If you need help quitting, speak to a healthcare provider or connect with your local addiction treatment services. Hot baths may relieve the nausea for a while, but they don’t cure CHS. Many people with CHS will compulsively shower or bathe — often for hours every day — to relieve CHS symptoms. While symptoms begin as mild, they can intensify and increase your risk of severe problems.

Signs and symptoms

In CHS, receptors that bind to the different components of marijuana can become altered. With the consumption of marijuana increasing due to the legalization of its recreational use in many states, doctors may receive more reports of side effects from marijuana use. The aim of this study was to outline current treatments for the management of CHS. If you have CHS and don’t stop using, your symptoms like nausea and vomiting are likely to come back.

How is cannabis hyperemesis syndrome treated?

As a somewhat new problem, CHS is often mistaken for other problems with the same symptoms. When combined with the fact that people may not reveal they use cannabis, getting the right diagnosis can take years. Cannabinoid hyperemesis syndrome (CHS) is a somewhat rare problem that involves severe bouts of vomiting. As more states make recreational use of cannabis legal, it is thought that this problem will become more common. After stopping cannabis use, symptoms typically start to disappear within one to two days though individual results can vary. However, symptoms almost always return if you resume using marijuana.

Can CBD products without THC cause cannabis hyperemesis syndrome?

The purpose of this review is to describe cannabinoid hyperemesis syndrome (CHS), which is thought to be induced by long-term cannabis use, and provide clinical pharmacists with information to manage the hyperemetic phase of CHS. Cannabinoid Hyperemesis Syndrome is a new and under recognized clinical entity. Although its prevalence is unknown, numerous publications have preliminarily established its unique clinical characteristics. CHS should be considered as a plausible diagnosis in the setting of patients with recurrent intractable vomiting and strong history of cannabis abuse. Despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS.

The Endogenous Cannabinoids (Endocannabinoids)

Further initiatives are needed to determine this disease prevalence and its other epidemiological characteristics, natural history, and pathophysiology. Additional treatments are needed and efforts to discontinue cannabis abuse are paramount. Ironically, one of the potential complications of long-term cannabis use is a condition called cannabis hyperemesis syndrome (CHS). Due to the growing use of cannabinoid integrative medicines, healthcare professionals must be cognizant that N/V in patients undergoing prolonged cannabis treatment may develop cannabinoid toxicity and CHS. N/V induced by cannabinoids may be masked by N/V related to cancer or side effects of chemotherapy drugs [5]. This awareness may help reduce, identify and effectively manage polypharmacy and cannabinoid-related side effects.

• 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.
• Symptoms will usually improve after 1 or 2 days, as long as you don’t use cannabis during this time.
• The only way to prevent CHS is to avoid using any form of marijuana.

First, doctors treating people with CHS advise them to stop using marijuana. During the hyperemesis stage, doctors focus on preventing dehydration and stopping the symptoms of nausea and vomiting. CHS is also underdiagnosed because people sometimes use marijuana to suppress nausea and vomiting. Doctors currently lack knowledge of the condition, and there are no clinical guidelines for its treatment and management. When you use marijuana for many years, it can start to slowly change how the receptors in your body respond to the cannabinoid chemicals.

What causes cannabis hyperemesis syndrome?

Similarly in Europe, cannabis use is prominent among young adults, with a prevalence that has increased from 5% in 1990 to 15% in 2005 [3]. While the overall prevalence of marijuana use has remained stable in the United States at 4%, the prevalence of cannabis use disorders (i.e. cannabis dependence, cannabis abuse) has continued to rise [4]. Risk factors for developing cannabis use disorders include male race, lower income, living in a Western culture, and being separated, divorced, or widowed [5]. Certain therapies, such as taking hot showers or using prescription medications, may help relieve symptoms. Severe nausea, vomiting, and stomach pain are the hallmark symptoms of cannabinoid hyperemesis syndrome (CHS). The word “cannabinoid” refers to compounds uniquely found in cannabis, and “hyperemesis” means severe vomiting.

Pharmacology of Cannabinoids

• Preventing dehydration and stopping nausea and vomiting are the treatment goals during the hyperemesis stage of the condition.
• An abdominal exam revealed a nontender, nondistended abdomen with no signs of rebound or guarding.
• For example, CVS patients usually have important psychological comorbidities including depression and anxiety [64,65].
• Diagnosis begins with a thorough physical examination and history for all patients presenting with nausea, vomiting, and abdominal pain.
• Nabilone, sold under the brand name Cesamet©, is a synthetic cannabinoid with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain.

Only 2 RCTs have investigated topical capsaicin and haloperidol use in patients with CHS [22, 32]. Three retrospective studies were short-term, with small sample sizes, without a standardized reporting of outcomes and subject to the risk of bias found in Tables ​Tables33 and ​and44 [24, 25, 28]. Conclusions made were limited due to the low-quality of available evidence. Additionally, some of the statistically significant studies did not measure symptom relief, instead looked at the reduced LOS in hospitals [23, 24, 25, 28, 31].

• Haloperidol should also be used with caution in patients with dementia and Parkinson’s disease, as dopamine blockade can dramatically worsen symptoms causing extrapyramidal side effects and incapacitation [46].
• Table 2 summarizes some of the epidemiological and clinical characteristics that may help distinguish CVS and CHS.
• THC is excreted mainly as acid metabolites, with 60–85% cleared through the feces and 20–35% in the urine [20,21].
• Precise diagnostic criteria for CHS should be postulated where duration and dose of cannabis are predetermined, especially in older adults or patients with renal impairment.

A diagnostic flow chart can be used by clinical pharmacists and clinicians for patients with suspected CHS to help reduce unnecessary costs and over-utilization of health care resources. Diagnosis begins with a thorough physical examination and history cannabinoid hyperemesis syndrome for all patients presenting with nausea, vomiting, and abdominal pain. This will help to rule out life-threatening causes or diagnoses that confer significant potential morbidity to the patient or to establish the presumptive diagnosis of CHS.

This consideration may prevent further unnecessary workup and health care costs for patients with CHS. Pharmacists have an important role in CHS recognition, education, and symptom management. Compulsive hot showering or bathing may be critical in distinguishing https://ecosoberhouse.com/ CHS from CVS and other conditions with similar symptoms. Studies show that between 90% to 100% of people with CHS use hot showering or bathing to relieve symptoms. Researchers have proposed that this behavior may be included in the diagnostic criteria for CHS.