Cannabis use in the United States has grown by leaps and bounds over the past decade and this has created new health problems for some users. One of these problems is cannabinoid hyperemesis syndrome (CHS).
CHS occurs in cannabis users with specific symptoms that include persistent cycles of nausea and vomiting. People often take hot baths to relieve nausea and suppress vomiting. Since cannabis is known to have anti-vomiting properties, it is paradoxical that its cannabinoids can also help induce vomiting under certain circumstances.[1]
Because CHS is a relatively newly recognized disease, it often is misdiagnosed and can stay there for years. Its symptoms are very similar to those of cyclic vomiting and other illnesses, and many health professionals initially choose these diagnoses over CHS.[1] However, CHS is a disease in its own right, affecting almost exclusively long-term users who use cannabis on a daily basis.
CHS manifests itself in three different phases. The first is called the prodromal phase. During this time, the affected person suffers from mild nausea, irregular eating habits and gastrointestinal complaints. However, at this stage, it is rare for patients or doctors to attribute these common symptoms to CHS. In fact, many patients use even more cannabis to manage symptoms.
In the second phase, the so-called hyperemetic phase, those affected experience vomiting and / or abdominal pain for 24-48 hours. Dehydration is a common occurrence during this phase as well. As in phase one, patients also tend to increase their cannabis use to relieve symptoms. Patients also compulsively immerse themselves in baths or showers, which many believe provides relief from their discomfort.
Recovery is the third phase. It sees the end of vomiting and a return to normal eating habits. In addition, people stop bathing and showering frequently and stop all cannabis use, which is one of the pillars of CHS treatment. The other is symptom management through the use of IV fluids and relaxation. Dopamine antagonists and benzodiazapenes have also shown promise in treating symptoms, but opioids have not.
Perhaps the most difficult aspect of treating CHS is diagnosis. Its symptoms are similar to many other diseases, and its cause (cannabis) is often used to alleviate these symptoms. However, with more research and more patients presenting with CHS, at some point more information will become available about how to treat this new disease.
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References:
- Galli, Jonathan A. et al. Cannabinoid Hyperemesis Syndrome. Curr Substance Abuse Rev. 2011, Volume 4 (4): 241-249