The rapid expansion of cannabis legalization has outpaced the research into its health impacts, particularly regarding conditions like CHS. Additionally, policies could focus on tracking and reporting cannabis-related health complications to better understand the full scope of CHS and its impact on public health. Unlike alcohol and tobacco, which have well-established health warnings and regulations, cannabis products are not universally required to include health warnings or educational materials. Despite the increasing popularity and legalization of cannabis in many states, there remains a lack of consistent and comprehensive public health policies to address cannabis-related disorders like CHS. The availability of higher-potency cannabis products, such as concentrates and edibles, poses a growing public health challenge. A significant public health limitation is the stigma surrounding cannabis use or potential implications with law enforcement, which may discourage individuals from seeking help for cannabis-related health issues.
- The development of such guidelines would not only benefit clinicians but could also improve patient outcomes by ensuring timely and accurate treatment.
- In the brain, marijuana often has the opposite effect of CHS.
- Despite negative workups, physicians must consider CHS when standard treatments fail and patients continue to present with persistent symptoms related to cannabis use.
- Abdominal pain is a key feature of CHS, although it is also present in a significant proportion of CVS cases .
- His focus and passion has always been taking care of his patients by getting accurate information and thorough education to those who need it most.
- When the patient presents to the ED, they’re usually doubled over, screaming, dry heaving, and vomiting.
Who is most at risk for CHS?
It’s important to be honest about your marijuana use if you have symptoms of CHS. This may lead to issues with your body’s natural control of nausea and vomiting. Many people with CHS will compulsively shower or bathe — often for hours every day — to relieve CHS symptoms. Symptoms of CHS typically come on several years after the start of chronic marijuana use. It’s a condition that can lead to serious health complications if you don’t get treatment for it.
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It occurs in daily, long-term users of marijuana. Symptoms should slowly resolve, but severe dehydration may require medical attention. Scromiting is another symptom of cannabinoid hyperemesis syndrome.
The leading theory is that long-term THC exposure overstimulates cannabinoid receptors and paradoxically upsets the body’s nausea control. It is now well-documented as a medical condition caused by cannabis use. A telltale sign, in most—but not all—patients, is the compulsive use of hot showers or baths taken for relief during episodes. Though once considered rare, CHS is increasingly recognized in clinical settings as more individuals report symptoms consistent with the syndrome. It causes recurring bouts of nausea, vomiting, and abdominal discomfort.
Most people with CHS who stop using cannabis have relief from symptoms within 10 days. You may use home treatments to relieve CHS symptoms immediately after quitting cannabis. Without knowing this background, providers often misdiagnose CHS as other conditions, like cyclic vomiting syndrome (CVS). One study found that 32.9% of self-reported frequent marijuana users who came to an emergency department for care met the criteria for CHS. Not everyone with the condition seeks medical help or tells their provider that they use marijuana. CHS causes frequent, severe nausea and vomiting.
- The response to stress is important in survival, but long-term stress can have negative effects on one’s health .
- Among these cannabinoids, tetrahydrocannabinol (THC) is the most well-known for its ability to induce euphoria, alter perception, and stimulate appetite.
- This often leads to misdiagnosis and delayed treatment that could otherwise alleviate symptoms.
- In emergency settings, benzodiazepines have demonstrated significant efficacy in reducing acute symptoms, providing symptomatic relief when conventional anti-emetics fail.
- Chronic cannabis users tend to have significant THC reserves in their fat tissue, which can be mobilized during stressful situations.
Labs need to be drawn at each visit to screen for electrolyte imbalance, and the patient’s nurse is monopolized as more and more medications are auditioned to try and control CHS symptoms. This proves frustrating for ED and EMS staff, who are responding to and treating the same patients week after week. One woman I had seen in the ED weekly for over a month did accept it was her cannabis use causing her daily debilitating abdominal cramps, throwing up, and dry heaving. Some patients are relieved that they feel better after being sick for so long without a known cause.
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Most patients improve within days to weeks, but full recovery can take months. The earliest CHS symptoms include morning nausea, reduced appetite, and abdominal discomfort. Some scientists also believe TRPV1 receptors (the same receptors affected by capsaicin, the compound in chili peppers) play a role — explaining why applying capsaicin cream or taking hot showers temporarily relieves symptoms.
Why does CHS happen?
Most importantly, the patient must try to stop using cannabis – abstinence is the only definitive cure for CHS. Applying capsaicin cream to the abdomen (to mimic the hot shower effect) can also help. During an acute CHS episode, treatment focuses on hydration and symptom control.
Frequently Asked Questions
Most people who develop CHS have been using marijuana your guide to cocaine withdrawal symptoms and recovery daily for years. Visit our cannabis treatment page for more details. Inability to keep fluids down for 24 hours, severe abdominal pain, or signs of dehydration warrant an emergency department visit.
Who is more at risk of getting CHS?
Scromiting is the combination of screaming and vomiting. That’s why it’s important to seek medical attention, especially if you become dehydrated. You may also feel hot and shaky and feel like your heart is beating fast. In this stage, the main symptom is cyclic vomiting and dry heaving up to several times per hour.
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However, their use is approached with caution due to the risk of dependence, especially in patients with a history of substance use. In emergency settings, benzodiazepines have demonstrated significant efficacy in reducing acute symptoms, providing symptomatic relief when conventional anti-emetics fail. Benzodiazepines have been shown to be effective in managing acute symptoms of CHS, particularly for their rapid-acting anti-emetic and anxiolytic properties. The response to stress is important in survival, but long-term stress can have negative effects on one’s health . Stress is regulated and controlled partially by the endocannabinoid system, and the HPA axis is the main neuroendocrine system activated by the stress response and therefore cannabinoids . If the endocannabinoid system gets disrupted by excessive use of cannabinoids, the stimulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system may occur.
The symptoms are challenging to treat, and much of the time, patients are discharged from the ED still feeling unwell. In addition, many patients either aren’t forthcoming about their weed consumption or don’t know to volunteer it as a contributing factor to their illness. Often, patients undergo costly procedures such as CT scans and a battery of lab work to ensure their symptoms aren’t indicative of something much worse. ED nurses and doctors are increasingly faced with the challenges of treating patients with cannabinoid hyperemesis.
Cannabinoid Hyperemesis Syndrome is a disorder seen in long-term, frequent cannabis users. Because of this possible complication, it’s important to use caution with marijuana and other cannabis products. Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use.
Cannabis, commonly known as marijuana, is a psychoactive plant that has been used for both medicinal and recreational purposes for centuries. A unique and highly specific symptom of CHS is the urge to take hot showers or baths, sometimes multiple times a day, which seems to temporarily relieve the discomfort. Stopping cannabis use altogether. This post breaks down what CHS is, why it happens, who’s at risk, and what recovery can look like—so you can make informed decisions and get help if you need it. Products and information are intended only for jurisdictions where cannabis use and possession is legal.By using this site, you affirm that you are of legal age (21+) and responsible for understanding your local laws. When she isn’t teaching cannabis cooking classes, Karen works as a cannabis business consultant, writes for online cannabis publications like Cannabis Training University, Leafly, and Weedmaps, and runs a CBD-infused-product business.
Narcotic pain medications, for instance, should generally be avoided in CHS patients. The modulation of CB1 receptors holds promise but also necessitates further investigation to ensure the safety and well-being of patients undergoing such treatments 44-46. Recent developments in cannabinoid research have led to the creation of novel modulators aimed at specifically targeting the CB1 receptors, which are integral to the psychoactive effects of cannabis. Research suggests that amitriptyline and other TCAs can significantly alleviate CHS symptoms, with remission rates reported in up to 70% of patients.
Nurses should know how to identify CHS, educate their patients, and provide resources non-judgmentally. Upon discharge, patients are often dissatisfied since they feel only mildly better or sometimes see no improvement. There is also continuous cleanup needed due to constant vomiting.
