Cannabinoid Hyperemesis Syndrome

It started out simple enough. Smoking a bowl, hanging with my friends. Fast-forward seven or eight years. I’m still smoking, but now it’s daily whether I’m with friends or not. Sometimes, I’d burn through an ounce within maybe… two weeks at most. This seemed fine since it’s not like something natural like weed could ever hurt me or cause issues.

Flash forward again to the last two years. I’ve had some of the worst nausea of my life. I haven’t been able to eat anything until the late afternoon at the earliest. Weight loss and a lack of appetite were my new normal. Suddenly, I started throwing up and well… I couldn’t stop.

Even smells would set me off. There were these brief windows between bouts of uncontrollable heaving that were so pure. Everything would be normal, even nausea that was consistent for the last two years was alleviated. Then quick as it came it would disappear, and I’d be stuck heaving again.

The vomiting and nausea landed me in the ER more than once. My family even claimed I must’ve been on other drugs or in withdrawal. The IV sticks became something I have gotten so used to that it stopped phasing me. Five visits just for fluid will do that to you. The biggest problem was—no one knew why this was happening. That is, until the ER doctor recommended I meet with a gastrointestinal specialist. The GI doctor quickly diagnosed me with CHS, or cannabinoid hyperemesis syndrome. Turns out, it’s been the weed all along. The thing I thought was helping me was the culprit from the jump.

I guess if I had known more about marijuana, I would have known sooner why I kept getting so sick for so long. I would’ve sought treatment for marijuana addiction.

A Quick Look At Marijuana

Marijuana is a plant that occurs naturally. It is actually a plant known as cannabis. As is the case with most plants, cannabis can come in a couple of different types. The two main types of cannabis are Cannabis sativa and Cannabis sativa L.

Cannabis sativa L is the non-psychotropic, or non-mind altering, type. It is most commonly used in the materials industry. It can be used to produce oils, materials for clothes, rope, and much more. It’s commonly referred to as hemp.

Cannabis sativa on the other hand is the strain that makes up what is commonly known as marijuana. Other names for this include:

  • weed
  • pot
  • dope
  • grass

It is made up of seeds, stems, roots, and other plant materials that range from green to purple in color. It is lauded for its psychoactive properties and medicinal aspects which are directly related to its active ingredient, THC. THC stands for delta-9 tetrahydrocannabinol.

Currently, marijuana is the leading most-used drug in America. Studies by the Centers for Disease Control (CDC), show that about 22.2 million people use it each month.

So, where and when did marijuana use even start?

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The History Of Using Cannabis

Cannabis use can be traced back as far as 500 BC! Ancient peoples in Asia frequently used plants as herbal medicine. Marijuana was one of those plants that often served as a medicine. Within the United States, the plant has a more colonial origin. It first came to America when colonists were using it for textiles and ropes.

Virginia, Massachusetts, and Connecticut were the first colonies to actively look for farmers for hemp and require current farmers to grow hemp. It wasn’t criminalized until the 20th century. 

Some experts suggest this change was related to political and racial factors of the time. Nowadays, it is becoming more and more common to see the substance be decriminalized and in some cases, legalized for medicinal or recreational uses.

There is also some evidence that types with higher THC content were created for the psychoactive effects for use in religious ceremonies. Other information suggests that the common use of marijuana even with higher THC concentrations were only medicinal.

In the 1800s, doctors began finding and recording the benefits of cannabis extracts. By the end of the decade, cannabis extract was readily available since it was sold in pharmacies and in doctor’s offices in both Europe and in the United States.

Recreationally, marijuana made its way into popular use in the United States during the early 1900s. Some of this is linked to the intense desire the country felt to relieve some of the stress of the Great Depression. Unfortunately, in America, the introduction of cannabis into the country was able to be tracked to immigrants from Mexico which led to a stark resentment of not only immigrants but those who used the “evil weed”. This fell right into the narrative being pushed during the prohibition era, and it led to more than 25 states outlawing cannabis before 1931.

By 1937, the U.S. had created a federal law that regulated the use and possession of hemp which made having any other strain of the plant illegal, even if it was for medicinal uses. The government doubled down on this during the 1970s “War on Drugs”, further criminalizing the substance—again, even if used medicinally.

The medicinal benefits of marijuana relate to its ability to lessen stomach cramps and sometimes help with vomiting or nausea by increasing hunger. The U.S. Food and Drug Administration (FDA), has actually even approved drugs that employ THC to treat nausea in patients with illnesses like cancer or AIDS.

But, like all medicines and substances, there is the chance and common occurrence of side effects.

Side Effects Of Using Marijuana

Most people use marijuana because It makes them feel good. When using the drug, people will often experience a “high”, this usually is seen with:

  • increased senses
  • a different sense of time
  • feeling humorous
  • relaxation
  • mood changes
  • decreased body movement
  • impaired thinking and memory

In some instances, if too much cannabis is had, whether it is from ingesting or smoking, it is possible to also have hallucinations, delusions, and other types of psychosis. Marijuana is often responsible for both long-term and short-term effects. Some short-term effects include:

  • altered senses (for example, seeing brighter colors)
  • altered sense of time
  • changes in mood
  • impaired body movement
  • difficulty with thinking and problem-solving
  • impaired memory
  • hallucinations (when taken in high doses)
  • delusions (when taken in high doses)
  • psychosis (risk is highest with regular use of high potency marijuana)

Currently, there is still no evidence that links marijuana to life-threatening overdoses. However, cannabis, or marijuana, has been linked to extreme feelings of anxiety and paranoia that can lead to panic attacks which are a result of overuse. It can also lead you to feel like you are experiencing an overdose on marijuana.

Sometimes these lead people to seek care in the local emergency clinic which allows them to get care for the psychotic episode triggered by the overuse of marijuana. Of course, not all the effects are short-lived. Some effects can be long-term and even lifelong. These include:

  • breathing problems
  • increased heart rate
  • intense nausea and vomiting

This intense nausea and vomiting are known in the medical field as cannabinoid hyperemesis syndrome.

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What Is Cannabinoid Hyperemesis Syndrome?

Cannabinoid hyperemesis syndrome (CHS) is a syndrome of cyclic vomiting associated with cannabis use. CHS is actually considered an adverse effect, which is basically a negative side effect. The first case of CHS was reported in 2004.

Typically, CHS is categorized as cyclic vomiting that comes from chronic, high dose cannabis use. Often, CHS is also associated with frequent and compulsive hot baths or showers that are taken to relieve symptoms.

In the medical field, cannabinoid hyperemesis syndrome is considerably under-recognized. This means that the story we started out with is incredibly accurate. Many of those with CHS head to their local ER time and time again with what is called “intractable nausea and vomiting”.

Part of what makes it hard to diagnose is the stigma around using marijuana and the legality of it. This leads a lot of those seeking care to lie about use or pretend that they don’t use at all. This can prevent the doctor from getting a clear picture of the issue at hand.

Another unfortunate truth of cannabinoid hyperemesis syndrome is that symptom management can be hard.

Cannabinoid Hyperemesis Symptoms

Through different case studies, doctors have identified three stages of CHS: prodromal, hyperemesis, and recovery.

Prodromal Stage

During the prodromal stage, people typically experience:

  • morning nausea
  • urges to vomit
  • stomach discomfort

These symptoms may last for months or years. It shouldn’t be too surprising that during this time most people use marijuana more since we know that it is used in nausea treatment.

Hyperemesis Stage

People in the hyperemesis stage of cannabinoid hyperemesis syndrome will experience intense and persistent nausea and vomiting. This is typically the stage in which people will seek relief in any way that they can, including baths and showers.

Recovery Stage

The recovery stage can last from days to months. People in the recovery stage often:

  • feel better
  • return to normal eating patterns
  • resume a regular frequency of showering

What Causes CHS?

Researchers have several theories on the causes of cannabinoid hyperemesis syndrome. Only a small number of regular and long-term users of marijuana develop CHS. Part of this leads some researchers to suggest that genetics might play a role. Other researchers theorize that the effects of marijuana can change with chronic use.

Much like addiction or dependence on a substance, it appears that CHS can be due to a combination of things. Currently, there are more studies being conducted and centered around CHS. Hopefully, as more research is done, more clarity will be gained on what the actual cause of cannabinoid hyperemesis is.

Where Do You Get A Diagnosis And Seek Treatment For Cannabinoid Hyperemesis Syndrome?

CHS is actually a gastrointestinal issue and so the best place to seek a diagnosis or treatment for it would be seeking care at a gastroenterologist’s office. Gastroenterologists, or GI doctors, are specialists in the gastrointestinal tract. This means that they know the ins and outs of everything from the esophagus to the far end of the system. They know the processes in which food goes in and waste goes out.

Most GI doctors will only accept patients after they have had a recommendation by a primary care physician. We suggest that you address concerns with your family doctor and ask them to give you a referral to a local gastroenterologist to address your symptoms if you think you may have CHS.

However, it is important to know that getting treatment for CHS is not going to solve the underlying issue.

Is Marijuana Addictive?

The short answer: yes, marijuana can be considered addictive. 

The longer answer is that research conducted by, and with, the National Institute of Drug Abuse (NIDA), shows that THC can lead to a marijuana use disorder or cannabis use disorder. This is a type of substance use disorder (SUD) that is characterized by dependence on a substance, in this case, marijuana.

Marijuana use disorder becomes an addiction when the person cannot stop using the drug even though it interferes with a lot of different aspects of everyday life. Some additional studies as reported by the Centers for Disease Control (CDC), suggest that 1 in 10 users will form a marijuana addiction.

The National Institute of Health (NIH), also says that part of the addictive nature of cannabis relates to the dependence on the substance that leads to symptoms of withdrawal. They also cite that as many as 30% of those who use marijuana may have a marijuana use disorder.

They go on to say that in 2015, 4 million people in America met the criteria for marijuana use disorder but only 138,000 voluntarily sought treatment for it.

Treatment For Addiction To Marijuana That Considers CHS

Currently, you can get treatment for marijuana addiction or a marijuana use disorder. Treatment options right now are most often centered around things like binge use. Binge use is when you are using a lot of a substance, especially in a short period of time.

Treatment also focuses on things like withdrawal. Studies show that withdrawal from marijuana is possible and it can lead to an increase in the side effects and symptoms we listed above. Aside from these two main pieces, the treatment also often tries to help with the feelings of preoccupation with using.

Part of addiction is the intense need or craving to use a substance. Addiction to marijuana is no different and some of that impacts the effectiveness of treatment and the potential for relapse. This means it is critical that care focuses on that as well.

Less common is the potential of pharmacological treatments for it. These would be treatments for marijuana use disorder that rely on medications to be effective. For other drugs of use like opioids, this type of treatment has been thoroughly proven as safe and effective. It is called medication-assisted treatment and has been around for a long time. For marijuana, however, it is not used, and studies are still being conducted to determine the safety and effectiveness of it.

Finding Your Resilience With Vertava Health

If you or someone you love is struggling with cannabis addiction, Vertava Health is here to help. We offer comprehensive and compassionate treatment for all types of addictions and can help guide you through the difficult portions, like withdrawal and detox.

There’s one specific thing we use to help you, something unique: we use your strength. Your own dedication and strength are key ingredients in your own recovery. It might not feel like it, but we’re confident you have the power to change your life. Call us at (615) 208-2941 and we can chat about how.

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Frequently Asked Questions

How long does it take CHS to go away?

This is entirely dependent on the time it takes for your body to go through the stages of CHS. If you are concerned about the time it is taking or want more information on what you can expect during recovery, we suggest that you ask your physician.

Is cannabinoid hyperemesis syndrome permanent?

It is not permanent if you stop using and seek appropriate treatment for both CHS and marijuana use disorder if you have these two disorders concurrently.

How long does it take to recover from cannabinoid hyperemesis syndrome?

The time it takes for recovery after CHS is dependent on your body, your care schedule, and if you refrain from any use during the recovery process. We recommend if you are concerned about how you are progressing that you reach out to your doctor.

Can CBD help cannabinoid hyperemesis syndrome?

As of now, we are not seeing any research coming through that CBD will help CHS. It is important that you ask your doctor before trying any new or different treatments than those that they recommend.