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Intern Med J. 2018 Nov 13. doi: 10.1111/imj.14164. [Epub ahead of print]

Recent Trends in Cyclic Vomiting Syndrome - Associated Hospitalizations with Liberalization of Cannabis Use in the State of Colorado.

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Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Department of Pharmacology and Toxicology, and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA.



Currently 29 states in the United States along with the District of Columbia have legalized cannabis in some forms. There is a paucity of data on the impact of legalization of cannabis use on hospitalizations due to cyclic vomiting syndrome (CVS).


To study the trends in CVS-related hospitalizations and cannabis use in CVS in relation to legalization of recreational cannabis use in Colorado.


All hospital admissions in Colorado between 2010 -2014 with the diagnosis of CVS were identified using the Colorado State Inpatient Database (SID). Five-year trends in CVS-related hospitalizations along with the cannabis use were analyzed. Multivariate logistic regression analysis was performed to determine predictors of cannabis use in CVS.


There was a significant increase in CVS- related hospitalizations by 46% from 806 in 2010 to 1,180 in 2014 when CVS was included as all-listed diagnoses (P<0.001). The overall prevalence of cannabis use in CVS (13% with CVS as primary diagnosis and 17% with CVS as all-listed diagnoses) was much higher than non-CVS related hospitalizations (1.7%) (P<0.001 for both comparisons). Cannabis use increased dramatically in both CVS and non-CVS related hospitalizations following legalization of cannabis for recreational use in 2012.


Our study shows a significant increase in CVS-related hospitalizations concomitant with an increase in cannabis use with its liberalization in Colorado. Future studies on the relationship between cannabis use and hyperemesis are warranted, especially with its ongoing legalization in the US. This article is protected by copyright. All rights reserved.


Colorado; cannabis; cyclic vomiting syndrome; hospitalization; legalization


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