Long, Hot Showers and Cannabinoid Hyperemesis Syndrome

Although the professional literature always provides me with important information that I hope to use clinically at some point, another source of information is the New York Times. I frequently read articles that contain useful information that I can apply directly in practice or that can lead me to the original source for further education before talking about it with a patient. This year, an article on cannabinoid hyperemesis syndrome (1) has been exceptionally useful in discussions with patients. An attending physician on our consultation-liaison service asked me about a patient who reported that only long, hot showers relieved his hyperemesis. She felt the hyperemesis was related to heavy marijuana use. This was literally a day after I read the Times article. We printed it out and gave it to him, and we have done so with patients who find it hard to accept that heavy marijuana use can result in hyperemesis. To quote from the article regarding a patient, “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.” Although physicians rely on the professional literature for education and clinical guidance, patients might be more swayed by reading articles such as this one. It has now helped several patients accept that the only way to resolve the hyperemesis is to stop using marijuana—or hope that the hot water does not run out.