“The way to make the diagnosis is to come off cannabis, proving retrospectively that it’s the cannabis [that was causing the symptoms],” Andrews explains. Because it requires many months of abstinence to diagnose CHS, some chronic cannabis users are reluctant to go down that path, experts say.
When CHS flare-ups occur and the vomiting is profuse, people can become dehydrated, which is why they should seek urgent medical care. That way, they can receive intravenous fluids (with electrolytes) and anti-emetics drugs (anti-nausea medications such as ondansetron, promethazine, or prochlorperazine) to stop the vomiting. In other instances, they may be given a benzodiazepine (such as alprazolam) or an antipsychotic medication (such as haloperidol) to try to stop an episode in its tracks.
During a flare-up, people with CHS also often take hot baths or showers, sometimes multiple times per day, to try to relieve their discomfort. “People with CHS often report temporary relief of symptoms from bathing in hot water, which may lead to compulsive bathing,” Angulo says. This suggests that the area of the brain that’s involved in regulating body temperature—the hypothalamus—might be involved in CHS, D’Souza says.
A lesser known intervention: Application of topical capsaicin (0.1%) cream to the upper abdomen can reduce nausea and vomiting associated with CHS. A study in the journal Academic Emergency Medicinefound that when people with nausea and vomiting due to CHS were treated with capsaicin cream, they experienced a significant reduction in nausea within an hour.
So far, giving up cannabis has been shown to be the only long-term solution. But quitting cold turkey can lead to cannabis withdrawal symptoms such as anxiety, irritability, anger, sleep disturbances, depressed mood, and loss of appetite. Working with a counselor and taking a tricyclic antidepressant (such as amitriptyline) “can help with marijuana cessation,” Angulo says. Another option is to slowly taper off use of THC.
Nausea. Severe abdominal pain. Compulsive bathing. These are some of the hallmarks of cannabinoid hyperemesis syndrome, a medical condition that’s on the rise. Read More
