Hair cannabinoid concentrations in emergency patients with cannabis hyperemesis syndrome

CJEM
Khala AlbertLawrence C Hookey

Abstract

Cannabis hyperemesis syndrome is characterized by bouts of protracted vomiting in regular users of cannabis. We wondered whether this poorly understood condition is idiosyncratic, like motion sickness or hyperemesis gravidarum, or the predictable dose-response effect of prolonged heavy use. Adults with an emergency department visit diagnosed as cannabis hyperemesis syndrome, near-daily use of cannabis for ≥6 months, and ≥2 episodes of severe vomiting in the previous year were age- and sex-matched to two control groups: RU controls (recreational users without vomiting), and ED controls (patients in the emergency department for an unrelated condition). Δ9-Tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol, and 11-nor-9-carboxy-THC concentrations in scalp hair were compared for subjects with positive urine THC. We obtained satisfactory hair samples from 46 subjects with positive urine THC: 16 cases (age 26.8 ± 9.2 years; 69% male), 16 RU controls and 14 ED controls. Hair cannabinoid concentrations were similar between all three groups (e.g. cases THC 220 [median; IQR 100,730] pg/mg hair, RU controls 150 [71,320] and ED controls 270 [120,560]). Only the THC:CBN ratio was different between groups, with a 2.6-fold (95%CI 1.3,5...Continue Reading

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Citations

Mar 13, 2020·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Hervé Laborde-CasterotDominique Vodovar

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