What is Cannabinoid Hyperemesis Syndrome?

A 27-year-old woman with a mysterious illness that causes marijuana users to develop extreme nausea and vomiting landed in the hospital after burning herself when she fell asleep showering.


According to a March 24 case study in the journal BMJ Case Reports, the Florida woman used marijuana daily for many years but developed nausea and vomiting only over the past 18 months. To soothe her nausea and abdominal pain at home, she would use heating pads and warm baths or showers.


Her doctors initially thought she had gallbladder damage. But after she shared her marijuana use and home treatment regimen, the doctors diagnosed her with cannabinoid hyperemesis syndrome, or CHS.


CHS affects frequent marijuana users who suddenly develop adverse reactions to the substance, usually in their 30s, after using the substance daily or weekly beginning in their teens. The condition was first described in the early 2000s, and experts are still unsure what causes the unrelenting nausea and vomiting.


Like the woman in the case study, people with CHS tend to rely on hot showers, baths, and heating pads to soothe their pain. According to a 2016 systematic review of CHS patients, 92% of diagnosed patients have "compulsive" use of these pain-management techniques.


When a person applies heat to their skin, it can open their blood vessels and relieve blood clots that are causing pain in a specific area, which could explain why the soothing method is so popular for people with CHS, according to Temple University researchers.


Once they examined her, they found her stomach covered in red splotches and suggested she stop using marijuana to prevent further nausea and potentially dangerous soothing techniques.


Abstaining from marijuana use is the only way to treat CHS, University of Oklahoma internal medicine doctors wrote in a 2011 review of the condition.


When the woman heard this advice, she was hesitant to stop using marijuana.


According to the doctors on the case, she said, "Are you sure it's the weed?"


Cannabis isn't one drug. It is a plant with hundreds of compounds. Each of them could have a unique effect on our health. But we are only just beginning to scratch the surface of what those effects look like because the drug was widely illegal for decades, experts say.


Marijuana's benefits could include relief for the symptoms linked with serious health conditions, from pain and nausea to digestive issues and seizures. At the same time, its risks might include addiction, reduced cognitive performance, and CHS.


"We must recognize that the full range of potential adverse health consequences from cannabis consumption are not fully understood," Dr. Nora Volkow, the director of the National Institute on Drug Abuse, wrote recently in a major medical journal.