{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:12:53Z","timestamp":1763017973480,"version":"3.40.5"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T00:00:00Z","timestamp":1551139200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1481803518004797_sec_a1\"><jats:title>Objectives<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803518004797_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Adults with an emergency department visit diagnosed as cannabis hyperemesis syndrome, near-daily use of cannabis for \u22656 months, and \u22652 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). \u0394<jats:sup>9<\/jats:sup>-Tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol, and 11-nor-9-carboxy-THC concentrations in scalp hair were compared for subjects with positive urine THC.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803518004797_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>We obtained satisfactory hair samples from 46 subjects with positive urine THC: 16 cases (age 26.8 \u00b1 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 1.3,5.7) lower age- and sex-adjusted ratio in cases than RU controls. Hair cannabidiol concentrations were often unquantifiably low in all subjects.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803518004797_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Similar hair cannabinoid concentrations in recreational users with and without hyperemesis suggest that heavy use is necessary but not sufficient for hyperemesis cannabis. Our results underline the high prevalence of chronic heavy cannabis use in emergency department patients and our limited understanding of this plant's adverse effects.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cem.2018.479","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T11:37:04Z","timestamp":1551181024000},"page":"477-481","source":"Crossref","is-referenced-by-count":9,"title":["Hair cannabinoid concentrations in emergency patients with cannabis hyperemesis syndrome"],"prefix":"10.1007","volume":"21","author":[{"given":"Khala","family":"Albert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6641-1118","authenticated-orcid":false,"given":"Marco L.A.","family":"Sivilotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joey","family":"Gareri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Day","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron J.","family":"Ruberto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence C.","family":"Hookey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,2,26]]},"reference":[{"key":"S1481803518004797_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2017.04.018"},{"key":"S1481803518004797_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717003877"},{"key":"S1481803518004797_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12412"},{"key":"S1481803518004797_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2016.01.004"},{"key":"S1481803518004797_ref4","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1002\/phar.1931","article-title":"Pharmacologic treatment of cannabinoid hyperemesis syndrome: a systematic review","volume":"37","author":"Richards","year":"2017","journal-title":"Pharmacotherapy"},{"key":"S1481803518004797_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/dta.2368"},{"key":"S1481803518004797_ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-016-0595-z"},{"key":"S1481803518004797_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/cem.2017.381"},{"key":"S1481803518004797_ref9","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1080\/15563650.2017.1324166","article-title":"Resolution of cannabis hyperemesis syndrome with topical capsaicin in the emergency department: a case series","volume":"55","author":"Dezieck","year":"2017","journal-title":"Clin Toxicol (Phila)"},{"key":"S1481803518004797_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2006.08.005"},{"key":"S1481803518004797_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2011.10.024"},{"key":"S1481803518004797_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2017.01.007"},{"key":"S1481803518004797_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/dta.1474"},{"key":"S1481803518004797_ref7","unstructured":"Albert K. Cannabinoid hyperemesis syndrome in a Canadian emergency department: a case-control study (MPH thesis dissertation); London School of Hygiene and Tropical Medicine, 2017."},{"key":"S1481803518004797_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2006.02.019"},{"key":"S1481803518004797_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2006.09.003"},{"key":"S1481803518004797_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12655"},{"key":"S1481803518004797_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.12962"}],"container-title":["CJEM"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1481803518004797","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T23:40:25Z","timestamp":1609458025000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1481803518004797\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,26]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["S1481803518004797"],"URL":"https:\/\/doi.org\/10.1017\/cem.2018.479","relation":{},"ISSN":["1481-8035","1481-8043"],"issn-type":[{"type":"print","value":"1481-8035"},{"type":"electronic","value":"1481-8043"}],"subject":[],"published":{"date-parts":[[2019,2,26]]}}}