Cannabinoid Hyperemesis Syndrome (CHS): An Obscure Disease Caused by Chronic Use of Cannabis

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One out of every three daily cannabis users — or 2.75 million Americans — will experience Cannabinoid Hyperemesis Syndrome (CHS), according to research published in the Basic and Clinical Pharmacology and Toxicology journal.

The condition affects some long-term cannabis users. Its symptoms include vomiting, abdominal discomfort, weight loss, and nausea. 

In Latin, hyper means excessive, and emesis indicates vomiting. Moreover, vomiting is the most common symptom of CHS. The symptoms are consistent among most sufferers, but the duration of cannabis consumption varies. Typically, the disease takes one to five years to develop after chronic cannabis use.

CHS is poorly understood among medical professionals. Due to its rarity, patients can be easily misdiagnosed. That has led to doubt among researchers. In fact, the medical term for CHS did not appear until 2004; only 17 years ago. This is explicable considering cannabis use increased in the early 1990s.  

 

The “Discovery” of CHS  

Now, let’s take a seat and go back to the year 2004 and see how scientists discovered CHS. According to an article, titled Cannabinoid Hyperemesis, researchers stated it all started in Australia when 19 different patients were diagnosed with the same symptom — vomiting. Those patients had one thing in common; they all reported excessive cannabis use in the span of several years. 

After this incident, cases of CHS started to appear in other countries, such as Canada, Spain, France, the Netherlands, and many more. 

 

Honing-in on a Cause 

Strangely, medical professionals do not know why chronic cannabis users experience CHS. They pondered the question and came up with a theory. 

Simply put, researchers believe that cannabis cultivators have altered the concentrations of tetrahydrocannabinol (THC) in cannabis plants, and amplified the amount of the psychoactive cannabinoid over time. 

As a result of decades of methods like crossbreeding, the cannabis we know today has become more potent than our parent’s weed. For example, one 2019 study found that THC concentrations have dramatically risen “over the last 10 years, from 8.9% in 2008 to 17.1% in 2017.” 

As a result of these enhancements, cannabis consumption has also progressively increased, exposing people to elevated levels of THC, according to Cannabinoid Hyperemesis – Medical Cannabis and Cannabinoids.

 

What is THC?

Let’s take a step back and explain what THC is and why it is significant. Although there are about 85 different naturally occurring phytocannabinoids in cannabis, THC is known as the psychoactive molecule that is accountable for the high sensation when consuming cannabis. As Uttam Gary and Carl Cooley stated in Tetrahydrocannabinol – an Overview, “it acts much like the cannabinoid chemicals made naturally by the body [aka endocannabinoids].”

THC begets the brain cells to release dopamine, a hormone which generates euphoric feelings. This is caused by the movement of THC through your bloodstream, targeting your hippocampus, a section of the brain that’s involved in forming memories and emotions. 

Dopamine manages the buzz which causes pleasure, calmness, happiness, and lightheadedness. After the body activates the hormone, it affects the neurological receptors associated with memory, thinking, movement, concentration and coordination.   

After ingestion, THC usually takes ten to 30 minutes to kick-in and can last about two hours. 

 

Treatment

Vomiting is associated with multiple medical conditions. As such, doctors must run diagnostic tests, including blood and urine tests, drug screens and CT scans. However, before this whole process, medical professionals will ask patients about their family history and lifestyle.  

Admitting to the use of cannabis can fasten the diagnostic process, ultimately saving patients time and money. 

 

The Three Stage of CHS

According to the 2018 study, Treating Cannabinoid Hyperemesis Syndrome, there are three phases that CHS sufferers go through. 

Patients start to experience symptoms, including distress and body aches, in the first phase of CHS. However, there is no emesis in this phase, explains the study’s author, Dr. Manisha Gupta.  During this stage, known as the pre-emetic phase, patients can tolerate liquid diets. 

More severe symptoms occur in the second stage of CHS. Those symptoms, which include vomiting and abdominal discomfort, typically lasts for 24 to 48 hours. 

Finally, the recovery phase is the last step the patients have to go through. Phew! This is when, “[patients] develop diaphoresis, restlessness, agitation, and weight loss,” explained Gupta.

Then, symptoms begin to diminish — but only if the person’s cannabis use comes to an end. Moreover, the recovery phase is straightforward, and patients can do it from home. 

All the patients have to do is simply take long hot baths or showers. Hot baths truncate the blood flow to the stomach “by affecting peripheral vasodilation and redistribution from the splanchnic circulation, resulting in decreased vomiting,” according to research published in The Pharmacist’s Resource for Clinical Excellence. 

Additionally, because of abdominal pain and dehydration, sufferers may need to take pain meds and IV fluids, respectively. That said, patients would have to stop ingesting cannabis in all forms or else they will experience the symptoms again. 

Don’t forget that CHS does not affect every cannabis user, which makes it rare and allows room for questions and doubts. If you have any questions, make sure to ask your primary care provider.

 

Emerald contributor since January 2021

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