Many CHS patients are long-term marijuana users who object to marijuana discontinuation, even though it provokes symptoms severe enough to require hospitalization. This leads to an important question, especially in light of our gradual societal paradigm shift toward liberalizing marijuana. Certainly marijuana use disorder exists, but it is not clear if it is addictive in the same manner as opioids or alcohol.
- Since marijuana is recommended as an antiemetic to chemotherapy patients, CHS seems paradoxical, but cannabinoids can have both proemetic as well as antiemetic effects.
- In a retrospective chart review of 13 patients treated for CHS at one of two centers, 100% of patients experienced relief when topical capsaicin was administered to help control symptoms of vomiting 96.
- The patient still uses a moderate cannabis dose for sleep and pain, a careful balance of THC and cannabidiol.
A paradoxical condition
These cannabinoids typically bind to receptors in different parts of the body, such as the brain, spinal cord, and gastrointestinal (GI) tract. While cannabis is often thought of as a remedy for nausea, CHS flips that script and leads to severe vomiting after chronic use. In women, a pregnancy test is necessary to assess for any pregnancies, especially ectopic pregnancies. Imaging is up to the discretion of the clinician, depending on various specific factors of history or physical exam, which may be concerning for surgical processes. Cannabinoid hyperemesis syndrome (CHS) is a condition that can happen to anyone who uses cannabis especially if you use it regularly.
How do doctors diagnose cannabinoid hyperemesis syndrome?
Three out of 4 patients resumed marijuana use and presented at the hospital again. One of the patients, a 27-year-old man, said he understood the cause of his symptoms but was “unable” to stop smoking marijuana. Another patient in the series, a 31-year-old man, discontinued marijuana for a short time, then resumed and periodically visits the ED to manage symptoms 102.
What Causes Cannabinoid Hyperemesis Syndrome? Chronic Marijuana Use
Researchers need to study CHS in more detail to make it easier for doctors to recognize and treat the condition. Further studies are also necessary to determine the causes of CHS and its risk factors. Since 2004, doctors have identified key symptoms and characteristics of the condition that can help speed up diagnosis.
Cannabinoids are compounds in the Cannabis sativa plant that bind to cannabinoid receptors in your brain, spinal cord, gastrointestinal tract and other body tissues. Examples of cannabinoids include tetrahydrocannabinol (THC) and cannabidiol (CBD). According to the Cleveland Clinic, CHS “can affect Oxford House people who use cannabis (marijuana) long-term,” and can cause “frequent, severe nausea and vomiting.” CHS patients are often resistant to finding out that marijuana causes their symptoms.
Utah medical cannabis law allows up to 113 grams of raw cannabis flower a month. Depending on the potency, that could be enough for seven joints a day. On top of that, the law allows 20 grams of purified THC in other forms like edibles, tinctures chs symptoms and signs and vapes. In short, under Utah law there is nothing stopping a willing doctor from giving eager patients all the THC their body could handle and more.
We understand the complexities of addiction and work closely with individuals to create personalized recovery plans that address both the physical and psychological aspects of addiction. Recognizing the risks of developing CHS can empower marijuana users to take preventative actions, such as reducing or ceasing their marijuana use if they experience any signs of the condition. The most effective way to reduce the effects and risks of CHS is to stop using cannabis. Medical treatment is recommended for managing symptoms and preventing complications.
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In this group, 9 patients smoked marijuana for recreation, while the other patient had been prescribed synthetic cannabinoids (nabilone 2 mg twice a day) to treat multiple sclerosis. The approximate consumption of THC per day was a mean of 70.3 ± 40.8 mg. Seventy percent of pa tients reported symptoms typically began in the morning 120. Cannabinoid hyperemesis syndrome (CHS) involves episodic cyclic vomiting that occurs in some cannabis users. Typical symptoms include intractable nausea and vomiting, refractory to conventional antiemetic therapy, often accompanied by abdominal pain.
- It has been suggested that this is due to the fact that cannabinoid use is about double in younger people compared to older individuals 135.
- Both patients reported a burning sensation where the capsaicin was applied but were satisfied with the results 97.
- As CHS is a relatively recently recognized and studied phenomenon easily confused with other diseases, there is a paucity of sizeable randomized control studies.
- But he was sympathetic to Canadian policymakers, who feared the black-market realities of trying to enforce prohibition until a later age.
While some patients use cannabis to manage GI symptoms, excessive use can actually worsen vomiting episodes, often resembling Cyclic Vomiting Syndrome (CVS). It is not known if certain varieties of botanical marijuana are more likely to produce CHS than others. Furthermore, the role of cytochrome (CYP) P450 metabolism and genetic polymorphisms might play a role in terms of why certain individuals are susceptible to CHS. Genetic polymorphisms of the cytochrome P (CYP) 450 enzyme system, such as CYP2CP, CYP2C19, or CYP3A4 could cause an individual to accumulate excessive amounts of cannabinoid metabolite(s) which might promote vomiting.