Cannabinoid Hyperemesis Syndrome

Cannabinoid Hyperemesis Syndrome (CHS) is caused by using cannabis for a long time. There is no definitive timeline for how long it takes to develop CHS, as it varies greatly between individuals. After consistently using marijuana long enough, some receptors in the body stop responding to marijuana the same way. Additionally, prolonged use of marijuana changes how the digestive tract works and that seems to be the cause of the repeated vomiting seen with this condition. It is good to know that CHS is not very common, with around 2.7 million US cases per year.

The symptoms of CHS include a lack of appetite, headache, abdominal pain, nausea, and vomiting. Taking a hot shower or bath can temporarily alleviate symptoms. However, it will not cure them. The only way to permanently stop symptoms is to stop using cannabis for at least 10 days in most cases, but for longer-time users, it could take up to 6 months. The increasing potency of Marijuana and increased usage since it has been legalized in more states has made CHS more common in the past few years.

People with CHS suffer from severe episodes of nausea, vomiting, dehydration, and more. Healthcare professionals have organized the symptoms into three phases below.

Prodromal phase: During the prodromal phase, individuals may experience symptoms including mild nausea, abdominal discomfort, feeling like vomiting, but maintaining normal eating habits. Typically, weeks to months in length.

Hyperemetic phase: Symptoms include multiple intense episodes of vomiting and severe abdominal pain. It is also common for people to start compulsively taking hot baths or showers to try and alleviate painful symptoms. This is the phase that nurses are most familiar with in the Emergency Room. The duration of this phase is dependent on stopping cannabis usage completely. If the individual does not stop in this phase their symptoms will continue. 

Recovery phase: In the final phase, you can resume normal behaviors and generally feel better. You can only begin the recovery process after being fully clean from cannabis. It is important to note that your symptoms will resume if you start using marijuana again.

Cannabinoid Hyperemesis Syndrome is often misdiagnosed because there is not a lot of awareness of it by the medical community, as it was only discovered recently. Additionally, many sicknesses have similar symptoms to CHS, so the only way to get a proper diagnosis would be to do many different tests that depend on your symptoms. These tests may include:

• Blood tests
• Tests for electrolytes
• Tests for pancreas and liver enzymes
• Urine analysis
• Drug screen
• X-rays of the stomach
• Upper endoscopy
• Head CT scan
• Abdominal CT scan

Misdiagnosis is common because some cannabis users do not always disclose their usage to doctors. There is no single diagnosis for CHS. The only way to tell if you have CHS is if you start seeing improvement after quitting marijuana, then you know that you had CHS. If your symptoms get too severe, you should consult with your healthcare provider on how you can start recovering. It is important to note that the only way to cure CHS is to stop using cannabis completely. If you resume using it at any point in the future, CHS can return.