Cannabis broadly affects the gastrointestinal system, affecting its secretions, appetite, inflammation, and motility 13,14,15. Cannabis has over 100 cannabinoids in it and has varied effects and toxicity dependent on the THC-to-other-cannabinoids ratio 16. Cannabinoids like anandamide https://ecosoberhouse.com/ (AEA) and 2-arachidonoylglycerol (2-AG) have shown anti-emetic effects in animals that can vomit (e.g., ferrets and shrews) and in those that cannot (e.g., rodents) 17,18. In rodents, indirect measures such as taste aversion and facial expressions are identified to confirm the anti-emetic properties of cannabinoids 18.
What are the risks of untreated CHS?
It is resistant to traditional anti-emetic and analgesic treatments, and the only treatments that have been demonstrated to be effective are benzodiazepines, haloperidol, capsaicin, and hot baths or showers. Patients often present with debilitating symptoms, so consultation and treatment are an opportunity to promote cannabis cessation in a non-judgmental manner. The immediate management of CHS focuses on symptom relief and rehydration.
Emerging Treatments for CHS
The endocannabinoid system, or ECS, is a network of cannabinoid receptors in your body that respond to compounds like THC and CBD. The symptoms of CHS include severe nausea, repeated vomiting, and stomach pain. The symptoms of CHS can be debilitating, and they can last for several days. Cannabis Hyperemesis Syndrome (CHS) can seriously impact a person’s life, causing ongoing nausea, vomiting, and abdominal pain that disrupt daily activities, work, and social interactions. These symptoms lower the quality of life, leading to physical exhaustion, emotional stress, and social isolation. Frequent symptoms like nausea and vomiting cause dehydration, fatigue, and weight loss, making it hard to perform everyday tasks or enjoy social activities.
Clinical Features
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. Haloperidol is a familiar but unconventional antiemetic that may benefit CHS patients, likely because it blocks the brain’s postsynaptic dopamine receptors 111, 112. When dopamine receptors are blocked, the blockade reduces the effect of dopamine on the dopamine-2 receptors in the vomiting center 96. Haloperidol may further relieve nausea and vomiting by indirect activity at the CB1 receptors 111, 113.
Is withdrawal from cannabis really that bad? How do I differentiate the symptoms from CHS?
The Drug Abuse Warning Network (DAWN) states that marijuana mentions (the number of times “marijuana” is mentioned in a medical record) have increased 21% from marijuana addiction 2009 to 2011 3. Since 2009, the rate of persistent vomiting has increased significantly and continues to increase at about 8% a year 5. This suggests that this once “rare” condition is going to emerge as an increasingly common presentation in emergency departments (ED) and clinics. CHS is not trivial; there are fatal cases of CHS (as cause of death or contributing to death) reported in the literature. Other suggestions are that with long-term consumption, cannabis becomes a receptor antagonist or that they become down-regulated or de-sensitised over time.
However, CHS presents a unique challenge for regular cannabis users, and understanding this syndrome is crucial for recognizing its signs and seeking proper treatment. Processed foods often contain additives, preservatives, and artificial flavors that could irritate the digestive system. Spicy foods, even those without capsaicin or piperine, can stimulate the digestive tract and potentially worsen nausea. Dairy products can be problematic for individuals with lactose intolerance or sensitivities, leading to gastrointestinal distress.
Who is most at risk for developing CHS?
- The condition can be particularly challenging because the symptoms are often mistaken for other gastrointestinal disorders, and they may not appear immediately after someone begins using marijuana.
- Cannabinoids have a strong affinity for fat and accumulate in cerebral fat, acting as a reservoir of THC in adipose tissue.
- A machine learning model was trained using the manually categorized data to automatically classify the themes for the rest of the posts so that their distributions could be quantified.
Finally, the TRPV1 receptors are located in the peripheral nervous system and have an effect on pain modulation and thermoregulation. Cessation of cannabinoid use will lead to complete resolution of symptoms. The time to improvement varies from 1 to 3 months in the current literature.12 Patients may be reluctant to accept that cannabis has played a role in their symptoms, and they should be educated about the nature of the disorder.
People might need to skip work, school, or social activities because they’re too sick to function normally. Over time, the act of bathing or showering excessively can also lead to its own set of issues. Hot water helps calm the symptoms for a while, but the relief doesn’t last long after stepping out. An even more troubling piece of the puzzle is that many people who feel nauseated due to CHS may try to use more marijuana to alleviate their symptoms, not realizing they’re only making the problem worse.
- These personal accounts underscore the importance of recognizing CHS and its significant impact on quality of life.
- If you think cannabis use is affecting your life, contact a rehab center for marijuana abuse.
- A total of 9,691 posts were collected from the chosen subreddits via the Application Programming Interface.
- Paradoxically, CHS causes excessive vomiting and is related to long-term marijuana use.
Patients presenting with severe vomiting and dehydration may require intravenous fluids and antiemetic medications to stabilize their condition. Additionally, healthcare providers should educate patients about the link between cannabis use and their symptoms. Capsaicin, a topical agent with an active compound derived from chili peppers, interacts with transient receptor potential vanilloid-1 (TRPV1) receptors 86. TRPV1 receptors are involved in the modulation of transmitting pain signals and how long does it take to recover from cannabinoid hyperemesis syndrome altering pain perception 87. These TRPV1 receptors are present throughout the gastrointestinal (G.I.) tract and the medullary vomiting center.
This strange syndrome is linked to regular cannabis use—and cases have doubled
With many states legalizing the use of both medical and nonmedical marijuana and increasingly favorable public opinion emphasizing the benefits marijuana, it is reasonable to expect its use will become more frequent and widespread. The literature contains a wealth of case studies and case reports on patients suffering from CHS; these case reports come from around the world but have striking similarities. Finally, there have been anecdotal reports that changing the variety or strain of botanical marijuana can mitigate or even alleviate CHS. It has been suggested that CHS may − in whole or in part − be the result of pesticides, toxins, or other substances accumulated on the plants during growth and harvest 67. Chemical residues on the plant can transfer to mainstream smoke with up to 60 or 70% inhaled via unfiltered glass pipes 68.