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When she leaves, the truth comes out. I learn that at 14 years old, Nick drinks alcohol casually and from his own estimate, has been smoking pot every day for the past two years.

Combined with that knowledge and a physical exam that reveals nothing of note, I think I’ve cinched my diagnosis. “Nick, I’m going to run a few tests to rule out anything worrisome. But I’m fairly confident your vomiting is because of all the pot you’ve been smoking.”

Nick was suffering from Cannabinoid Hyperemesis Syndrome (CHS) — abdominal pain, nausea and intractable vomiting due to chronic, regular cannabis use. Never heard of it? Neither had Nick’s parents. Just a short time ago, it wasn’t on most doctors’ radars either.

Nick was suffering from Cannabinoid Hyperemesis Syndrome

And this is a problem.

The legalization of recreational marijuana is upon us, and cannabis use in youth is already rampant.Surveyinggrade 7 to 12 students, one in five had tried cannabis, and over one in 10 had used it in the past month, with an average initiation age of 15 years. We already treat many of these patients for CHS. And, if we’re anything like the state of Colorado, we could seenearly a doublingof cases as they did following liberalization.

CHS poses serious health effects, such as dehydration. It also contributes to missed school and work, and is costly on our already faltering health-care system. Patients often present multiple times to emergency departments, undergo expensive and sometimes invasive tests, consultations and treatments before they are appropriately diagnosed. By increasing awareness amongst both the public and the health-care profession, patients can be treated promptly (with hot showers, topical capsaicin cream and firm advice to quit), and the cost savings could be significant.