A potential long-term effect of heavy cannabis (marijuana) use is a condition that causes frequent, severe vomiting and nausea. This condition, known as cannabinoid hyperemesis syndrome, has been affecting more and more people as the potency of cannabis products gets stronger.
People with this condition say that hot showers and baths temporarily relieve their symptoms, but the only way to get complete relief is to stop using cannabis altogether.
In this article, we’ll explore the signs and symptoms of cannabinoid hyperemesis syndrome or CHS. You will learn what causes it, the symptoms people often experience, and how it’s diagnosed and treated.
What is Cannabinoid Hyperemesis Syndrome (CHS)?
Cannabinoid hyperemesis syndrome (CHS) is a rare health condition that is associated with heavy and long-term cannabis use. It is characterized by repeated bouts of nausea, vomiting, and stomach pain.
This condition was first recorded in 2004 when Southern Australian doctors reported episodes of cyclical vomiting in adults who were heavy cannabis users. Since then, reports of these symptoms have increased, though the condition is still not fully understood. However, experts believe that rates of CHS are increasing due to the increasing potency of marijuana and other cannabis products, particularly concentrates that contain far more THC than the plant form.
Symptoms of CHS
Cannabinoid hyperemesis syndrome symptoms include:
- Early morning nausea
- Occasional stomach discomfort
- Severe, persistent nausea
- Repeated vomiting
- Abdominal pain
- Dehydration due to excessive vomiting
- Temporary relief from hot showers or baths
- Reduced appetite and weight loss
Causes
CHS is caused by long-term, heavy cannabis use. Researchers believe it happens due to overstimulation of the body’s endocannabinoid system (ECS). THC, the main psychoactive compound in cannabis, may disrupt the normal functioning of cannabinoid receptors in the digestive system, leading to nausea and vomiting.
Some possible causes include:
- THC Overload: Chronic cannabis use may overstimulate cannabinoid receptors in the digestive system, leading to nausea and vomiting.
- Disruption of the Brain’s Vomiting Control Center: THC affects the hypothalamus, which regulates nausea and vomiting, potentially causing it to malfunction.
- Delayed Gastric Emptying: Cannabis slows down digestion, which can contribute to nausea and bloating.
- Changes in the Nervous System: Long-term cannabis use may alter how the nervous system processes nausea and pain signals.
Relief
People commonly say that hot baths or showers provide symptom relief, but that the relief is temporary.
The only known cure for CHS is completely stopping cannabis use. Symptoms usually improve after quitting, but if cannabis is used again, the condition can return.
Understanding the Timeline and Phases of Cannabinoid Hyperemesis Syndrome
It can take many years of daily marijuana use to develop CHS. The condition is typically not seen in people who started using cannabis in the last 1-2 years.
Studies have identified three phases of CHS:
- Prodromal phase – This is the early stage that can last for months or years. Symptoms include mild nausea, especially in the morning, and occasional stomach discomfort. Many people continue using cannabis, believing it helps with nausea, but this actually worsens symptoms over time. Vomiting is uncommon during this stage.
- Hyperemetic phase – This is the most intense and distressing stage of CHS. Symptoms include severe nausea, frequent vomiting, and intense abdominal pain. Dehydration and weight loss are common due to persistent vomiting. The symptoms can be so bad that some people seek emergency medical care.
- Recovery phase – Once cannabis use is stopped, symptoms gradually disappear. Appetite returns and nausea and vomiting subside. However, if cannabis is used again, symptoms will likely return, restarting the cycle.
Possible Risks and Complications
Frequent vomiting can harm the body. In the short term, it can lead to dehydration and electrolyte imbalances. Without treatment, this can result in kidney failure or nutritional deficiencies.
Additionally, people with CHS may experience weight loss as they don’t have an appetite and struggle to keep food down.
Other potential risks and complications include:
- Low potassium levels
- Low phosphorus levels
- Aspiration (swallowing vomit)
- Pneumonitis
- Esophagus rupture or esophageal injury
- Pneumomediastinum (air that gets trapped between the lungs in the chest cavity)
Getting a CHS Diagnosis
Unfortunately, CHS is often misdiagnosed. One reason is that people with cannabis use disorder may be hesitant to seek help due to their drug use.
Another reason for missed diagnosis is that this condition is regularly overlooked in emergency departments, where many marijuana users end up when seeing help or cyclic vomiting.
CHS can also be mistaken for a similar condition known as cyclic vomiting syndrome (CVS). CVS presents in a way similar to CHS, but it is triggered by stress, lack of sleep, certain foods, or other causes, but is not associated with tetrahydrocannabinol (THC).
Treatment and Tips for Dealing With Cannabinoid Hyperemesis Syndrome
The most effective treatment for CHS is completely stopping cannabis use. Once THC is fully cleared from the body, symptoms gradually disappear. Unfortunately, the only medical care available is supportive care that focuses on reducing symptoms.
If you suspect you have CHS, here are some steps you can take:
- Stop using cannabis immediately. This is the only proven way to prevent CHS symptoms from recurring.
- Stay hydrated. Frequent vomiting can lead to dehydration, so it’s important to replenish lost fluids with water or electrolyte drinks.
- Take warm showers. While hot showers temporarily relieve symptoms, excessive use can lead to burns or skin irritation.
- Seek medical care. If vomiting is severe, you may need IV fluids or anti-nausea medications to prevent dehydration and nutrient deficiencies.
- Manage symptoms with medications. Some doctors prescribe anti-nausea drugs, pain relievers, or acid reducers to help manage discomfort.
- Consider behavioral support. If quitting cannabis is difficult, therapy or support groups can help address dependence and withdrawal symptoms.
For those with cannabis use disorder, professional treatment may be necessary to stop using marijuana and prevent CHS from returning.
Find Help for Cannabis Use Disorder
For many people, quitting cannabis is easier said than done, especially if it has become a regular part of their routine. If you or a loved one needs support, there are resources available. Professional addiction treatment programs like First Step Behavioral Health can help with detox, withdrawal symptoms, and behavioral therapy to address cannabis dependence.
By quitting cannabis, you not only eliminate CHS symptoms but also improve your overall health, well-being, and quality of life. If you need help, reach out to a team member today for a confidential, risk-free assessment.
References:
- National Institute of Health (NIH): Cannabinoid Hyperemesis Syndrome
- JAMA Network: Cannabinoid Hyperemesis Syndrome
- Science Direct: Cannabis hyperemesis syndrome: A case report review of treatment
