A chronic marijuana user died after a severe attack of vomiting and abdominal pain that lasted several days caused a fatal heart rhythm disorder that left him brain dead.
The 22-year-old woman treated in Canada began using marijuana at age 14 and had been suffering from multiple attacks of severe cannabis hyperemesis syndrome, a condition characterized by violent, painful and repeated episodes of intense vomiting, for more than three years.
When he was admitted to the hospital with vomiting and abdominal pain, he developed a specific life-threatening irregular heartbeat, called torsades de pointes, which caused his heart to stop.
While doctors were able to restart her heart, her brain had already suffered a catastrophic loss of oxygen and four days later she was declared brain dead.
Cannabis hyperemesis syndrome can develop with regular marijuana because the drug can cause certain receptors in the brain to malfunction.
In people who begin using cannabis or in those who do not use it regularly, signals to cannabinoid receptors in the brain and gastrointestinal tract generally continue to function normally.
But with chronic marijuana use, those receptors become desensitized and do not respond to the drug in the same way, disrupting the body’s natural ability to control nausea, which can lead to cannabis hyperemesis syndrome.
CT scans of the woman’s brain showed the extent of damage caused by lack of oxygen when her intense vomiting caused a fatal irregular heartbeat. The brain folds have flattened and the entire brain has swollen.
The cause of the woman’s death was ultimately attributed to a fatal irregular heartbeat worsened by low potassium levels caused by her frequent vomiting and by medications that can affect the heart’s rhythm.
He also had genetic mutations that contributed to his heart problems and had been taking haloperidol and ondansetron, an antipsychotic and anti-nausea medication, respectively.
According to the Toronto doctors who wrote the case report, published in the journal Springer LinkThere have only been two other deaths due to cannabis hyperemesis syndrome described in the medical literature.
In the six months prior to the woman’s hospitalization, she visited the emergency department six different times with episodes of vomiting and nausea that lasted about a week each time.
He had low potassium levels during almost all of his ED visits. To treat it, they gave him fluids and electrolytes.
Low potassium levels can cause muscle cramps and weakness, heart rhythm abnormalities, kidney stones, and digestive problems.
During her severe episodes and to prevent them at home, she was treated with a combination of medications, including several anti-nausea and anti-anxiety medications, as well as sedatives.
On the day of her admission to the hospital, the woman arrived at the emergency room around 9:30 a.m. and was found to have a low heart rate and high blood pressure. Her potassium was also low, indicating an electrolyte imbalance.
Throughout the afternoon, he was given intravenous potassium, as well as several other medications, until around 6 p.m. The last medication they gave him was dimenhydrinate, an anti-vomiting medication.
But 25 minutes later, nurses checked her and found no vital signs. While doctors attempted to resuscitate her, they used an electrocardiogram (ECG) to monitor her heart rate.
Initially, the ECG detected ventricular fibrillation, a serious condition in which the lower chambers of the heart lose their ability to pump normally, making the heart rhythm chaotic and disorganized.
After being shocked with a defibrillator in an effort to restart his heart, his rhythm worsened to the point where his heartbeat showed a twisting pattern on the ECG known as torsades de pointes, a fatal type of arrhythmia: heart palpitations irregular.
The woman’s heart rate was disorganized and at times very low and other seconds very high. The photo above is an example of an irregular heat beat.
Doctors restarted her heart, but her brain’s “downtime” had exceeded 30 minutes, meaning she had not been receiving crucial oxygen, killing brain cells that left her in a vegetative state.
She was declared brain dead, taken off life support four days later, and died.
Cannabis hyperemesis can potentially be caused by any form of cannabis, from smoking and vaping to edibles, although the case study does not say how the woman consumed her cannabis.
The condition causes compulsive vomiting that is often painful and includes intense retching. Long-term cannabis use causes a buildup of cannabinoids and other toxins in the body, affecting receptors in the brain and gastrointestinal tract, causing nausea and vomiting.
It can also affect the motility and function of the gastrointestinal tract.
A unique sign of CHS is the temporary relief that comes from taking a hot shower, and people with this condition often take several a day to reduce nausea.
CT scans of the woman after her death that examined the extent of her brain injury showed that the sulci of her brain had flattened, her entire brain had become swollen, and the boundary between the outer and inner layer of the brain was not right. definite. , indicating widespread damage caused by lack of oxygen.
Cannabis use has seen a meteoric rise over the past decade, culminating in legal recreational use in 24 states.
And while it has been shown to have benefits for epilepsy and chemotherapy-related nausea, daily use of the drug has also proven to be extremely risky.
Cannabis use disorder is loosely defined as people who smoke marijuana every day and cannot stop using it even though it is causing them social and health problems, such as affecting their work and relationships.
It affects approximately 30 percent of users, although that number may be an underestimate.
A study by Canadian researchers last year compared people who had been diagnosed with cannabis use disorder with people who had not been diagnosed.
During the study period, 721 (2.4 percent) of people in the cannabis use disorder group suffered a first-time cardiovascular disease event, such as a heart attack or stroke, compared to 458 ( 1.5 percent) of the people in the group who did. Do not abuse the drug.
Adults with cannabis use disorder had about a 60 percent higher risk of heart attacks and strokes than those without the disorder.
Cannabis can also harm a person’s sleep health. Daily marijuana users were more likely than non-users and even occasional users to suffer from insomnia.
According to a 2016 study published in the Journal of Addictive Diseases, 39 percent of daily users met criteria for clinical insomnia, compared to 20 percent of non-users.
Marijuana has also been linked to potentially serious mental health events, such as psychotic episodes, major depression, and suicidal thoughts.
A study published in the May issue of the journal Psychological Medicine found that cannabis use disorder was linked to approximately 30 percent of schizophrenia diagnoses in young Danish men in 2021.
Regular cannabis use can disrupt the delicate balance of neurotransmitters responsible for regulating mood and motivation.
Many people already living with depression may self-medicate with marijuana for its calming properties, but continued use could have the opposite effect.
As marijuana laws have relaxed, a black market industry of high-potency strains and vaporizers has emerged, with products that provide a much more powerful high than before.
Now, more than 40 million adults (16 percent of the population) use marijuana, a rate that has more than doubled in the past 10 years amid a seismic cultural shift that sees greater acceptance toward medical use and recreational.