Unusual marijuana-related illness grabbing attention of Boston doctors

BOSTON — Using marijuana for medical or recreational purposes is legal in Massachusetts, but doctors are finding some cases where the drug itself is actually making people sick.

The illness is often hard to diagnose and it’s cropping up more and more in states that have legalized marijuana.

Patients show up in the emergency room complaining of severe abdominal pain, nausea, and intense vomiting, sometimes more than 20 times a day.

“I was very afraid. I think the first time I really thought i was going to die in the hospital," patient Jigna Howland told Boston 25 News.

Compulsive symptom helps solve the medical mystery

Patients say the only relief comes from a hot bath or shower.

"I see plenty of other diseases that cause nausea, vomiting, and abdominal pain like appendicitis, and various viruses, and the last thing people want to do is take a hot bath or a hot shower," said Dr. Michael Donnino of Beth Israel Deaconess Medical Center.

It was that strange compulsion to bathe that led Dr. Donnino to launch what would become one of the nation's first case studies into Cannabinoid Hyperemesis Syndrome or CHS - a syndrome caused by excessive marijuana use.

"I was taking care of a patient who had come into the emergency room multiple times for complaints of nausea, vomiting and abdominal pain, and he had had CT scans, ultrasounds, MRIs, scoping procedures, all looking for a cause, and nobody could find anything," Donnino said.

That Boston patient is not alone. It took doctors in Washington eight bouts of CHS and five hospital stays to diagnose Jigna Howland this spring. Doctors say the marijuana she was taking to ease her nausea, was actually the cause of her symptoms.

"I didn't want to believe it at first," Howland said.

Patient Dixie Beal had a similar experience.

"When I was in the hot shower I was sweating profusely because of heat and not taking anything in, and so twice I ended up in the hospital because my kidneys were starting to fail," Beal told Boston 25 News.

Beal, a self-described heavy pot smoker of more than 50 years, says the V.A. spent tens of thousands of dollars on his tests, but they all came back inconclusive.

Dr. Donnino says a lack of research and knowledge stumped doctors who didn't realize they were looking at cases of CHS for many years.

"Fast forward to 2017, I'd say there's a lot of case reports and information now on this syndrome," Dr. Donnino said.

In Colorado, known cases have more than doubled since legalization in 2009. In part, because patients are more likely to talk about their marijuana use.

Questions Remain

Many questions remain about exactly how someone gets CHS or why warm water makes the nausea subside. Some studies suggest it has to do with your brain chemistry.

Cannabinoid Hyperemesis Syndrome is not life threatening in and of itself. Doctors say if you stop or change your marijuana habits, the symptoms will subside in days or weeks. But CHS can be dangerous for people with other diseases, and dehydration and kidney damage from the constant vomiting are huge risks.

“I really don't want this to be used as some anti-marijuana propaganda because I really believe in the beneficial properties of both recreational and medicinal marijuana,” Dixie Beal said.  “All I can say to the people who doubt it is, it's as real as a heart attack, and I hope it never happens to you.”