Cannabis Use Patterns and Whole-Blood Cannabinoid Profiles of Emergency Department Patients With Suspected Cannabinoid Hyperemesis Syndrome.
Cannabis Use Patterns and Whole-Blood Cannabinoid Profiles of Emergency Department Patients With Suspected Cannabinoid Hyperemesis Syndrome.
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DOI：
10.1016/j.annemergmed.2023.03.005
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发表时间：
2023-08
影响因子：
6.2
通讯作者：
中科院分区：
文献类型：
--
作者：
本研究的目的是描述详细的大麻使用模式（例如频率、模式和产品），并确定在症状发作期间从急诊科（ED）招募的疑似大麻素剧吐综合征参与者在有症状与无症状期间全血大麻素谱的差异。这是一项针对长期使用大麻后出现症状性周期性呕吐的参与者的前瞻性观察队列研究。进行了标准化评估，以评估终生和近期的大麻使用、大麻使用障碍和大麻戒断症状。定量全血大麻素检测进行两次，第一次是在有症状时（即基线），在急诊就诊后至少两周进行无症状时。比较有症状和无症状测试之间大麻素浓度的差异。该研究于2021年9月至2022年8月进行。在症状发作和无症状期间，观察到δ9-四氢大麻酚代谢物之间存在差异，但母体化合物之间没有差异。大多数参与者 (84%) 报告每天使用大麻 > 一次（工作日平均每天 3 次，周末每天 4 次）。参与者普遍使用危险的大麻；大麻戒断不适平均评分为 13，表明停止使用大麻戒断症状的临床显着率。大多数参与者（79%）之前曾尝试停止使用大麻，但其中少数（13%）曾寻求治疗。因大麻素剧吐综合征而到急诊室就诊的患者具有较高的大麻使用障碍评分。需要进一步的研究来更好地了解 THC 代谢和浓度对症状性周期性呕吐的影响。
The objectives of this study were to characterize the detailed cannabis use patterns (eg, frequency, mode, and product) and determine the differences in the whole-blood cannabinoid profiles during symptomatic versus asymptomatic periods of participants with suspected cannabinoid hyperemesis syndrome recruited from the emergency department (ED) during a symptomatic episode. This is a prospective observational cohort study of participants with symptomatic cyclic vomiting onset after chronic cannabis use. Standardized assessments were conducted to evaluate for lifetime and recent cannabis use, cannabis use disorder, and cannabis withdrawal symptoms. Quantitative whole-blood cannabinoid testing was performed at 2 times, first when symptomatic (ie, baseline) and at least 2 weeks after the ED visit when asymptomatic. The differences in cannabinoid concentrations were compared between symptomatic and asymptomatic testing. The study was conducted from September 2021 to August 2022. There was a difference observed between delta-9-tetrahydrocannabinol metabolites, but not the parent compound during symptomatic episodes and asymptomatic periods. Most participants (84%) reported using cannabis > once per day (median 3 times per day on weekdays, 4 times per day on weekends). Hazardous cannabis use was universal among participants; the mean cannabis withdrawal discomfort score was 13, indicating clinically significant rates of cannabis withdrawal symptoms with cessation of use. Most participants (79%) previously tried to stop cannabis use, but a few (13%) of them had sought treatment. Patients presenting to the ED with cannabinoid hyperemesis syndrome have high cannabis use disorder scores. Further studies are needed to better understand the influence of THC metabolism and concentrations on symptomatic cyclic vomiting.
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