The rise of a puzzling new marijuana malady Dr. Prescott prescribes
Adam’s journal
A friend of mine recently told me that her son had been suffering from debilitating nausea and stomach pain. The bouts of vomiting and severe pain twice sent this otherwise healthy 19-year-old to health care providers, both of whom told him that his chronic marijuana use was causing the symptoms.
They said that, in the short term, the only way patients had seen relief was to take hot showers. In the long term, the cure was a simple one: Stop using marijuana.
Is this syndrome for real? To my cynical ear, it sounds more like something doctors are cooking up to coax their young, gullible patients to stop smoking pot.
Yes, this condition is as real as Oklahoma State Question 788. It’s called cannabinoid hyperemesis syndrome or CHS.
Until recently, CHS was believed to be uncommon, even rare. But as marijuana use has increased, physicians have seen a steady uptick in the number of patients who undergo recurring episodes of abdominal pain and vomiting as a result of regular marijuana use.
While at first these episodes confounded caregivers, patients’ willingness to talk openly about their marijuana use — especially in states where it’s been legalized — helped doctors find the connection. A new study, based on interviews with emergency room patients, found that roughly one in three who smoked marijuana 20 days or more per month suffered from the syndrome.
The symptoms of CHS rarely seem to respond to drug treatment, although some physicians report success with the antipsychotic drug Haldol. Others with CHS also have experienced relief using capsaicin cream, a compound whose active ingredient derives from chili peppers and is sold under a variety of brand names.
Still, for acute relief, hot showers have proved the most reliable treatment. Some patients will stay in the shower for hours, as it’s the only reliable way to stop the pain and vomiting. However, once the hot water runs out, the symptoms typically return.
Researchers don’t yet understand what causes CHS. But some believe that it’s akin to the body developing an allergy to a favorite food.
As with such allergies, the only surefire cure is to avoid that food.
Of course, for regular marijuana users, a diagnosis of CHS often is met with denial. After all, marijuana’s primary medicinal use is to stimulate appetite and quell nausea, particularly in cancer and AIDS patients.
So, it can be difficult to convince people that it’s having exactly the opposite effect on them, especially when they’ve been using marijuana habitually, often for years.
The good news is that CHS seems to disappear when users give up marijuana. But if they return to the drug, they also can expect a return of vomiting and stomach pain.
When I’ve read accounts of CHS, patients describe bouts that can last as long as an entire day. When they arrive at the hospital, they often are severely dehydrated and unable to keep food or liquids down.
I cannot imagine how difficult it must be to live life — let alone keep a job or attend school — when regularly afflicted with this condition. I hope your friend’s son will find a path forward that puts his marijuana use and CHS behind him.
Prescott, a physician and medical researcher, is president of the Oklahoma Medical Research Foundation. Cohen is a marathoner and OMRF’s senior vice president and general counsel.