About 75 percent reported using cannabis regularly for over a year. If not adequately managed, CHS can lead to severe complications like dehydration, brain swelling, esophageal tears (Mallory Weiss tear), electrolyte imbalances, kidney failure, and, in severe cases, death. To prevent worsening CHS symptoms, medical advice suggests complete cessation of all cannabis usage. No, continuing to use cannabis in any form can exacerbate the symptoms of CHS and delay recovery. If cannabis use is resumed, symptoms of CHS can return, often heralding a return of the hyperemesis many weeks or months later. Over the weeks following the cessation of cannabis use, individuals will start to notice a reduction in the severity and frequency of their symptoms.
Initial Treatment to Recovery: A Timeline
- “Cannabinoid” points to the active chemical compounds in the Cannabis sativa plant, including THC (tetrahydrocannabinol) and CBD (cannabidiol).
- These vomiting bouts feel relentless and severe, and over-the-counter medications rarely help.
- 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.
Some people may feel better with cream (capsaicin) applied to the stomach area. If you are worried about your symptoms, see your doctor or go to the hospital. what is alcoholism When you stop using cannabis completely, you will usually feel better in 10 days.
Cannabis Allergy: Symptoms, Relief and Prevention (The Complete Guide)
The authors found no cases of geriatric CHS (≥65 years), but there is no reason evident why geriatric individuals who used marijuana long term would be immune from CHS. It is not known why the syndrome develops in some, but not all, long-term marijuana users and why symptoms take longer to manifest in some patients than others. Although there were very few case studies involving CHS patients with eating disorders, bulimia might present in such a way that it could be confused with CHS. About 35% of individuals with some form of substance use disorder have an eating disorder (which typically precedes the substance use disorder) versus 5% of the general population 174. In a retrospective chart review of 13 patients treated for CHS at one of two centers, 100% of patients experienced relief when topical capsaicin was administered to help control symptoms of vomiting 96.
- Many only get a correct diagnosis after making multiple emergency room visits for unstoppable vomiting.
- “We allowed people to vote whether or not cannabis is a medicine,” noted Yasmin Hurd, a neurobiologist at the Mount Sinai Medical Center in New York City.
- If you already suspect you’re at risk, the best move is to cut back or quit cannabis altogether.
- These episodes of vomiting are often separated by weeks or months, and there is a return to baseline between episodes.
- In some cases, IV haloperidol or lorazepam (for anxiety) may provide relief for the CHS patient 14, 89.
Cannabinoid Hyperemesis Syndrome Treatment Guidelines
It tends to affect people who chs symptoms and signs use cannabis at least once a week and happens more often in adults who’ve been using cannabis since their adolescent years.
- But he is opiate-free, married with two children, and runs a business with 10 employees.
- When you do this, your symptoms usually start to go away in few days to a few months.
- CHS is a rare condition that may result from long-term cannabis use.
- There is currently not a vast amount of medical literature about CHS, and most of the clinical reports are case reports of individuals or small case series, which do not provide high-quality medical evidence.
How is cannabinoid hyperemesis syndrome diagnosed?
In some cases, IV haloperidol or lorazepam (for anxiety) may provide relief for the CHS patient 14, 89. In the literature, there is one case report of “atypical CHS” in which the patient found relief from cold showers or other ways to chill himself (use of a fan, lying on cold marble floor) but this case must be viewed as an outlier 99. Treatment guidelines published by the San Diego Emergency Medicine Oversight Commission recommend supportive care (rehydration), patient education, and counsel to stop the use of cannabinoids 100. Topical capsaicin can be used to provide symptomatic relief but symptoms typically resolve in a day or two without cannabinoid use regardless of treatment. Benzodiazepines and opioids, although sometimes prescribed, have very limited effectiveness for this condition 100. 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.
Cannabis Hyperemesis Syndrome (CHS)
Endogenous cannabinoids or endocannabinoids may also play a role in CHS. Endocannabinoids are arachidonic acid derivatives that are biochemically similar to anandamide and 2-AG and likewise bind to CB1 and CB2 27, 28. Endocannabinoids may be neuromodulators or neurotransmitters 29. Once they are activated, anandamide and 2-AG have different pathways for biosynthesis and subsequent degradation, in that anandamide is metabolized mainly by FAAH while 2-AG is metabolized via monoacylglycerol lipase 30. Endocannabinoids are present in the CNS and enteric nervous systems and are released locally on demand by neuronal signaling; they are released in small amounts and become rapidly inactivated 28. Since CHS is caused by chronic marijuana use, the first and most critical step is stopping any cannabis product.