Patient Education ►
Cannabinoid
Hyperemesis Syndrome
Commonly Known as Cyclical Vomiting Syndrome
by Peter Kershaw , Contributing Writer
In the August 2023 issue , we discussed Cannabis Use Disorder ( CUD ). In certain cases , one possible outcome of CUD is Cannabinoid Hyperemesis Syndrome ( CHS ). CHS is characterized by cyclical vomiting — repeated episodes of severe nausea with stomach aches and vomiting without any indication of underlying infection or illness — more commonly known as Cyclical Vomiting Syndrome ( CVS ). CHS sufferers often experience cravings for hot baths or showers , which , inexplicably enough , does tend to provide relief . Though the condition is reported as “ rare ” by the medical establishment , it ’ s likely to be far more common than reported — common enough for there to be at least one online CHS support group . 1
A 2004 South Australian study was among the first to make the correlation between chronic ( one year or longer ) daily heavy cannabis use and CVS . “ In all cases , including the published case , chronic cannabis abuse predated the onset of the cyclical vomiting illness . Cessation of cannabis abuse led to cessation of the cyclical vomiting illness in seven cases .” 2 From that correlation : “ We conclude that chronic cannabis abuse was the cause of the cyclical vomiting illness in all cases , including the previously described case of psychogenic vomiting .”
The South Australian study coined the term “ Cannabinoid Hyperemesis Syndrome ,” sending a clear message to the medical establishment that cannabis alone was responsible for the resulting CVS . The study offered no explanation as to the underlying mechanism of how or why cannabis caused CVS , just that there was a seeming correlation . Twenty years later , medical experts still acknowledge they ’ re at a loss to identify the underlying mechanism
20 October 2023 of cannabis resulting in CHS , let alone even which cannabinoids are responsible . Is it THC ? Have they ruled out CBD or any other cannabinoids ? On these questions , they remain strangely silent . Though they do propose several possibilities , they still have nothing definitive to explain it .
Medical science has long known that cannabis reduces , if not prevents , nausea and vomiting . Common sense would call into question the credibility and science of the conclusions drawn from the 2004 study , and pretty much every similar subsequent study that has fallen lockstep in line with it . Though all such studies have demonstrated a correlation , as we know , correlation does not equal causation . Where there are other possible correlations , they also should be examined . For example , is the cause of the CVS entirely due to excessive cannabis consumption ? Or could it potentially have something instead to do with how the cannabis is cultivated ? For example , could chemical pesticides be the cause ?
While it is true that patients who ceased cannabis use altogether did see their CVS symptoms abate , what none of the studies questioned is what happens to those patients who changed to a different source of cannabis cultivated in a different manner . To date , any such formal studies don ’ t appear to exist . Nor is it in the interests of the medical establishment to make such common sense inquiries , let alone study the outcomes . It ’ s all too reminiscent of , “ Hey , doc , it hurts when I move my leg like this .” “ Okay , well , don ’ t move your leg like that .”
Cannabis cultivation practices can differ dramatically , but this is entirely ignored by the medical establishment . For example , there ’ s the matter of pesticides and how consuming them might adversely affect human health , especially in those who suffer from Multiple Chemical Sensitivity ( MCS ). Just as troubling is the seeming lack of interest in what happens to certain pesticides that are combusted and inhaled . Again , the medical establishment appears to show little interest in examining these in relation to CHS .
Like other commercially produced plants , cannabis plants are subject to pest infestations . Left unchecked , pests can result in significant financial losses , all the more so with a valuable crop like cannabis . Professionally run cultivation facilities should have integrated pest management ( IPM ) protocols in place and strictly enforce them . Outdoor grows are particularly vulnerable to pests , but even indoor grows may experience pest outbreaks , particularly where IPM practices aren ’ t strictly enforced . Some pests are tiny and , even with 20 / 20 vision , challenging to spot ( e . g ., spider mites ). Absent strict IPM practices , pests can go unnoticed until the damage is already well advanced .
One of the most common sources of pest infestations in commercial grows is the result of staff members who home-grow . Without realizing it , they can transfer pests in their clothing from home to work . For this reason , many cultivation facilities prohibit employees from having home grows , but this is almost impossible to enforce .
Even where IPM practices are strictly enforced , it doesn ’ t always mean they ’ ve been well thought out . Good prevention strategies don ’ t always work out as planned . When pests do invade , the IPM manager ( if there even is one ) has quite a few options available for eradication . Not all those choices are safe for the consumer . Chemical pesticides that may be safe to spray outdoors on tomatoes could potentially be harmful for cannabis