Cannabinoid Hyperemesis Syndrome CHS: Causes, Symptoms & Treatment

what is cannabinoid hyperemesis syndrome

As CHS is a relatively recently recognized and studied phenomenon easily confused with other diseases, there is a paucity of sizeable randomized control studies. Most resources and recommendations come from case studies and expert opinions. In addition to appropriate antiemetic therapy, fluid resuscitation, and management of the patient’s symptoms, patients must recognize behaviors and exposures that place them at risk for their pathology. For supportive care, a clinician should work together with the pharmacist to see if any medications could contribute to the patient’s presentation. If administering antiemetics, the nursing staff should be familiar with the adverse event profile so they can report any concerns that may arise. Severe and uncontrollable vomiting increases the risk of dehydration and electrolyte imbalances, and in rare cases, patients can experience esophageal tears, Camenga said.

CHS Symptoms

Initial symptoms are feeling sick to the stomach, belly pain and the feeling like you may throw up. After about years of chronic marijuana use, patients begin to have a strong feeling of sickness, throwing up, and belly pain. This is normally when people go see a doctor to find out what is causing these problems. They start to feel better when they stop using marijuana but can feel bad if they use it again. Doctors also noticed that individuals with CHS would take frequent hot showers and baths.

Who is at risk for developing Cannabinoid Hyperemesis Syndrome?

  • CHS is unique in presentation, because of the cannabis’s biphasic effect as anti-emetic at low doses and pro-emetic at higher doses, and the association with pathological hot water bathing.
  • Other theories behind rising cases include the widespread legalization and cultural acceptance of cannabis, as well as the higher tetrahydrocannabinol (THC) content in modern marijuana, experts told the NewsHour.
  • They may also prescribe antipsychotic medications such as haloperidol (Haldol) or olanzapine (Zyprexa) to help you calm down as you switch to the recovery phase.
  • Dehydration from vomiting can be fatal, so these symptoms should be taken seriously.

According to data from the Department of Public Health, cannabis-related emergency room visits increased by 53% in Maryland from 2022 to 2023. Recreational marijuana use became legal for adults in Maryland on July 1, 2023. Akshima is a registered dentist and seasoned medical writer from Dharamshala, India. Akshima is actively involved in educating people about the importance of good dental health. Taking her passion for medical writing ahead, her aim is to educate the masses about the value of good oral health. CHS is a recently discovered disease and can remain undiagnosed for many years.

Causes of CHS

what is cannabinoid hyperemesis syndrome

When cannabinoids bind with brain receptors, they tend to prevent nausea and vomiting. Experts think that when you first smoke weed, your brain signals are more important, but after repeated use of the drug, the brain receptors may no longer respond to marijuana in the same way, causing Alcoholics Anonymous more nausea and vomiting. When you use marijuana for many years, it can start to slowly change how the receptors in your body respond to the cannabinoid chemicals.

How states have reshaped marijuana laws and what’s next

what is cannabinoid hyperemesis syndrome

Cannabinoid Hyperemesis Syndrome is often linked to marijuana addiction, as those with CHS typically have a long history of chronic marijuana use. Addiction treatment is a critical component of managing CHS, helping individuals not only to alleviate symptoms but also to address the underlying cause of the condition—marijuana dependency. Another misconception is that CHS is a subtype of cyclic vomiting syndrome (CVS). While these are similar conditions symptomatically, they have very different root causes. CVS is actually a type of migraine condition that usually appears during infancy or childhood and develops into more classic migraine symptoms later on.

What medical treatments work to alleviate CHS symptoms in health care settings?

Many people experience temporary relief from their nausea and vomiting when bathing in hot water. Some people with CHS may compulsively bathe in hot water for hours a day to find relief. While marijuana seems to bring on nausea in the stomach, in the brain it usually has opposite effect.

Symptoms and Causes

what is cannabinoid hyperemesis syndrome

The Washington State Liquor and Cannabis Board was unable to provide an exact percentage of the state market for high-potency sales in 2024. Communications Director Brian Smith said via email that the “processing sector” now accounts for more than half of all retail sales, although that can include products that contain less than 35% THC. But measuring dose is a challenging task for people smoking and vaping cannabis, and for researchers trying to gauge the effects of daily use.

  • Many people with CHS go to their doctor or an emergency room (ER) for treatment.
  • “It may be that the cannabinoid is only sort of one aspect of the way the patient is hurting that needs to be addressed to really get them to heal,” he said.
  • Cannabis hyperemesis syndrome (CHS) is a form of functional gut-brain axis disorder characterized by bouts of episodic nausea and vomiting worsened by cannabis intake.
  • Like many people who develop CHS, Brandon Danielson was initially misdiagnosed.
  • Akshima is actively involved in educating people about the importance of good dental health.
  • Since its founding in 1973, the institute has awarded more than $3.5 million to researchers in 40 UW departments, funding about 350 projects.

Researchers need to study CHS in more detail to make it easier for doctors to recognize and what is chs treat the condition. Further studies are also necessary to determine the causes of CHS and its risk factors. Since 2004, doctors have identified key symptoms and characteristics of the condition that can help speed up diagnosis.

what is cannabinoid hyperemesis syndrome

As CHS is a new diagnosis, the manufacturers of these drugs did not design them for treating CHS, but a doctor may opt to prescribe them for this use. Doctors have a lack of knowledge of CHS, and this makes it hard to identify people with the condition. Another doctor reported using a combination of injectable lorazepam and promethazine, another antinausea medication. In CHS, receptors that bind to the different components of marijuana can become altered. But occasionally, patients who arrive at a hospital with what initially looks like CHS can instead have pancreatitis, gastritis, gastrointestinal reflux disease (GERD), appendicitis, or other problems. So, Heard says, these patients often end up going through a lot of testing.


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