Also, it’s possible there are more cases than have been reported, since not everyone with the illness will seek medical help or tell their doctor they use cannabis, the Cleveland Clinic notes. Doctors at the hospital ran tests and ordered scans but could not name the source of her unrelenting nausea and vomiting. It was so bad she thought it might be a recurrence of her severe pancreatitis, the illness for which cannabinoid hyperemesis syndrome she once had been hospitalized and put on life support. Richards and Dutzak 34 presented a single case study that examined an extreme case of CHS in the ER who had intractable N/V, abdominal discomfort and who was unresponsive to standard antiemetics. 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.
Results
She asked to be identified only by her first name for fear of how future employers may view her history of marijuana use. Chronic cannabinoid usage can lead to recurrent N/V with distinct pathogenesis, known as CHS. There is a need for awareness among the medical community about what cannabis can and cannot do as CHS can lead to death 36. Three mechanisms have been proposed for the development of CHS; these are gastrointestinal CB1 overriding, cannabinoid lipid buildup, and genetic polymorphisms in the P450 system.
What are other impacts of cannabis use?
- Richards and Dutzak 34 presented a single case study that examined an extreme case of CHS in the ER who had intractable N/V, abdominal discomfort and who was unresponsive to standard antiemetics.
- Researchers are trying to understand why some people develop it and others don’t.
- The aim of this study was to outline current treatments for the management of CHS.
- There is a history of depression in our family, and Brian had developed it during preadolescence.
Knowledge of pharmacological treatments for managing CHS may lessen the burden of ED resources with the recurring admission of patients with CHS 20, 23, 25, 28, 31, 33, 35. We included systematic reviews, retrospective cohorts, case reports, and randomized-controlled trials (RCTs), written in the English language; from January 2009 to June 2021 that described the use of cannabinoids and CHS in adult and older populations (18 years and older) were included. The PICO tool was used to inform and guide the keywords used in the search. We assessed adults and older populations with N/V who were using recreational or medicinal cannabinoids. The management options included pharmacological treatments and water hydrotherapy which were compared to placebo. The outcomes included the effectiveness of https://ecosoberhouse.com/ the interventions seen in decreasing N/V induced by cannabinoids.
Topical Capsaicin
- One 2018 study found that 32.9% of self-reported frequent marijuana users who’d gone to the emergency room (ER) had symptoms of CHS.
- It is my mission to raise awareness of CHS in the hope that others do not have to endure the same fate as Brian.
- A systematic review was conducted using PubMed, Ovid MEDLINE, Cochrane Central, EMBASE, and Google Scholar.
Cannabis cessation is noted to be the most successful management, but other treatments also demonstrated symptom relief; these include hot water hydrotherapy, topical capsaicin cream, haloperidol, droperidol, benzodiazepines, propranolol, and aprepitant administration. This could be another contributing factor in the pathophysiology of CHS (Fig. 1). With the emergence of cannabis and its widespread usage in various settings, clinicians and users should be more aware of the long-term effects of cannabinoids. CHS is a potential side effect of prolonged cannabis use, causing major distress to consumers.
Haloperidol
In-depth mechanisms for different CHS hypotheses are presented in Figure Figure11. Nabilone, sold under the brand name Cesamet©, is a synthetic cannabinoid with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain. Nabilone mimics THC, the primary psychoactive compound found naturally occurring in cannabis. Despite the current acceptance of Nabilone as a treatment option for N/V in patients with CHS, there is a lack of data regarding the side effects of its prolonged use such as accumulation and toxicity, resulting in exacerbation of N/V rather than curing it. Cannabinoids are compounds in the Cannabis sativa plant that bind to cannabinoid receptors in your brain, spinal cord, gastrointestinal tract and other body tissues.
How states have reshaped marijuana laws and what’s next
A doctor confirmed that Brittany’s years of cannabis use had manifested in CHS. A systematic review was conducted using PubMed, Ovid MEDLINE, Cochrane Central, EMBASE, and Google Scholar. Databases were used to search for articles on CHS published from January 2009 to June 2021, yielding 225 results of which 17 were deemed relevant and underwent review by 2 separate reviewers. Remembering his kidneys had suffered in his previous attacks, Denney called 911. When she picked him up Oct. 21, he felt a little nauseated but had not been vomiting.
Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms
It may calm the muscle spasms that multiple sclerosis can cause, and some claim that it reduces seizures. Brian Smith Jr. was diagnosed with a rare condition called cannabinoid hyperemesis syndrome (CHS). To help you transition to the recovery phase, you can try a few home remedies such as regular hot baths. But too many of them may increase your risk for dehydration due to sweating.
Reports in the Canadian Medical Association Journal and the Boston Globe this week speculated whether CHS is underdiagnosed in Canada and the U.S., but a lack of data on the condition prevents a clear picture of how widespread it is. Dr. Taylor Lougheed, Ottawa family physician who works in sports, emergency and cannabinoid medicine, said there appears to be a link to cannabis strains with high levels of tetrahydrocannabinol (THC) but not cannabidiol (CBD). Denney said he still had symptoms leading up to that appointment and thought if they were related to his cannabis use, he would have been symptom free. The symptoms typically last a few weeks, though the throwing up should ease up in a day or two. The best and only way to prevent or reduce your risk for CHS is to avoid or quit marijuana use.
Careful consideration is imperative in older individuals where comorbidities and pharmacological interacts can mask or exacerbate CHS. The novel and highlighted unconventional management options for CHS can be solidified as best practice guidelines with future large-scale research initiatives. Due to the global acceptance of medicinal cannabis, further studies should be conducted to fully understand both the beneficial and detrimental effects of cannabinoid drugs, as well as the consequences of its prolonged use and increased concentrations of cannabinoids. RCTs with larger sample sizes and longer follow-ups are warranted. Precise diagnostic criteria for CHS should be postulated where duration and dose of cannabis are predetermined, especially in older adults or patients with renal impairment.