Not really that new... it's been described in the medial literature since at least 1974. I typically see 2-3 cases per month. Despite what users might claim, it is a real condition, and has recognizable symptoms:
- chronic use, typically every day over several years (mean 9.6 years, low 3, high 16 years);
- crampy, epigastric or periumbical abdominal pain;
- age typically <50 (mean age 23), although this is expected to rise;
- symptoms predominate in the morning during the prodromal phase (months to years);
- normal bowel habits (in contrast to most other abdominal pain/vomiting presentations);
- normal laboratory, radiographic, and endoscopic test results;
- compulsive bathing to alleviate symptoms (a pathognomonic symptom); and
- resolution of symptoms upon cessation of cannabis.
The syndrome is thought to be caused by disregulation of the hypothalamus (hence the compulsive bathing). The current opinion on the mechanism is that cannabinoids are fat soluble, so a slow rise to toxicity takes place. Haloperidol at the anit-nauseant dose (2.5mg IV) is highly effective.
Sufferers are almost universal in their belief that their cannabis consumption is not to blame. What they misunderstand is the concept of a paradoxical drug reaction. Where low dose cannabis does have anti-emetic and appetite enhancing properties, over consumption can turn this completely around. Cannabis is not the only drug that produces paradoxical reactions. We frequently see a similar phenomenon with Gravol (Dimenhydrinate) overdose for example. Where you would expect profound sedation, you actually get considerable excitation and agitation (people who overdose on Gravol are quite literally stark raving mad). Benzodiazepines and some classes of antidepressants are also known to produce paradoxical reactions.
Here's a
2011 paper if you want to read more.
The foregoing is provided solely for educational purposes. It is not meant as a commentary on the appropriateness of cannabis use.
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