Episode 8: What is Cannabinoid Hyperemesis Syndrome?
Cannabinoid Hyperemesis Syndrome (also called CHS) is the topic of this week’s episode. Melissa and Dr. Erik answer the question “How can something that’s an anti-vomiting medicine be the cause of a vomiting illness”?
Dr. Erik Messamore
Cannabinoid hyperemesis syndrome involves symptoms like loss of appetite, stomach pain, nausea, and vomiting. Vomiting attacks come in waves or cycles. A vomiting attack can last many hours or several days and can be severe enough to cause dehydration or a host of other serious complications.
Cannabinoid hyperemesis syndrome affects some people who use cannabis regularly. The typical CHS patient will have used cannabis nearly daily for several years. However, there are cases of CHS developing in people who have used it as little as once per week for 6 months.
Time and topics
1:41 — What is cannabinoid hyperemesis syndrome?
2:53 — Symptoms are often relieved by hot water baths or showers
04:30 — The first report of cannabinoid hyperemesis syndrome was published in 2004
05:45 — Cannabinoid hyperemesis syndrome might have been around longer, but not recognized
06:29 — Cannabinoid hyperemesis syndrome might be the result of stronger cannabis being easier to get and use regularly
07:12 — Why has CHS not more widely known?
08:41 — It’s not profitable to publicize CHS
10:48 — Why don’t cannabis companies warn consumers?
14:00 — Cannabis prohibition was a bad policy
15:16 — State governments are mostly silent about CHS
18:40 — Knowing about risks is important for consumers to make informed decisions
22:29 — Is CHS dangerous? What are the possible complications of CHS?
26:26 — How often and for how long before cannabis use poses a risk of CHS?
28:49 — Treatments for the active phase symptoms of CHS
31:55 — The definitive treatment for CHS
33:51 — What to do if you think you might have CHS
34:59 — The leading theory about what causes CHS
36:51 — Tips for stopping cannabis use
Notable quotes
“If you don’t know that something exists, it’s hard to see it.”
“This could be a newly-recognized fallout from greater access to higher strength, longer-term use of cannabinoids.”
“There can be extremely important medical information that gets published, that probably everybody ought to know about. But there’s just not a mechanism to disseminate the kind of information to people… Absent funding to disseminate knowledge at scale, knowledge dissemination happens at a trickle”
“Because of prohibition, we know relatively little scientifically about marijuana’s risk profile. Through prohibition policies, you’ve made cannabis way popular. And through prohibition policies, you’ve made its safety profile a subject of debate”
“States, in my view, have done a good thing by trying to make a substance available that might help people… But the idea of having a state government endorse marijuana as a medicine, display medical benefits on their website, and not say one word about risks is irresponsible”
“You’re not supposed to feel nauseated. You’re not supposed to have unexplained appetite loss. And you’re certainly not supposed to be vomiting a lot. So, if you have any of those things, do get checked out.”
“It can become very confusing. How can something that is supposed to help with vomiting cause vomiting? The answer is because the body develops tolerance, and the body wants to kind of fight back against whatever the drugs are making it do. So, if you take a drug constantly, which turns down the vomiting response, the parts of your brain that regulate vomiting, are actively pushing back against the action of the drug. In chronic suppression of the vomiting system, the vomiting system like builds muscle and gets stronger.”
“You might be one of these people for whom the body has just revved up its vomiting machinery. The only way to get back to normal is to put a pause to cannabis use and let the body’s vomiting machinery get unwound back to its normal state.”
“Recovery is not a solo sport. Recovery is a team effort. So, if you put a pause on cannabis and your stomach is feeling better, then do get friends, get family, get new friends, find online support groups, find a new team, or enhance your current team to help you to support you, so that you can try to figure out other things to do what cannabis used to be doing for you.”
“A whole lot of people who are in recovery have been where you’re at. And they will lend you some confidence and probably all sorts of love and support in trying to help you to get to a better quality of life.”
“Nobody wants you to stop weed and suffer. Everybody wants you to stop weed and to have, you know. a more awesome life as a result.”
About the Host:
Dr. Erik Messamore is a board-certified psychiatric physician and PhD-level pharmacologist. He’s a consultant psychiatrist, researcher, lecturer, teacher, and solution-focused scholar currently affiliated with the Northeast Ohio Medical University in Rootstown, Ohio. He is joined on this podcast by Melissa Xenophontos, a journalist, radio producer and longtime mental health advocate.
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