Hurling While High

Untitled Slide

• Emergency Physician RIH
• Clinical Associate Professor, Dept of EM
• Site Scholar, Kamloops Family Medicine Residency Program

Cannabis

• QI for RCT of cannabis for PTSD- UBCO
• Provider- MCRCI
• Editor/Contributor - Using Medical Cannabis/Tilray
• Senate Report on Cannabis

Disclosures

• Speaking fees: Tilray, Maricann
• Consulting: Tilray, Shoppers Drug Mart, MD Briefcase
• Investments: SDM

Allen,2004, Adelaide

CHS patients

• male
• prolonged cannabis use
• abdominal pain
• scromiting
• hot showers/baths give relief

Untitled Slide

• Investigations negative
• $25 000/year costs
• Cessation only cure
• Challenge causes return of symptoms

CHS vs CVS

• CVS more in women
• Heat cure rare in CVS
• CVS begins in childhood
• mitochondrial DNA ?

Etiology

• THC decreases temperature
• Cannabinoid receptors in hippocampus and gut

TRPV

• pain (capsaicin)
• triggered by high temperatures

Jamaica

Neem Oil Hypothesis

• unapproved pesticide
• toxicity leads to vomiting
• no CHS from edibles
• sporadic distribution of CHS

Neem Oil Hypothesis

• toxicity doesn't include hot showers
• CHS seen with synthetic cannabinoids

Treatment

• Rehydration
• Antiemetics
• Benzodiazepines

Haloperidol 5 mg im/iv

Capsaicin

How Long?

Recidivism

Legalization

Stigma

CHS:Public Health Implications and a Novel Treatment Guideline, LaPoint, et al, 2017, West J E M

Questions?