Newly Recognized Vomiting Disorder Linked to Long-Term Marijuana Use
A peculiar vomiting disorder associated with prolonged marijuana use has gained official recognition from global health authorities. Experts believe this acknowledgment could play a significant role in saving lives, particularly as cases continue to rise in various regions.
The World Health Organization (WHO) has added cannabis hyperemesis syndrome (CHS) to its diagnostic manual. This inclusion marks the first time the syndrome has been assigned its own diagnostic code, an update that came into effect on October 1. The Centers for Disease Control and Prevention (CDC) has also adopted this classification, empowering medical professionals nationwide to recognize, monitor, and investigate symptoms more accurately, rather than grouping them under broader gastrointestinal issues.
As stated by the National Institutes of Health, CHS is a serious and potentially lethal syndrome affecting chronic cannabis users. It leads to intense nausea, recurrent vomiting, abdominal pain, dehydration, weight loss, and in rare cases, serious complications like heart rhythm disturbances, seizures, kidney failure, and even death. The Cleveland Clinic notes that patients can go through extreme distress, often exhibiting a condition referred to as “scrotum,” which involves crying and vomiting simultaneously due to severe pain.
Doctors have faced challenges in diagnosing CHS because its symptoms can mimic those of food poisoning or gastroenteritis. Consequently, some individuals might spend months or even years looking for answers.
Beatriz Carlini, an associate professor at the University of Washington School of Medicine, indicated that the new code would enable better tracking of cases. “This is crucial for us to count and monitor these incidents,” she stated, expressing approval of the WHO’s decision. Carlini, who investigates the adverse health impacts of cannabis, mentioned, “We’re receiving feedback from doctors indicating that this issue is worsening.”
A recent study published in JAMA Network Open revealed that visits to emergency departments for CHS surged during the COVID-19 pandemic and have remained elevated ever since. Researchers assert that factors like isolation, stress, and increased access to high-potency cannabis could have driven this escalation.
The study highlighted that CHS-related emergency department visits climbed by around 650% from 2016, peaking during the pandemic, particularly among individuals aged 18 to 35. The authors observed a significant increase in THC potency, with today’s cannabis products often exceeding 20% THC, compared to about 5% in the 1990s.
John Pulse, a psychotherapist from Florida and certified addiction specialist, remarked on the “alarming” rise in CHS cases, particularly among young people who consume high-potency cannabis.
Pals noted that, according to his observations and supporting research, the growing incidence of CHS correlates strongly with the use of potent cannabis. He pointed out that many products now contain 90% THC or higher. Despite this, he mentioned a common misconception that CHS isn’t a legitimate condition, making the new diagnostic code an essential advancement.
Nevertheless, some researchers highlight that the exact cause of CHS remains unclear. There’s no established causal link, and the epidemiological data is still incomplete. One theory suggests that heavy, long-term cannabis use may overstimulate the body’s cannabinoid system, resulting in effects contrary to cannabis’s usual anti-nausea benefits. “Cannabis can be helpful for nausea when used in lower doses,” Pals explained.
The Cleveland Clinic and the NIH indicate that stopping cannabis use seems to be the only guaranteed treatment for CHS. Standard anti-nausea medications often fall short, leading doctors to opt for more potent drugs or capsaicin cream, which can replicate the soothing effect that many patients experience from hot showers.
A distinctive sign of CHS is the temporary relief that many patients find only through long hot showers, although why this happens isn’t well understood.
Some users may mistakenly believe that their instances of illness are isolated events and continue to consume cannabis without further issues, only to experience severe symptoms again. Experts note that many individuals resist accepting the diagnosis, and even those who do often struggle to quit cannabis due to dependency.
Dr. Chris Bresch, an emergency medicine expert, shared that some patients claim to have used marijuana problem-free for years, but even small amounts can trigger REE symptoms. Pals emphasized that once someone experiences CHS, they are likely to encounter it again. “With this new diagnosis code, hopefully, we’ll see more accurate identifications in emergency rooms,” he remarked.
Public health advocates are optimistic that the WHO’s new standards will enhance surveillance and allow doctors to identify patterns, especially as legal cannabis becomes more prevalent and stronger products enter the market.
