What Is Cannabinoid Hyperemesis Syndrome?
What Is Cannabinoid Hyperemesis Syndrome?
Cannabinoid Hyperemesis Syndrome (CHS) is new to popular awareness, so many people still do not know exactly what it is or that it even exists. People with this condition cannot continue with the symptoms as they most always worsen, causing an ever-increasing deterioration of health that can be prevented if the proper education and awareness is given.
Cannabinoid Hyperemesis Syndrome: The Highlights
- Cannabinoid Hyperemesis Syndrome is a condition affecting chronic cannabis users over time
- CHS usually affects those who use cannabis multiple times a day for a long time
- The condition worsens if left untreated or if the patient continues using cannabis
- CHS produces nausea, vomiting, weight loss, and abdominal pain
- Even though it can become severe, Cannabinoid Hyperemesis Syndrome can be treated
What is Cannabinoid Hyperemesis Syndrome?
Cannabinoid Hyperemesis Syndrome, or CHS, is a condition that develops in marijuana users due to their chronic cannabis abuse over time. This condition tends to develop in people who take cannabis multiple times a day, every day for a long period of time. It has three stages and steadily worsens if not treated by the discontinuation of cannabis.
The condition manifests in the body as nausea, vomiting, and gastrointestinal discomfort or pain. These symptoms grow stronger over time, which then encourages health problems to arise.
What is the exact reason why cannabis creates this condition in the body? Science reveals that the culprit is Tetrahydrocannabinol, or THC, which is a cannabinoid found in marijuana. Cannabinoid receptors in the brain bind to the THC molecules producing a high that relaxes the body and mind as well as aiding in nausea reduction.
What happens with heavy, daily use over time is that the receptors start to respond to the THC molecules differently than they did previously, therefore causing the opposite effect to take place. Namely, nausea, abdominal pain, and vomiting.
Research on Cannabinoid Hyperemesis Syndrome
The handful of cases that have been studied do indicate that cannabis does indeed cause Cannabinoid hyperemesis syndrome in some people who chronically consume marijuana over a long period of time. However, because CHS is still new to the medical field, the case reports are few and more studies must be performed to further validate this new condition.
Does CBD cause Cannabinoid Hyperemesis Syndrome?
The cases that support the theory that cannabis does cause CHS are as follows:
A 2004 study done by a team of Australian medical professionals saw all Cannabinoid Hyperemesis Syndrome symptoms drop away in all 7 patients who ceased using cannabis. The other three patients studied refused to quit and their CHS symptoms remained. Three people in this study decided to go back to taking marijuana after their long abstinence and their symptoms returned. Two of these three same people abstained once again and then once more found complete relief from CHS symptoms.
Other individual cases follow the one above. Two 2009 cases done by Yale University had similar results. The patients in each case both took marijuana every day and had developed abdominal pain, cyclical vomiting syndrome, and took excessive hot showers to alleviate symptoms. They both admitted themselves into emergency room care. Within 48 hours of not taking cannabis, both people were symptom-free.
Another 2009 study done by Creighton University studied a young man who had a history of chronic marijuana abuse. After he started to abstain from cannabis, his abdominal pain and continual vomiting completely stopped. The researchers concluded the study by stating: “in the absence of other obvious causes, a diagnosis of cannabinoid hyperemesis syndrome should be considered.”
Yet another 2014 case studied by the Birmingham City University in the U.K found that a 42-year-old man, who had been a long-time cannabis user, emitted himself into the emergency department. Within three months of abstaining from marijuana, he was CHS symptom-free.
The evidence presented, albeit little in comparison to other conditions that are more heavily studied, suggests that this condition is real and that it is caused by heavy cannabis use. However, there are those in the medical field who hold much skepticism.
Skepticism of Cannabinoid Hyperemesis Syndrome
The biggest reason why so many in the medical field are still very doubtful that cannabinoid hyperemesis syndrome is caused by THC found in marijuana is that people have been consuming it for thousands of years. Additionally, there are millions of people today all over the world who take it.
This leads one to wonder why there haven’t been collective complaints of CHS symptoms in history or in recent times. Why is it only recently that the consistent, daily dosages of marijuana are becoming a problem?
A 2006 Australian review stated this in questioning the legitimacy of cannabinoid hyperemesis syndrome: “We suggest that alternative explanations need to be sought for these cases. This syndrome should not be accepted as being caused by cannabis without additional reports and other evidence.”
Signs and Symptoms of Cannabinoid Hyperemesis Syndrome
There are three phases of Cannabinoid Hyperemesis Syndrome, two of which include the symptoms listed below with differing severity:
- Consistent nausea, especially in the mornings
- Vomiting multiple times daily, every day
- Abdominal pain and general gastrointestinal discomfort
- Weight loss
- Increased desire for multiple hot showers daily
These CHS symptoms increase in frequency and in intensity as the condition worsens with the continued use of cannabis. The first two phases reveal how CHS progresses:
The Prodromal phase is the first phase and has the mildest symptoms. This phase can last for months or even years before turning into a hyperemetic state. The symptoms include:
- Morning nausea which usually lessons as the day progresses
- Fear of vomiting but little to no actual vomiting at this stage
- Sporadic abdominal pain
At this stage, appetite and weight are usually not negatively affected. However, as CHS progresses, appetite and weight can be highly affected. Additionally, people in this stage usually continue to take cannabis because they still believe that it cures nausea and stomach discomfort rather than it actually being the cause.
In this stage, the patients who are still using cannabis are starting to see heightened symptoms as the CHS syndrome worsens. The symptoms include:
- Cyclical vomiting or continual vomiting at different times of the day, every day
- Almost constant nausea
- Compulsive desire to be in hot water
- Chronic abdominal pain
- Loss of appetite
- Weight loss
- Dehydration symptoms
At this stage, the vomiting turns into cyclic vomiting syndrome, which means that the patients do not get much relief from their vomiting episodes unless they take hot showers or baths. This is why sufferers of CHS tend to take multiple showers daily.
Also, weight loss becomes very apparent at this stage because nausea and vomiting have become so acute that they have little to no appetite and cannot keep their food down. With all of these extreme symptoms, it becomes very apparent to patients that something is very wrong and that they must seek professional help, even to the point of seeking out their nearest emergency department for quick symptom relief.
This phase happens once patients decide to stop using marijuana. Once the cannabis is eliminated, the body will respond by healing and ceasing to react. Appetite is restored. The weight lost during the hyperemetic stage is regained. The cessation of nausea, vomiting, and abdominal pain depends on the person but most patients notice improvements within days to weeks, although, for some, the recovery might take a bit longer.
How Is Cannabinoid Hyperemesis Syndrome Treated?
The only way to treat Cannabinoid Hyperemesis Syndrome is to stop using marijuana altogether. However, during the treatment period where symptoms might persist, other measures may be taken to eliminate them quicker.
Stop Using Marijuana
As the studies above clearly show, the most obvious solution for anyone who suffers from this syndrome is to stop taking cannabis immediately. Although this may be hard for many, the alternative consequences in continuing to take cannabis can be far worse.
CHS causes dehydration, and sometimes even severe cases. This is due to the excessive vomiting that takes place during the second phase. Therefore, it is essential that as patients recover, they drink as much fluid as possible, especially those that hydrate well like water or beverages with electrolytes. Avoid caffeine and alcohol during the recovery phase.
Although most people recovering from CHS stop having symptoms fairly quickly, this may not be the case for some. Therefore, sometimes prescription medication may be needed for nausea and vomiting.
Additionally, there a topical capsaicin cream that seems to work quite well in treating CHS symptoms. In a 2016 Clinical Toxicology report, the study revealed a dramatic symptom relief after the administration of the capsaicin cream in 100 percent of the patients who exhibited CHS symptoms.
How does capsaicin relieve the symptoms one may wonder? The study above stated this: “Topical capsaicin is a proposed treatment for CHS; it binds TRPV1 with high specificity, impairing substance P signaling in the area postrema and nucleus tractus solitarius via overstimulation of TRPV1. This may explain its apparent antiemetic effect in this syndrome.”
How Hot Showers Help
Many patients who suffered greatly from nausea during the prodromal and hyperemic phases might already know that hot water helps in alleviating CHS symptoms. But for those who do not know this, it is a great tool to utilize while recovering from Cannabinoid Hyperemesis Syndrome. In every case study mentioned above, all of the patients found symptom relief from extended periods of time in hot water, whether showering or bathing.
The idea is that the heat that comes from the water helps to trigger the hypothalamus into correcting the disequilibrium effect caused by the THC in the cannabis. However doubtful scientists are on this theory, the fact remains that many people recovering from CHS do experience substantial relief from hot showers.
Does CBD Cause Cannabinoid Hyperemesis Syndrome?
With the evidence presented, it does seem that cannabis does indeed cause cannabinoid hyperemesis syndrome. All of the cases presented revealed the same symptoms with habitual marijuana use and also complete symptom relief once the drug was no longer used by the patients.
However, as with every condition that needs more study before being acknowledged as true, it is good to always look at all the facts and do one’s own research. Whether or not it is, in fact, a medical condition brought on by the use of cannabis, it is nonetheless good to be aware of the condition in relation to the drug.
A word of caution
With the increasing amount of evidence revealing itself to the masses in regards to Cannabinoid hyperemesis syndrome, it is important to heed this newfound knowledge if you are a consumer of cannabis or if you know someone who is. CHS can cause great health damage and a severe compromise to one’s quality of life if not treated.