Prevalence and trends of suspected cannabinoid hyperemesis syndrome over an 11-year period in Northern California: An electronic health record study

Drug Alcohol Depend. 2024 Oct 1:263:112418. doi: 10.1016/j.drugalcdep.2024.112418. Epub 2024 Aug 17.

Abstract

Background: As access to cannabis has increased, there has been a rise in a condition called cannabinoid hyperemesis syndrome (CHS). This study estimates annual prevalence of suspected CHS at emergency department visits (ED) over an 11-year period in Northern California.

Methods: This retrospective observational cohort study used electronic health records from Kaiser Permanente Northern California. Two CHS case definitions were used to construct two cohorts of adults (18+) with ≥1 CHS visits from 2009 to 2019. The primary definition used a narrow definition based on past studies (CHS group 1) and an exploratory definition allowed for a broader range of codes (CHS group 2); both definitions required a primary diagnosis of vomiting. Annual prevalence of CHS and annual rates of counts of CHS visits estimated using a log-link Poisson model are reported per group.

Findings: There were 57,227 patients with ≥1 CHS visits included in CHS group 1 and 65,645 patients included in CHS group 2. Over eleven years, CHS increased across groups with the fastest rise in CHS group 1 (prevalence ratio = 2.75, 95 % confidence interval [CI] 2.65-2.85, p<.0001 from 2009 to 2019 vs. prevalence ratio = 2.34, 95 % CI 2.27-2.43). CHS group 1 also exhibited the largest increase in ED visits (rate ratio = 2.35, 95 % CI 2.27-2.43, p<.0001).

Conclusion: In a large California population, suspected CHS increased over time across definitions. Annual prevalence increased by 134-175 %, depending on CHS definition. CHS group 2's definition may have been too broad and changes in ICD-10-CM coding may have impacted estimates.

Keywords: cannabinoid hyperemesis syndrome; cannabis; emergency medicine; hyperemesis; marijuana; nausea; vomiting.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • California / epidemiology
  • Cannabinoid Hyperemesis Syndrome
  • Cannabinoids* / adverse effects
  • Cohort Studies
  • Electronic Health Records*
  • Emergency Service, Hospital / trends
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Vomiting* / chemically induced
  • Vomiting* / epidemiology
  • Young Adult

Substances

  • Cannabinoids