Increased use drives cannabis hyperemesis syndrome rates, not legalization

SAN DIEGO — States with legalized cannabis have not seen higher hospitalization rates for cannabis hyperemesis syndrome compared with other states, according to research presented at Digestive Disease Week.

Laura Nemer, MD, of the division of gastroenterology, hepatology and nutrition at The Ohio State University Wexner Medical Center, said that rates have gone up regardless of the legal status of cannabis.

“Cannabis is one of the most widely used, historically illicit, drugs in the United States,” she said in her presentation. “Its use has progressively increased over the last 20 years.”

Nemer and colleagues wanted to determine if the move toward legalization in states across the country has resulted in increased hospitalizations for cannabis hyperemesis syndrome.

Hence, they looked at data from four states, two where adult recreational use is legal – Colorado and Washington – and two where it is not, Florida and Arizona. Because cannabis was legalized in Colorado and Washington in 2012, researchers obtained data from all four states for 2011 and 2015 to explore trends in hyperemesis hospitalization before and after legalization.

Investigators found that in all four states in both years, more than 15,000 people were admitted for hyperemesis. They found that cannabis use was associated with higher odds of hyperemesis in Colorado (OR = 4.16; 95% CI, 3.61–4.81), Washington (OR = 3.35; 95% CI, 2.94–3.82), Arizona (OR = 2.42; 95% CI, 2.1–2.78) and Florida (OR = 3.05; 95% CI, 2.79–3.33). Cannabis use and hyperemesis admission increased from 2011 to 2015 in both sets of states.

After adjusting for several factors, including sex, age and race, Nemer and colleagues found that the odds for presentation with hyperemesis were higher in 2015 in both the legalized (OR = 1.42; 1.33–1.51) and non-legalized states (OR = 1.51; 95% CI, 1.45–1.57) compared with 2011.

“The trend was the same irrespective of recreational legalization,” Nemer said. “Which suggests that the legalization part itself did not account for the increased admissions we’ve seen for hyperemesis. ... Perhaps this may be because people are increasingly using cannabis regardless of legality.” – by Alex Young

Reference:

Nemer L, et al. Abstract 1,001. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.

Disclosures: Nemer reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.