THC induced hyperemesis syndrome
Cannabis is one of the most commonly abused drugs worldwide. Over the past decade, marijuana has remained the most commonly used illicit substance with close to 50% of high school seniors admitting use at some time. It is estimated that each year 2.6 million individuals in the USA become new users and most are younger than 19 years of age.
The long-term and short-term toxicity of cannabis abuse is associated with pathological and behavioural effects. However, cannabis has also been suggested to have therapeutic properties with anticonvulsive, analgesic, antianxiety and anti-emetic activities. Cannabis has also been used to treat anorexia in patients with acquired immunodeficiency syndrome[3–5]. The actions of cannabis are mediated by specific cannabinoid receptors. The first of the cannabinoid receptors-CB-1-was identified in 1990 and this finding revolutionized the study of cannabinoid biology. Since then, a multitude of roles for the endogenous cannabinoid system has been proposed. A large number of endogenous cannabinoid neurotransmitters or endocannabinoids have been identified, and the CB-1 and CB-2 cannabinoid receptors have been characterized. The CB-1 receptors exert a neuromodulatory role in the central nervous system and enteric plexus. Cannabinoid type 2 receptors have an immunomodulatory effect and are located on tissues such as microglia. The presence of other receptors, transporters, and enzymes responsible for the synthesis or metabolism of endocannabinoids are being recognised at an extraordinary pace. Cannabinoids have a wide variety of effects on the body systems and physiologic states due to their actions on the receptors as well as direct toxic effects.