If you’re seeing signs of severe dehydration—like dizziness, confusion, or fainting—seek emergency medical help immediately. Still, the condition may remain under-reported, especially in places where discussing marijuana use is less accepted. If you’ve been using cannabis heavily and suspect your ongoing stomach issues might be related, drug addiction honesty with your healthcare provider is key to getting a correct diagnosis. However, one study indicated that over 32% of people who identified as frequent marijuana users and visited an emergency department met the criteria for CHS. This figure might suggest the problem is more common than many realize, especially as more U.S. states legalize marijuana and higher-potency products flood the market.
Overall Approach to Treatment
- Propranolol is a nonspecific, lipophilic beta-1/beta-2-blocker that has been used to treat CVS, particularly in pediatric patients 119.
- Due to the rise in CHS prevalence, likely from cannabis legalization in more states, public health outreach programs can play a crucial role in bringing awareness and prevention to this condition.
- This study is limited by the heterogeneity of the case series and case reports and the lack of controlled studies examining this syndrome.
Despite the lack of evidence, clinical experience has led to lorazepam being recommended as an adjunct in recent cyclic vomiting syndrome guidelines for patients who have an anxiety component to their presentation 8. Since 40-50% of traditional cyclic vomiting syndrome patients were chronic cannabis users, it is reasonable to extrapolate these guidelines to CHS until more specific literature is published. In the early phase of CHS, the individual may experience more subtle abdominal pain and nausea, especially in the morning. The condition seems to intensify over the course of months or years, and symptoms may escalate to more debilitating nausea, episodic vomiting, abdominal https://cesig.com.pe/most-physically-addictive-drugs-to-avoid/ pain, weight loss, and dehydration.
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In this case series, the investigators noted that this latter patient − who continued to use cannabis − had the greatest number of acute episodes of CHS 129. Thus, severe symptoms may not be sufficient to compel an individual to discontinue marijuana or cannabis may have an adverse effect on the individual’s ability to make sound decisions 129. Immersing oneself in very hot water relieves vomiting symptoms in CHS patients but has no antiemetic effect on patients with other types of CVS or PV. Thus, learned behavior of bathing in hot water may be used to help diagnose CHS and differentiate it from other CVS 93. Over 90% of CHS patients exhibit this behavior 75, which is sometimes described as compulsive. The patient found that hot water relieved his symptoms better than anything else.
Cannabinoid Hyperemesis Syndrome Treatment Guidelines
- Chronic cannabis use can lower pituitary hormone levels, including the growth hormone, follicle-stimulating hormone, and luteinizing hormone, which has been shown to normalize after stopping use 23,24.
- Real-world examples show that individuals who follow these guidelines often experience significant improvements in their health and well-being.
- Lidocaine patches have been proposed as a means to relax the rectus muscle, potentially alleviating abdominal pain during acute flares 91.
- 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.
The ongoing but mild nature of this phase can fool people into thinking they just have a sensitive stomach or deal with morning sickness. Cannabinoid hyperemesis syndrome follows a repeating cycle, with three distinct phases that people move through while continuing to use marijuana. These phases can last different lengths of time, and not everyone’s experience is identical. Long-term marijuana use, typically spanning 10 to 12 years or more, is the biggest risk factor for developing cannabinoid hyperemesis syndrome (chs) CHS. This variance suggests that a range of elements, including individual biology, metabolism, and genetics, can play a role.
Nevertheless, some limited evidence suggests a dynamic interplay between cannabinoid metabolism and complex pharmacodynamics at the CB-1 receptor. Limited evidence also suggests that an individual’s genetics, as well as variability in the cannabinoid components of individual plants 131, may play a role in the manifestation of CHS. The reviewers assigned each included article to nonexclusive groups of diagnosis, pathophysiology, or treatment. Relevant study characteristics were abstracted including study design and primary findings. These medications aim to manage symptoms and support recovery while discontinuing cannabis use. The best way to manage CHS and prevent complications is to discontinue cannabis use.
On the second visit, CHS was diagnosed and the patients were treated with capsaicin cream 0.025% applied in a layer approximately 1 mm thick on the abdomen. In both cases, topical capsaicin provided symptomatic relief in about 30 min. Both patients reported a burning sensation where the capsaicin was applied but were satisfied with the results 97.
No clinical studies have shown a successful alternative to complete abstinence for permanent relief from cannabis hyperemesis syndrome. Most sufferers report an unusual home treatment–taking long, hot showers or baths–temporarily alleviates these symptoms. However, with the underlying condition left untreated, CHS can cause serious medical issues.
