Compulsive showering and marijuana use – the cannabis hyperemisis syndrome

Patient: Male, 26 Final Diagnosis: Marihuana addiction Symptoms: Compulsive showering • nausea • vomiting Medication: — Clinical Procedure: — Specialty: Toxicology OBJECTIVE: Unexpected drug reaction BACKGROUND: The use or misuse of Cannabis is well recognized in the Caribbean region. Recently, the cannabinoid hyperemesis syndrome has been described. The triad is characterized by chronic marijuana use, cyclical vomiting, and compulsive bathing. With the extensive use to marijuana as a recreational drug and also the increased use as prescription medication, a patient presenting with this symptomatology needs to be assessed appropriately and this syndrome needs to be one of the differential diagnoses. CASE REPORT: To our knowledge, we report the first such case in the Caribbean region. Here, we report on the case of a 26-year-old Caucasian male with a 3-week history of nausea and week of epigastric pain and vomiting. The patient was known to use marijuana daily for 2 years and had similar complaints for the last 6 months. CONCLUSIONS: Because this popular recreational drug is now being used with increased frequency as a prescribed medication, it is crucial that clinicians be aware of this condition, which can present as a diagnostic dilemma.