Mysterious Marijuana Syndrome Leaves Heavy Users In Pain, Doctors Perplexed

By Paul Gaita 04/10/18

Reports of the syndrome are on the rise as doctors struggle to figure out a long-term way to treat the affliction.

man in the process of lighting a joint

Emergency room physicians across the country are reporting an increase of an illness that causes severe vomiting and is linked to excessive use of marijuana.

For more than a decade, cannabinoid hyperemesis syndrome (CHS) was considered a rare condition among frequent marijuana users, but doctors in states that have enacted decriminalization laws have noted more instances of the syndrome; in the case of Colorado, one doctor noted that cases have doubled since legalization.

A new study appears to corroborate these reports by suggesting that more than half of its subjects—adults admitted to a public hospital in New York City who reported smoking marijuana for at least 20 days—experienced the nausea and vomiting that are earmarks of the syndrome.

Individuals suffering from CHS state that the syndrome manifests itself as cyclical bouts of severe nausea and vomiting, though abdominal discomfort, weight loss and excessive sweating have also been reported.

Relief from these symptoms appears to come from taking hot baths or showers; a story in the New York Times recounted the experiences of one individual, who endured pain and nausea for nearly a decade, and found that showering for hours at a time was the only way he could make the symptoms subside.

The constant loss of fluids can pose an additional threat from dehydration, which can cause damage to the kidneys. Such cases may require hospital treatment, but can be resolved in a few days. Some instances, however, can take up to a week or a month, and in the most extreme scenarios, can go on for a year or more, as the New York Times showed.

The exact cause of CHS has yet to be determined, though high levels of the cannabinoid THC, which causes a euphoric response in marijuana users, has been suggested as a possible cause.

As the Times noted, doctors who treat patients with marijuana for conditions like epilepsy have not seen instances of the syndrome in their patients, possibly due to the fact that their prescriptions contain very low levels of THC.

The increase in reported cases has doctors in states like Colorado concerned. "CHS went from being something we didn't know about and never talked about to a very common problem over the last five years," said Dr. Eric Lavonas, director of emergency medicine at Denver Health and a spokesperson for the American College of Emergency Physicians.

These findings concur with the new study, which was published in Basic & Clinical Pharmacology & Toxicology. The authors interviewed more than 2,000 adult emergency room patients under 50 at Bellevue Medical Center in New York City, of which 155 reported smoking marijuana for at least 20 days a month.

Of that number, 51 interviewees said that they had experienced the traditional symptoms of CHS—nausea and vomiting—that were relieved by hot showers. Based on those numbers, the study authors theorized that 2.7 of the 8.3 million Americans who smoke marijuana on a daily basis may suffer from CHS on at least an occasional basis.

Doctors have experienced some success in treating CHS with Haldol, an antipsychotic, while others have reported positive results with capsaicin cream. But beyond showering, the only successful long-term way to treat instances of CHS appears to abstinence from marijuana.

The Times notes that medical professionals have found that when patients stop smoking marijuana, they also stop experiencing the symptoms of the condition. 

Getting patients to agree to stop smoking, however, has proven challenging.

According to Lavonas, "People have been told for so long that marijuana helps with nausea, and they feel temporarily better when they smoke it. It's definitely an uphill battle." For now, he believes that cases of CHS will increase as time goes on. "I'm afraid this is the tip of the iceberg," he said.

Please read our comment policy. - The Fix

Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.