Ongoing research investigating the health benefits of marijuana indicates that cannabis may help reduce symptoms of neurological or autoimmune conditions. In addition, chemotherapy patients suffering nausea and vomiting often use medicinal cannabis for its anti-emetic properties.
However, evidence also suggests that marijuana can have a paradoxical effect on the central nervous and gastrointestinal system, with reports of long-term pot users suffering severe nausea, vomiting, and rapid dehydration. Physicians call this effect “cannabinoid hyperemesis syndrome” (CHS).
What Causes Cannabinoid Hyperemesis Syndrome?
Neurological studies into why marijuana can treat nausea and vomiting in chemotherapy patients involve the brain’s endocannabinoid system. Home to millions of THC and CBD receptors, this system interacts with the “emetic nuclei” located in the brainstem. Scientists think cannabis interferes with emetic nuclei activity.
Normally, when the gastrointestinal system detects that a toxin or other pathogen has entered the stomach, it “tells” the brain to release neurotransmitters into the gastrointestinal tract. Cannabis seems to stop the release of chemicals that cause nausea and, sometimes, vomiting.
Researchers haven’t yet discovered why long-term marijuana use causes the brain’s endocannabinoid system to stop responding to pot’s anti-emetic effects. They speculate that some cannabis users may develop cannabinoid hyperemesis syndrome when receptors in the brain and gastrointestinal system inexplicably experience a “glitch” in the way they signal each other. This glitch is why pot smokers with CHS suffer episodic and sometimes severe bouts of nausea and vomiting.
What are Symptoms of Cannabinoid Hyperemesis Syndrome?
Results of longitudinal studies that have assessed cannabis users with CHS indicate that this syndrome can be divided into three phases: prodromal, hyperemetic, and recovery.
Prodromal Phase
Primary symptoms of the prodromal phase include abdominal pain and morning nausea. Vomiting doesn’t occur in the prodromal phase of CHS. Because prodromal symptoms typically come and go, individuals usually rely on self-treatment measures to reduce nausea. In some cases, the prodomal phase may last several months before transitioning into the hyperemetic phase.
Hyperemetic Phase
Nausea remains ongoing during the hyperemetic phase and is no longer confined to the morning hours. Vomiting is severe and uncontrollable, accompanied by abdominal pain, dehydration, and weight loss. Unless a marijuana user in the hyperemetic phase of CHS stops smoking pot, it’s likely their symptoms will continue. Consequently, many people require medical care or hospitalization during this stage.
Recovery Phase
Symptoms will go away if the person stops using marijuana. However, it could take months before the person is able to eat normally again. If someone who recovers from CHS starts smoking marijuana again, prodromal phase symptoms are likely to return.
How Is Cannabinoid Hyperemesis Syndrome Diagnosed?
Nausea and vomiting are symptoms common to many illnesses, such as influenza, gastroesophogeal reflux disease (GERD), irritable bowel syndrome, and pancreatitis. To accurately diagnose CHS, doctors may order blood, electrolyte, urine, and enzyme tests to determine if the person has an infection, is anemic or severely dehydrated. Abdominal x-rays and head CT scans may also be needed to confirm a CHS diagnosis.
If you are a long-term marijuana user (have smoked pot daily for at least a year) and have symptoms of CHS, your doctor will be able to detect THC in blood and urine tests. Make sure you tell your doctor upfront that you are a heavy pot user (whether recreational or medicinal), before undergoing lab work.
Is There Treatment for Cannabinoid Hyperemesis Syndrome?
While medications may help reduce nausea, vomiting, and belly pain, only the cessation of marijuana will stop symptoms from returning. Supportive treatment for individuals in the hyperemetic phase may involve IV fluid therapy for dehydration. Severe dehydration and malnutrition due to the inability to stop vomiting will require hospitalization to prevent potentially life-threatening health problems.
When researchers started investigating CHS several years ago, they found that people in the hyperemetic stage were taking numerous hot showers during the day to relieve nausea and vomiting. At first, researchers thought the compulsion to take hot showers was a psychological side effect of CHS. They later learned this was a type of “learned” behavior due to the ability of hot water to lessen the severity of nausea, vomiting, and stomach pain.
Although it’s not clear why hot water helps reduce symptoms of CHS, researchers suspect that bathing in hot water somehow corrects a thermoregulatory system imbalance within the hypothalamus. Some doctors think that marijuana raises the body’s core temperature while simultaneously decreasing the skin’s temperature. This action promotes blood flow to the upper layers of the skin while reducing core body heat. All the processes combined work to alleviate nausea and vomiting associated with CHS.
What Are the Health Consequences of Cannabinoid Hyperemesis Syndrome?
Unless a person with CHS can stop using cannabis, they may risk suffering severe adverse effects of prolonged dehydration and extreme weight loss. Dehydration and electrolyte imbalance can cause muscle tremors, heart arrhythmia, seizures and kidney failure. More rarely, swelling of the brain can happen if dehydration happens rapidly and is not reversed as quickly as possible.
Is There Anything That Will Prevent Cannabinoid Hyperemesis Syndrome?
While not all long-term pot users will develop CHS, there is increasing evidence that CHS is becoming more commonly diagnosed. This is likely due to the legalization of recreational marijuana and the easy availability of more potent pot strains.
If you have used cannabis for a long time and worry about becoming sick with CHS, be aware the only cure for this syndrome is not using pot. Individuals who have smoked cannabis for years without experiencing health issues often resist the idea that using pot is causing their nausea, vomiting and abdominal pain. But, when they are eventually hospitalized because of severe dehydration, shock, or organ failure, they will be told in no uncertain terms by their doctors that continuing to use pot could seriously endanger their lives.
Key Points to Know About CHS:
- Only long-term cannabis users have been diagnosed with CHS.
- CHS causes severe, repeated bouts of nausea, vomiting, and stomach pain.
- Taking multiple hot showers every day may help manage symptoms of CHS but will not prevent CHS.
- Hospitalization is frequently necessary for people in the hyperemetic phase of CHS.
- In most cases, CHS symptoms diminish and disappear altogether within two to three days of stopping pot use. However, smoking just half a joint will cause symptoms to emerge again. In research studies examining cannabis users who quit using pot due to CHS, those who started using again always re-developed symptoms of CHS.
Get Help for a Marijuana Addiction by Calling FHE Today
While medicinal marijuana seems to achieve therapeutic benefits for certain illnesses, heavy use of recreational marijuana can cause cannabis use disorder (CUD) and may be associated with increasing your risk for cardiovascular disease, chronic bronchitis, and even lung cancer.
The difficulty of marijuana addiction is more psychological than physical. Marijuana withdrawal symptoms like severe anxiety, depression, irritability, and agitation often force the addicted individual to get immediate relief by relapsing—but there is help. With evidence-based psychotherapy techniques and medications to reduce anxiety and depression, you can overcome a marijuana problem and avoid CHS. Contact us today regarding next steps.
