What symptoms of Cannabinoid Hyperemesis should I be looking for?
Q: "I was hoping you could provide some information on Cannabinoid Hyperemesis Syndrome. My friend’s daughter was just diagnosed with it, and I’m concerned about my son, who uses marijuana for depression. Are there symptoms I should be looking for?"
— Audrey G.
A: Cannabinoid Hyperemesis Syndrome (CHS) is a side effect that can occur in heavy, long-term cannabis users. Currently, it is believed to affect less than one per cent of cannabis users. CHS was first reported in Australia in 2004. Symptoms are characterized by abdominal pain, weight loss, cyclic vomiting, nausea, and compulsive hot bathing or showering. To date, the key diagnostic criteria has been compulsive hot bathing as it often relieves the cyclic vomiting and nausea. As of today, the exact cause of CHS is still unknown and many cannabis users may go undiagnosed or misdiagnosed.
There have been reports of increased incidences of CHS in jurisdictions that have legalized cannabis, particularly in young males. It appears that the higher THC concentrated products have contributed to increased case reports of CHS.
Unfortunately, there is no test for CHS, and it is diagnosed through exclusion of other possible conditions. Additionally, some cannabis clinicians have been reporting atypical CHS cases. In the American Journal of Endocannabinoid Medicine, Dr. Dustin Sulak and myself wrote up two atypical CHS case reports. Both patients were long-term heavy medical cannabis users who reported vague symptoms such as nausea, weight loss, appetite loss, and diarrhea. Neither one reported the need for hot showers or baths to control their symptoms.
Treatment for CHS is cessation of all cannabis products. Even small amounts of THC in hemp-based products have been found to trigger symptoms associated with CHS. Because the symptoms can be mild and vague in some people, it is important to work with a qualified cannabis healthcare professional that can help diagnose and treat CHS. Often, the clinician will recommend eliminating the cannabis products for several weeks to determine if the symptoms are indeed from cannabis. If CHS is diagnosed, it is imperative that the clinician can offer alternatives to help manage the medical condition that was being treated with cannabis. Most people diagnosed with CHS have reported that they have been unsuccessful at using cannabis without recurrence of the symptoms, even with occasional/infrequent use.
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