Medical Research

Cannabinoid Hyperemesis Syndrome

Written by Derek Johnson

Cannabis use in the United States has skyrocketed over the past decade, and this has led to the development of new health issues among some users. One of these issues is Cannabinoid Hyperemesis Syndrome (CHS).

CHS presents in cannabis users with specific symptoms which include continuing cycles of nausea and vomiting. Sufferers will take hot baths frequently to help alleviate the nausea and suppress the vomiting. Since cannabis is well-known to have anti-vomiting properties, it is somewhat of a paradox that its cannabinoids may also aid in the induction of vomiting under certain circumstances.[1]

Because CHS is a relatively newly recognized illness, it is often misdiagnosed and can remain so for years. Its symptoms closely mimic those of Cyclic Vomiting Syndrome and other illnesses, and many medical professionals choose these diagnoses instead of CHS initially.[1] However, CHS is a distinct illness almost exclusively affecting long-term users who consume cannabis daily.

CHS manifests in three distinct phases. The first is called the prodromal phase. During this period, the sufferer experiences mild nausea, irregular eating habits and GI discomfort. However, during this phase, it is rare for patients or doctors to attribute these common symptoms to CHS. In fact, many patients consume even more cannabis in an effort to treat the symptoms.

The second phase, known as the hyperemetic phase, sees sufferers experiencing 24-48 hours of vomiting and/or abdominal pain. Dehydration is also a common occurrence during this phase. As with phase one, patients also tend to increase their cannabis use to alleviate the symptoms. Patients also obsessively immerse themselves in baths or showers, which, according to many of them, provides relief from the discomfort.

Recovery is the third phase. It sees the end of vomiting and a return to normal eating habits. Additionally, sufferers cease their frequent baths and showers, and they stop all cannabis consumption, which is one of the pillars of CHS treatment. The other is symptom management through the use of I.V. fluids and relaxation. Also, dopamine antagonists as well as benzodiazapenes have shown promise in symptom management but opioids have not.

Perhaps the most challenging aspect of treating CHS is diagnosing it. Its symptoms are similar to those of many other diseases, and its cause (cannabis) is often used to alleviate these same symptoms. However, with more research and more patients presenting with CHS, more information will eventually be available to help  treat this new illness.

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  1. Galli, Jonathan A, et al. Cannabinoid Hyperemesis Syndrome. Curr Drug Abuse Rev. 2011, Vol 4(4): 241-249

About the author

Derek Johnson