For some chronic cannabis users, a case of the munchies is the least of their problems.<\/p>\n
Over the past decade, ERs have seen a surge in regular tokers showing up with sudden, stomach-churning attacks that leave them doubled over in pain. <\/p>\n
The worst part? Many sufferers experience these episodes three or four times a year, often leaving both patients and providers scratching their heads.<\/p>\n
Chronic cannabis users are increasingly facing a temporarily debilitating health concern. Seventyfour \u2013 stock.adobe.com<\/p>\n
What is CHS?<\/p>\n
The culprit is cannabis hyperemesis syndrome (CHS), a gut-wrenching disorder that triggers relentless nausea, abdominal pain and severe vomiting that can strike four or five times an hour, according to the Cleveland Clinic<\/a>. <\/p>\n Symptoms usually appear within 24 hours of cannabis use and can last for days. The episodes are so brutal that ER staff have coined a term for them: \u201cscromiting<\/a>\u201d \u2014 a chilling mashup of screaming and vomiting.<\/p>\n Tough to treat<\/p>\n Despite its growing prevalence, many doctors are still unfamiliar with the syndrome, which was only recently defined, making it hard to distinguish from medical issues like food poisoning or the stomach flu.<\/p>\n \u201cA person often will have multiple [emergency department] visits until it is correctly recognized, costing thousands of dollars each time,\u201d Dr. Beatriz Carlini<\/a>, a research associate professor at the University of Washington (UW) School of Medicine who studies adverse health effects of cannabis use, said in a statement<\/a>. <\/p>\n Cannabis hyperemesis syndrome patients often present with the combination of screaming and loud vomiting, which has led to the term \u201cscromiting.\u201d Monkey Business \u2013 stock.adobe.com<\/p>\n But even after a diagnosis, CHS can be difficult to treat.<\/p>\n There are currently no FDA-approved therapies, and standard anti-nausea medications often don\u2019t work, according to Dr. Chris Buresh<\/a>, an emergency medicine specialist with UW Medicine and Seattle Children\u2019s Hospital. <\/p>\n That sometimes forces clinicians to try second- and third-line options, including Haldol<\/a>, a medication more commonly used for psychotic episodes.<\/p>\n Some patients find limited relief by rubbing capsaicin cream<\/a> on their stomachs, which creates a warming sensation that can temporarily ease discomfort.<\/p>\n Hot baths and showers also often help curb symptoms, with many patients driven to bathe for hours each day to soothe their pain.<\/p>\n \u201cThat\u2019s something that can clinch the diagnosis for me, when someone says they\u2019re better with a hot shower,\u201d Buresh said. \u201cPatients describe going through all the hot water in their house.\u201d <\/p>\n Recovery challenges<\/p>\n Even after symptoms subside, long-term recovery can be tricky. <\/p>\n Because the syndrome strikes intermittently, some cannabis users assume a recent episode was unrelated and continue using \u2014 only to become severely ill again, according to UW. <\/p>\n For those who accept the diagnosis and try to quit, addiction often makes abstinence a major challenge, prolonging the cycle of illness. Carlini said.<\/p>\n Stopping cannabis use is currently the only way to fully cure the condition.<\/p>\n From teens to long-time users<\/p>\n Scientists don\u2019t know the exact cause of CHS, but the leading theory is that long-term overstimulation of receptors in the endocannabinoid system may disrupt the body\u2019s natural control of nausea and vomiting, per the Cleveland Clinic. <\/p>\n CHS can be tough to spot, often blending in with far more common gastrointestinal illnesses. Mdv Edwards \u2013 stock.adobe.com<\/p>\n Why it affects some cannabis users but not others remains a mystery.<\/p>\n \u201cWe don\u2019t know if it\u2019s related to the greater general availability of cannabis or the higher THC potency of some products or something else,\u201d Buresh said. <\/p>\n \u201cIt seems like there\u2019s a threshold when people can become vulnerable to this condition, and that threshold is different for everyone,\u201d he added. \u201cEven using in small amounts can make these people start throwing up.\u201d <\/p>\n