In the meantime, the best way to relieve CHS symptoms is to stop using the drug. If symptoms persist and you continue to use cannabis, you may experience more severe problems that require hospitalization for treatment. While it is possible to return to feeling normal during the recovery phase, research indicates that symptoms recur if cannabis use resumes. Cannabinoid hyperemesis syndrome (CHS) is a rare problem that causes constant vomiting. Two well-characterized naturally occurring endocannabinoids are anandamide and 2-arachidonoylglycerol. Cannabinoids discovered in the cannabis plant with known what is alcoholism effects on the regulation of emesis include tetrahydrocannabinol, cannabidiol, and cannabigerol.
What are the symptoms of CHS?
The duration of cannabis use prior to symptom onset was categorized as either less than or equal to 1, 2 to 5, 6 to 10, and greater than 11 years. The amount of cannabis consumed was categorized as either less than daily, daily, weekly, less than weekly, or dose not specified. Cannabinoid hyperemesis syndrome (CHS) is a condition in which a patient experiences cyclical nausea, vomiting, and abdominal pain after using cannabis. The almost pathognomic aspect of a patient’s presenting history is that their symptoms are relieved by hot baths or shower.
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Unfortunately, many of these patients relapse upon resuming cannabis 6,59,61,62. It has been suggested that many of these patients increase or continue their cannabis use because of their perception that it will have beneficial effects on nausea 52. Patient education should therefore be provided with emphasis on the paradoxical nature of the symptoms of CHS.
What are other impacts of cannabis use?
Severe and uncontrollable vomiting increases the risk of dehydration and electrolyte imbalances, and in rare cases, patients can experience esophageal tears, Camenga said. Doctors often treat CHS patients who seek help at hospitals with fluids. “There is evidence that if you send a message to the brain that competes with the message that’s causing the nausea, vomiting, that you can suppress it,” Camilleri said. One possible explanation for this is called “gate control theory,” which postulates that to some extent, the brain can regulate how much pain it perceives. Experts also aren’t clear on what causes CHS, or why some people develop it while others don’t.
These help quantify the degree of substance use to build insight and direct referrals. This systematic review is the first and most comprehensive characterization of the CHS literature. We believe that these evidence-based recommendations will improve diagnosis, highlight the limitations of pathophysiology understanding, and provide guidelines for treatment of this difficult condition. Our proposed diagnostic characteristics are listed in Table 6 with corresponding GRADE quality recommendations. While symptoms can be managed, the only way to stop CHS for good is to quit using cannabis in any form. Addiction rehab programs or CBT may be helpful resources for quitting cannabinoid hyperemesis syndrome cannabis.
Help quitting cannabis
- According to data from the Department of Public Health, cannabis-related emergency room visits increased by 53% in Maryland from 2022 to 2023.
- A greater understanding of the natural course of the syndrome and response to marijuana cessation may be gained with longer lengths of follow-up.
- We limited the search to English-language articles, so any relevant articles published in foreign languages were not included, and articles not indexed in MEDLINE, Embase, Web of Science, or the Cochrane Library would be missed.
- One study looking at Reddit posts on the subject found that spicy food, greasy food, coffee, black tea, and alcohol were frequently mentioned as CHS triggers.
- In one small study of eight patients hospitalized with CHS, four of the five who stopped using weed recovered from CHS.
- The association did not comment on public health concerns related to high-THC products sold legally in Washington state, which are at the heart of regulation efforts.
When you use weed, these compounds bind to cannabinoid receptors found in your brain, digestive tract (gut), and certain cells in your body. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main cannabinoids in marijuana products. THC is what’s responsible for the “high” most people feel when they use marijuana. If you have cannabis use disorder and need help quitting, professional treatment is available. More recent studies also suggest that the risk of psychosis is not connected to genetic predispositions, a claim often made by cannabis industry lobbyists. In other words, using high-potency THC can lead to schizophrenia even if users don’t have relatives who suffer from the disease.
Reporting is often subjective and qualitative, and there is no metric for how much physiologically active compounds are contained in one joint, cone, bong, etc. In addition, higher THC content through selective breeding of plants and more selective use of female buds that contain more concentrated THC levels may cause CHS to appear in patients who report lower amounts of cannabis use 170. The quality of evidence for each main outcome of this systematic review was evaluated using the GRADE working group metrics 83. High-quality outcomes are defined as those for which further research is very unlikely to change our confidence in the estimate of effect. Moderate-quality outcomes are defined as those for which further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
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These agents are potent agonists of the cannabinoid CB1 receptors, similar to THC, suggesting that agonism at the CB1 receptor may be responsible for CHS. Supportive care with IV fluids and anti-emetics is the mainstay of treatment in the acute phase of illness. There is very limited evidence to suggest that agents such as dopamine antagonists and capsaicin cream and avoidance of opiate pain medications may be of benefit. While many providers utilize these agents in practice and find them effective, prospective case-control studies are needed before recommendations can be made based upon effectiveness. The authors of this study acknowledge the potential difficulties of such studies, owing to the fact that CHS is a heterogeneous clinical entity, and thus, selecting a comparable group of patients may prove difficult. Additionally, agents such as topical capsaicin cream are not commonly stocked in hospitals https://ecosoberhouse.com/ and emergency departments but could be made available in the outpatient setting.
Practice Management
The pathophysiologic processes underlying CHS are unclear at this time. Many hypotheses exist, yet there is very limited evidence to support any one unifying mechanism. The best evidence suggests a dynamic interplay between cannabinoid metabolism and complex pharmacodynamics at the CB-1 receptor. In addition, our study identified three unique cases of CHS caused by synthetic cannabinoids 23, 41, 182.
Cannabinoid Hyperemesis Syndrome (CHS) and the Cyclic Vomiting Syndrome (CVS) in Adults
Since the 1990s, there has been a progressive change in the composition of the plant, with increases in the tetrahydrocannabinol (THC) and a reduction of cannabidiol (CBD).6 This trend correlates with increased cannabis use. Some individuals, for instance, also admitted to smoking 2000 mg of THC per day. The symptoms typically last a few weeks, though the throwing up should ease up in a day or two. They may also prescribe antipsychotic medications such as haloperidol (Haldol) or olanzapine (Zyprexa) to help you calm down as you switch to the recovery phase. Your doctor may ask you questions, like how long you’ve been using cannabis and what type of products you normally use. For example, if you smoke weed, eat edibles, use tinctures, or dab or vape THC, tell your doctor about any or all of them.