Studies exploring novel treatments, diagnostic criteria, or the pathophysiology of CHS were also prioritized. Marijuana vape pens have also made it more convenient for young people, with a significant increase of 10th and 12th graders using this method in 2020 compared to 2019, according to the National Institute on Drug Abuse . 2.6 million Americans become new users each year; the majority of this group is under the age of 19 . As of December 2024, all but four states have full or partial legal marijuana laws or decriminalization laws in effect .
These medications exert their effects by inhibiting the medullary and vestibular nuclei in the brain, which play a key role in nausea and vomiting regulation. Capsaicin, applied to the abdomen, has shown success in resolving symptoms in all 15 CHS patients studied in one case report and two case series 38-40. In addition to the supportive measures mentioned above, certain pharmacological treatments have shown promise in alleviating symptoms.
CHS Symptoms
The use of marijuana has surged significantly in recent years, fueled by legalization efforts and increasing societal acceptance. Cannabidiol (CBD), another major cannabinoid, has gained attention for its potential therapeutic properties, including anti-inflammatory, anxiolytic, and neuroprotective effects . Among these cannabinoids, tetrahydrocannabinol (THC) is the most well-known for its ability to induce euphoria, alter perception, and stimulate appetite. The plant’s psychoactive and medicinal effects are attributed to its cannabinoids, chemical compounds that interact with the body’s endocannabinoid system. Cannabis, commonly referred to as marijuana, is a plant from the Cannabis sativa species that has been cultivated and consumed for medicinal, industrial, and recreational purposes for thousands of years. It contains over 100 biologically active compounds known as cannabinoids, the most notable of which are tetrahydrocannabinol (THC) and cannabidiol (CBD).
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Diagnoses Navigating the Nursing Profession When You Have Chronic Health Conditions Nurses care for patients who have varying degrees of illnesses, injuries, and chronic health conditions. Many of them come in by EMS, standard-issue vomit bag in hand, and are barely able to speak with their healthcare team. CHS is a syndrome in which long-term, frequent cannabis use leads to recurring episodes of nausea and vomiting. If you experience symptoms related to cannabinoid hyperemesis syndrome, you should immediately stop using cannabis. CHS is marked by persistent vomiting and ongoing abdominal pain, primarily affecting long-term, daily cannabis users.
Hyperemetic Stage
David is a seasoned Pharmacist, natural medicines expert, medical reviewer, and pastor. Deaths are exceptionally uncommon, but they have been reported when prolonged vomiting led to critical dehydration and electrolyte imbalance. If you do resume heavy use, unfortunately, the syndrome is very likely to return. It will not come back unless you start using cannabis again. Yes – CHS goes away entirely once you quit cannabis. Any cannabis product with THC can cause CHS if used heavily.
What makes CHS especially tricky is that it often goes unrecognized or misdiagnosed, especially because many people use cannabis specifically to ease symptoms such as nausea. Despite cannabis being known for its anti-nausea properties, CHS causes the exact opposite effect – recurrent cycles of intense nausea, vomiting, and stomach pain. For years, cannabis has been touted as a natural remedy for everything from anxiety and insomnia to chronic pain and nausea. Cannabinoid hyperemesis syndrome (CHS) can affect people who use cannabis (marijuana) long-term.
- In the acute phase, supportive care may include IV fluids for dehydration, anti-nausea medications, and rest.
- The absence of specific biomarkers for CHS means that physicians must rely primarily on clinical history, which can be challenging when the patient does not openly disclose cannabis use or when cannabis use is intermittent.
- As legislation changes and more states legalize marijuana, there has been an uptick in marijuana-related emergency department (ED) visits.
- There is also continuous cleanup needed due to constant vomiting.
However, many visits are due to something most people aren’t even aware of, and they certainly don’t realize initially that their ED visit is marijuana related. Access State-Specific Provider Directories for detailed information on locating licensed service providers and recovery residences in your area. We do not receive any fee or commission dependent upon which treatment or provider a caller chooses. 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. Prompt rehydration and medical care can prevent fatal outcomes. Many CHS patients start feeling relief in the first 1–2 days after quitting, and the vomiting stops completely within about a week (7-10 days) in most cases.
What are the risk factors for cannabinoid hyperemesis syndrome?
Many people, in general, and patients seeking ED services for 2c-b alcohol and drug foundation CHS have no idea what it is. However, she maintained smoking weed was the only remedy for her chronic pain, so she continued to do so. This is because the only “cure” for CHS is time and abstinence from marijuana or severely cutting down.
How long after quitting will the vomiting stop?
She began her journey in cannabis as a patient, searching for a way to heal herself. By understanding CHS symptoms and their progression, we can ensure earlier diagnoses, fewer ER visits, and better patient outcomes. Recognizing the signs, especially the unique compulsion to bathe in hot water, is crucial for diagnosis. Capsaicin cream, IV fluids, and haloperidol may provide temporary relief, but quitting cannabis is the only lasting solution.
Dealing with CHS
Standard anti-nausea drugs often don’t help. While CHS itself is not usually fatal, severe dehydration and electrolyte imbalances can be life-threatening if untreated. The only true cure is stopping cannabis completely.
With the widespread use, increased potency and legalization of marijuana in multiple states in the U.S., CHS may be becoming increasingly common. CHS is more than just a side effect of marijuana use. Examples of cannabinoids include tetrahydrocannabinol (THC) and cannabidiol (CBD). Cleveland Clinic is a non-profit academic medical center.
Is CHS fatal?
Overlapping symptoms such as abdominal pain and cyclic vomiting are especially difficult to pinpoint to a specific illness. The difficulty in diagnosing CHS arises because its symptoms overlap with other gastrointestinal and metabolic disorders, such as gastroparesis, cyclic vomiting syndrome, or peptic ulcer disease. Common clinical findings include signs of dehydration, electrolyte imbalances, and ketonuria following episodes of severe nausea and vomiting. During this phase, patients often develop a reluctance to consume solid foods, as ingestion typically triggers vomiting. Research indicates the prevalence of CHS has risen in tandem with increasing cannabis use, particularly among chronic users.
- 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.
- 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.
- However, if they use cannabis again, the symptoms tend to come back almost every time.
- This proves frustrating for ED and EMS staff, who are responding to and treating the same patients week after week.
Severe CHS episodes require emergency treatment for dehydration. Thus, heavy, prolonged cannabis use is the trigger for CHS; beyond that, the exact mechanism is still under study. Early identification and understanding of its patterns are important, especially for those experiencing unexplained digestive issues alongside regular cannabis use. Cedars-Sinai has a range of comprehensive treatment options. If they don’t, their symptoms will likely come back. The syndrome may take several years to develop.
Get the in-person or virtual care you need. Need a primary care doctor or a specialist? They provide treatment referrals and information in English and Spanish. CHS can increase your risk for severe dehydration. Taking too many hot baths can increase dehydration due to sweating. Hot baths may relieve the nausea for a while, but they don’t cure CHS.
These medications can be initiated during acute episodes of CVS and CHS to help stabilize symptoms and are often continued in a tapered manner following hospital discharge as part of long-term outpatient maintenance therapy. Tricyclic antidepressants (TCAs), such as amitriptyline, have shown promising efficacy in the management of CVS and have been explored as a potential prophylactic treatment for CHS. This concern is particularly pronounced in individuals already experiencing sequelae of recreational drug use, necessitating careful patient selection and monitoring when considering benzodiazepines as part of CHS management .