Cannabinoid hyperemesis syndrome: what is it?

The legalization of cannabis in some states and in Canada has spurred enthusiasm for its potential therapeutic properties. However, healthcare professionals have reported an increased incidence of cannabinoid hyperemesis syndrome (CHS), a condition specific to regular cannabis users that’s characterized by cyclic nausea and vomiting and abdominal pain. Here’s what you should know.

Symptoms
In the early stages of CHS, persistent morning nausea and abdominal pain may be the only symptoms. However, the more active phase of the condition is characterized by moderate to severe abdominal pain accompanied by persistent and potentially severe nausea and vomiting which can only be relieved by very hot baths or showers. Some patients experience symptoms of dehydration due to extreme vomiting. This is typically what prompts them to seek medical attention.

Diagnosis
As vomiting and abdominal pain are common complaints, a diagnosis of CHS can be difficult to establish. In addition, the disorder was first identified in 2004, meaning some medical professionals may not be aware of it and misdiagnose it as cyclic vomiting syndrome, a condition with similar symptoms. The only definitive diagnostic finding is improvement after quitting cannabis.

Treatment
While intravenous fluid replacement, medication to reduce vomiting and painkillers may be provided to alleviate the symptoms of CHS, prolonged, persistent vomiting can lead to serious complications. The only known treatment for the syndrome is to stop using cannabis. Afterward, symptoms usually disappear within one or two days.

Risk factors
CHS is a rare condition and the main risk factor is chronic, heavy cannabis use, defined as 20 days a month for at least six months. It’s unclear why some users develop the syndrome while others don’t.

While rare, CHS diagnoses are increasing. If you or someone you know is experiencing symptoms such as persistent vomiting and abdominal pain, it’s important to seek medical attention.