It has been proposed that hot bathing may act by correcting the cannabis-induced disequilibrium of the thermoregulatory system of the hypothalamus 6. Darmani has suggested that cannabis increases the core body temperature while concomitantly decreasing skin temperature thus increasing blood flow to the skin and dissipating excess core body heat 72. Two case series and numerous individual case reports have been published on Cannabinoid Hyperemesis Syndrome (CHS) (Table 1). Patients present with recurrent episodes of nausea, vomiting, and dehydration with frequent visits to the emergency department. Patients are typically what is chs young adults with a long history of cannabis use. In nearly all cases there is a delay of several years in the onset of symptoms preceded by chronic marijuana abuse 6.
Prodromal phase
Patients who fail to respond to antiemetic therapy are at high risk for dehydration and resulting in nutritional deficiencies. Other known complications of forceful and uncontrolled vomiting include aspiration and subsequent pneumonitis or aspiration pneumonia as well as injury to the esophageal wall such as Boerhaave’s syndrome. When you use marijuana for many years, it can start to slowly change how the receptors in your body respond to the cannabinoid chemicals. For example, the drug affects the receptors in the esophageal sphincter, the tight band of muscle that opens and closes to let food go from your throat to your stomach.
- Since 2004, doctors have identified key symptoms and characteristics of the condition that can help speed up diagnosis.
- One possible treatment option involves the use of benzodiazepines, such as lorazepam, to control nausea and vomiting.
- What most people don’t realize, researchers say, is that the THC young people are vaping and dabbing today has little resemblance to the marijuana of decades past.
- That’s because hot water can help ease cannabinoid hyperemesis syndrome symptoms like nausea.
- The symptoms typically last a few weeks, though the throwing up should ease up in a day or two.
- Both cannabinoid hyperemesis syndrome (CHS) and cyclic vomiting syndrome (CVS) cause people to feel sick to the stomach and throw up at times, while feeling normal at other times.
Pharmacology of Cannabinoids
The word “cannabinoid” refers to compounds uniquely found in cannabis, and “hyperemesis” means severe vomiting. Supportive care in the form of intravenous hydration and anti-emetics may be necessary secondary to profound dehydration and acute renal failure. Very limited evidence suggests that dopamine antagonist medications and the application of capsaicin cream to the abdomen may be helpful strategies to manage acute symptoms. Though there is not any direct evidence, avoidance of narcotic pain medication may be useful due to the possibility of worsening symptoms and creating dependence. The mechanism by which cannabis induces hyperemesis is presently unknown. A recent review has explored numerous potential explanations regarding various pharmacokinetic and pharmacodynamic factors of the cannabinoids 72.
- The pathophysiologic processes underlying CHS are unclear at this time.
- The use of lorazepam for CHS is also off-label, so a person’s doctor would need to make them aware of this fact.
- On several occasions, she got so ill that even the smell of food made her throw up.
- It appears from the current literature that the prevalence of cannabis hyperemesis syndrome (CHS) is higher in the US compared to Canada and the United Kingdom, although the prevalence of cannabis use is similar in these countries 7,8.
How is Cannabinoid Hyperemesis Syndrome Treated?
In one 2018 study, a group of researchers surveyed 2,127 U.S. adults between the ages of 18 and 49 at an emergency department in New York. Of those surveyed, 155 met the criteria of smoking cannabis at least 20 days per month. CHS is a newly identified condition, so doctors currently know little about it.
- Other researchers theorize that the effects of marijuana can change with chronic use.
- Supportive care in the form of intravenous hydration and anti-emetics may be necessary secondary to profound dehydration and acute renal failure.
- Importantly, for the definition of cyclic vomiting syndrome, these episodes of vomiting cannot be attributed to other disorders.
Help quitting cannabis
Compulsive use of hot water bathing or showering to relieve symptoms has been described but is not required for diagnosis. Ultimately, cannabis abstinence is the only documented treatment to date that results in disease resolution,3,4 though with limited longitudinal follow up data available, the required period of abstinence is poorly characterized. Cannabinoid hyperemesis syndrome (CHS) is a condition that you might get if you’ve regularly smoked weed or used marijuana in some other form for a long time. CHS causes you to have repeated episodes of vomiting, severe nausea, stomach pain, and dehydration. You’re more likely to get CHS if you use marijuana at least once a week and have been doing so since you were a teenager. „Cannabinoid” refers to cannabis (marijuana) and „hyperemesis” is a word meaning „prolonged vomiting.”
What are the symptoms of cannabis hyperemesis syndrome?
The response said the state had a potency cap of heroin addiction 10% THC on edibles and 30% potency on flower (or bud). Any effort to regulate Washington’s cannabis has faced stiff resistance from industry lobbyists in Olympia, including tactics that lawmakers and researchers compare to those used by big tobacco and big pharma. But even Russo, whose professional life revolves around the benefits of cannabis, has been calling out the dangers of high-potency concentrates — a danger he said is universally applicable to any drug. What most people don’t realize, researchers say, is that the THC young people are vaping and dabbing today has little resemblance to the marijuana of decades past.
Living With Cannabinoid Hyperemesis Syndrome
In one case series the average number of emergency room visits (7.1 ± 4.3) prior to diagnosis and the delay in diagnosis (for up to 9 years) was substantial 62. Not surprisingly, the early identification of patients with CHS leads to a reduction in morbidity and costs 6. The differential diagnosis of nausea and vomiting is extensive and includes a broad range of pathologic conditions affecting the gastrointestinal tract, the peritoneal cavity, CNS, as well as endocrine and metabolic functions 63.