Monday, May 27, 2024

Cannabinoid Hyperemesis Syndrome

It is hypothesized that CHS may be a result of overstimulation of endocannabinoid receptors. Genetics may also have a role to play.


There’s one way to die from cannabis, and it’s cannabinoid hyperemesis syndrome (CHS). According to the Official Journal of the American College of Gastroenterology, there have been about 2217 reported deaths from CHS. The figure is probably higher considering that most cases are never diagnosed and hence never reported.

CHS is a rather new diagnosis that is often confused with cyclic vomiting syndrome (CVS). Both conditions are characterized by cyclic episodes of excessive vomiting (hyperemesis) that may eventually lead to death. Even though exact mechanisms are yet to be confirmed, THC has been implicated in CHS.

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On the flip side, one of the approved uses of THC is in the treatment of chemotherapy-induced nausea and vomiting (CINV). Isn’t it paradoxical that THC would trigger both CHS and be an effective cure for CINV nonetheless?

CHS was first described in a 2004 paper as cyclical hyperemesis (vomiting) as a result of chronic cannabis abuse. Apart from the vomiting, the researchers also noted that the patients were taking frequent hot baths for relief, as a learned behavior. It is hypothesized that CHS may be a result of overstimulation of endocannabinoid receptors. Genetics may also have a role to play, according to preliminary research.

RELATED: Is ‘Uncontrollable Vomiting’ Really A Serious Side Effect Of Marijuana?

CHS is often divided into three phases. The first is the prodromal phase where the patient experiences early morning nausea and slight abdominal discomfort. This phase may last for several years. The second is the hyperemetic phase that’s characterized by severe nausea and vomiting, abdominal pain and the learned behavior of taking hot baths. Left untreated, the patient can deteriorate quite fast during this stage due to electrolyte imbalance and dehydration. The final stage is the recovery phase.

Most of the patients who’ve been diagnosed with CHS are young adults with a history of chronic cannabis use (16 years on average). They reported daily use of cannabis, up to three or five times per day. Chronic cannabis use is what differentiates CHS from cyclic vomiting syndrome. In addition, the behavior of taking compulsive hot showers is only observed in CHS.

RELATED: A Brief Examination Of Cannabinoid Hyperemesis Syndrome

Treatment for CHS revolves around treating nausea and vomiting and preventing a relapse during the recovery phase. Even with the proven anti-emetic properties of cannabis, this is one case where offering it as a form of treatment may cause more harm than good.


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