If you have cannabinoid hyperemesis syndrome (CHS), the best treatment is to stop using weed, even if you’ve been doing it for years with no previous side effects. Once you do that, your repeated nausea and vomiting should go away and not return. Since THC is stored in your body fat, it can take weeks to months before all the symptoms go away and you notice a difference.
- In a team-based modality, the successful employment of a specialized addiction team to address the need for abstinence from cannabis in which 5 of 7 patients enrolled into the program achieved both abstinence as well as resolution of symptoms 33.
- She has a past medical history of hypertension, type II diabetes, and polysubstance abuse.
- There are at least four reported cases where the time lag was equal to or less than three years 54,59,60.
- As CHS is a relatively recently recognized and studied phenomenon easily confused with other diseases, there is a paucity of sizeable randomized control studies.
- With the widespread use, increased potency and legalization of marijuana in multiple states in the U.S., CHS may be becoming increasingly common.
Clinical Considerations
This was her third ER trip with cannabinoid hyperemesis syndrome (CHS) in as many years. This time, the worst and last, the intense pain lasted five days, during which, she was later told, she had hallucinatory conversations and threatened to leap from a fourth story window. One possible treatment option involves the use of benzodiazepines, such as lorazepam, to control nausea and vomiting. Benzodiazepines are controlled substances that people must use with caution, particularly those with a history of drug use.
- Topical capsaicin can be used to provide symptomatic relief but symptoms typically resolve in a day or two without cannabinoid use regardless of treatment.
- This would mean that the proemetic effects observed in CHS involve an interplay of processes, possibly including high levels of CBD reversed by CBG 39.
- The most effective treatment during the hyperemetic phase of CHS is the use of hot showers by patients.
- The average length of time between the onset of symptoms and a CHS diagnosis was 6.1 years (range 1–10 years) and patients visited the ED at average of 10 times before diagnosis was made.
- In addition, it is unclear why cannabis changes from a drug that has been known to ease nausea and vomiting, especially among patients undergoing chemotherapy, to causing nausea and vomiting in a subset of people.
- However, there are three articles in which corticosteroids were administered in combination with other agents without significant improvement in symptoms 20•, 28, 30.
- The best and only way to prevent or reduce your risk for CHS is to avoid or quit marijuana use.
What is cannabinoid hyperemesis syndrome?
The onset of symptoms was reported in 13 of those cases at a median of 9 years (range 3–25 years). In the limited subset of cases where data were available, it appeared that it took a mean of 2.6 years (range 1 day to 9 years) to get a CHS diagnosis. All patients reported intractable vomiting for 24–48 h, and all patients suffered abdominal pain; many experienced weight loss as well. Hot showers for symptomatic relief were reported by 17/19 patients 128. Marijuana cessation was recommended to all patients, but there was no long-term follow-up. Immersing oneself in very hot water relieves vomiting symptoms in CHS patients but has no antiemetic effect on patients with other types of CVS or PV.
Skin Conditions
Overall, the grade of evidence of any of these theories is very low and, in some ways, helps to explain why multiple interventions may help with CHS management. Cannabinoid hyperemesis syndrome (CHS) is a (probably) rare syndrome that occurs in frequent and chronic cannabis users. CHS is frequently misdiagnosed resulting in extensive investigations and delayed diagnosis and treatment. Standard anti-emetic treatments are typically not effective, and no standardised treatment protocol exists for CHS. Little is known of the aetiology of CHS as the literature is predominantly informed by case reports and chart reviews. Similarly, little is known of the demographics and cannabis use patterns of those who develop CHS.
What is Cannabinoid Hyperemesis Syndrome (CHS)? Part 1
Propranolol is a nonspecific, lipophilic beta-1/beta-2-blocker that has been used to treat CVS, particularly in pediatric patients 119. Most CHS patients discover the symptomatic relief of hot showers on their own and use this method to control symptoms 1. In a case study from Texas, a 27-year-old male patient with CHS reported he found relief in hot showers but over time, he became refractory to the hot water and ended up having to visit the ED 105. A diagnosis of CHS is confirmed when all symptoms resolve for a long period of time (∼12 months) with the cessation of marijuana 15.
- Just contemplating the plethora of delivery devices and variety of formulas and potencies on the dispensary sales floor is nearly as mind-blowing as consuming them.
- Cannabinoid hyperemesis syndrome (CHS) is a condition that sometimes develops due to the long term use of marijuana.
- The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana).
Cannabinoids discovered in the cannabis plant with known effects on the regulation of emesis include tetrahydrocannabinol, cannabidiol, and cannabigerol. If you have CHS and don’t stop using, your symptoms like nausea and vomiting are likely chs symptoms and signs to come back. Because CHS is a fairly new medical condition, not all doctors know about it. Or they might think it’s something else, since repeated throwing up is a sign of many health problems. You may need to see a gastroenterologist, a doctor who specializes in the digestive tract, for a proper diagnosis.
Conventional antiemetics are not contraindicated but are generally ineffective likely because of the atypical mechanisms behind CHS. Cannabinoid hyperemesis syndrome (CHS) is a very drug addiction treatment unpleasant — and potentially dangerous — complication of long-term marijuana use. Because of this possible complication, it’s important to use caution with marijuana and other cannabis products.