Graphic for the Veterans Action Council Roundtable #84, with guest Ethan Russo, MD | Image Credit: © Veterans Action Council
On January 17, 2025, the Veterans Action Council (VAC) held its live, hourlong Roundtable #84, discussing cannabinoid hyperemesis syndrome (CHS) with guest speaker neurologist and medical researcher, Ethan Russo, MD. Founded in 2020, the VAC is a group of international veterans working with organizations, policymakers, researchers, and more with the aim of policy reform and increasing access healthcare, including to natural medicines and alternative therapies such as cannabis. This Roundtable was introduced by VAC member Etienne Fontan, with several members asking nearly two dozen questions on various aspects of the syndrome. With Venetia Whiteley, Dr. Russo co-authored “Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure,” published in Frontiers in Toxicology in October 2024.
As Fontan explained, CHS has been linked with several deaths since the first diagnosis in 2004 and has been a polarizing issue surrounded by misinformation. “As members of the Veterans Action Council, we’ve seen how this can be weaponized, including at the United Nations, where education and science provide vital in countering misconceptions. That’s why we’ve invited Dr Ethan Russo, a leading expert and researcher, to help us explore the science, dispel myths and provide insights into this complex condition,” he explained. “His groundbreaking work on CHS and his commitments to evidence-based education are unmatched. Together, we’ll explore the science, address the pressing questions and pave the way for a more informed approach to this complex and often misunderstood condition.”
Dr. Ethan Russo began the discussion with the context of CHS, describing the symptoms of nausea, vomiting, abdominal pain, and hot water bathing behavior, and the two driving factors of the increase in the syndrome: the prevalence of high-tetrahydrocannabinol (THC) products, and the greater recognition of CHS. He also elaborated on the four phases of the syndrome and limited treatment options: “The only definitive treatment of CHS is abstinence from its use…In terms of other treatments, capsaicin on the skin creates a burning heat effect that allay symptoms for a period of hours. The hot water bathing helps. The most effective drug is haloperidol, given intravenously. The more common antiemetics, drugs for vomiting don’t work here.” He stated that the threshold for CHS is unknown, varying by individual, though the average daily intake of the individuals studied in the research article was 4 g of predominantly THC material. Additionally, the estimates of percentages of heavy cannabis users affected by CHS vary greatly, with some estimating 350,000 and others estimating three million.
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Dr. Russo explained that through his article, he was able to demonstrate a genetic predisposition for individuals with CHS. “We were able to demonstrate this through our first publication, which identified five different genes with mutations that were statistically significantly more present in people who had CHS symptoms, as compared to people using as much cannabis as a day, who did not have the symptoms. We believe that this provides the foundation for our theory that this is genetically caused.” He noted the overlap between CHS and cyclic vomiting syndrome, and the importance of medical professional considering a patient’s family history. He also elaborated on the genetic mutations researched and their implications for other conditions. “To me, it’s really ominous,” he stated. “This is really a public health disaster in the making, if we don’t address it properly.”
Dr. Russo also discussed where more research is needed for this condition, namely, lager studies to confirm the preliminary studies on genetic mutations, and a better understanding of the psychiatric aspect of the diagnosis. “Legalization and regulation is the only answer,” he emphasized. “CHS is largely a byproduct of prohibition. Why is that? Well, when a substance is prohibited, the industry is going to use the highest potency material and the smallest volume to get it out into the landscape.” Dr. Russo also noted that more freedom within the industry would allow more options for consumers, expanding the focus beyond THC products.
Dr. Russo also disclosed that his company, CReDO Science, has a patent pending on DNA testing for CHS susceptibility, though he explained the lack of a conflict of interest.
View the full recording of the VAC Roundtable on cannabis hyperemesis syndrome with guest speaker Ethan Russo, MD.
In a special Roundtable discussion, the Veterans Action Council (VAC) invited Dr. Ethan Russo to discuss this syndrome, its growing prevalence, research, potential dangers, and possible solutions. Read More
