Cannabis Hyperemisis Syndrome

[anon4675195]

Cannabis Hyperemisis Syndrome is characterized by cyclic vomiting in people (usually under 50) who are frequent Cannabis users, usually with 10+ years of at least weekly use. Often they self discover hot baths/showers can alleviate acute symptoms. Ondasetron and other first line antiemetics usually are ineffective, though halperodol and benzodiazapines may work better.CHS is not caused by neem oil as some deniers have tried to claim. CHS is potentially fatal in extreme cases.

I suffer from CHS. I have had 4 severe episodes in the last 6 years. During the interim I have spent years in the “prodromal” phase of morning nausea, occasional vomiting, and nauseous sneezing (?!). I would like to talk reasonably about this very real condition and let others know there is support for them.

The following are personal opinions and are not yet supported by evidence:

One issue I take with the literature is characterizing all regular use as disuse/abuse. I use Cannabis medically to treat pain and insomnia. Another is that they state the only treatment is “complete cessation of all Cannabis use.” I suspect, and have some personal experience to suggest, only high-THC/THC dominant Cannabis is responsible. If CBD and perhaps other cannabinoids are present at high levels alongside or without THC it would likely greatly mitigate CHS. The relatively recent identification of this syndrome (2004) in areas with high-THC Cannabis use, without such history in areas with long traditions of heavy use (often of hashish with CBD content) also supports this possibility.

Some research links:
Cannabinoid Hyperemesis Syndrome Survey and Genomic Investigation

Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms

Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment

Cannabis hyperemesis syndrome: an update on the pathophysiology and management

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

Cannabinoid Hyperemesis Syndrome

Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin

Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases

Cannabinoid hyperemesis syndrome: A review of the literature

Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment

Cannabis Hyperemesis Syndrome: A Still Under-Recognized Syndrome

Cannabinoid hyperemesis syndrome presentation to the emergency department: A two-year multicentre retrospective chart review in a major urban area