The New Zealand medical journal
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Cannabis use is common among the general population in many areas of the world and cannibis is readily available in much of New Zealand. We report an unusual complication of chronic cannabis use which has recently been described overseas. Cannabinoid hyperemesis with abnormal bathing behaviour is a syndrome of episodic cyclic vomiting, often associated with relief being obtained by hot water bathing or showering. ⋯ The proposed mechanism of the syndrome is accumulation of cannabis metabolites in the brain. Abstaining from cannabis use is likely to prevent ongoing recurrences. Although there have been limited reports in the medical literature, it is likely that the syndrome is commoner than previously recognised and the presentation could easily be confused with psychiatric illness or cyclic vomiting syndromes.
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In 2004, the NZ Branch of the TSANZ published "Standards for Adult Respiratory and Sleep Services" on the Ministry of Health's (MoH) website.1 The aim of this survey was to evaluate each of the 21 District Health Boards' (DHBs) performance against the published standards, concentrating particularly on staffing, infrastructure, clinical support services, implementation of guidelines, quality assurance activity, and basic services (sleep, lung function, and oxygen). ⋯ When evaluated against minimum standards of care published in 2004, major gaps in service provision exist in New Zealand. Access to services is variable. There is a lack of national leadership and insufficient regional organisation leading to large gaps in service provision of even basic respiratory services. Immediate changes to the current service provision structures are required.