Cannabinoid Hyperemesis Syndrome

Frequent users of cannabis often talk about the drug as harmless and possibly having a series of positive effects on body and mind. There are, however, some serious medical issues that can arise when using cannabis.

In your brain, cannabis can overwhelm the endocannabinoid system, which is a complex and important regulator of stress response and allostasis. The result is Cannabinoid Hyperemesis Syndrome[1].

Cannabinoid Hyperemesis Syndrome is characterized by recurrent nausea, vomiting and crampy abdominal pain[2]. It can easily lead to dehydration and electrolyte abnormalities.

The symptoms may be improved temporarily by taking a hot shower or hot bath. The symptoms return the moment the water turns tepid. The recurring problem may lead to compulsive bathing behaviours. The only fully foolproof cure is stopping the use of cannabis.

The problem is of course that the use of cannabis in the US has been decriminalised in several states. This may result in a dramatic increase in the number of cases.

While there are no known cases of fatal overdose from cannabis use in the epidemiologic literature, the use is certainly detrimental to your health in the long run. Studies suggest that some adverse health outcomes may be elevated among heavy cannabis users, namely, fatal motor vehicle accidents, and possibly respiratory and brain cancers[3].

Compulsive Vomiting Syndrome is a possible differential diagnosis if and when the use of cannabis can be ruled out.

[1] Sontineni et al: Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse in World Journal of Gastroenterology – 2009. See here.
[2] Sorensen et al: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review in Journal of Medical Toxicology – 2017
[3] Calabria et al: Does cannabis use increase the risk of death? Systematic review of epidemiological evidence on adverse effects of cannabis use in Drug and Alcohol Review - 2010