As cannabis use becomes more prevalent, healthcare providers are seeing an increase in a concerning condition called Cannabinoid Hyperemesis Syndrome (CHS). This complex disorder affects some regular cannabis users, causing severe cycles of nausea, vomiting, and abdominal pain. Understanding CHS is crucial for both medical professionals and individuals who use cannabis, as early recognition can prevent serious complications and improve outcomes.
What Is Cannabinoid Hyperemesis Syndrome?
CHS is a paradoxical condition where long-term cannabis use leads to severe episodes of vomiting and nausea – symptoms that cannabis is often used to treat. First described in medical literature in 2004, CHS has become increasingly recognized as a distinct clinical entity, though it remains frequently misdiagnosed.
Research from the American Journal of Emergency Medicine indicates that CHS-related emergency department visits have risen significantly in states with legalized cannabis use. A 2022 JAMA Network Open study found that emergency department visits for CHS increased 13-fold over a 7.5-year period, with particularly high rates among young adults aged 19-24. The study found that CHS severe enough to require emergency care affected approximately 3.43 per 100,000 people by mid-2021.
The Three Phases of CHS
Prodromal Phase
During this initial phase, patients typically experience:
- Morning nausea
- Mild abdominal discomfort
- Food aversion
- Anxiety about nausea symptoms
This phase can last months or even years, with many individuals increasing their cannabis use in an attempt to alleviate symptoms – unfortunately making the condition worse.
Hyperemetic Phase
The hyperemetic phase represents the acute stage of CHS, characterized by:
- Intense and persistent vomiting
- Severe abdominal pain
- Dehydration
- Compulsive hot showering or bathing
- Weight loss
During this phase, patients often require emergency medical intervention due to dehydration and electrolyte imbalances.
Recovery Phase
Following cannabis cessation, patients enter the recovery phase, which typically involves:
- Gradual resolution of symptoms
- Return of normal eating patterns
- Improvement in overall well-being
- Healing of any nutritional deficiencies
Complete recovery usually occurs within 7-10 days of stopping cannabis use, though some patients may experience longer recovery periods.
The Hot Shower Phenomenon
One of the most distinctive features of CHS is the temporary relief patients find in hot showers or baths. Recent research published in the Journal of Medical Toxicology suggests this behavior relates to how temperature affects the hypothalamus, where many cannabinoid receptors are located. The hot water appears to temporarily correct the dysregulation of the body’s temperature control and nausea centers caused by chronic cannabis use.
Why Some Users Develop CHS While Others Don’t
Medical researchers are still working to understand why CHS affects only a subset of regular cannabis users. Current theories focus on:
- Genetic variations in cannabinoid metabolism
- Individual differences in receptor sensitivity
- Potential role of specific cannabis strains or consumption methods
- Cumulative exposure thresholds
A 2022 study suggests that variations in the CYP2C9 enzyme, which metabolizes THC, may play a crucial role in determining susceptibility to CHS.
Diagnostic Challenges for CHS Cases
Diagnosing CHS presents several challenges for healthcare providers. The condition can mimic other gastrointestinal disorders, leading to extensive and often unnecessary testing. Key diagnostic criteria include:
- History of regular cannabis use (typically weekly for a year or more)
- Severe cyclic nausea and vomiting
- Relief with hot showers or baths
- Resolution of symptoms with cannabis cessation
Treatment at The Bluffs
At The Bluffs Addiction Campuses, we take a comprehensive approach to treating CHS and the underlying cannabis use disorder. Our treatment program includes:
Acute Symptom Management
- IV fluid replacement therapy
- Anti-emetic medications
- Nutritional support
- Temperature-controlled therapeutic environments
Addiction Treatment
- Individual counseling
- Group therapy
- Cognitive behavioral therapy
- Stress management techniques
- Relapse prevention strategies
Long-term Recovery Support
- Aftercare planning
- Support group connections
- Family education
- Ongoing medical monitoring
Breaking Common Misconceptions About Cannabis and CHS
Many patients struggle to accept that cannabis – often viewed as a natural remedy for nausea – could be causing their symptoms. Education about the complex interactions between cannabinoids and the body’s endocannabinoid system is crucial for treatment compliance and recovery success.
The Importance of Professional Treatment for CHS
If you or someone you know is experiencing symptoms of CHS, seeking professional treatment is crucial. The experienced team at The Bluffs understands the complexities of CHS and can provide the comprehensive care needed for recovery.
Don’t let CHS control your life. Contact The Bluffs today at 850-374-5331 to speak with our caring admissions team about our evidence-based treatment programs. Our specialists are available 24/7 to answer your questions and help you start your journey to recovery.
