What Is Cannabinoid Hyperemesis Syndrome (CHS) and How to Treat It?

Never heard of Cannabinoid Hyperemesis Syndrome before? Welcome to the club.

The science says that chronic and heavy marijuana use can sometimes trigger episodes of nausea, vomiting, and hot bathing, a group of symptoms conveniently named the Cannabinoid Hyperemesis Syndrome (CHS).

This mysterious condition unique to pot smokers was identified in 2004. It sounds a bit scary at first, but thankfully, it’s not that common.

If you’ve started experiencing the above symptoms and are worried that CHS is to blame, read on, as we’ll now explore the cause of cannabinoid hyperemesis syndrome and what to do if you are affected by it.

What is Cannabinoid Hyperemesis Syndrome?

Cannabinoid Hyperemesis Syndrome is a set of symptoms caused by chronic and heavy cannabis use. It is characterized by cyclic episodes of nausea and vomiting and frequent hot bathing. It occurs through an unknown mechanism. (1)

CHS starts off with nausea, vomiting and moderate to the severe abdominal pain that lasts for 1 to 7 days.

Patients soon figure out that hot showers relieve their symptoms so they develop a habit of having frequent hot baths.

CHS happens with heavy cannabis use, defined as exceeding 3-5 smoke sessions per day over a long period of time. Patients who tend to abuse strains high in THC are more likely to develop it, as well.

The fact that CHS causes nausea is interesting, considering that cannabis is being used as an antiemetic (medicine for reducing nausea) in cancer patients undergoing chemotherapy, as well as in HIV/AIDS patients.

CHS should not be mistaken with cyclical vomiting syndrome (CVS), although the symptoms are similar. (1)

The only difference between these two conditions is that CVS is not caused by cannabis use.

What causes Cannabinoid Hyperemesis Syndrome?

When it comes to pot and health it’s difficult to make definitive claims—cannabis is a Schedule 1 substance in the US and so there is a lack of research in the field. This lack of research also applies to Cannabinoid Hyperemesis Syndrome.

CHS has been discovered fairly recently and there are over 100 academic papers exploring it.

There’s one common thread in the majority of those papers: The only validated cure for cannabinoid hyperemesis syndrome is to simply stop using cannabis.

By ceasing all cannabis intake, the vomiting and nausea go away almost instantly.

Cannabinoid Hyperemesis Syndrome is believed to affect both gastrointestinal and central nervous system. (2)

There are two main theories that explain how CHS develops:

  • Cannabinoid buildup theory;
  • Hypothalamic theory.

When it comes to the cannabinoid buildup theory, a 2011 study suggested that Cannabinoid Hyperemesis Syndrome occurs because of a disturbance in the central stress response system. This theory argues that heavy, longtime smokers build up cannabinoids in their system, which can lead to dysfunctioning CB1 and CB2 receptors in the hypothalamus. (3)

Overuse of cannabis can also lead to storing THC in our fat cells and getting THC out of body fat takes a long time.

When we use our fat as energy, the previously stored THC re-enters our bloodstream.

At this point, since there is already a high concentration of THC in the blood, consuming more cannabis can lead to cannabinoid toxicity, today known as Cannabinoid Hyperemesis Syndrome. (1)

The hypothalamic theory argues that CBD increases the expression of CB1 receptors in the hypothalamus while THC lowers the body temperature. (1) Scientists in favor of this theory believe that this could explain why hot showers are so effective in reducing the symptoms of Cannabinoid Hyperemesis Syndrome.

These are still just theories that need to be proven or debunked, but they are a good starting point for further exploration of CHS.

Is Cannabinoid Hyperemesis Syndrome a common thing?

Cannabinoid Hyperemesis Syndrome

Cannabinoid Hyperemesis Syndrome is considered rare statistically, but it’s still more common than you would think.

According to a recent paper, almost a third of regular marijuana smokers admitted to the New York City hospital have experienced Cannabinoid Hyperemesis Syndrome. (4)

However, since the conclusions were based on medical records of only 150 patients, we can’t take these findings for granted.

Still, because of the stigma around cannabis use, it’s hard to tell how common this syndrome really is.

Some users simply don’t connect vomiting (and other symptoms) with cannabis use, while others are just not comfortable sharing their cannabis habits with doctors. This makes diagnosing and treating Cannabinoid Hyperemesis Syndrome difficult.

Since the majority of doctors are not even aware of Cannabinoid Hyperemesis Syndrome and not much is known about it in general, CHS can be left undiagnosed for a very long time.

Regardless of whether 10 or 10 million people suffer from it, we cannot deny that CHS is a real condition.

How is Cannabinoid Hyperemesis Syndrome treated?

Considering that the symptoms of CHS are nausea and vomiting, the first thing you should do is visit your doctor to rule out any other condition.

When you rule out everything else, the best and most effective cure for Cannabinoid Hyperemesis Syndrome is to just stop using cannabis altogether. Simple as that.

Now, you might be asking yourself, is there any way to get rid of the symptoms and continue using cannabis? Is taking a break from cannabis going to help you recover from the syndrome?

Well, that’s still hard to say.

Conventional medications usually used for vomiting and nausea just don’t work for Cannabinoid Hyperemesis Syndrome. So, until science discovers more about this condition, the best thing you can do is to stay away from weed altogether.

When the initial symptoms begin, try taking a hot shower or a nice hot bath.

If you find that this improves your nausea, vomiting or discomfort, quit smoking cannabis right away. Have in mind that frequent hot showers and vomiting can lead to dehydration and acute kidney damage, so don’t forget to drink enough fluids.

Some doctors recommend capsaicin topicals for reducing acute symptoms and some patients have responded well to this therapy. (5)

Moderate pot smoking is key!

The key consideration when it comes to CHS is the “volume of use”, leaving us to conclude that long-term heavy pot use leads to oversaturation of cannabinoid receptors and potentially to the development of Cannabinoid Hyperemesis Syndrome.

This syndrome could become a real problem, especially with medical marijuana users being advised by the Internet to just take as much weed as they can, which is simply wrong and unethical.

If you start developing any CHS symptoms after using marijuana talk to your doctor openly about it, even they are not familiar with Cannabinoid Hyperemesis Syndrome. At least you’ll be able to get to the bottom of the problem and learn if cannabis is causing your symptoms.

If it is, just quit using cannabis and you’ll be fine.

References:

  1. Galli JA, Sawaya RA, Friedenberg FK; Cannabinoid Hyperemesis Syndrome; Current Drug Abuse Reviews; December 2011; 4(4): 241–249
  2. Ruffle JK, Bajgoric S, Samra K, Chandrapalan S, Aziz Q, Farmer AD; Cannabinoid hyperemesis syndrome: an important differential diagnosis of persistent unexplained vomiting; European Journal of Gastroenterology Hepatology; December 2015; 27(12):1403-8
  3. Simonetto DA, Oxentenko AS, Herman ML, Szostek JH; Cannabinoid hyperemesis: a case series of 98 patients; Mayo Clinic Proceedings; February 2012; 87(2):114-9
  4. Habboushe J, Rubin A, Liu H, Hoffman RS; The Prevalence of Cannabinoid Hyperemesis Syndrome Among Regular Marijuana Smokers in an Urban Public Hospital; Basic and Clinical Pharmacology and Toxicology; June 2018; 122(6):660-662
  5. Lapoint J, Meyer S, Yu CK, Koenig KL, Lev R, Thihalolipavan S, Staats K, Kahn CA; Cannabinoid Hyperemesis Syndrome: Public Health Implications and a Novel Model Treatment Guideline; Western Journal of Emergency Medicine; March 2018; 19(2):380-386
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Journalist with a decade-long experience of using cannabis for stress relief. Her spare time is mostly divided between dancing, traveling and reading.

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