In his view, the very respect he has for the drug’s potency pushes back against its unsupervised casual use for entertainment or self-medication. Finally, he suggested that teens who use cannabis for anxiety may shortchange their emotional development. The stress and confusion in youth, he said, is sometimes just part of learning life skills under pressure. Early cannabis use that masks stress may not only damage neural networks but also undercut psychological growth.
Marijuana Cessation
If you think you have CHS or cannabis use disorder, talk to a healthcare provider. Cannabinoids are compounds in the Cannabis sativa plant that bind to cannabinoid receptors in your brain, spinal cord, gastrointestinal tract and other body tissues. Examples of cannabinoids include tetrahydrocannabinol (THC) and cannabidiol (CBD).
Other Literature Sources
Anandamide and 2-AG are released locally on demand by neurons, are present in small quantities, and undergo rapid inactivation 8. Endocannabinoids are thought to act as either neuromodulators or neurotransmitters 11. Anandamide and 2-AG possess similar biochemical structures, but each has a distinct pathway for biosynthesis and degradation. Anandamide is synthesized from the precursor N-arachidonoyl phosphatidylethanolamine, while 2-AG is produced from an inositol-1,2-diacylglycerol precursor 8,16,17.
Cannabinoid Hyperemesis Syndrome FAQs
This antagonism reverses the anti-emetic actions of low-dose CBD, which likely occurs at the 5-HT1A receptor 33. The pro-emetic properties of CBD (at higher doses) and CBG may play a role in the severe nausea and vomiting observed in patients with Cannabinoid Hyperemesis Syndrome (Figure 2). Serotonin antagonism in the gastrointestinal tract from medications such as ondansetron, dolasetron, and granisetron likewise have varying levels of efficacy. Drugs with an anticholinergic effect chs symptoms and signs may likewise block medullary mediated vomiting, though they may have minimal impact on visceral stimulation, including the crippling abdominal cramping pain that patients with CHS experience. Opioids, while often prescribed for the patient’s debilitating abdominal pain, are not appropriate for CHS, as they may, in fact, worsen nausea and vomiting.
History and Physical
It has been proposed that hot bathing may act by correcting the cannabis-induced disequilibrium of the thermoregulatory system of the hypothalamus 6. Darmani has suggested that cannabis increases the core body temperature while concomitantly decreasing skin temperature thus increasing blood flow to the skin and dissipating excess core body heat 72. Cannabinoid hyperemesis syndrome (CHS) is a condition in which a patient experiences cyclical nausea, vomiting, and abdominal pain after using cannabis. The almost pathognomic aspect of a patient’s presenting history is that their symptoms are relieved by hot baths or shower. This activity introduces the pathophysiology, clinical manifestation, and management of cannabis hyperemesis. Unlike CVS and PV, CHS is not usually relieved by antiemetic pharmacological therapy, but many patients exhibit the learned behavior of taking hot showers and baths for temporary symptomatic relief.
- To assess the burden of disease, Meltzer and his colleagues conducted a survey of 1,052 people who report suffering from cannabinoid hyperemesis syndrome.
- This effect causes delayed gastric emptying and continues to inhibit transit through the small intestine.
- People with CHS also tend to have a strong urge to take very hot showers or baths.
- The efficacy of haloperidol as an antiemetic in post-surgical and chemotherapy patients has also been reported 15, 23•.
- In this article, we describe CHS and discuss the causes, symptoms, diagnosis, and treatment of the condition.
Clinical Considerations
- If you have symptoms, your doctor will do a physical exam and ask for your detailed medical history.
- In all 4 cases, CHS was diagnosed, and patients were counseled to avoid cannabis in the future.
- In older patients, especially those with hypertension, cardiovascular illnesses such as aortic pathology and atypical coronary artery syndromes may present as vague abdominal pain, nausea, and vomiting.
Further studies are also necessary to determine the causes of CHS and its risk factors. The only treatments available to people with CHS are those that restore hydration and help control nausea and vomiting. However, many experts consider these treatments to be ineffective for managing nausea and vomiting in people with CHS.
Receptors are specialized cells marijuana addiction that respond to specific stimuli or changes in the environment. As CHS is a newly described condition, many doctors may find it challenging to diagnose and treat. Researchers have tried to explain what causes CHS, but further study is necessary. The patient’s laboratory results showed a glucose of 353 mg/dL, Na of 136 mmol/L, BUN of 11 mg/dL, creatinine of 0.65 mg/dL, chloride of 95 mmol/L, a CO2 of 26 mmol/L, and an anion gap of 15. She had a leukocytosis of 14.4 k/uL, a normal hemoglobin of 13.7 g/dL, and a serum lactate of 1.9 mmol/L.