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Marijuana in the ER: Overdose

My cousin is a nurse in the emergency room of a large hospital in a nearby California city. Whenever we reconnect we catch up on how things are going in our lives, special events, health, family, and work. Through her eyes, I have gotten a glimpse of how fascinating and challenging her job can be. What I’ve learned from her stories is that the emergency room sees many extreme cases, including marijuana overdose cases. I was surprised to learn how bad this has become.

I asked my cousin to tell me more so I could share it with others in this article. She not only agreed but offered to ask 3 other ER nurses/triage nurses and the head Doctor she works with for their input and experiences on this important topic. I started by asking some basics, below.


1. When did you first learn about marijuana overdose professionally?

- ER Nurse: “5 Five years ago, when I first started working. Ever since, I have seen it.”

- Head Doctor: “It has been around since 2015”


2. How informed are the nurses on withdrawal or overdose on marijuana? Is there any professional education or training on marijuana overdose?

- Triage Nurse: “There isn’t a specific educational class that is run by the education manager. Instead the seasoned nurses or nurses that have been in the ER for a couple of years just know about it. New nurses (6 months to a year) don’t know about cyclic vomiting that was due to marijuana overdose until they see the cases.”


- Charge Nurse: “When I train new nurses, I make sure to educate them about it and teach them how to look for the signs.”


I was also anxious to interview my cousin about a new cannabis overdose syndrome I’d been hearing about called Cannabinoid Hyperemesis Syndrome (CHS). It was nicknamed “scromiting” by ER nurses because people came into the ER screaming from abdominal pain and cyclic vomiting. Along with those symptoms, people take very hot showers/baths to relieve some of their pains.


The Dr’s learned early on that the syndrome is due to toxic levels of marijuana in the system from long term daily marijuana use. The only long-term treatment to entirely stop these symptoms was to stop using marijuana, until it was fully eliminated out of the body. Unfortunately in most cases that can take 2-4 weeks (Pruett, 2020).


This is what I learned:


3. Have you seen any cases of Cannabinoid Hypermesis Syndrome (Scromiting)? Or heard of that syndrome?

- ER Nurse: “Yes, I have seen that syndrome and it is very common in the ER. It’s when someone smokes weed, drinks/eats weed, or vapes weed - uses weed constantly, they are diagnosed with cannabinoid hyperemesis syndrome. “Hyper” means a lot and “emesis” means vomiting.”


4. How often do you or other nurses/doctors see marijuana overdose cases? Is it common on a daily shift?

- Doctor: I see this once or twice a week.

- Triage Nurse: “I personally see it once a month, and some nurses see it every other month. It ranges on how many cases we see, but it is definitely common”

(Doctors see more patients than nurses in a shift. A nurse typically sees 4-8 patients a night while a Doctor is assigned to half the population in the ER)



5. What are some of the worse cases of marijuana overdose have you seen?

- ER Nurse: “The worst case that I ever saw in the ER was an 18yr old male. He was so out of it when he came in and was constantly vomiting. When we received his toxic screening back, his results confirmed that he had cannabinoids and meth in his system. Because he was so out of it, he swallowed his vomit, it went to into his lungs which caused ammonia and we had to intubate him with a ventilator to help with his breathing.”


“When you overdose it suppresses your breathing system and makes you breathe super slow, when you’re out of it your mind and are not conscious enough, your brain can not keep up and tell you to breathe.”


Conclusion:


I had an eye-opening experience interviewing my cousin about how common marijuana overdose cases in the ER, and seeing how the nurses/doctors are responding. Stay tuned for part 2 of this interview, “Marijuana in the ER: Trends” where I ask ER Nurses about the current marijuana trends they have noticed in their workplace including average age, how marijuana affects a person’s mental health, and other concerning drug trends with youth. Please share what you’re learning about how marijuana can harm teens, to help them make an informed decision. Talk to your teen. And give them the chance to talk to you.


To learn about how marijuana has evolved in the recent years, see our other article “Not Your Mammas Weed”. And check out “Using in Plain Sight” to read about new trends on how youth are using in secret and how easy it is for them to access marijuana.



Sources:

Pruett, Gretchen. “What Is Scromiting?” The Recovery Village Drug and Alcohol Rehab, The Recovery Village Drug and Alcohol Rehab, 29 Jan. 2020, www.therecoveryvillage.com/marijuana-addiction/faq/what-is-scromiting/.

https://www.therecoveryvillage.com/marijuana-addiction/faq/what-is-scromiting/

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