Marijuana-Induced Uncontrollable Vomiting On The Rise, Study Finds

 

A research study published in the journal JAMA Network Open this September saw a significant spike in cases of Cannabis Hyperemesis Syndrome (CHS) among marijuana users in Colorado between 2013 and 2018. The 5-year period is notably the time frame from when marijuana was legalized in the State.

While the use of cannabis for medicinal purposes has been legal in Colorado since 2000, it wasn’t until 2012 that the drug was made legal for recreational use as well. The JNO study found that of the more than 800,000 reported cases of CHS between 2013 and 2018, the rate was highest in Colorado counties with no marijuana dispensaries until the drug was legalized in the State.

But, what exactly is CHS? CHS (Cannabis Hyperemesis Syndrome) is a rare condition, particularly in long-term marijuana users, with symptoms including recurrent and severe bouts of vomiting and nausea. The vomiting is often accompanied by vague abdominal pain and a compulsion to have a hot bath.

The CNN quoted Dr. Sam Wang, a pediatric emergency medicine specialist and toxicologist at Children's Hospital Colorado, as saying more than half of patients that came to the hospital with complaints of marijuana-induced chronic vomiting and stomach pain say they "took a scalding hot shower before they came to the ER but it didn't help." In fact, the intense desire to self-treat with an extremely hot bath was so common that it quickly became a popular home remedy for CHS- and it did help.

Hot baths helped alleviate the peculiar symptoms of CHS because the stimulation from the hot water produces a different sensory signal that distracts the body from the pain signal associated with CHS. CHS sufferers experience abdominal pain due to increased blood flow to the gut. The simulation from the hot showers induces another set of blood vessels closer to the skin to dilate, ultimately leading to stomach pain relief.

CHS first became a “thing” in the medical field in 2004, when a group of Australian researchers documented cases of 19 habitual marijuana users who experienced recurrent episodes of abdominal pain and retching. The researchers found that the condition ceased after the patients quit using the drug but returned when they resumed. 

 

Most people experiencing cannabinoid hyperemesis syndrome get better within ten days of quitting marijuana or cannabis use, although it could take months to fully recover from the condition. As CHS only recently burst onto the medical scene, doctors may struggle to diagnose and treat the condition. Unfortunately, while CHS is very much treatable, severe cases can be fatal, as vomiting can lead to dehydration, leading to a type of kidney failure experts refer to as Hyperemesis Acute Renal Failure.

The JNO study found that more than a third of the marijuana-induced vomiting in the US State of Colorado was in people aged 25 and younger. Teenagers were among those showing up in emergency rooms with complaints of abdominal pain, according to Dr. Wang. Wang said the vomiting could go on for hours at a time, with the patients often saying they tried getting some relief by taking a very hot shower. Wang said, "That's when we know we may have a case of cannabis hyperemesis syndrome.”

It's interesting that pain (scalding hot shower) serves as a pain reliever for those suffering from CHS. While the explanation for this isn't written in stone, experts generally believe the simulation of extreme heat from the hot showers interrupts the pain cycle caused by the psychoactive compounds in cannabis that have access to the body's pain receptors. These receptors literally go haywire- so to speak- in people experiencing CHS.

Interestingly, THC and other cannabinoids in the marijuana plant have been used to treat symptoms including nausea and vomiting in cancer patients undergoing chemotherapy. The compounds are, in fact, used as pain relievers. However, scientific studies do not have a firm conclusion on the effectiveness of marijuana as a pain reliever.

Still, the fact that marijuana, which can be medicinal for cancer patients, also causes the same symptoms it helps relieve can be confusing- to say the least- for cannabis users and the public. However, the answer to this, Dr. Wang says, is dosage. "The amount of THC that now comes in cannabis is increasing substantially," the doctor pointed out. "In the '90s the average was like 4% or 5%. Now in Colorado, it's anywhere from 15% to 20%."

Naturally, the amount of THC in a product translates to the potency of the product. While experts cannot say exactly who is at risk of CHS since not all heavy cannabis users suffer from the condition, there are known indicators- frequency, potency, and duration of use. There is also the chance it could be a specific type of cannabis product, although there is currently no data to support that.

Should you be worried? No matter whether cannabis has been legalized both for recreational and medical purposes in many parts of the United States and around the world, the drug is still not entirely harmless. Experts around the world agree that marijuana is not altogether harmless. It is addictive, and regular use of the drug can cause mental and physical disorders.

The UK’s National Health Service warned that “Regular cannabis use increases the risk of developing a psychotic illness, such as schizophrenia.” Drugabuse.org says even the use of marijuana as medicine also poses other problems, such as the adverse health effects of smoking and THC-induced cognitive impairment. This isn’t surprising, considering that marijuana smoke is also filled with many of the same chemicals as tobacco smoke, including ammonia, hydrogen cyanide, and formaldehyde.

Colorado may be seeing increased cases of Cannabis Hyperemesis Syndrome, but the condition is not common. However, marijuana or cannabis addiction can have serious health consequences. Many rehab centers exist in Colorado, as well as the continental United States, capable of treating people with marijuana addiction. CHS, however, is so new that there is no medical diagnosis or insurance billing code for the disease.

It is important, Wang Says, for researchers to document cases and compare symptoms in order to fully understand, treat, and prevent the disease. What this means is that the best way for people to address CHS at the moment is to abstain or cut back the use of cannabis, which can be hard for an individual to do by themselves without the help of a licensed substance use disorder treatment facility.

If you are a cannabis user and experience recurrent abdominal pain accompanied by vomiting, you might have Cannabis Hyperemesis Syndrome and should seek help immediately. With other possible causes of your stomach pain and retching ruled out by a battery of tests at the hospital, treatment for CHS typically consists of anti-nausea medications and IV fluids to address dehydration from the vomiting. Unfortunately, CHS can be fatal if treatment is delayed.