They should further advise patients that Drug rehabilitation immediate cessation of cannabis use is the only method that has been shown to completely resolve symptoms. Reassure patients that symptoms resolve with cessation of cannabinoid use and that full resolution can take anywhere from 7–10 days of abstinence.7 Educate patients that symptoms may return with re-exposure to cannabis. Provide clear documentation in the medical record to assist colleagues with confirming a diagnosis, as these patients will frequently re-present to the ED.
What is Cannabinoid Hyperemesis Syndrome (CHS)?
Read on to understand what CHS is, how it develops, what the main signs are, and how long does it take to recover from cannabinoid hyperemesis syndrome why seeking help is critical if you want to break free from this difficult cycle. Dr. Byron McQuirt leads works closely with our addictionologist, offering holistic, evidence-based mental health and addiction care while educating future professionals. Exogenous ligands, such as N-acyl ethanolamines and mono-acyl-glycerols, include notable compounds like THC (which contains a dibenzopyran ring), cannabidiol, cannabigerol, and cannabinol 23,30. These ligands interact with G protein-coupled receptors (GPR), GPR18 and GPR55, peroxisome proliferator-activated receptors (PPARs), and TRPV1.
What causes CHS?
Potential causes of CHS include influence on the activity of cannabinoid receptors, conversion of cannabis into emetic substances, or contamination with other toxins 36. Cannabis leads to upregulation of CB1 receptor activity in the hypothalamus, which enhances the hypothermic effects of THC. Cannabinoid hyperemesis syndrome (CHS) is a very unpleasant — and potentially dangerous — complication of long-term marijuana use.
- A systematic review of 29 cases of CHS in France was reported by Schreck et al.131 in 2018.
- Still, even when accurately diagnosed, many patients do not believe that cannabis is at the root of their problem, and may delay stopping cannabinoids for some period of time while they attempt to find other causes of their condition.
- Many cases of CHS are likely misdiagnosed or not medically treated at all.
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Symptoms will usually improve after 1 or 2 days, as long as you don’t use cannabis during this time. CHS symptoms typically present in a cyclical pattern every few weeks to months when cannabis is being used. We fix this by giving the water back through the veins and giving drugs to stop the sick feeling and lower the acid in the stomach. It’s still not clear which of the more than 100 cannabinoids found in cannabis are responsible for CHS, but it’s thought that CBD could potentially be a contributor.
Pediatric Patients
When it binds to the said receptors in the brain, it leads to a high or a rush of pleasurable feelings. Now, these cannabinoid receptors are also present in the digestive tract of the body. Over time, cannabis use changes the way in which the molecules present in the digestive tract respond, leading to CHS. The syndrome can appear without warning after years or even decades of cannabis use, and the only definitive treatment for CHS is abstaining from cannabis altogether.
- If you’re seeing signs of severe dehydration—like dizziness, confusion, or fainting—seek emergency medical help immediately.
- Continuing to use cannabis despite CHS can lead to potentially life threatening complications.
- These symptoms lower the quality of life, leading to physical exhaustion, emotional stress, and social isolation.
- Some patients may require rehabilitation programs to monitor the patient’s progress, ensure treatment adherence, and offer therapeutic support to achieve and maintain recovery.
However, current research suggests that CHS occurs due to large amounts of tetrahydrocannabinol (THC) overstimulating parts of the endocannabinoid system — specifically the cannabinoid receptors located in https://ecosoberhouse.com/ the gut. This level of overstimulation may occur as a result of prolonged, chronic cannabis use. In select cases, topical application of capsaicin cream on the abdomen has demonstrated promise in alleviating CHS symptoms. Capsaicin, the active compound in chili peppers, acts on TRPV1 receptors, potentially modulating gastrointestinal sensory pathways and altering intestinal blood flow to provide relief from nausea and vomiting. The vasodilation induced by heat exposure in hot showers can enhance peripheral blood vessel dilation, promoting improved circulation.
As recovery progresses, patients are initially given clear liquids and gradually advance to a regular diet as tolerated. In patients treated at home, recommendations are emphasized to consume fluids containing glucose and electrolytes between vomiting episodes to ensure adequate hydration. CHS patients generally do not experience significant weight loss, as periods of regular oral intake often compensate for the days of vomiting. CHS patients present to the emergency department (E.D.) during the hyperemesis phase. Complications of CHS may include acute renal failure, hypokalemia, hypophosphatemia, esophageal injuries such as Mallory–Weiss tear, and pneumomediastinum.
- The fundamental and definitive treatment for CHS involves ceasing cannabis consumption.
- We understand the complexities of addiction and work closely with individuals to create personalized recovery plans that address both the physical and psychological aspects of addiction.
- The impact of endocannabinoid system dysregulation on various neurobiological systems and their possible contribution to nausea and vomiting, and consequently CHS, are discussed in the following section.
ECS and CHS
Additionally, the prolonged use of certain antiemetics, such as ondansetron, may have limited benefit in CHS, further highlighting the need for individualized management plans. The studies included focused on individuals diagnosed with CHS, as well as those with comparable conditions such as CVS, and chronic cannabis users exhibiting symptoms similar to CHS. A key focus was on studies that included detailed demographic information such as age, gender, and cannabis usage patterns, as well as data regarding co-morbidities, substance use history, and prior treatments.