People recognize cannabis for its recreational high, but more and more studies showcase its potential therapeutic efficacy for managing many ailments, including nausea and pain. However, the other end of the spectrum contains cannabinoid hyperemesis syndrome (CHS), a condition in which cannabis consumption amplifies nausea, abdominal pain, and vomiting instead of potentially reducing them.
Researchers confirm the existence of this horrible gastrointestinal syndrome and its effects, but let’s also explore why CHS happens to only some cannabis consumers and not a lot of others.
CHS is a condition that plagues some heavy cannabis consumers after high THC consumption. Symptoms include nausea, abdominal pains and aches, and cyclical vomiting. Australian researchers first coined the term ‘cannabinoid hyperemesis syndrome’ in a 2004 study that explored the correlations between heavy cannabis consumption and a string of cyclical vomiting incidents.
Many people use cannabis and cannabis products like concentrates for a variety of potential benefits, including gastrointestinal issues. CHS brings a completely different dynamic to the table—no potential therapeutic properties of cannabis can resolve it. A sample size survey study from 2018 determined that heavy users of cannabis consume for at least 20 days a month, while further estimating around 2.75 million people in the U.S. are susceptible to CHS annually.
Researchers now consider CHS a public health issue, emerging over the last 20 years. CHS was previously considered more of a rare syndrome; however, it’s expected to be more prevalent as more U.S. states institute adult-use and medical marijuana programs within their respective borders. There are three main factors involved in the rise of CHS cases.
Many of today’s tetrahydrocannabinol (THC)-dominant, psychoactive powerhouse strains top out well over the average of about 17–28% THC from several years ago. This is a 212% increase in flower potency since the mid 90s.
Concentrates aren’t messing around, either; many high-quality extractions are capable of producing products in the 95% THC range. These high levels of THC have the potential to affect the psychological health of individuals with pre-existing mental health issues, as well as some adolescents whose brains are still developing.
A large swath of U.S. states either legalized medical marijuana, adult-use marijuana, or both. Dispensaries rake in record-breaking sales year after year post-legalization—safe to say consumers aren’t going anywhere. A local dispensary is now as common as a pizza place in many neighborhoods, dispelling stigmas while also attracting a lot of new consumers to the lifestyle.
Black and gray markets still thrive despite legalization, with a large percentage of consumers seeking these networks out to save considerably compared to legal markets. These alternative means of obtaining some green also have their drawbacks. Dealers don’t test products for contaminants and potency, potentially activating psychological effects and adverse health conditions in consumers.
The availability of cannabis and concentrates appeals to many as an alternative to other dangerously addictive drugs, like the ubiquity of alcohol in our society. Weed as an option to ‘take the edge’ off is popular due to its concealability in products like beverages, vapes, edibles, and the overall lack of ‘hangover’-like effects the next day.
Popular culture is also full of portrayals of weed in a more laid-back light, while hip-hop artists infuse their love of the plant into the lyrics for any number of top hits. These factors also tend to bring in younger generations of consumers, who may be unaware of the potential heavy use can have on them at such an early age.
READ: Everything You’ll Want To Know About Cannabis Hyperemesis Syndrome
Previous studies establish a correlation between heavy and prolonged cannabis use and a desensitization of transmitters in the human endocannabinoid system (ECS). CB1 receptors, in particular, may lose the ability to regulate enzyme balance and signals in the gastrointestinal system that activate feelings of nausea and vomiting. Dysfunction and desensitization in the CB2 receptor’s ECS activity also lead to regular vomiting and nausea.
Researchers recently discovered the possibility of genetic predispositions that may be at the root of CHS. A 2022 dataset study by renowned cannabis researcher E.B. Russo examines the role of genetics concerning CHS.
Heavy consumers of about 4 grams of high THC weed were broken into two groups: consumers suffering from symptoms of CHS and consumers who didn’t. The CHS group displayed several different mutations found in the following genes:
The group with CHS was also missing a CB1 receptor gene that was found in the study participants without CHS. These remarkable findings demonstrate the potential link between subjective genetic variations of each individual and how cannabis gets processed in the gut and ECS. Individual responses to stress may also influence symptoms of CHS.
These mutations may cause a higher risk of dementia, heart disease, and type 2 diabetes. DRD2 and COMT mutations, meanwhile, can potentially cause more vulnerability to:
The only true cure for CHS is abstaining from cannabis—if you don’t consume it, it can’t make you sick. Even substitution for CBD, CBG, or delta-8 products may not help. Management of CHS before and after the discovery of genetic predisposition includes several different acute therapies.
Researchers suggest new prospective therapies to treat the potential source of the problem. Potential correlations between genetic variations and anxiety, depression, and addiction make it possible to manage lifestyle triggers that cause CHS. Russo recommends sufferers diagnosed with CHS undergo early genetic testing and health counseling. However, he also recognizes that people with CHS are loath to do so, and he has a patented, disclosed financial interest in EndocannaHealth, a genetic testing company.
Regardless, the importance of genetic testing combined with therapy is now being investigated as an evaluation and management tool for CHS symptoms, but it needs further validation. However, total abstinence from cannabis usage is still the only way to make the pain and suffering from CHS completely go away.
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