Cannabinoid Hyperemesis Syndrome (CHS) is emerging as a significant health concern linked to the frequent and prolonged use of cannabis. This gastrointestinal condition is characterised by acute episodes of severe nausea, vomiting, and intense abdominal pain, typically manifesting within 24 hours after the last cannabis use. Intriguingly, many sufferers find temporary relief through compulsive hot showers or baths.
The prevalence of CHS is on the rise, with estimates suggesting it affects approximately 2.75 million individuals in the US annually. Notably, emergency department visits for CHS have doubled between 2017 and 2021 in the US and Canada. This increase coincides with the broader legalisation of recreational cannabis and a rise in the concentration of delta-9-tetrahydrocannabinol (THC) in cannabis products. The syndrome is most commonly observed among males aged 16 to 34, particularly those with a history of heavy and early cannabis use.
Risk factors for developing CHS include daily cannabis use for over a year, starting cannabis use before age 16, and having other substance use disorders or smoking habits. Diagnosis is typically confirmed if an individual experiences three or more annual episodes of related symptoms, which subside after at least six months of cannabis cessation.
CHS poses several serious health risks. Frequent vomiting can erode tooth enamel, leading to potential tooth loss, and may cause dehydration, acute kidney injury, and electrolyte imbalances. In rare cases, severe complications such as heart rhythm abnormalities, kidney failure, seizures, and even death can occur.
Treatment for CHS often begins in the emergency department, where patients receive intravenous fluids and anti-nausea medications. Topical capsaicin cream applied to the abdomen can help alleviate nausea. In some cases, benzodiazepines and haloperidol might be used for short-term relief. However, the most effective long-term solution is the complete cessation of cannabis use. This process can be challenging due to withdrawal symptoms, highlighting the need for counselling and, in some cases, tricyclic antidepressants. Those who do not respond to initial treatments may benefit from psychological support.
As cannabis becomes more widely accepted, it’s really important to raise awareness about Cannabinoid Hyperemesis Syndrome (CHS) and what it means. Many users might not realise the signs or how serious this condition can be. By sharing knowledge about CHS, we can help people feel confident in seeking help when they need it and make safer choices about their cannabis use.
Source: Jama Network
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