What is Cannabinoid Hyperemesis Syndrome?
Cannabis is a widely used recreational drug. The popularity of this drug is constantly rising thanks to its legalization in different parts of the world. A lot of studies already show us just how powerful it is in delivering various medicinal benefits. While the compound is usually safe for the most part, in a few cases, Cannabis has been known to cause some adverse reactions leading to different medical conditions one of which is known as Cannabinoid Hyperemesis Syndrome (CHS).
Cannabinoid hyperemesis syndrome is a recently discovered condition linked to the heavy and long-term use of cannabis. This condition was first identified in 2004, and since then the number of people suffering from CHS has gone up. CHS is characterized by nausea, vomiting, compulsive bathing, and GI discomforts. The condition is known to occur either episodically or cyclically. This basically means that the patients of this condition may see the symptoms occur and disappear after some time without the need of taking any medications. You could, for instance, experience vomiting and nausea for a few days or even 10 days before they disappear for some time. This usually dupes people into thinking that they have healed, but the truth is unless you stop taking marijuana completely, the symptoms will most probably come back sooner or later.
Causes of Cannabinoid Hyperemesis Syndrome
Marijuana has for the longest time been used in treating vomiting and nausea. With the increase in cases of CHS, things became a bit complicated because scientists realized that cannabis can also have the exact opposite effect leading to increased nausea and vomiting. This was very confusing at first until clinical studies pointed out that marijuana not only interacted with one’s brain but it also had an effect on the GI tract.
Once consumed, cannabis interacts with the endocannabinoid system to yield the different effects that you always experience. The endocannabinoid system contains receptors called CB1 and CB2. CB1 receptors are mainly found in the brain, nervous system and a few in the digestive tract while CB2 receptors are located within the immune system. When using cannabis for the first time and in low doses, the compounds react with the CB1 found in the brain to release signals that help in reducing nausea and vomiting. With continued use of cannabis, however, the efficiency of the CB1 receptors in the brain will drop significantly decreasing their sensitivity to THC, CBD, and CBG, i.e. the compounds contained in cannabis. As a result, fewer signals will be released to stop vomiting and nausea. Scientists believe that the CBG (cannabigerol) found in marijuana is the compound responsible for inducing vomiting and nausea in the GI tract. With the brain unable to send signals for stopping these symptoms, you will start experiencing them in episodes until you stop taking cannabis.
The weird thing is that not all heavy marijuana users get this condition. We know of people who have been taking the drug for years and not once have they had to check into a hospital with any vomiting, nausea or GI discomfort issues. More research is being done to understand why the condition affects only a fraction of cannabis users.
Signs and Symptoms of Cannabinoid Hyperemesis Syndrome
The symptoms of CHS have been broken down into three phases:
- Prodromal Phase
This is the initial stage of CHS where the symptoms are not yet very severe, but the patient has already started experiencing some discomforts. The stage is marked with symptoms such as morning sickness, nausea, abdominal pain and fear of vomiting. Note that the patient will not actually vomit in this stage, but they will feel like doing so. Appetite won’t be affected at this stage but the knowledge that cannabis helps in easing nausea and vomiting prompts people to use even more of the drug, and this escalates the symptoms further. The Prodromal phase can last for months or even years before progressing to the next stage.
- Hyperemesis Phase
This stage is usually serious, and most patients end up being hospitalized and receiving IV fluids with close supervision. Hyperemesis phase is where the patient is now going through severe dehydration, constant vomiting, ongoing nausea, abdominal pain, weight loss, and decreased food intake. It’s also at this stage that most patients go through compulsive hot bathing. This symptom is usually as a result of cannabis interfering with the thermoregulatory system in the hypothalamus part of your brain. This stimulates you into taking more hot showers in an attempt to restore the right temperatures.
The Hyperemesis phase will continue until you stop taking marijuana. The stage should then end after a couple of days or weeks.
- Recovery phase
It is at the recovery phase that the patient will now resume normal eating and daily routines. The other symptoms will go away gradually. They’ll also regain some weight at this stage. The recovery phase normally lasts a couple of days or weeks. If the patient tries to use cannabis again symptoms of CHS will come back.
Cannabinoid Hyperemesis Syndrome Complications
Rarely do we come across complications arising from CHS but if you ignore treatment, the rapid drop in electrolytes in your blood puts you at risk of experiencing any of the following issues:
- Muscle spasm
- Brain swelling
- Kidney failure
- Abnormal heart rhythm
Treating Cannabinoid Hyperemesis Syndrome
The only way to guarantee a full recovery from CHS is to stop using marijuana. This will be difficult to a lot of people, but it is the only way that you’ll be able to get rid of all the symptoms of CHS completely with no chance of experiencing a similar episode in future. The good news is that if you decide to stop using the drug, you should see the symptom disappear in 10 days or so allowing you to resume your normal routines.
In case you find it too difficult to quit, or if you need some time to do so, there are a couple of remedies that can help you ease the symptoms. You can use medications such as antiemetic to reduce vomiting and nausea. These drugs are usually taken orally, but you will have to use an IV drip if you can’t hold them down. Physicians will also prescribe benzodiazepines such as diazepam and lorazepam to deal with abdominal pain. You should, however, avoid using them too often as you may develop high dependence.
You can also reduce the symptoms of CHS through a hot bath or capsaicin cream. Both of these will help to restore normal body temperature, and the cream may also help with vomiting and nausea symptoms. You should, however, be keen before using the cream because some people react to it and tend to develop rashes. The cream should also never be used on broken or damaged skin.
Taking some electrolytes will also help to deal with the dehydration problem. Sports drinks and water containing electrolytes are perfect for this purpose, and you should take them in small quantities to avoid throwing them up.
Cannabinoid Hyperemesis Syndrome doesn’t affect all heavy marijuana users. This is good news to everyone who was worrying about getting the condition and to avoid contracting it even further, they can reduce the consumption of this drug. If you are unlucky enough to be one of the people already with the condition, the only way to treat and avoid going through the symptoms again is by abstaining from the drug. We understand that this isn’t very easy at all, but it is your best shot at living a normal life again.