vomiting, he had been to the emergency room dozens of times, tried anti-nausea drugs, anti-anxiety medications and antidepressants, endured an upper endoscopy procedure and two colonoscopies, seen a psychiatrist and had his appendix and gallbladder removed.

The only way to get relief for the nausea and pain was to take a hot shower. He often stayed in the shower for hours at a time and could be in and out of the shower for days. When the hot water ran out, “the pain was unbearable, like somebody was wringing my stomach out like a washcloth,” said the 28-year-old.

It was nearly 10 years until a doctor finally convinced him the diagnosis was cannabinoid hyperemesis syndrome, a condition that causes cyclic vomiting in heavy marijuana users and can be cured by quitting marijuana.

Until recently the syndrome was thought to be uncommon or even rare. But as marijuana use has increased, emergency room physicians say they have been seeing a steady flow of patients with the telltale symptoms.

“C.H.S. went from being something we didn’t know about and never talked about to a very common problem over the last five years,” said Dr. Eric Lavonas, director of emergency medicine at Denver Health and a spokesman for the American College of Emergency Physicians.

Authors of a study based on interviews at Bellevue Hospital in New York City estimated that up to 2.7 million of the 8.3 million Americans known to smoke marijuana on a daily or near-daily basis may suffer from at least occasional bouts of C.H.S.

The condition can be quite serious. One 33-year-old military veteran who asked not to be identified by name described bouts lasting up to 12 hours in which he felt “like a puffer fish with sharp spikes was inflating and driving spikes into my spine from both sides. I’ve broken bones, and this blew it out of the water.”

Patients often arrive at the hospital severely dehydrated from the combination of hot showers and the inability to keep food or liquids down, and that can lead to acute kidney injury, said Dr. Habboushe.

It’s unclear why marijuana can produce such discordant effects in some users. But Dr. Cecilia J. Sorensen, an emergency room doctor at University of Colorado Hospital at the Anschutz medical campus in Aurora, often tells patients that it’s similar to developing an allergy to a favorite food.

Getting the right diagnosis often takes a long time. The average patient makes seven trips to the emergency room, sees five doctors and is hospitalized four times before a definitive diagnosis is made, running up approximately $100,000 in medical bills, Dr. Sorensen’s study found.

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The New York Times. “A Perplexing Marijuana Side Effect Relieved by Hot Showers” www.nytimes.com. 5 April 2018. Web. 15 May 2018.