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MAPTalk-Digest Wednesday, December 21 2005 Volume 05 : Number 153

001 Fw: Cannabis 'hyperemesis' questioned. Our letter in January 'Gut' jour
    From: "D.H. Michon" <>
002 Kirk has a fan
    From: "Larry Seguin" <>


Subj: 001 Fw: Cannabis 'hyperemesis' questioned. Our letter in January 'Gut' journal. 
From: "D.H. Michon" <>
Date: Tue, 20 Dec 2005 16:33:24 -0800

- ----- Original Message ----- 
From: Andrew Byrne
Sent: Tuesday, December 20, 2005 4:59 PM
Subject: Cannabis 'hyperemesis' questioned. Our letter in January "Gut" journal. 

"Cannabis hyperemesis" causation questioned:


Dear Editor, 

The authors describe a number of cases of a bizarre syndrome of severe vomiting, abdominal symptoms leading to dehydration, in combination with repetitive bathing behaviour (Gut 2004;53:1566-70). They have concluded that these symptoms are due to cannabis use. 


Cannabis has been consumed for many centuries and is currently used by millions of people in many countries. It is hard to believe that a distinctive syndrome caused by cannabis has never been noted before by users or clinicians. 


The authors assert that cannabis laws are particularly liberal in South Australia. Four Australian jurisdictions now have a cannabis expiation notice system which South Australia first introduced in 1986. The other four Australian jurisdictions have variations on a bond system. Several European countries have far more lenient legislative arrangements. After over a generation of liberalisation of cannabis laws in many countries around the world, there is little evidence of a subsequent increase in cannabis use.


In a comparative study using the same methodology, the prevalence of cannabis use in more 'liberal' Amsterdam was lower than in more 'punitive' San Francisco [Reinarman C, Cohen PDA, Kaal HL. The Limited Relevance of Drug Policy: Cannabis in Amsterdam and in San Francisco. Am J Public Health. (2004) 94:836 842].


The title of the paper, 'Cannabinoid hyperemesis' is unduly presumptive. Some of these cases appeared to improve with abstinence and then relapsed when patients were 'rechallenged' with cannabis, however neither the patients nor the authors appear to have been blinded in the rechallenge. The proposed biological explanation is weak.


We suggest that alternative explanations need to be sought for these cases. This syndrome should not be accepted as being caused by cannabis without additional reports and other evidence.


A Byrne1, R Hallinan1 and A Wodak2 

1 Byrne Surgery, Sydney, Australia

2 St Vincent's Hospital, Darlinghurst, New South Wales, Australia 



Correspondence to: 

Dr A Byrne 

Byrne Surgery, 75 Redfern St, Redfern, 2016, Sydney, Australia; (snip)


Keywords: cannabis hyperemesis; cannabis; hyperemesis


The original authors defend their position in reply.  


Original reference: Allen JH, de Moore GM, Heddle R, Twartz JC. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse. GUT (2004) 53;11:1566-1570




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Subj: 002 Kirk has a fan
From: "Larry Seguin" <>
Date: Wed, 21 Dec 2005 21:14:10 -0500

She did her homework Kirk. I bet she looked up your letters at MAP!




Few in society today know much about Prohibition other than tirades
like the Dec. 6 letter, "Prohibition didn't work," of Kirk Muse 


End of MAPTalk-Digest V05 #153

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