Cannabinoid Hyperemesis Syndrome, or CHS, has been in the news lately, a mysterious disorder that makes chronic pot smokers vomit. Although it sounds like something out of a stoner’s nightmare, there may be some evidence to support this rare syndrome is, unfortunately, fact and not fiction.
What is Cannabinoid Hyperemesis Syndrome?
When you search for Cannabinoid Hyperemesis Syndrome in PubMed, there are 123 studies dating back to 2005. The most recent study, from March 2018, defines the syndrome as, “an entity associated with cannabinoid overuse. CHS typically presents with cyclical vomiting, diffuse abdominal pain, and relief with hot showers.” A 2013 study clarified those vomiting episodes could last between 24 and 48 hours.
Most of the studies agree that the common link between all those with this peculiar vomiting disorder is chronic cannabis use. They also agree that most straightforward cure is for patients to stop using cannabis.
Most people with Cannabinoid Hyperemesis Syndrome report hot showers are the only way they can find relief from symptoms, especially nausea. Thomas Hodorowski, who had CHS, told the New York Times, “The pain was unbearable, like somebody wringing my stomach out like a washcloth.” Because hot showers were Hodorowski’s only form of relief, he also told the Times he would spend hours in the shower at a time.
How Common is Cannabinoid Hyperemesis Syndrome?
As of now, it seems Cannabinoid Hyperemesis Syndrome is very rare. But that New York Times piece insists it’s more prevalent than people think. A 2018 study looked at the prevalence of Cannabinoid Hyperemesis Syndrome among cannabis users in a New York City public hospital. They claim 32.9 percent of regular cannabis smokers had experienced CHS, and they estimate 2.13 to 3.38 million Americans may suffer from the syndrome, or something similar.
However, the sample size of that study was only 155 people, so those estimates could be way off. The disorder appears to be rare enough that most doctors don’t even know about it. Many patients suffering from the cyclical vomiting syndrome go years before being diagnosed. Some receive all sorts of tests and treatment without success that can cost thousands of dollars.
This could be, in part, because many are afraid to be open with their doctor about cannabis use. Stigma is still high even in places where cannabis is legal for adult and medical use. Plus, many sufferings from Cannabinoid Hyperemesis Syndrome don’t connect their cannabis use with the vomiting and nausea. It’s widely known in the cannabis community that the herb can help relieve nausea and vomiting, and so the connection is counterintuitive to many.
What causes Cannabinoid Hyperemesis Syndrome?
Researchers are still not totally clear why a small percent of regular cannabis users are developing Cannabinoid Hyperemesis Syndrome. Some research points to a disturbance of the hypothalamic-pituitary-adrenal (HPA) axis, which is our central stress response system. Studies suggest CB1 and CB2 receptors in the hypothalamus could be dysfunctional, perhaps caused by a buildup of cannabinoids.
Basically, not much is known about what is causing this odd and frankly haunting phenomenon. What is clear is that more research is desperately needed. Not just on CHS, but on cannabis in general. Because of cannabis’ Schedule I classification in the Controlled Substances Act 1970, research into the plant is shockingly limited.
Cannabis is used by millions medicinally; one in five American adults have access to completely legal weed. But confusing side effects like Cannabinoid Hyperemesis Syndrome, are proof that of how little we really understand about the herb, and how much more research needs to be done.