Cannabis Hyperemesis Syndrome: What It Is and How to Treat It Effectively
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Frequent alcohol and cannabis co-use has been previously documented on a population level, but the impact of these factors on cannabinoid hyperemesis syndrome should be examined in future work. CHS is marked by persistent vomiting and ongoing abdominal pain, primarily affecting long-term, daily cannabis users. As cannabis becomes more potent and widely available, CHS is increasingly prevalent. Many patients are hesitant to consider cannabis as the cause of their symptoms, which can delay diagnosis and hinder further research. Moving forward, physicians should be aware of rising cannabis use and identify potential CHS cases to ensure proper treatment and investigation. Further research, particularly at the microscopic level, is essential to better understand this condition.
The Gut-Brain Connection
The user base of social media platforms such as Reddit may not be representative of the population suffering from cannabinoid hyperemesis syndrome. For example, prior reports have documented that people who use Reddit are majority male, younger, and non-Hispanic white 25. However, it is likely that the base of people using Reddit has expanded since that report. Finally, only 69 posts were manually reviewed for the thematic analysis and training of machine learning models. While we applied a net vote-based filtering to ensure that the manually reviewed posts were highly informative, our findings and the performances of the trained machine learning models were limited by this number. Despite these limitations, this analysis was a first step to describing cannabinoid hyperemesis syndrome in Reddit community posts and documenting general themes.
Links to NCBI Databases
Researchers are still trying to figure out exactly what causes CHS in some people who regularly use cannabis but drug addiction treatment not others. This article will explain the causes of CHS and the available treatment options. As CHS is a new diagnosis, the manufacturers of these drugs did not design them for treating CHS, but a doctor may opt to prescribe them for this use. However, doctors exercise caution when prescribing lorazepam because it is a controlled substance with the potential for abuse and addiction. The use of lorazepam for CHS is also off-label, so a person’s doctor would need to make them aware of this fact.
Exploring Alternative Therapies
Scientists do not know much about the function of the CB2 receptors. On the basis that only a small number of regular and long term users of marijuana develop CHS, some researchers suggest that genetics might play a role. Other researchers theorize that the effects of marijuana can change with chronic use. Many people with CHS go to their doctor or an emergency room (ER) for treatment.
CHS Phases
It’s important to be honest about your marijuana use if you have symptoms of CHS. Without knowing this background, providers often misdiagnose CHS as other conditions, like cyclic vomiting syndrome (CVS). Severe nausea, vomiting, and stomach pain are the hallmark symptoms of cannabinoid hyperemesis syndrome (CHS). The word “cannabinoid” refers to compounds uniquely found in cannabis, and “hyperemesis” means severe vomiting. With cannabis use on the rise, awareness of hyperemesis cannabis syndrome must increase.
Educating Cannabis Users
- As cannabis legalization continues to spread across the United States, healthcare systems may face an increasing burden from cannabis-related conditions like CHS.
- Cannabis has long been tied to the infamous “munchies,” that irresistible urge to raid the fridge after a few puffs.
- Additionally, policies could focus on tracking and reporting cannabis-related health complications to better understand the full scope of CHS and its impact on public health.
- People with CHS also tend to have a strong urge to take very hot showers or baths.
- 2.6 million Americans become new users each year; the majority of this group is under the age of 19 3.
Articles published in English were included to maintain consistency and ensure accessibility of the studies. Non-English publications were excluded unless an English abstract was available. Symptoms often ease after a day or two unless marijuana is used before this time. Experts are still trying to learn exactly how it causes CHS in some people.
⃣ Alternative Therapies for Symptom Relief
- These approaches teach coping and problem-solving skills and promote the substitution of cannabis-related behaviors with healthier alternative behaviors 93.
- These medications exert their effects by inhibiting the medullary and vestibular nuclei in the brain, which play a key role in nausea and vomiting regulation.
- Many people with CHS find relief through hot showers or baths, which provide temporary comfort.
- Or hospital, and dosage titration can be made during closer outpatient care.
- THC can overdo hunger, per a 2014 study linking heavy use to higher calorie intake (Penner et al., 2014).
- 11-OH-THC is psychoactive and shares similar potency to THC, whereas THC-COOH is non-psychoactive and has anti-inflammatory effects 27-29.
Patients experience complete relief of the symptoms, which can last days, weeks, or even months. The duration of this phase ranges from weeks to months, depending on resuming marijuana use, which may trigger another relapse. Throughout this phase, the patient maintains an average weight and returns to their baseline state 49. Hot showers have emerged as an intriguing phenomenon in assuaging the symptoms of Cannabis Hyperemesis Syndrome (CHS), offering a peculiar yet effective avenue for relief.
These advances enhanced the understanding of cannabinoid (CB) receptors, which led to a better appreciation of the role of cannabis in inflammation, seizures, emesis, and as an appetite stimulant. There is a growing body of research showing the benefit of cannabis in the aforementioned disorders, and its legalization will further augment research on understanding its critical role in new drug developments 3,4. However, these changes also come with substantial risks regarding its adverse effects, such as paradoxical hyperemesis, intoxication and behavioral changes (anxiety, panic attacks, and psychoactive changes). Approximately 9% of individuals who use cannabis report dependence at some point in their use 5. Cannabis can paradoxically act as an antiemetic during acute ingestion at low doses, whereas persistent high-dose ingestion could result in vomiting, a behavior similar to cyclical vomiting 6. It is unclear whether the increased legalization of cannabis has also https://ecosoberhouse.com/article/cannabinoid-hyperemesis-syndrome-what-is-chs/ contributed to these findings, but this certainly could be a possibility.
Treatment
- One 2018 study found that 32.9% of self-reported frequent marijuana users who’d gone to the emergency room (ER) had symptoms of CHS.
- Patients may also benefit from oral lorazepam tablets, doses between 0.5 to 1 mg every 6 to 8 h on discharge.
- They also experience episodes of vomiting that return every few weeks or months.
- It’s not just about late-night snacks; it’s about harnessing its therapeutic potential thoughtfully.
Potential causes of CHS include influence on the activity of cannabinoid receptors, conversion of cannabis into emetic substances, or contamination with other toxins 36. Cannabis leads to upregulation of CB1 receptor activity in the hypothalamus, which enhances the hypothermic effects of THC. The effects of cannabis and its interactions on the various organ systems were elucidated further with the discovery of the endocannabinoid system (ECS) 1. Tetrahydrocannabinol (THC) is the primary psychoactive compound in cannabis. The role of cannabinoid (C.B.) receptors has enhanced our understanding of cannabis’s effects on inflammation, seizures, nausea, and appetite regulation 5,6,7. The ongoing cannabis legalization is expected to advance more research into its therapeutic potential.
Psychological stress, such as post-traumatic stress disorder or a history of physical and sexual abuse, are potential triggers for disrupting the expected anti-emetic effects of THC. Though the precise mechanisms remain unclear, higher amounts of marijuana consumption, genetic influences, and psychological stress lead to intoxication and paradoxically promote vomiting. Sympathetic and parasympathetic systems play interlinked roles in emesis.