Informed High - Becoming Informed about Cannabis

What is Cannabis Hyperemesis Syndrome (CHS)?

Cannabis Hyperemesis Syndrome

Many readers may have never heard of this condition before, and get thrown off by the complicated name. Cannabis hyperemesis Syndrome (or CHS to make it easy) is a relatively new clinical condition drawing more attention lately. Unfortunately, many cannabis consumers are unaware of this problem, which can lead to dire consequences. CHS can be made worse by further consumption of cannabis to deal with the symptoms of this condition itself. 

Individuals often consume cannabis to reduce vomiting and nausea. So when some develop a condition where they have lots of vomiting, they may continue to use cannabis to try to reduce symptoms. Unfortunately, this paradoxical syndrome may be caused by cannabis, and continued consumption will only prolong the suffering. We’ll learn what CHS is and the symptoms associated with it in today’s article. 

Often characterized by chronic cannabis use, although individuals have reported it without heavy or chronic personal weed history. This syndrome is terrifying and can be a great motivator for moderate consumption. While we do not know enough about it, developing healthy high habits can help your body gain resilience and potentially help reduce the occurrence of CHS. Some of the only things you can do to potentially prevent this syndrome are to moderate your consumption, take occasional t-breaks, and ensure you are smoking safe and regulated cannabis. 

What Causes CHS

In short, we don’t know how it develops. The pathogenesis (fancy word for how the condition develops) is unclear. There does appear to be some involvement of the enteric nervous system (the nerves in your gut). It appears to involve the TRVP receptors, which are involved in the perception of pressure and chemical irritation. The regulation of temperature appears to be involved, and specifically in the gut. 

In terms of behaviour, we do know that CHS is associated with cannabis use. Although we do not understand how the frequency, intensity, and choice of delivery methods impact development. Avoiding the super-high potency products like shatter and huge-dose edibles is one good place to start.

Signs and Symptoms of CHS

 Whatever the case may be with the pathogenesis, the result is a lot of pain and vomiting. Symptoms can be severe enough to require hospitalization. The full list of symptoms of CHS include:

  • Cyclic attacks of nausea and vomiting
  • Abdominal pain or cramping
  • Symptoms relieved with very hot showers or topical capsaicin on the belly
  • Sweating, flushing, and weight loss
  • Thirst
  • Changes in body temperature
  • Periods without symptoms between attacks

Cannabis Overuse and CHS

In the literature, they do talk about cannabinoid overuse, which is very likely involved. Some appear to get it more from high-potency products like shatter and wax, while others have a history of edible consumption. There is not even evidence to determine if any single delivery method for cannabis presents higher risks of CHS than any other. 

Some individuals get CHS with a shorter and more moderate history of use. A few even report development after the first few times getting high. This leads us to wonder if this is more of an overuse condition or a more allergy-like reaction. One that you could have immediately the first time you consume, or develop over time (just like how we can gain and lose allergies over a lifetime).

Currently, the cause of CHS is an unknown mechanism. We are starting to develop an understanding of what may be causing it, and the parts of the body involved, but there is a far way to go yet. The complicated part of CHS is the paradoxical presentation of this syndrome. Cannabis is known to have well-established anti-vomiting properties. And that is what makes this condition paradoxical since under this syndrome it produces opposite effects on the gastrointestinal tract and CNS.

Drink lots of Water!

Treatment of CHS

There is no specific treatment for CHS. The only known way to solve the issue is by ultimately stopping all cannabis consumption. Cessation may include all hemp-based CBD products as well, not just THC itself. Individuals who suffer from CHS may suffer from symptoms for far longer than anyone would hope. The sooner you stop smoking weed the sooner you will get through the worst of it. Sadly, this bad period may last weeks or even months.

Outside of this long term fix, the immediate focus is on symptomatic relief. This often includes hydration as individuals can develop severe complications with this level of vomiting. At home, taking a hot shower or using a heat pack on your abdomen may provide some relief. Others have reported that long runs somehow reduce symptoms (we don’t understand that one right now).

T-Breaks and Moderation

I don’t have any evidence to support the claim that taking breaks from cannabis will reduce the likelihood of CHS. There is also no evidence that consuming moderately will also decrease your chances of developing it. Frankly, we don’t know enough to make these claims. Nonetheless, these are reasonable preventative measures that have numerous other benefits.

As you know, on this blog I encourage healthy high habits like moderating how much you consume each day, exercising, and eating well. I think T-breaks are great for people when done properly. Both of these measures have overall benefits, and logically it would make sense that they may help reduce the likelihood of CHS. Sadly, some of us will get this condition, and what should we do if we do? Seek Medical Attention!

Seek Medical Attention if you might have CHS

Seeking Medical Assistance for CHS

If you have signs or symptoms that seem like they could be CHS, go to a doctor immediately. Likely, you’ll be throwing up and in lots of pain, so you may be heading there already. You should seek medical attention, as fluids could be urgently needed to avoid severe kidney problems. It should be noted, CHS itself does not appear to kill, but the impacts on the body can lead to kidney failure and other serious issues. Drink lots of water and go to a hospital if you experience symptoms that look like CHS.

For those who are going to a doctor or who have seen one, here are two major considerations. You may have a doctor who doesn’t know about CHS and will diagnose you incorrectly. On the other hand, doctors who are aware of CHS may be overly likely to assume any cannabis consumer with these symptoms must be CHS. Both are problems and require intentional solutions. Make sure your doctor knows about CHS and your cannabis consumption.

After that, however, make sure they are also taking the time to rule out other vomiting-based conditions. If a doctor thinks you have it, listen to their medical advice, but also ask about other similar vomiting conditions and what makes them sure that you don’t have one of those. Request that you undergo all the usual tests, scans, and procedures needed for an accurate diagnosis of CHS and other similar conditions.

CHS Research: Further Reading

Read CHS research, all open-access, here:

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Arnold Warkentin

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