What is Cannabinoid Hyperemesis Syndrome?

You’ve probably seen stories circulating from the media about severe vomiting illnesses from heavy cannabis use. Yes, this is a real thing. It’s called cannabinoid hyperemesis syndrome or CHS. Some explain the symptoms as “skirting death”, “like the flu but worse” and “the worst case of food poisoning ever”. These are accurate descriptions.

What Causes Cannabinoid Hyperemesis Syndrome?

The cause is simple – excessive and heavy use of cannabis on a daily basis over a period of time. The body really can handle only so much of the various cannabinoids in cannabis. While small doses of cannabis tend to soothe nausea, in the digestive tract, too much can actually cause it.

Basically, your body is reacting to cannabinoid overload. When your brain and endocannabinoid system have been stimulated enough by cannabinoids, they stop reacting to them. This also goes along with the theory that you can only get so high – which is true. You can only smoke so much, you can only get so high because at a certain point (which is different for everyone) your body just stops responding, or responds in a negative way because it has had enough.

Symptoms of Cannabinoid Hyperemesis Syndrome

The most common symptom is uncontrollable or violent bouts of vomiting. There are three stages of the illness – the prodromal phase, the hyperemetic phase and the recovery phase.

In the first phase (the prodromal phase) nausea in the early morning hours or even some abdominal pain can be experienced. For women, these can also be symptoms of PMS and early pregnancy.

During the second, hyperemetic phase, the nausea can increase and the vomiting typically starts. Abdominal pain increases and interest in food seems to go away. Dehydration and weight loss can occur. The vomiting can be overwhelming and is described as being “intense”.

The recovery phase is when symptoms start to diminish. When you can eat again without being nauseated, you’re in the recovery phase. How long does the recovery stage last? It varies from days to months.

Severe cases of CHS can also cause muscle spasms, numbness and tingling.

How is CHS Diagnosed?

Doctors will run a battery of tests to provide a proper diagnosis. Since continuous, intense or repeated bouts of vomiting can coincide with dozens of other ailments, several tests need to be run to rule other ailments out. Questions regarding your overall health and symptoms over a period of time.

Some things that the doctors may check for include:

  • Anemia
  • Blood infections
  • Electrolyte levels
  • Pregnancy
  • Liver enzyme levels
  • Pancreas enzyme levels
  • Urinalysis
  • X-rays to rule out abdominal injuries, blockages and other ailments
  • A drug screening

More invasive tests such as CT scans of the head and abdomen might be ordered if the routine tests don’t provide enough answers. In some of the more severe cases, upper endoscopies may be ordered to check for stomach and esophageal injuries/causes of the sickness.

Treating CHS

The best cure for CHS is to avoid using any type of cannabis and/or hemp products (yes, this includes non-intoxicating cannabinoids like CBD, CBG, THCA, CBN and CBDA). Take hot showers. The hot showers tend to soothe the nausea and slow down or stop the vomiting.

IV fluids are also given to rehydrate your body. Anti-nausea medication may be ordered. Pain medication may be offered to help reduce the abdominal pain. If inflammation of your stomach is noted, protocols to reduce it may be discussed.

The brain is part of what helps your body react to temperature, when it’s stimulated by heat, it helps reduce the nausea and vomiting. It may seem backwards for those that don’t like to be hot, but to the body, being warm can be comforting and relaxing.

How long do you need to refrain from using cannabis or hemp products? It’s different for each person. For some, a week or two without any cannabinoids seems to do the trick. The sooner your body enters the recovery stage, the sooner you can return to cannabis use. However, this does not mean that you should dive right back into heavy use – low and slow is the key. Microdose at first and slowly increase your dose as your body tolerates it.

Taking a break from cannabinoids might not make you feel great during the break since you’ll have to alleviate your typical symptoms in another way or just deal with them – but the upside is – your tolerance is likely to decrease. Yes, that is an upside – you’ll spend less on cannabis and will learn how to appreciate the true effects of different strains and products better. Microdosing might become your preferred method of medicating.

Closing Thoughts

CHS is something that no cannabis user wants to endure. It isn’t fun. It really is pure misery. Think about the sickest you’ve ever been from the flu, a virus or even just a nasty cold – double or triple that and that’s what you might expect to experience with CHS. Whether you use cannabis medicinally or recreationally – this isn’t something you’d brag about having because it really is just miserable.

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