Is cannabinoid hyperemesis syndrome overshadowed?

The first opinion is the STAT platform for interesting, enlightening and provocative articles on wholesale life sciences, written by biotechnological initiates, health workers, researchers and others.

To encourage a robust and good faith discussion on the questions raised in opinion tests, Stat publishes letters selected to the publisher received in response. You can submit a letter to the publisher here, or find the submission form at the end of any opinion test.

The story

“ER documents are too fast to assume that cannabis users know this rare side effect”, by Jordan Tishler

The answer

The president of the specialists of the Cannabinoid Association, Jordan Tishler, maintains that cannabinoid hyperemesis syndrome, or SHC, is “dangerously” over-diagnosed in the emergency room of Massachusetts. Unfortunately, his conclusion is based on anecdotal reports and his own informal survey of his colleagues – not difficult data or statistics.

I am a practicing gastroenterologist and a CHS researcher, and the epidemiological work of our group shows the opposite. Following our analysis of the Massachusetts emergency rooms between 2012 and 2021 (more than 15 million visits), we found that SHC cases have skyrocketed by more than 1,350%. In our study, published in the American Journal of Gastroenterology on June 13, we took care to count only diagnoses of CHS after having excluded other causes of nausea and vomiting that could have otherwise confused the diagnosis.

For this moment, the increase in CHS cases was the largest in young adults between 18 and 34 years old, a population often the most vulnerable to marketing and the highest risk of developing dependence on substance. In addition, the growing concentrations and power of tetrahydrocannabinol – the active THC ingredient in cannabis – are parallel to the increased risk of emergency visits to SHC.

Our work supports the statement of Tishler that the SHC has led to an increase in costs that overloaded an already worn health care system, my own hospitals spending 150% more for hospitalizations related to CHS after the legalization of cannabis.

However, we have found that these costs are due to our health care team carrying out X -rays, computed tomography and endoscopies, among other studies, to exclude alternative conditions, before reaching a diagnosis of CHS. Other health care systems have cited similar trends in high costs attributed to the diagnosis of SHC.

Our state and health care system should better diagnose and support people with cannabis -related diseases. We need a national billing code for the CHS to better understand its prevalence. Medical systems must train clinicians for how to ask questions with sensitivity about cannabis consumption and learn to engage people in a without judgment. In the Massachusetts, we need money outside the records of $ 1.64 billion in raw cannabis sales last year ($ 272 million in massachusetts tax revenue in 2024) to finance research in order to better understand the good and poor effects of a wide public consumption of cannabis.

As cannabis consumption is accelerating, we must approach with sensitivity how to better recognize and treat CH – a condition that we have shown to increase in the prevalence. Denying or ignoring that CHS cases are increasing is not the solution.

– Sushrut Jangi, MD, gastroenterologist at the TUFTS Medical Center and assistant professor at the Tofts University School of Medicine.

The answer

A specialist in London, Ontario, strongly suggested that my morning nausea and my jet were CHS. Even if I told him that my symptoms were only in the morning and once I served myself, I felt better, he stopped listening to me. I had never had a hot bath to relieve my nausea. I still smoke marijuana to date, and everything that happened in the morning has stopped. This doctor made me feel defensive because I could say that he had decided. A very frustrating experience for me.

– Linda there is

The answer

As a doctor from the recently retired emergency department, I find that this article indeed raises a valid point on the anchoring. There are many patients whose appearance, frequent visits, history of drugs or alcohol abuse, or something else, trigger an anchor response among us. As an Ed suppliers, we must be very careful to recognize and overcome our prejudices.

However, working largely each patient who consumes marijuana and presents nausea and vomiting raise other critical problems. SMA syndrome is very, very rare – cannabis hyperemesis syndrome is not. Should the abdominal CT be ordered on each patient suspected of having hyperemesis cannabis? This would result in unnecessary radiation, excessive costs, accessory results which in turn could cause anxiety and cause unnecessary work. The vast majority of these cases do not require computed tomography.

In addition, computed tomography, especially in younger patients, increase the risk of cancer for life. If a small nodule, which is often on CT, is noted, then another work with a periodic CTS can be indicated, even if the risk that this nodule developed cancer is very low. I have witnessed colleagues who, at some point in their emergency career, missed a rare condition and, thereafter, in each similar case, unnecessary and useless laboratories and CTs. In conclusion, neither the anchoring nor the search for “zebras” (medical jargon for rare conditions) in each case is a good medical practice.

– Rick Tietz

The story

“CEO of Phrma: the” most favored nation “policy is not the means to reduce the prices of drugs”, by Stephen J. Ubl

The answer

Big Pharma does what he does best: defend his benefits by distorting the facts. The arguments of the CEO of Phrma, Stephen J. Ubl, in his recent editorial against the most favored executive decree of President Trump (MFN) distorts the reality of the prices of medicines on the United States. Here is the truth: Trump’s MFN executive decree takes a critical first step to tackle the high prices of drugs by linking American prices for medicines at the lowest price in other comparable countries. The Trump administration rightly points out that the United States represents less than 5% of the world’s population but finance approximately three-quarters of the world’s pharmaceutical profits.

And this is not an accident. Big Pharma invoices Americans more than three times more than other countries rich for the same drugs and does not Nothing To comply with the Trump administration – despite the fact that 78% of American voters support their efforts to reduce American prices of medicines in accordance with those abroad. Instead, drug manufacturers focused on exporting their influence abroad to increase prices in Europe – a tactic to avoid lowering the prices of medicines for Americans.

The facts are clear: Big Pharma prioritizes its profits before the interests of Americans. The industry has deployed an arsenal of direct advertisements to consumers and anti -competitive tactics to hide the truth from its role in the rowing of drug prices, while distributing the fears that innovation slows if prices decrease. We know that this is simply false, because a recent evaluation of the 10 largest pharmaceutical companies found that they spent $ 36 billion more in advertising medicines than for R&D in one year.

In addition, Big Pharma regularly operates the American patent system to block the cheaper generic alternatives to enter the market. Fortunately, legislators have introduced legislation to encourage more generic competitors to enter the market.

The American people recognize Big Pharma’s game book and support President Trump’s efforts to give Americans a better deal. A recent national survey revealed that 85% of American voters support the broader pharmaceutical reforms of “America”.

The Trump administration and the legislators have taken the first crucial steps, but they must continue these common sense reforms to ensure that Big Pharms stop taking advantage of American patients.

– JD Hayworth, spokesperson for the pharmaceutical reform alliance and representative of Arizona in the House of Representatives of the United States from 1995 to 2007

The story

“The United States must invest in mRNA vaccines against pandemic influenza viruses now,” by Steve Osofsky

The answer

Steve Osofsky notes that operation Warp Speed saved lives not only in the United States, but in the world. Living in Canada, I benefited from quick access to hairstyle vaccines made by Moderna and Pfizer. The voluntary ignorance of the current administration also endangers not only the life of citizens and residents of the United States, but the peoples of the world. There is no doubt that Canada and many other countries have been veiled on military preparation. But the decision to cancel the contracts with Moderna by the richest country in the world reveals a set of values that lack a moral foundation.

– John G. Hollins, Ph.D.