There is a trend in our society to view marijuana use as harmless. While there is a large body of research documenting marijuana’s harmful effects on the developing teenage brain, we would also like to highlight some of the lesser-known and under-recognized adverse effects of using marijuana.
Research dating back as early as 2012 has recognized a clinical condition known as cannabinoid hyperemesis syndrome (CHS), or marijuana hyperemesis. It is characterized by cyclic bouts of persistent nausea and vomiting which can last 24-48 hours and lead to dangerous levels of dehydration or death (in extreme cases).
To many, the occurrence of this condition is counter-intuitive because of the well-documented anti-emetic (anti-nausea) effects of marijuana. However, due to the recent trend of widespread acceptance of pro-recreational marijuana use in the United States, there are more chronic marijuana users in our society than ever before.
This, combined with the massive increase in THC concentration levels in marijuana and marijuana concentrates is believed to be causing the uptick in cases.
As a newly named condition, many medical professionals won’t issue a diagnosis of CHS because they aren’t aware that it exists. This can sometimes lead patients with CHS through an expensive testing process for their “mysterious” cyclical vomiting. The mechanism by which people develop CHS is unclear. What is known is the most direct way to respond to this condition is through cessation of cannabis use (details below).
Cannabinoid hyperemesis syndrome symptoms
Symptoms of CHS are extremely unpleasant and are typically characterized by severe cyclic nausea and vomiting that lasts around 24-48 hours. However, one 2012 case series on 98 patients noted that less severe symptoms can persist for several months. This cyclic vomiting is accompanied with abdominal pain and most people report that hot showers and hot water bathing eases their symptoms. The symptoms of this condition share similarities with cyclic vomiting syndrome, and the two are often confused by medical professionals. Often the onset of symptoms occurs for no apparent reason, with the only known stimulus being chronic cannabis use. It has been noted that more research will be required to learn the exact mechanism by which this condition occurs.
Cessation of cannabis use will cause symptoms to subside, but in many cases this is accompanied by an emergency room visit for extreme dehydration. This dehydration can lead to kidney failure (known in clinical practice as cannabinoid hyperemesis acute renal failure) and has resulted in death in severe cases.
How common is cannabinoid hyperemesis syndrome?
It’s easy to assume that marijuana hyperemesis only occurs in multiple-times-a-day chronic users, or long term users. However, this assumption would be wrong. A 2016 systematic review compiled data from 170 studies and peer-reviewed articles on cannabinoid hyperemesis syndrome. What they found:
- 4% of CHS cases reported less than weekly use.
- 4% of CHS cases reported weekly use.
- 9% of CHS cases reported daily use.
- 7% of CHS cases reported greater than daily use.
What’s clear from these results is that the majority of people with CHS are from daily use or greater. However, over 1 in 5 cases reported weekly use or less.
Cannabinoid hyperemesis syndrome treatment
As noted other places in this article, cessation of use is the most direct way to treat the symptoms of nausea, vomiting, and abdominal pain. This is confirmed by the systematic review mentioned above, which mentions that several studies included in the review demonstrated this effect. When it comes to responding to the symptoms of marijuana hyperemesis, a number of solutions were attempted, ranging from dopamine antagonists to capsaicin cream. However, the evidence for these types of treatments is limited as of this writing. We recommend that you contact a healthcare professional for the most effective treatment options. The one conclusive piece of evidence across all the studies reviewed was that if someone presents with cannabinoid hyperemesis syndrome, they should stop smoking pot.