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. The serum levels of psychiatric drugs may be reduced in patients suffering from CHS or other vomiting syndrome.
What is the treatment for CHS?
- Typical antiemetics such as ondansetron, commonly known as Zofran, have often been found ineffective at suppressing nausea caused by CHS.
- A lack of long-term follow-up is also a major shortcoming in our knowledge of CHS.
- Other researchers theorize that the effects of marijuana can change with chronic use.
- Every time we accept a narrative that blames the plant instead of investigating alternative explanations, we’re allowing prohibition forces to maintain their grip on public perception.
- This is evidenced by symptoms like rapid heartbeat, sweating, hot flashes, high blood pressure, and tremors, often during the hyperemesis phase 49.
CHS should be considered as a plausible diagnosis in the setting of patients with recurrent intractable vomiting and strong history of cannabis abuse. Despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS. Further initiatives are needed to determine this disease prevalence and its other epidemiological characteristics, natural history, and pathophysiology. Additional treatments are needed and efforts to discontinue cannabis abuse are paramount. CHS is marked by persistent vomiting and ongoing abdominal pain, primarily affecting long-term, daily cannabis users.
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- Capsaicin, a topical agent with an active compound derived from chili peppers, interacts with transient receptor potential vanilloid-1 (TRPV1) receptors 86.
- Cannabis legalization should include balanced details on its benefits and potential risks.
- This applies not just to botanical marijuana; dronabinol (delta-9-tetrahydrocannabinol) slows gastric emptying and decreases colonic tone as well 54.
- Along with the discovery of the CB1 and CB2 receptors has been the identification of endogenous arachidonic acid derivatives that bind to these receptors (Figure 1).
- If you use cannabis often and frequently experience vomiting and nausea, you should tell a healthcare professional.
- While their genetic underpinnings are still not fully understood, research has suggested potential genetic predispositions for each.
The recent body of research recognizes that patients with CHS impose a burden on the healthcare systems. Understanding the pathophysiology of the endocannabinoid system (ECS) remains central in explaining the clinical features and potential drug targets for the treatment of CHS. The frequency and prevalence of CHS change in accordance with the canabis syndrome doses of tetrahydrocannabinol and other cannabinoids in various formulations of cannabis.
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These patients typically present multiple times to health care facilities with similar symptoms and receive multiple diagnostic tests and invasive procedures without a clear diagnosis or treatment plan. Treatment of CHS typically occurs during the hyperemetic phase, which often requires hospitalization due to the severity of symptoms. In this phase, patients frequently experience intractable nausea and vomiting that is unresponsive to conventional antiemetic medications 33. As noted earlier, hot baths or showers provide temporary relief for many patients. Warm stimulation is hypothesized to transiently activate transient receptor potential vanilloid-1 (TRPV1) in the hypothalamus which would otherwise be downregulated by chronic cannabis use 34.
Health Conditions
After stopping cannabis use, symptoms generally resolve within days or months. A 2017 review of studies found that 97.4 percent of people who developed CHS reported using cannabis at least weekly. Research suggests that CHS is a permanent condition that can only be effectively treated by quitting cannabis.
While the condition is still being studied, the impact of CHS is none-the-less debilitating. Cannabidiol (CBD) and cannabigerol (CBG) are two additional cannabinoids found in cannabis that appear to modulate the anti-emetic properties of THC. Cannabidiol, in contrast to THC, is non-psychotropic, has a low affinity for CB1 and CB2 receptors 27, and acts as a partial agonist at the 5-HT1A receptor 28. CBD enhances the expression of CB1 receptors in the hypothalamus and amplifies the hypothermic effects caused by THC 29.
After you quit, you may still have symptoms and side effects for a few days to a few weeks. Although it was considered to be rare, the number of cases has increased with the legalization of marijuana in many places and the opening of retail stores to easily get it. This has increased both the number of people using the drug and the “high” in the available weed.
Also, it’s possible there are more cases than have been reported, since not everyone with the illness will seek medical help or tell their doctor they use cannabis, the Cleveland Clinic notes. If you have Oxford House symptoms, your doctor will do a physical exam and ask for your detailed medical history. Let your doctor know how much marijuana you use and how often you use it.
What are the symptoms?
The ongoing cannabis legalization is expected to advance more research into its therapeutic potential. Ultimately, the treatment of any illness is the removal of precipitating factors, not merely the management of its symptoms. Experts say the medical field is woefully behind on understanding the rapidly changing drugs. “There’s a difference in legalizing the original cannabis on the planet and the products that exist today,” neuroscientist Yasmin Hurd said to the Times. Hurd was the lead author of a 2017 report on the health effects of cannabis from the National Academies of Sciences, Engineering and Medicine, which warned that the lack of evidence-based information posed a public health risk. Until more studies are done on cannabis in all its new forms, putting cannabis “under the umbrella of a safe, legal drug is wrong,” she said.
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TRPV1 receptors are involved in the modulation of transmitting pain signals and altering pain perception 87. These TRPV1 receptors are present throughout the gastrointestinal (G.I.) tract and the medullary vomiting center. They are frequently located closer to CB1 receptors, indicating a potential functional interaction. Upon topical application as a cream to the abdomen, capsaicin causes a sensation of heat at the application site, suppressing the underlying abdominal pain.
To help you transition to the recovery phase, you can try a few home remedies such as regular hot baths. But too many of them may increase your risk for dehydration due to sweating. If you need help quitting, speak to a healthcare provider or connect with your local addiction treatment services.