Finding MA and the wonderful fellowship has forever changed my life for the better. Tetrahydrocannabinolic acid (THCA) is anti-emetic in laboratory animals (Rock et al., 2020), but is an unstable molecule that decarboxylates to THC, and is likely problematic. Tetrahydrocannabivarin (THCV) has an unusual profile as a neutral antagonist of CB1 at low doses, but an agonist at much higher doses (Thomas et al., 2005). Although selective breeding has produced plants with 93% of total cannabinoid content as THCV (de Meijer and Hammond, 2016), residual THC content remains the rule, as THCA synthase produces both the pentyl and propyl molecules in the cannabis plant.
The Washington State Liquor and Cannabis Board was unable to provide an exact percentage of the state market for high-potency sales in 2024. Communications Director Brian Smith said via email that the “processing sector” now accounts for more than half of all retail sales, although that can include products that contain less than 35% THC. But even Russo, whose professional life revolves around the benefits of cannabis, has been calling out the dangers of high-potency concentrates — a danger he said is universally applicable to any drug.
4 CHS and plant viruses
Psychosocial factors may also influence the diagnosis and reporting of CHS. The stigma surrounding cannabis use, especially in populations who consume cannabis how long does it take to recover from cannabinoid hyperemesis syndrome regularly, can deter patients from disclosing their usage to healthcare providers. Therefore, cultivating a more accepting healthcare environment for patients using cannabis could improve the accuracy of self-reported data and help in the earlier identification of CHS. The difficulty in diagnosing CHS arises because its symptoms overlap with other gastrointestinal and metabolic disorders, such as gastroparesis, cyclic vomiting syndrome, or peptic ulcer disease. Overlapping symptoms such as abdominal pain and cyclic vomiting are especially difficult to pinpoint to a specific illness. CB-1 receptors are present in the heart, which makes it possible that cannabinoids might affect myocardial performance 150.
On the other hand, I knew it was going to take all of my willpower to stay clean. It was hard to surrender to the fact that I had developed CHS within a few months of https://ecosoberhouse.com/ marijuana becoming legal in New York state. It wasn’t until I got very sick on a plane traveling for vacation—vomiting nonstop, for the third time in four months, that I thought my increased marijuana use may be an issue. I spent that entire vacation in bed getting sick throughout the day, unable to eat and could barely drink water. I had lost over twenty pounds in four months from vomiting, being severely nauseous and unable to eat anything other than soup and protein smoothies.
Cannabinoid Hyperemesis Syndrome Treatment
The patient was referred to a nutritionist for additional support and education. She had not gained substantial weight by 1 week after hospital discharge, and she reported continued nausea with no emesis. At a gastroenterology consultation 7 months after discharge, she had improvement of symptoms, although early satiety Alcoholics Anonymous remained. Surgical consultation was not sought by the patient, and it remains unclear whether she continued to use cannabis upon symptom relief.
Cannabis and psychosis
The stress and food deprivation induced by malignancy and chemotherapy in the patient’s case could have contributed to the breakdown of fat causing nausea and vomiting. The patient’s vomiting may have been multifactorial, related to the advanced stage of small-cell lung cancer and medication side effects (i.e., chemotherapy agents). Toxicity induced by drug-drug interactions with paclitaxel may have led to reduced renal clearance of nabilone, perpetuating nausea, and vomiting. Alternatively, the stress of undergoing chemotherapy in advanced stage lung cancer combined with food deprivation could have contributed to further breakdown of her fat stores causing a mass release of delta (9)-tetrahydrocannabinol from years of nabilone use. She underwent a course of chemotherapy consisted of paclitaxel, docetaxel, and cisplatin soon after the diagnosis, complicated by hair loss, sore mouth, loss of appetite, diarrhea, neuralgia, nausea, and vomiting developed approximately 5 h after chemotherapy. Nabilone was used for the last 5 years to manage the patient’s neuralgia leading to a significant reduction in problematic nausea and vomiting that developed post-chemotherapy.
- She said she wouldn’t want to discourage anybody from smoking weed; she just wants people to know heavy use can bring them some serious misery.
- The reason why I know so much about this is that it happened to my son.
- It’s thought that genetics may play a role because only a small number of people who regularly use cannabis develop CHS.
- More research on CHS is needed to enhance knowledge translation, education, and create awareness in the medical community on the side effects of cannabinoids and to propose the best treatment options.
The youngest age for a CHS case in the literature found by the authors is 15 years 125. In a report on a 16-year-old CHS patient, she reported that she used marijuana herself but had been exposed prior to that to secondhand smoke for many years, as her family used marijuana 125. Other cannabinoids have been implicated in the pathogenesis of CHS, such as CBD and cannabigerol (CBG).
The belief in marijuana as a therapeutic and benign agent is so pervasive among some patients and certain healthcare personnel that they will persist in using cannabinoids, even if they are educated about the role of marijuana as a potential proemetic 1, 13. In some case reports in the literature, a few patients rejected the notion that marijuana might in some way be the cause of their symptoms and refused to give it up even to see if it might relieve their symptoms 1. The literature reports on global clinical experience with CHS to date in the form of case studies, case reports, and case series. While case reports are not the strongest form of evidence, the range of case reports in the literature over the past years presents a coherent picture of the condition, its diagnosis, and treatment.
In the patient’s case, nabilone led to the development of CHS, and as a result, she was switched to opioids, gabapentin, and selective serotonin reuptake inhibitors to target her pain. Nausea and vomiting subsided and no additional intervention was needed in this regard as time passed post chemotherapy. If she would become symptomatic from nausea and vomiting perspectives alternative antiemetics could be used as the drug of choice in this situation. While it is effective, other medications are still needed in conjunction with topical capsaicin for total symptom resolution.178 The mechanism of how capsaicin reduces CHS symptoms is not known; therefore, its exact role in CHS treatment is not yet clear. According to his death certificate, Brandon Danielson died of cannabinoid hyperemesis syndrome, or CHS, a condition that results from daily use of cannabis, especially high-THC concentrates.
Chronic cannabis use raises the risk of major depression, bipolar disorder and psychosis by up to FOUR TIMES
- One milligram followed by 1 mg IV injections of propranolol 1 h apart led to rapid termination of N/V and complete resolution of hyperemesis after the second injection 34.
- The patient’s vomiting may have been multifactorial, related to the advanced stage of small-cell lung cancer and medication side effects (i.e., chemotherapy agents).
- Many patients don’t realize that the syndrome is connected with their use of cannabis, and may even be using cannabis in attempts to ease their nausea.
From MA, I have learned to choose a life in which I prioritize the well-being that I, for so long, decided was not worth it. I had been a chronic pot smoker for ten years before I had two major flare ups of CHS, both of which required hospitalization. They said it resembled ulcerative colitis, so that’s what they treated me for. Although one might consider the use of more powerful CB1 antagonists for CHS, these are unlikely to be of benefit. Cannabigerol (CBG) also inhibits FAAH (Bisogno et al., 2001) but has been reported in surveys to alleviate gastrointestinal symptoms including inflammatory bowel diseases (Russo et al., 2021).
In six sessions with the working group, Haley said she has seen the tone change and people connect on issues that before seemed impossible, areas like preventing youth access and even increasing regulations on high-THC products. Walker said the biggest obstacles they face are the public perception that cannabis is harmless and the struggle to find money to continue their research. Irby had a hard time connecting the high-potency weed she considered a miracle cure for her depression to the disabling sickness that occurred a few years later. On several occasions, she got so ill that even the smell of food made her throw up.
Not everyone with the condition seeks medical help or tells their provider that they use marijuana. It’s a condition that can lead to serious health complications if you don’t get treatment for it. A study this year in the Journal of Forensic Science described two people in Canada who died from CHS and a third for whom the condition contributed to death. Many of Lapoint’s patients returned time after time when the next bout hit, seeking relief from their stomach woes. There is no blood test to link the stomach ailment with marijuana use, so physicians often order pricey CT scans and lab tests to rule out other medical problems.