Cannabinoid Hyperemesis Syndrome CHS: Causes, Symptoms & Treatment

With liberalization of marijuana laws and favorable public opinion about the healing properties of cannabis, CHS may be more frequently observed in clinical practice. However, our understanding of its effects has unfolded significantly over the last 3 decades. The extract of the plant cannabis sativa has been reported to be used for decades in the control of pain and cramps, according to the Chinese literature 1. Recognition of the function of the endocannabinoid system (ECS) was a breakthrough in explaining the effects of cannabis on different organs, at least in part 2.
- A 2019 article reported on thedeaths of three patients who experienced CHS; two of these deaths were directly caused by CHS-related dehydration, which caused low blood sugar and electrolyte abnormalities.
- This suggests that high doses of THC can lead to low levels of endocannabinoids within the hypothalamus, which may prevent inhibitory control of the HPA axis.
- The mechanism by which THC and cannabinoids might decrease myocardial contractility remains to be elucidated.
- Marijuana cessation was recommended to all patients, but there was no long-term follow-up.
- The blood work results came back, showing that his kidneys were failing and that all of his levels were out of the normal range.
What are the symptoms of cannabinoid hyperemesis syndrome?
Of the people who reported vaping cannabis in the 2023 International Cannabis Policy Study, the average oil they vaped was 71.6% THC. That’s almost 20 times stronger than the potency of weed that was for sale illegally in the U.S. in 1995, which had an average THC content of 4%, said Denise Walker, a research professor at the University of Washington School of Social Work in Seattle. For years, marijuana has been used recreationally and medically to treat chronic pain and nausea, but for some, it causes the opposite, which is why the condition is sometimes misdiagnosed. Mr Smith, who died in 2018 from CHS, first went to the hospital with his mother, Regina Denney, to complain about severe vomiting and abdominal pain and, at the time, had Drug rehabilitation lost about 30 pounds in a single month.

What causes CHS?
You may have symptoms and side effects of CHS for a few weeks after quitting cannabis. There were several people in and out of the house during this time, including police, firefighters, EMTs, and detectives. In the state of Indiana, if anyone under the age of 18 dies, the death requires investigation as a homicide. Once a person develops the condition, he or she has probably done something permanent. /r/emergencymedicine is a subreddit for healthcare providers in the emergency setting to discuss their encounters and find ways to improve their knowledge of various parts of EM. There is no blood test to link the stomach ailment with marijuana use, so physicians often order pricey CT scans and lab tests to rule out other medical problems.
Cannabinoid Hyperemesis Syndrome Treatment
The underlying mechanism of the cannabis-induced biphasic effect related to emesis is not clearly understood, but the literature supports the role of the brainstem and hypothalamic–pituitary–adrenal (HPA) axis. The possible mechanisms described include changes in the density of the receptors, interaction with active cannabis metabolites, the potency of agents, disequilibrium with the hypothalamic–gut axis, and interactions with active agents (explained below) 33. It could be a combination of these that produces the various clinical effects of cannabis.

The patient was referred to a nutritionist for additional support and education. She had not gained substantial weight by 1 week after hospital discharge, and she reported continued nausea with no emesis. At a gastroenterology consultation 7 months after discharge, she had improvement of symptoms, although early satiety remained. Surgical consultation was not sought by the patient, and it remains unclear whether she continued to use cannabis upon symptom relief. Rare diagnoses and disease interactions such as these, and lack of awareness of them, can lead to cognitive errors. Cognitive errors are pervasive chs syndrome in medical practice – influencing clinical decision-making and thereby disease management.
Chalfonte LeNee Queen of San Diego grappled with violent vomiting episodes for 17 years until she found out her illness was related to her marijuana use. The majority of CHS research to date has been focused on characterizing the syndrome, exploring acute symptomatic treatments, and attempting to determine the prevalence of CHS cases. If you need help quitting cannabis, the Substance Abuse and Mental Health Services Administration offers a 24/7 helpline in English and Spanish. A representative can refer you to local treatment facilities, support groups, and community-based organizations. Stopping cannabis use is the only known way to permanently get rid of CHS. Researchers are continuing to examine potential treatment options for CHS.

- The memo also said sales of high-potency products more than doubled in four years, from less than 14% of the market in 2015 to 37% in 2019.
- It has been suggested that CHS may − in whole or in part − be the result of pesticides, toxins, or other substances accumulated on the plants during growth and harvest 67.
- 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.
Interestingly, endocannabinoids play a role in allostasis, that is, they promote the recovery from stress and help to reestablish homeostasis of neurotransmitters, neurohormones, and neuropeptides 60. Despite the possible pharmacological and behavioral therapies, the only way to eliminate CHS is abstaining from cannabinoids. Acute treatment is necessary to avoid dehydration, renal failure, and death, but long-term treatments need to emphasize that sustained abstinence is required to https://ecosoberhouse.com/ permanently cease symptoms. Education regarding the potential effects of long-term high doses of cannabinoids should be disseminated to physicians and the public to better detect and manage this debilitating syndrome.
- Queen is still struggling to completely quit marijuana, but her symptoms are down to a dull stomachache.
- The reason why I know so much about this is that it happened to my son.
ECS and CHS
In the meantime, Brian began using marijuana again, and for several weeks, he did not have any symptoms at all. He was not a daily smoker, and he had been smoking on and off for about 3 years before he developed symptoms. Brian was also experiencing symptoms even after he had quit smoking, which caused us to doubt the diagnosis further. We had never heard of marijuana causing nausea or vomiting and were only familiar with its various health benefits, so we did not believe that CHS was what Brian had.


















