Endogenous cannabinoids or endocannabinoids may also play a role in CHS. Endocannabinoids are arachidonic acid derivatives that are biochemically similar to anandamide and 2-AG and likewise bind to CB1 and CB2 27, 28. Once they are activated, anandamide and 2-AG have different pathways for biosynthesis and subsequent degradation, in that anandamide is metabolized mainly by FAAH while 2-AG is metabolized via monoacylglycerol lipase 30. Endocannabinoids are present in the CNS and enteric nervous systems and are released locally on demand by neuronal signaling; they are released in small amounts and become rapidly inactivated 28. what is chs If you know marijuana is causing your symptoms but are unable to quit, it’s a sign you need marijuana detox and marijuana addiction treatment. A comprehensive treatment program can help you address the underlying issues that cause your marijuana abuse, help you build coping skills and relapse prevention strategies, and help build a foundation for long-term recovery.
How is cannabis hyperemesis syndrome treated?
- When it comes to Cannabinoid Hyperemesis Syndrome (CHS) treatment, it’s essential to differentiate between controlling the symptoms and treating the actual condition.
- At this time, the only known way to cure CHS is by quitting cannabis.
- Researchers aren’t sure exactly why weed causes CHS symptoms only in some people.
- The throwing up can be bad and can cause you to be low on body water.
Dysfunction in these pathways leads to recurrent nausea and vomiting in CHS. Potential causes of CHS include influence on the activity of cannabinoid receptors, conversion of cannabis into drug addiction emetic substances, or contamination with other toxins 36. Cannabis leads to upregulation of CB1 receptor activity in the hypothalamus, which enhances the hypothermic effects of THC.
Can you smoke CBD if you have CHS?
Some patients use hot water bags across the center of their belly and can burn the skin if done a lot. Most people with CHS who stop using cannabis have relief from symptoms within 10 days. Nicki’s long-term career goals include advancing in leadership roles within Virtue Recovery Center which is a quickly growing substance use disorder treatment facility. She hopes that one day her research and advocacy will help to save the lives of those who have been affected by substance use.
Pediatric Patients
As cannabis products like vapes, shatter, and dabs have reached near 100% potency, doctors across Washington state are seeing an increase in cannabis-related disorders, including CHS. CHS, or Cannabinoid Hyperemesis Syndrome, is diagnosed through medical history, cannabis use assessment, and ruling out other conditions. Treatment often includes stopping cannabis use, hydration, anti-nausea medications, and hot showers or baths for symptom relief.
TRPV1, transient receptor potential cation channel subfamily V member 1; TCA, tricyclic antidepressant; CB, cannabinoid; CTZ, chemoreceptor trigger zone. Four in five people who have CHS recover when they stop taking marijuana products.8 If you keep using cannabis, you will continue to have problems with this syndrome for the rest of your life. 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. To prevent worsening CHS symptoms, medical advice suggests complete cessation of all cannabis usage.
Visits and extensive recurring serum testing and imaging evaluations with increased healthcare-related costs. It is crucial to exclude other entities such as Addison’s disease, migraines, hyperemesis gravidarum, bulimia, and psychogenic vomiting, which can mimic CHS symptoms and may also occur alongside it. A thorough medical history, complete physical examination, and focused diagnostic testing help differentiate from these other differential conditions. CHS is classified as a type of functional gut–brain disorder and a variant of cyclic vomiting syndrome (CVS) per the Rome IV structured framework. Venkatesan et al. 21 described the features of CHS, including clinical features, cannabis use patterns, and symptom resolution after at least six months of abstinence, helping differentiate it from CVS.
How soon after cannabis hyperemesis syndrome treatment will I feel better?
In some cases, IV haloperidol or lorazepam (for anxiety) may provide relief for the CHS patient 14, 89. In the literature, there is one case report of “atypical CHS” in which the patient found relief from cold showers or other ways to chill himself (use of a fan, lying on cold marble floor) but this case must be viewed as an outlier 99. Treatment guidelines published by the San Diego Emergency Medicine Oversight Commission recommend supportive care (rehydration), patient education, and counsel to stop the use of cannabinoids 100. Topical capsaicin can be used to provide symptomatic relief but symptoms typically resolve in a day or two without cannabinoid use regardless of treatment. Benzodiazepines and opioids, although sometimes prescribed, have very limited effectiveness for this condition 100. A case series from 2010 in the United States described 4 individuals with a history of cannabinoid use who developed episodes of abdominal pain, nausea, and vomiting which could be relieved, in all cases, by bathing in hot water 102.
Marijuana Cessation
Patients often adopt this behavior to alleviate nausea, vomiting, and abdominal pain symptoms of CHS, and some reports have referred to this symptom as CHS as “cannabis hot shower syndrome”. It is hypothesized that hot showers help stabilize the thalamic thermostat, which is frequently disrupted by chronic cannabis use, including CHS. However, this proposed mechanism has not been empirically validated 59. Though many patients with CHS may use hot bathing or showering to obtain relief from its symptoms, more than 10% may not exhibit this behavior 60. The onset of symptoms was reported in 13 of those cases at a median of 9 years (range 3–25 years). In the limited subset of cases where data were available, it appeared that it took a mean of 2.6 years (range 1 day to 9 years) to get a CHS diagnosis.
- As many other health problems could lead to repeated vomiting, it’s important to discuss your complete health history, including your cannabis use, with any provider you see for your symptoms.
- An intriguing point to keep in mind is that the Rome IV criteria include the phrase “resembling cyclical vomiting syndrome.” In that regard, it is important to distinguish between the two.
- When recovering from cannabinoid hyperemesis syndrome, it’s wise to avoid anything that could potentially exacerbate symptoms or slow recovery.
- There is only one way to prevent cannabinoid hyperemesis syndrome, and that is to avoid cannabis.
- During this phase, patients may experience morning nausea, abdominal discomfort, or anxiety about vomiting.
After quitting weed, most people start to feel better within 10 days or so, although it may take a few weeks or months to fully recover from CHS. Once the individual abstains from using cannabis, symptoms gradually decrease. The recovery speed may depend on the severity of physical trauma sustained through chronic vomiting and dehydration. 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.