Understanding Cannabinoid Hyperemesis Syndrome

If you were to ask a group of individuals that use marijuana, you would likely hear many of them state that the drug is not addictive and has no harmful effects. However, these statements are not valid. Marijuana is addictive, with up to 30% of those using the drug having some degree of marijuana use disorder. Long-term, chronic marijuana use can lead to multiple health complications, including cannabinoid hyperemesis syndrome. Many do not know of this syndrome and are surprised when they begin experiencing adverse symptoms due to their chronic use. By learning about cannabinoid hyperemesis syndrome, individuals can make more informed choices regarding their marijuana use.

What Is Cannabinoid Hyperemesis Syndrome?

Cannabinoid hyperemesis syndrome (CHS) is a condition that occurs after chronic cannabis use causing cyclic episodes of nausea and vomiting and frequent hot bathing. This syndrome is typically rare and only occurs in individuals that are daily long-term users of the drug. However, not all heavy users will develop the syndrome. There are three stages of the condition, prodromal, hyperemetic, and recovery. 


  1. Prodromal: This stage typically involves early morning nausea and vomiting with abdominal pain. Some individuals may develop a fear of vomiting due to this, although appetites usually remain the same. Many individuals use marijuana more often to cope with these symptoms, causing this stage to last for months or even years.
  2. Hyperemetic: During the hyperemetic phase, vomiting becomes more intense. This phase is typically accompanied by nausea, abdominal pain, dehydration, and decreased appetite. Many individuals take hot baths or showers during the day to ease their nausea. Medical care is usually sought out during the hyperemetic stage, and the individual will not enter the recovery phase until they cease marijuana use.
  3. Recovery: Decreased symptoms characterize the recovery phase. Regular appetite returns, there is less nausea and vomiting, and the person returns to everyday life. The recovery phase can last anywhere from days to months. However, symptoms typically return when the person uses marijuana again.


What Causes CHS?

Scientists still aren’t 100% sure what causes CHS in the body, but a general understanding is available. By understanding the effects of marijuana on the brain and gastrointestinal system, one can more easily understand the causes of CHS. 

The cannabis plant contains tetrahydrocannabinol (THC), the primary chemical that causes the psychological effects associated with the drug. THC significantly impacts the central nervous system, causing memory problems, changes in appetite, and analgesia. It typically helps prevent nausea and vomiting, which is why many individuals use it while undergoing chemotherapy or other health problems that cause sickness. In the gastrointestinal tract, marijuana stimulates nausea and vomiting; however, the receptors in your brain often stop these symptoms, thus preventing them. Repeated marijuana use can cause the receptors to stop responding in the same way, thus causing repeated episodes of nausea and vomiting in those with CHS. 

One study found that 97.4% of individuals that developed CHS in 2017 were at least weekly users; 75% of this group reported that they used marijuana regularly for more than a year. While still not understood why some heavy users develop the condition, suggestions concerning genetics have been made. Another theory is that chronic use overstimulates endocannabinoid receptors, thus causing your body to be unable to control nausea and vomiting while using the drug.


Treatment for CHS

The only known cure for CHS is to stop using cannabis. Symptoms usually return upon reusing the drug, so doctors advise avoiding it altogether. However, doctors may also suggest various treatments to manage symptoms. These include antipsychotics, pain relief medications, antihistamines, intravenous (IV) solutions, and capsaicin cream. Some individuals may take repeated hot baths or showers throughout the day to relieve symptoms, as the high temperature helps reduce nausea. It is best to consult with a medical professional if you believe you have CHS, as not treating the condition can lead to health complications and even death.

Without proper treatment, you could be at risk of numerous health problems. These include, but are not limited to, dehydration, malnutrition, esophagitis, tooth decay, electrolyte imbalances, and Mallory-Weiss syndrome. In some cases, death has occurred as a result of hyponatremic dehydration (low sodium levels). To avoid further health complications, you should see your doctor immediately if you are a heavy smoker and experience severe nausea and vomiting. Be forthcoming about your marijuana use, as you may be misdiagnosed, leading to further problems. A doctor may refer you to an addiction treatment specialist to help you live life in sobriety to avoid future symptoms.

Cannabinoid hyperemesis syndrome (CHS) is not fully understood, but scientists know enough about its risks. Regular heavy smokers of marijuana are more at risk for developing it, although it is not understood why some individuals have the conditions while others don’t. However, you should still take the necessary precautions to protect yourself and your health. NorthStar Transitions is well-versed in addiction treatment, including marijuana smokers. We can help you regain your footing in life through our various therapy programs, health and wellness programs, family education programs, workshops, and more. With NorthStar, you will be connected with hundreds of other individuals who have successfully maintained sobriety due to our programs. You can learn how to enjoy life in sobriety in ways you never thought before. Situated in the beautiful Colorado mountains, our facility provides the perfect space for healing. Call us today to learn more at (303) 558-6400. Freedom from addiction begins at NorthStar Transitions.

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