Cannabis Intoxication and Hyperemesis

EVIDENCE REPOSITORIES

This evidence repository is a collection of best available resources and evidence collated by a knowledge synthesis team at Alberta Research for Health Evidence (ARCHE) and the clinical content team. The knowledge synthesis team utilizes a pyramid-shaped framework, built upon the “4S” hierarchy of evidence model, to provide detailed evidence appropriate to meet stakeholders’ needs. They search a combination of databases (Cochrane Library, PubMed, TRIP Database) and web-based search engines (Google, Google Scholar) to locate evidence for the knowledge pyramids. Publication types sought in the initial topic searches are organized into five levels that determine the order in which resources are presented: (2)

(3)

Overviews and Summaries of

(5)

Where applicable resources for families and parents are also listed. The knowledge synthesis team collaborates with the clinical content team to select the most relevant guidelines, reviews, and key studies, which can be found below. This evidence repository is not intended to be an exhaustive list of resources for a topic, but rather a curated list of current, evidence-based resources, based on expert consensus of relevance and usability for a general emergency department setting. Every effort is made to identify resources that are open access (i.e. publicly available, free of charge, not requiring a subscription). More information about the creation of our evidence repositories can be found here.

Thank you to the following clinical content experts and Knowledge Synthesis team who led the development of this evidence repository. Kaitlin Hogue, MD; Pediatric Emergency Medicine, Health Sciences Centre, Children's Hospital of Winnipeg Neil Desai, MD, FRCPC; Clinical Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, Faculty of Medicine, University of British Columbia Liza Bialy, BSc, MPH, Knowledge Synthesis Project Coordinator, Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta Sarah Elliott, PhD, Assistant Director, Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta

TREKK developed resources for healthcare providers and parents & families can be found here.

1. Borgundvaag B, Bellolio F, Miles I, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Acad Emerg Med. 2024 May;31(5):425- 455.
2. Humphries C, Gillings M. RCEM best practice guideline: suspected cannabinoid hyperemesis syndrome in emergency departments. Emerg Med J. 2024 Apr 22;41(5):328-331.
3. Amirshahi MM, Moss MJ, Smith SW, et al. ACMT Position Statement: Addressing Pediatric Cannabis Exposure. J Med Toxicol. 2019 Jul;15(3):212-214. doi: 10.1007/s13181-019-00708-z. Epub 2019 Apr 3.

1. Solmi M, De Toffol M, Kim JY, et al. Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies. BMJ. 2023 Aug 30;382:e072348. doi: 10.1136/bmj-2022-072348.

1. Gaudet L, Hogue K, Scott SD, Hartling L, Elliott SA. Acute pediatric cannabis intoxication: A scoping review. J Child Health Care. 2024 Mar;28(1):196-214.
2. Tuvel AL, Winiger EA, Ross JM. A review of the effects of adolescent cannabis use on physical health. Child Adolesc Psychiatr Clin N Am. 2023;32(1):85-105.
3. Takakuwa KM, Schears RM. The emergency department care of the cannabis and synthetic cannabinoid patient: A narrative review. Int J Emerg Med. 2021;14(1):10.
4. Wong KU, Baum CR. Acute cannabis toxicity. Pediatr Emerg Care. 2019;35(11):799-804.
5. Blohm E, Sell P, Neavyn M. Cannabinoid toxicity in pediatrics. Curr Opin Pediatr. 2019;31(2):256- 61.
6. Richards JR, Smith NE, Moulin AK. Unintentional cannabis ingestion in children: A systematic review. J Pediatr. 2017;190:142-52.

1. Sabbineni M, Scott W, Punia K, et al. SAEM GRACE: Dopamine antagonists and topical capsaicin for cannabis hyperemesis syndrome in the emergency department: A systematic review of direct evidence. Acad Emerg Med. 2024 May;31(5):493-503.
2. Frazier R, Li BUK, Venkatesan T. Diagnosis and management of cyclic vomiting syndrome: A critical review. Am J Gastroenterol. 2023;118(7):1157-67.
3. Chu F, Cascella M. Cannabinoid hyperemesis syndrome. Statpearls. Treasure Island (FL): StatPearls Publishing. 2023
4. Senderovich H, Patel P, Jimenez Lopez B, Waicus S. A systematic review on cannabis hyperemesis syndrome and its management options. Med Princ Pract. 2022;31(1):29-38.
5. Razban M, Exadaktylos AK, Santa VD, Heymann EP. Cannabinoid hyperemesis syndrome and cannabis withdrawal syndrome: A review of the management of cannabis-related syndrome in the emergency department. Int J Emerg Med. 2022;15(1):45.
6. Zhu JW, Gonsalves CL, Issenman RM, Kam AJ. Diagnosis and acute management of adolescent cannabinoid hyperemesis syndrome: A systematic review. J Adolesc Health. 2021;68(2):246-54.
7. Takakuwa KM, Schears RM. The emergency department care of the cannabis and synthetic cannabinoid patient: A narrative review. Int J Emerg Med. 2021;14(1):10.
8. Reinert JP, Niyamugabo O, Harmon KS, Fenn NE, 3rd. Management of pediatric cannabinoid hyperemesis syndrome: A review. J Pediatr Pharmacol Ther. 2021;26(4):339-45.
9. DeVuono MV, Parker LA. Cannabinoid hyperemesis syndrome: A review of potential mechanisms. Cannabis Cannabinoid Res. 2020;5(2):132-44.
10. Sorensen CJ, DeSanto K, Borgelt L, et al. Cannabinoid hyperemesis syndrome: Diagnosis, pathophysiology, and treatment—a systematic review. Journal of Medical Toxicology. 2017;13(1):71-87.

1. Roehler DR, Smith Ht, Radhakrishnan L, et al. Cannabis-involved emergency department visits among persons aged <25 years before and during the covid-19 pandemic – United States, 2019-
2. MMWR Morb Mortal Wkly Rep. 2023;72(28):758-65.
3. Kourgiantakis T, Lee E, Kosar AKT, et al. Youth cannabis use in Canada post-legalization: Service providers' perceptions, practices, and recommendations. Subst Abuse Treat Prev Policy. 2023;18(1):36.
4. Keung MY, Leach E, Kreuser K, et al. Cannabis-induced anxiety disorder in the emergency department. Cureus. 2023;15(4):e38158.
5. Denissoff A, Mustonen A, Miettunen J, et al. Trajectories of adolescent psychotic-like experiences and early cannabis exposure: Results from a Finnish birth cohort study. Schizophr Res. 2022;246:95-102.
6. Coret A, Rowan-Legg A. Unintentional cannabis exposures in children pre- and post-legalization: A retrospective review from a Canadian paediatric hospital. Paediatr Child Health. 2022;27(5):265- 71.
7. Cohen N, Galvis Blanco L, Davis A, et al. Pediatric cannabis intoxication trends in the pre and post-legalization era. Clin Toxicol (Phila). 2022;60(1):53-8.
8. Thomas AA, Dickerson-Young T, Mazor S. Unintentional pediatric marijuana exposures at a tertiary care children's hospital in Washington state: A retrospective review. Pediatr Emerg Care. 2021;37(10):e594-e8.
9. Mehamha H, Doudka N, Minodier P, et al. Unintentional cannabis poisoning in toddlers: A one year study in Marseille. Forensic Sci Int. 2021;325:110858.
10. Gilley M, Brent J, Calello DP, et al. Synthetic cannabinoid exposure in adolescents presenting for emergency care. Pediatr Emerg Care. 2021;37(1):e13-e6.
11. Burns MM, Toce MS. Pediatric cannabis use and cardiac complications. CMAJ. 2021;193(45):E1737.
12. Bashqoy F, Heizer JW, Reiter PD, et al. Increased testing and health care costs for pediatric cannabis exposures. Pediatr Emerg Care. 2021;37(12):e850-e4.
13. Schmid Y, Scholz I, Mueller L, et al. Emergency department presentations related to acute toxicity following recreational use of cannabis products in Switzerland. Drug Alcohol Depend. 2020;206:107726.
14. Cheng P, Zagaran A, Rajabali F, et al. Setting the baseline: A description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis. Health Promot Chronic Dis Prev Can. 2020;40(5-6):193-200.
15. Champagne AS, McFaull SR, Thompson W, Bang F. Surveillance from the high ground: Sentinel surveillance of injuries and poisonings associated with cannabis. Health Promot Chronic Dis Prev Can. 2020;40(5-6):184-92.
16. Boadu O, Gombolay GY, Caviness VS, El Saleeby CM. Intoxication from accidental marijuana ingestion in pediatric patients: What may lie ahead. Pediatr Emerg Care. 2020;36(6):e349-e54.
17. Noble MJ, Hedberg K, Hendrickson RG. Acute cannabis toxicity. Clin Toxicol (Phila). 2019;57(8):735-42.
18. Levene RJ, Pollak-Christian E, Wolfram S. A 21st century problem: Cannabis toxicity in a 13- month-old child. J Emerg Med. 2019;56(1):94-6.
19. Vo KT, Horng H, Li K, et al. Cannabis intoxication case series: The dangers of edibles containing tetrahydrocannabinol. Ann Emerg Med. 2018;71(3):306-13.
20. Heizer JW, Borgelt LM, Bashqoy F, et al. Marijuana misadventures in children: Exploration of a dose-response relationship and summary of clinical effects and outcomes. Pediatr Emerg Care. 2018;34(7):457-62.
21. Fluharty ME, Heron J, Munafò MR. Longitudinal associations of social cognition and substance use in childhood and early adolescence: Findings from the AVON longitudinal study of parents and children. Eur Child Adolesc Psychiatry. 2018;27(6):739-52.
22. Burns C, Burns R, Sanseau E, et al. Pediatric emergency medicine simulation curriculum: Marijuana ingestion. MedEdPORTAL. 2018;14:10780.
23. Wilson KM, Torok MR, Wei B, et al. Detecting biomarkers of second hand marijuana smoke in young children. Pediatric Research. 2017;81(4):589-92.
24. Finkelstein Y, Goel G, Hutson JR, et al. Drug misuse in adolescents presenting to the emergency department. Pediatr Emerg Care. 2017;33(7):451-6.
25. Claudet I, Mouvier S, Labadie M, et al. Unintentional cannabis intoxication in toddlers. Pediatrics. 2017;140(3).
26. Claudet I, Le Breton M, Bréhin C, Franchitto N. A 10-year review of cannabis exposure in children under 3-years of age: Do we need a more global approach? Eur J Pediatr. 2017;176(4):553-6.
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32. Lovecchio F, Heise CW. Accidental pediatric ingestions of medical marijuana: A 4-year poison center experience. The American Journal of Emergency Medicine. 2015;33(6):844-5.
33. Herrmann ES, Cone EJ, Mitchell JM, et al. Non-smoker exposure to second hand cannabis smoke II: Effect of room ventilation on the physiological, subjective, and behavioral/cognitive effects. Drug and Alcohol Dependence. 2015;151:194-202.
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1. Geraci E, Cake C, et al. Comparison of antiemetics in the management of pediatric cannabinoid hyperemesis syndrome. J Pediatr Pharmacol Ther. 2023;28(3):222-7.
2. Nachnani R, Hushagen K, Swaffield T, et al. Cannabinoid hyperemesis syndrome and hypophosphatemia in adolescents. JPGN Rep. 2022;3(4):e248.
3. Camcejo M, Hillman E, Isom H. Cannabinoid hyperemesis syndrome: Lighting up an emergency department near you. Mo Med. 2022;119(3):266-70.
4. Yeung MEM, Weaver CG, Hartmann R, et al. Emergency department pediatric visits in alberta for cannabis after legalization. Pediatrics. 2021;148(4).
5. Wang GS, Buttorff C, Wilks A, et al. Changes in emergency department encounters for vomiting after cannabis legalization in Colorado. JAMA Netw Open. 2021;4(9):e2125063.
6. Ruberto AJ, Sivilotti MLA, Forrester S, et al. Intravenous haloperidol versus ondansetron for cannabis hyperemesis syndrome (havoc): A randomized, controlled trial. Ann Emerg Med. 2021;77(6):613-9.
7. Lonsdale H, Kimsey KM, Brown JM, et al. Pediatric cannabinoid hyperemesis: A single institution 10-year case series. J Adolesc Health. 2021;68(2):255-61.
8. Dosani K, Koletic C, Alhosh R. Cannabinoid hyperemesis syndrome in pediatrics: An emerging problem. Pediatr Rev. 2021;42(9):500-6.
9. Auger N, Luu TM, Ayoub A, et al. Cannabis-related hospitalizations among youth in canada before and after cannabis legalization. J Addict Med. 2021;15(3):245-7.
10. Perisetti A, Gajendran M, Dasari CS, et al. Cannabis hyperemesis syndrome: An update on the pathophysiology and management. Ann Gastroenterol. 2020;33(6):571-8.
11. Leveille CF, Issenman RM, Kam AJ. A case of cannabinoid hyperemesis syndrome highlighting related key paediatric issues. Paediatr Child Health. 2020;25(Suppl 1):S7-s9.
12. Foster D VAK, Yan J, Teefy J, Lynch T. 75 paediatric cannabinoid hyperemesis syndrome in the emergency department: A 5-year retrospective review. Paediatr Child Health. 2020;Aug;25(Suppl 2):e31.
13. Venkatesan T, Levinthal DJ, Li BUK, et al. Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome. Neurogastroenterol Motil. 2019;31 Suppl 2(Suppl 2):e13606.

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