Synthetic cannabinoid leading to cannabinoid hyperemesis syndrome.
نویسندگان
چکیده
To the Editor: In their editorial on opiate overdose, Berge and Burkle list the release of new opioid drugs, the aggressive marketing to physicians, the declaration of pain as “the fifth vital sign,” and the increased willingness of physicians to treat noncancer pain with opioids as the measures that led to the explosion of sales of prescription opioid pain relievers. It is imperative that 3 others be added to this list: the patient satisfaction survey industry, the Centers for Medicare and Medicaid Services (CMS), and hospital administrators. Despite conflicting literature, the patient satisfaction survey industry was able to convince payers and hospitals that patient satisfaction and quality of care are directly correlated. The CMS, in their drive to pay for quality instead of quantity, had such faith in this flawed concept that they weighed patient satisfaction at 30% in their value-based purchasing program. As a result, hospitals bought patient satisfaction survey tools and consulting services from these companies and started providing physicians with “feedback” on their performance, asking those with poor scores to improve. To that end, physicians started working harder to please patients, giving them what they wanted (which was not always the same as what they needed) and erring on the side of overprescribing to avoid being scored poorly. Patients seeking opiate prescriptions then learned to tell physicians that an opiate prescription would make them “highly satisfied,” a not-soveiled threat that anything less would result in a poor satisfaction score and the resultant increased scrutiny by hospital administration.
منابع مشابه
A Gut Gone to Pot: A Case of Cannabinoid Hyperemesis Syndrome due to K2, a Synthetic Cannabinoid
Cannabinoid Hyperemesis Syndrome (CHS) was first described in 2004. Due to its novelty, CHS is often unrecognized by clinicians leading to expensive workup of these patients with cyclical symptoms. It may take up to 9 years to diagnose CHS. CHS is characterized by cyclical nausea and vomiting, abdominal pain, and an unusual compulsion to take hot showers in the presence of chronic use of cannab...
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Legalization of marijuana use will increase the number of people who will become long-term users. A prior medical record review study in Australia, in 2004, identified 19 chronic marijuana users who entered the emergency department with recurrent vomiting associated with abdominal pain. Routine treatment of the nausea and vomiting, associated with the chronic marijuana abuse, with antiemetics i...
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Cannabinoid hyperemesis syndrome (CHS) is a clinical entity in which marijuana users develop nausea, vomiting, and abdominal pain that improves with hot water bathing or cannabis cessation. Previous models suggest that CHS arises solely from the derangement of cannabinoid receptor type 1 signaling. However, involvement of transient receptor potential vanilloid subtype 1 (TRPV1) receptor, which ...
متن کاملCannabinoid-Induced Hyperemesis: A Conundrum—From Clinical Recognition to Basic Science Mechanisms
Cannabinoids are used clinically on a subacute basis as prophylactic agonist antiemetics for the prevention of nausea and vomiting caused by chemotherapeutics. Cannabinoids prevent vomiting by inhibition of release of emetic neurotransmitters via stimulation of presynaptic cannabinoid CB₁ receptors. Cannabis-induced hyperemesis is a recently recognized syndrome associated with chronic cannabis ...
متن کاملCannabinoid hyperemesis syndrome: a case report and review of pathophysiology.
Cannabis is the most widely used illicit drug in the United States, with lifetime prevalence of use estimated at 42% to 46%. The antiemetic properties of cannabis are well-known by the medical community and the general public; however, less well-recognized is the paradoxical potential for certain chronic users to develop hyperemesis. We describe in this case a patient with prior extensive work-...
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عنوان ژورنال:
- Mayo Clinic proceedings
دوره 89 8 شماره
صفحات -
تاریخ انتشار 2014