What is CHS? The leading cause of marijuana-related ER visits

You’ll likely undergo a physical exam, cannabinoid hyperemesis syndrome (chs) and your doctor might ask questions like how often you use cannabis, how long you’ve been using, and what patterns you notice about your nausea. If you’re not upfront about your marijuana use, your provider may diagnose you with a completely different issue. It can rob your body of essential fluids, leading to dehydration and serious health issues. People with CHS might also struggle with an electrolyte imbalance, which can harm the heart, kidneys, and other vital organs.

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One letter to the editor in an online medical journal forum speculated that it was caused by plant viruses and viroid’s. None of these things seem to be true given recent scientific investigation. Patients are encouraged to order the test through their physician as a part of the diagnostic process. An advantage to the patient for doing so is that the test is more likely to be covered by insurance and physicians can help the patient make sense of the results and suggest best next steps for relief and onward care. It is important to note Twelve-step program that for the vast majority of people Cannabis is a safe and versatile medicine, or social agent.

• Continual bouts of extreme vomiting and pain can have a severe impact on overall health, including risks like dehydration and electrolyte imbalances.
• Marijuana dependency can develop, making it hard to stop, even if you realize it’s hurting your life.
• Patients experience complete relief of the symptoms, which can last days, weeks, or even months.
• The best way to manage CHS and prevent complications is to discontinue cannabis use.
• Despite these established characteristics, there is no definitive guideline on how many criteria are required for diagnosis.
• Thus, prompt diagnosis of CHS can save valuable clinical time and resources.

Cannabinoid Hyperemesis Syndrome Treatment

But not every person who uses marijuana, even long-term use, develops CHS. Symptoms of withdrawal can include disrupted sleep, increased heart rate, sweating, irritability and mood swings, according to the Centers for Disease Control and Prevention. “It may be that the cannabinoid is only sort of one aspect of the way the patient is hurting that needs to be addressed to really get them to heal,” he said. Our dedicated professional staff is here to guide you or your loved one on the journey to lasting recovery, offering support every step of the way. Patients should not bring large sums of money or valuables into hospital. Please note that East Kent Hospitals accepts no responsibility for the loss or damage to personal property, unless the property has been handed into Trust staff for safe-keeping.

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Chronic cannabis use can lower pituitary hormone levels, including the growth hormone, follicle-stimulating hormone, and luteinizing hormone, which has been shown to normalize after stopping use 23,24. It tends to affect people who use cannabis at least once a week and happens more often in adults who’ve been using cannabis since their adolescent years.

3. Recovery Phase

Most of the evidence on https://ecosoberhouse.com/ effective treatment and management comes from published case reports. Although this information comes from case reports, doctors can use these criteria to diagnose the condition more quickly. Doctors have also noticed that people in the hyperemesis stage take frequent showers and baths, which seem to relieve nausea. Many people with CHS go to their doctor or an emergency room (ER) for treatment. However, doctors may find it challenging to diagnose the syndrome because people tend not to report their use of marijuana.

History

Endocannabinoids are present in the CNS and enteric nervous systems and are released locally on demand by neuronal signaling; they are released in small amounts and become rapidly inactivated 28. This review aims to provide a comprehensive summary of current global knowledge on CHS in adolescents, including its epidemiology, diagnosis, pathogenesis, and management. Probably, a crucial factor in the genesis of CHS is the composition of cannabis. Since the 1990s, there has been a progressive change in the composition of the plant, with increases in the tetrahydrocannabinol (THC) and a reduction of cannabidiol (CBD).6 This trend correlates with increased cannabis use. Some individuals, for instance, also admitted to smoking 2000 mg of THC per day.

Verify your insurance today – treatment could be more affordable than you think. As the laws regarding the possession and use of marijuana change, CHS may become more prevalent because more people will have legal access to the drug. Doctors have a lack of knowledge of CHS, and this makes it hard to identify people with the condition. Another doctor reported using a combination of injectable lorazepam and promethazine, another antinausea medication. Researchers have identified two receptors called CB1 and CB2 to which marijuana molecules attach.

Information for patients from the Alcohol and Substance Misuse Team

This raises important concerns about the safety profile of future cannabinoid-based medications and therapies. As research progresses, careful consideration will be needed to balance therapeutic benefits with the potential for harmful side effects, particularly for vulnerable populations. The modulation of CB1 receptors holds promise but also necessitates further investigation to ensure the safety and well-being of patients undergoing such treatments 44-46. Although laboratory examinations and advanced imaging studies (e.g., CT scans, ultrasounds) are often negative, they play a crucial role in ruling out other conditions. The lack of significant diagnostic findings in CHS patients underscores the importance of a thorough patient history and clinical suspicion. Despite negative workups, physicians must consider CHS when standard treatments fail and patients continue to present with persistent symptoms related to cannabis use.

• Gastric motility and gastroparesis must be discussed in the context of CHS.
• When patients are discharged from a UCHealth emergency department, the official diagnosis is typically “vomiting,” though the CHS details are entered into the medical record’s notes.
• It triggers intense, repeated vomiting episodes that can quickly disrupt your day-to-day life.

Cannabis hyperemesis syndrome (CHS) may require emergency medicine to relieve CHS symptoms, including IV fluids, anti-nausea medications, and supportive care. Recent developments in cannabinoid research have led to the creation of novel modulators aimed at specifically targeting the CB1 receptors, which are integral to the psychoactive effects of cannabis. When these receptors are activated, they can influence mood and behavior, and in some individuals, may contribute to adverse psychological effects such as depression and suicidal ideation.

• Most available data come from individual case reports or small case series, making it challenging to fully characterize the disease.
• Amitriptyline and lorazepam can be used to mitigate withdrawal effects of cannabis.
• These genes impact the TRPV1 receptor, dopamine receptors, and the enzyme CYP2C9 (which is responsible for metabolising THC in the liver).
• Paradoxically, CHS causes excessive vomiting and is related to long-term marijuana use.

The syndrome presents with repeated and severe bouts of vomiting (being sick). Cannabis researcher Ethan Russo recently published a new study which found 5 statistically significant mutations in CHS patients. Importantly, they are all mutations that are not found in frequent cannabis users without CHS symptoms.

Treatment Outcomes

The prevalence of those suffering with CHS is unknown, but estimates have ranged in the medical literature from 350,000 to 2.75 million in the USA. As more people consume cannabis worldwide, it is realistic to expect that the number of those afflicted will increase. A physical exam is important when quitting marijuana, especially if forceful vomiting occurs, as it may indicate CHS syndrome, a condition sometimes linked to cerebral edema. Capsaicin cream is a common treatment, and individuals with bipolar disorder may require additional monitoring. Early morning nausea, repeated vomiting, and disrupted normal eating patterns may indicate cannabis hyperemesis syndrome. CHS syndrome causes cyclic vomiting from chronic cannabis use and is not linked to multiple sclerosis or immune cell-related side effects.