Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence
Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence
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DOI：
10.1111/apt.17265
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发表时间：
2022-10-28
影响因子：
7.6
通讯作者：
Sharkey, Keith A.
中科院分区：
文献类型：
--
作者：
Andrews, Christopher N.;Rehak, Renata;Sharkey, Keith A.
背景大麻样多吐综合征(CHS)是一种与长期使用大麻有关的鲜为人知的呕吐障碍。旨在描述北美CHS患者的特征，并获得在新冠肺炎大流行之前和期间对加拿大CHS治疗流行率的基于人群的估计。方法对加拿大和美国的157CHS患者进行互联网调查。访问了艾伯塔省(人口500万)的行政卫生数据库，以衡量急诊科(ED)的呕吐就诊情况，以及大麻使用的并发诊断代码。评估了三个为期一年的时间段：娱乐性大麻合法化之前(2017-2018年)、娱乐性大麻合法化后(2018-2019年)和新冠肺炎大流行的第一年(2020年-2021年)。结果问题大麻的使用(定义为CUDIT-R评分=8)在调查队列中普遍存在，59%和68%的人分别筛查中度或更严重的焦虑或抑郁。所有年龄段CHS的总体治疗流行率从合法化前每100,000人15次急诊(95%CI，14-17)增加到合法化后的21次(95%CI，20-23)，再到新冠肺炎大流行开始期间的32次(95%CI，31-35)(P<；0.001)。在16-24岁年龄组中，长期吸食大麻的流行率高达每1000人中有6人接受治疗。结论调查数据显示，CHS患者几乎普遍存在大麻使用障碍，这对治疗具有重要意义。急诊室的治疗流行率在很短的时间内大幅上升，出现了新冠肺炎大流行期间的最高比率。
Background Cannabinoid hyperemesis syndrome (CHS) is a poorly understood vomiting disorder associated with chronic cannabis use. Aims To characterise patients experiencing CHS in North America and to obtain a population-based estimate of CHS treatment prevalence in Canada before and during the Covid-19 pandemic Methods Internet survey of 157 CHS sufferers in Canada and the United States. Administrative health databases for the province of Alberta (population 5 million) were accessed to measure emergency department (ED) visits for vomiting, with a concurrent diagnostic code for cannabis use. Three time periods of 1 year were assessed: prior to recreational cannabis legalisation (2017-2018), after recreational legalisation (2018-2019) and during the first year of the Covid-19 pandemic (2020-2021). Results Problematic cannabis use (defined as a CUDIT-R score >= 8) was universal among the survey cohort, and 59% and 68% screening for moderate or worse anxiety or depression, respectively. The overall treatment prevalence of CHS across all ages increased from 15 ED visits per 100,000 population (95% CI, 14-17) prior to legalisation, to 21 (95% CI, 20-23) after legalisation, to 32 (95% CI, 31-35) during the beginning of the Covid-19 pandemic (p < 0.001). Treatment prevalence amongst chronic cannabis users was as high as 6 per 1000 in the 16-24 age group. Conclusion Survey data suggest patients with CHS almost universally suffer from a cannabis use disorder, which has significant treatment implications. Treatment prevalence in the ED has increased substantially over a very short time period, with the highest rates seen during the Covid-19 pandemic.