This overstimulation disrupts the delicate balance of the GI functions, resulting in the characteristic symptoms of severe nausea, vomiting, and abdominal pain. The direct effects of cannabinoids include the activation of cannabinoid receptors on the surface of GI cells, which can influence the release of neurotransmitters and hormones that regulate GI function. The exact cause of Cannabinoid Hyperemesis Syndrome (CHS) is not fully understood. Cannabis affects the body’s endocannabinoid system, which helps regulate various functions like mood, appetite, and pain. In some people, prolonged exposure to cannabis may disrupt this system, leading to symptoms like nausea and vomiting. Genetic factors and individual differences in how the body processes cannabis may also play a role in the development of CHS.

Clinical Presentation, work up and differential diagnosis of Cannabinoid Hyperemesis Syndrome

CHS patients are often resistant to finding out that marijuana causes their symptoms. 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. A lack of long-term follow-up is also a major shortcoming in our knowledge of CHS. The majority of reported cases that have provided follow-up included a period of less than one year 6,52,54,56–60,62,68,71.

Skin Care

• CHS is also underdiagnosed because people sometimes use marijuana to suppress nausea and vomiting.
• Mental health services administration may also be involved in managing the psychological impact of cannabis use and the challenges of quitting.
• Recognizing the symptoms and their severity can lead to a more accurate diagnosis and effective treatment plan, ultimately improving the quality of life for those affected by this challenging condition.
• Haloperidol may further relieve nausea and vomiting by indirect activity at the CB1 receptors 111, 113.
• Awareness of this condition can prevent unnecessary investigations, save costs, and reduce hospital admissions in selected patients.

CBD enhances the expression of the CB1 receptors in the hypothalamus, plus it amplifies the hypothermic effects of THC 44. In preclinical studies, toxin-induced vomiting treated with CBD showed a biphasic response, that is, low doses of CBD had an antiemetic effect while higher doses had a proemetic effect 37, 45. CBG is not psychotropic and acts as an antagonist at both CB1 and serotonin receptors 46. This antagonism might theoretically reverse the antiemetic effects of low doses of CBD at the serotonin receptor 38. Thus, it is possible that the severe nausea and intractable vomiting of CHS might be due to the combined proemetic effects of high-dose CBD coupled with CBG’s antagonism at the serotonin receptors 13. Tricyclic antidepressants (TCAs), such as amitriptyline, have shown promising efficacy in the management of CVS and have been explored as a potential prophylactic treatment for CHS.

Hyperemetic phase

• 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.
• If it continued indefinitely, that would “force a person to stop” using cannabis.
• While marijuana seems to bring on nausea in the stomach, in the brain it usually has opposite effect.

These diagnostic criteria can aid clinical pharmacists in the evaluation of patients presenting with cyclic vomiting with no obvious organic cause and a history of repeated ED visits for the same condition. Cannabinoid Hyperemesis Syndrome (CHS) is relatively rare, but its prevalence is increasing as cannabis use becomes more widespread. Estimates suggest that CHS affects a small percentage of long-term cannabis users, with studies showing rates ranging from 2% to 10% of frequent cannabis consumers. The condition is more common in individuals who have used cannabis regularly and in large amounts over several years. The prevalence of CHS is influenced by various risk factors, including long-term cannabis use, age, gender, and sociocultural background. However, because CHS is not always diagnosed correctly, its true prevalence may be underreported.

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In addition to appropriate antiemetic therapy, fluid resuscitation, and management of the patient’s symptoms, patients must recognize behaviors and exposures that place them at risk for their pathology. For supportive care, a clinician should work together with the pharmacist to see if any medications could contribute to the patient’s presentation. If administering antiemetics, the nursing staff should be familiar with the adverse event profile so they can report any concerns that may arise. If you have cannabis use disorder and need help quitting, professional treatment is available.

When it does strike, the signs can be both overwhelming and confusing, especially since people often think of marijuana as something that settles their stomach rather than something that triggers vomiting. If you or someone you care about is struggling with heavy marijuana use and unrelenting vomiting, learning about CHS might explain many of the symptoms you’re seeing. Read on to understand what CHS is, how it develops, what the main signs are, and why seeking help is critical if you want to break free from this difficult cycle. Dr. Byron McQuirt leads works closely with our addictionologist, offering holistic, evidence-based mental health and addiction care while educating future professionals. 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.

• Acute treatment of CHS is supportive care and patient education; the only effective long-term approach to CHS is marijuana cessation.
• The patient also reported burning abdominal pain but no diarrhoea or fever.
• For supportive care, a clinician should work together with the pharmacist to see if any medications could contribute to the patient’s presentation.
• The studies included focused on individuals diagnosed with CHS, as well as those with comparable conditions such as CVS, and chronic cannabis users exhibiting symptoms similar to CHS.
• People with CHS also tend to have a strong urge to take very hot showers or baths.

Hospital admission in and of itself can serve to resolve CHS in that patients abstain from marijuana during the time they are inpatients. Since marijuana resumption will cause CHS to return, patient education is important in order to prevent recurrence. If patients suffer repeatedly from CHS despite their being informed of the connection between marijuana and CHS, it may be appropriate to refer these patients to addiction specialists, https://ecosoberhouse.com/ substance use counselors, or other rehabilitation programs.

Cannabinoid Hyperemesis Syndrome: Symptoms, Causes, and Treatment

Similar to hot water, capsaicin provides symptomatic relief of CHS 95, 96, 97 but not other vomiting disorders. Topical capsaicin has been advocated for use as a diagnostic tool for how long does it take to recover from cannabinoid hyperemesis syndrome CHS to differentiate it from other vomiting syndromes 36. A diagnostic flow chart can be used by clinical pharmacists and clinicians for patients with suspected CHS to help reduce unnecessary costs and over-utilization of health care resources.

Don’t Let Addiction Control You

Thus, severe symptoms may not be sufficient to compel an individual to discontinue marijuana or cannabis may have an adverse effect on the individual’s ability to make sound decisions 129. The most effective treatment during the hyperemetic phase of CHS is the use of hot showers by patients. The effects of this learned behavior are temperature-dependent 6, fast acting 6, but short-lived 6,56,62. Hot showers improve symptoms of nausea and vomiting 6,52–56,60,62,68,71, abdominal pain 6,56,71, and decreased appetite 68 during the hyperemetic phase.

Diagnosing CHS might take time because not all medical professionals are familiar with it yet. You might need to share specific details or request a referral to a specialist, like a gastroenterologist, if symptoms persist. But once you and your provider identify CHS, you can start working on an effective plan to stop drug addiction treatment the cycle of vomiting. It can rob your body of essential fluids, leading to dehydration and serious health issues. People with CHS might also struggle with an electrolyte imbalance, which can harm the heart, kidneys, and other vital organs. When your internal electrolyte levels go off the rails, your body’s ability to function properly gets compromised.