Cannabis Hyperemesis: My experience, and a quick way to stop an attack

buzz62

Well-Known Member
Hi All, thought I would share my experience with this syndrome. I am in my late 50's, a lifelong daily cannabis smoker, and have had a few bouts of illness which I finally may have to admit is cannabis hyperemisis. I don't think my experience is typical, however most of the associated symptoms are there. If you think you are experiencing this syndrome, please add your story to the thread.

For the last 5 years I have had an attack of this usually starting in January to March, which is one odd thing as I consume the same amount all year, so there may be a stress element to it (Xmas?) or a vitamin D angle. My attacks always start in the morning, before I have smoked, and begin after a bowel movement, then severe salivating and sweating, then 10 minutes or so of violent retching. I do not continue with vomiting, which is not typical of the usual presentation of this syndrome. Then I get a very odd feeling across my abdomen, sometimes with nausea, along with the desire to continually stretch my limbs, and sometimes some mental confusion. Hot showers help to temporarily relieve the desire to stretch and distract from the abdominal discomfort, but eventually the hot water runs out, and the sensations return. Laying on my stomach with a pillow under it also helps relieve the pain a bit. I finally get to a point where I go to the local ER, and after MRI's, Cat scans, X-rays, two different internal medicine specialists, and a tube up both ends!! they have found nothing physically wrong with me, (I am so lucky to be in Canada where all that is financially covered for every citizen!).

What does stop the attack almost instantly is 1 mg dilaudid or morphine intravenously. It acts literally like a light switch and I am "cured" for the next 9-12 months, till the next winter season. Now the seasonal element of this I nor my doctors understand. They also have no explanation why an opiate stops it. This year my attacks increased a bit where I had to go to the ER twice in one week, and now after checking my records they finally just listen to my request for 1 mg dilaudid I.V. without a bunch of other tests and I'm fixed. The Er doc gave me a prescription for 2 mg dilaudid pills, and I have had about a 50% success rate of stopping the attack at home with them. Apparently it doesn't like the trip though the stomach so I dissolve it under my tongue. Morphine also works to stop it, but for me drops my heart rate to 40 which is not a good thing!

So I have stopped smoking entirely 2 weeks ago after my latest attack, and I guess if I can get through the next winter season without an attack I can be more sure of the diagnosis. My family doctor's knowledge of this is limited, other than telling me to stop smoking. As with most daily stoners, my entire social group are smokers, so it is hard at first to not be stoned along with everyone else, but I will persevere! I had stopped smoking for 6 months a few years ago for a different reason, and still had an attack 4 months after quitting, which I then used to convince myself that it couldn't be hyperemesis, and started smoking again! So this time I will increase the time off, and see what happens. If you are having symptoms like this, do not despair as it will not kill you, but it sure feels like it at the time! If its your first time definitely see a doc to rule out appendicitis, or an intestinal problem. The irony that its' finally legal here, and that I have been very successful growing my own is a bit of a kicker!

Buzz
 
Yeah that's a real kick in the ass. Sorry you can't enjoy token no more Guess you got to start growing veggies instead.
Got lots of peppers, cucs & tomatoes started
Ate my first spring cuc yesterday
 
Yeah that's a real kick in the ass. Sorry you can't enjoy token no more Guess you got to start growing veggies instead.
Got lots of peppers, cucs & tomatoes started
Ate my first spring cuc yesterday

Yeah, except I'm more of a potatoes and ribs guy! :Rasta: I will probably cheat a very little bit eventually, but for now I'm basically proof that thc is definitely not addictive! And my other half still partokes so I still intend to grow a bit!
 
Hey buzz here's a post that seems to have got more attention than yours
you might want to check it out
 
If you find relief with hot showers, try to see if you can get ahold of some capsaicin cream. There's some research being done that shows the heat, or the sensation of heat, at the belly prevents cannabinoids from binding to receptors in the gut area, and stops the attack.

Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin | ACG Case Reports Journal - An online journal of case reports edited by gastroenterology & hepatology fellows

Dilaudid probably works simply because of its sedative effect. It has a similar effect for people suffering from more generalized cyclical vomiting. My GI doctor recommends it as well, but also suggests using whatever type of sedative you can that will induce sleep.

Do you or anyone in your family have a history of migraines, depression/anxiety, or chronic pain? Hopefully stopping cannabis is the key, but it can be hard to tell, especially if your episodes are infrequent. You could think stopping has cured you, but then six months down the line still have an episode.

If you find that ceasing cannabis doesn't help, you might actually have the more generalized Cyclical Vomiting Syndrome like I do. There's not really much you can do to treat this except track and monitor what triggers it. A lot of doctors think it's related to stress, and that it acts on the same pathways as migraine headaches, but in the stomach area.

Hopefully it's not Cyclical Vomiting Syndrome. I know not being able to smoke anymore will probably suck, but I wish I could just stop smoking and have this stop. One treatment some people have success with that I've yet to try is a regiment of amitryptiline. It somehow acts as a preventative.

Be sure to ask your doctors about CVS. It's probably not that, and honestly they probably will have never heard of it. It's very rare, and at 50, you would have probably had problems with it earlier in life. Here is some information about the differences.

Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment

CVS is very rare and there's not a lot of awareness out there about it versus CHS, so I like to spread as much information about it as I can. I learned about it by reading the comments section of some blog site frequented by emergency department staff who were talking about CHS, so I think a lot of CVS sufferers are learning about it for the first time when researching CHS.

There is a lot of other speculation that CHS may be caused by the use of azadirachtin based pesticides ( neem oil, Azamax, Azatrol ) and/or that the over-accumulation of THC without the "entourage effect" of other cannabinoids and terpenes causes irregularity with the hypothalamus and body temperature regulation. As you may see from the other thread, I'm much more of a proponent of the over-accumulation of THC theory than the pesticide theory, but you could try to grow a 1:1 ratio THC/CBD strain and not use any pesticides and see if it helps. (I don't think you can use azadirachtin-based pesticides in Canada anyway from what I can tell)

Also, as just a small side-note... You can become extremely dehydrated during an episode of vomiting. If you do try to continue cannabis use, and you do have a vomiting episode, don't be like me, get to the ER immediately. I tried to just keep myself hydrated at home and wasn't able to; my potassium levels dropped so bad I almost went into cardiac arrest. It probably won't kill you, but it can.
 
If you find relief with hot showers, try to see if you can get ahold of some capsaicin cream. There's some research being done that shows the heat, or the sensation of heat, at the belly prevents cannabinoids from binding to receptors in the gut area, and stops the attack.

Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin | ACG Case Reports Journal - An online journal of case reports edited by gastroenterology & hepatology fellows

Dilaudid probably works simply because of its sedative effect. It has a similar effect for people suffering from more generalized cyclical vomiting. My GI doctor recommends it as well, but also suggests using whatever type of sedative you can that will induce sleep.

Do you or anyone in your family have a history of migraines, depression/anxiety, or chronic pain? Hopefully stopping cannabis is the key, but it can be hard to tell, especially if your episodes are infrequent. You could think stopping has cured you, but then six months down the line still have an episode.

If you find that ceasing cannabis doesn't help, you might actually have the more generalized Cyclical Vomiting Syndrome like I do. There's not really much you can do to treat this except track and monitor what triggers it. A lot of doctors think it's related to stress, and that it acts on the same pathways as migraine headaches, but in the stomach area.

Hopefully it's not Cyclical Vomiting Syndrome. I know not being able to smoke anymore will probably suck, but I wish I could just stop smoking and have this stop. One treatment some people have success with that I've yet to try is a regiment of amitryptiline. It somehow acts as a preventative.

Be sure to ask your doctors about CVS. It's probably not that, and honestly they probably will have never heard of it. It's very rare, and at 50, you would have probably had problems with it earlier in life. Here is some information about the differences.

Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment

CVS is very rare and there's not a lot of awareness out there about it versus CHS, so I like to spread as much information about it as I can. I learned about it by reading the comments section of some blog site frequented by emergency department staff who were talking about CHS, so I think a lot of CVS sufferers are learning about it for the first time when researching CHS.

There is a lot of other speculation that CHS may be caused by the use of azadirachtin based pesticides ( neem oil, Azamax, Azatrol ) and/or that the over-accumulation of THC without the "entourage effect" of other cannabinoids and terpenes causes irregularity with the hypothalamus and body temperature regulation. As you may see from the other thread, I'm much more of a proponent of the over-accumulation of THC theory than the pesticide theory, but you could try to grow a 1:1 ratio THC/CBD strain and not use any pesticides and see if it helps. (I don't think you can use azadirachtin-based pesticides in Canada anyway from what I can tell)

Also, as just a small side-note... You can become extremely dehydrated during an episode of vomiting. If you do try to continue cannabis use, and you do have a vomiting episode, don't be like me, get to the ER immediately. I tried to just keep myself hydrated at home and wasn't able to; my potassium levels dropped so bad I almost went into cardiac arrest. It probably won't kill you, but it can.


Thanks for the reply, I do not seem to have the long vomiting phase of this, just the abdominal pain that is a bit sated by the hot showers. I will try the cream, and I do think I am triggered by stress as it happens every winter after Xmas, which is particularly stressful for me for some reason. As its a new thing to western doctors, I think there are different presentations that haven't been quantified medically yet. I had trouble once with phosphorus levels, but only once in the 10 times or so this has hit me hard. I have never used pesticides in my grows.
 
Here's a link to the Cedars-Sinai page on Hyperemesis, it appears I am at the prodromal stage, and I don't intend to get to the next one! Oddly, it says that one of the benefits of not smoking is better sleep, which so far has not been my experience ! All the years I smoked my remembrance of dreaming was nil, and now my dreams are getting me up at night!

cannabinoid-hyperemesis-syndrome.html
 
Here's a link to the Cedars-Sinai page on Hyperemesis, it appears I am at the prodromal stage, and I don't intend to get to the next one! Oddly, it says that one of the benefits of not smoking is better sleep, which so far has not been my experience ! All the years I smoked my remembrance of dreaming was nil, and now my dreams are getting me up at night!

cannabinoid-hyperemesis-syndrome.html
Interesting. I think it's a little different for CHS vs CVS based on that literature and what my GI specialist described to me. For Cyclical Vomting Syndrome, the prodrome is typically a short-term experience. A better layman's term would simply be the "onset". You can feel yourself beginning to get sick. My GI recommends that I use something rich in THC during my prodromes to sedate the central nervous system. I use bubblehash because it's potent enough and is the most reliable. I had been buying those pre-loaded cartridges from dispensaries, but they were hit-or-miss on whether they worked. Regular flower isn't potent enough since I use that regularly for PTSD. Now when I'm in the prodromal phase, if I take a couple hits of bubblehash it usually aborts the emetic phase.

When I was investigating whether I had CHS or CVS, I quit for about a month and a half and never had any periods of less severe symptoms. In the mean time, my PTSD was left untreated because I wasn't smoking, and the stress and anxiety caused more triggers so I actually ended up having more episodes. By the 6th week the only possibility was that I was somehow the only person on earth having emetic symptoms from THC withdrawal, or that I had CVS. My GI specialist agreed and we've made cannabis a part of my treatment plant ever since. I am probably lucky to have found a GI that is pot-friendly, with most I think it's an uphill battle to convince them that cannabis is not a problem, let alone make it part of the treatment.

It's really interesting you don't have the cyclical vomiting side of things (i.e. the emetic phase). I'd consider that lucky, but also maybe worth getting a second opinion over. That's typically a pretty major criteria for diagnosing CHS, so my fear is that you'll abstain and still have problems down the road because it's something else entirely. I sure hope not, but if things don't improve for you, I'd start asking them about CVS. It's good that you actually are abstaining though, since they'll probably do a urine analysis to be sure.
 
Interesting. I think it's a little different for CHS vs CVS based on that literature and what my GI specialist described to me. For Cyclical Vomting Syndrome, the prodrome is typically a short-term experience. A better layman's term would simply be the "onset". You can feel yourself beginning to get sick. My GI recommends that I use something rich in THC during my prodromes to sedate the central nervous system. I use bubblehash because it's potent enough and is the most reliable. I had been buying those pre-loaded cartridges from dispensaries, but they were hit-or-miss on whether they worked. Regular flower isn't potent enough since I use that regularly for PTSD. Now when I'm in the prodromal phase, if I take a couple hits of bubblehash it usually aborts the emetic phase.

When I was investigating whether I had CHS or CVS, I quit for about a month and a half and never had any periods of less severe symptoms. In the mean time, my PTSD was left untreated because I wasn't smoking, and the stress and anxiety caused more triggers so I actually ended up having more episodes. By the 6th week the only possibility was that I was somehow the only person on earth having emetic symptoms from THC withdrawal, or that I had CVS. My GI specialist agreed and we've made cannabis a part of my treatment plant ever since. I am probably lucky to have found a GI that is pot-friendly, with most I think it's an uphill battle to convince them that cannabis is not a problem, let alone make it part of the treatment.

It's really interesting you don't have the cyclical vomiting side of things (i.e. the emetic phase). I'd consider that lucky, but also maybe worth getting a second opinion over. That's typically a pretty major criteria for diagnosing CHS, so my fear is that you'll abstain and still have problems down the road because it's something else entirely. I sure hope not, but if things don't improve for you, I'd start asking them about CVS. It's good that you actually are abstaining though, since they'll probably do a urine analysis to be sure.

Thanks for your info, The Cedars Sinai site states that with CHS, the first stage (prodromal) doesn't have cyclical vomiting, just extreme nausea followed by stomach pain, which is exactly what happens to me. The vomiting starts in the 2nd stage which I apparently have not achieved yet and don't plan to! I plan to take a year off and if I get through next winter without an attack it will basically confirm the CHS. If I have another attack after being off thc for so long it must be something else. It only happens about twice a year, always in the winter, so kind of random , but that is also stated in the cedar synopsis. I have been thoroughly checked for all manner of other things and they have found nothing. And I have smoked so much, for so long, its probably good to take a break.
 
Here's a link to the Cedars-Sinai page on Hyperemesis, it appears I am at the prodromal stage, and I don't intend to get to the next one! Oddly, it says that one of the benefits of not smoking is better sleep, which so far has not been my experience ! All the years I smoked my remembrance of dreaming was nil, and now my dreams are getting me up at night!

cannabinoid-hyperemesis-syndrome.html
I have traveled abroad for weeks at a time, and I go through a withdrawal that includes vivid dreams.
 
i can confirm chs. i don't use any pesticides so it can't be a reaction to any kind of pesticide.
it started suddenly and i didn't know it was cannabis related so i kept on smoking.
i had extreme nausea,stomach cramps, appetite loss, weight loss, showered a lot because it made the symptoms better. after a year i stopped smoking and after a few weeks it got better but i didn't connect it to the stopping of my cannabis use. i started to smoke again and the symptoms came back. several times i thought i was going to die. thhen i looked around the internet and found chs and knew that it must be it. of course i tried to deny it because i love this plant so much but i have to admit that it is chs. i stopped agsin and it got better.
now i am on the path of recovery and hope i will gget back to normal again. damn shame but i have to accept the reality.
what helped me was a lorazepam (tavor). after 0,5 mg the symptoms disappeared for a few days. but it is also highly addictive so do not take consecutive days.
best
 
i can confirm chs. i don't use any pesticides so it can't be a reaction to any kind of pesticide.
it started suddenly and i didn't know it was cannabis related so i kept on smoking.
i had extreme nausea,stomach cramps, appetite loss, weight loss, showered a lot because it made the symptoms better. after a year i stopped smoking and after a few weeks it got better but i didn't connect it to the stopping of my cannabis use. i started to smoke again and the symptoms came back. several times i thought i was going to die. thhen i looked around the internet and found chs and knew that it must be it. of course i tried to deny it because i love this plant so much but i have to admit that it is chs. i stopped agsin and it got better.
now i am on the path of recovery and hope i will gget back to normal again. damn shame but i have to accept the reality.
what helped me was a lorazepam (tavor). after 0,5 mg the symptoms disappeared for a few days. but it is also highly addictive so do not take consecutive days.
best
The jury is still out with me. I only seem to have an attack in the winter, and it does not get triggered by smoking. Due to its seasonal nature with me, this year I started taking 1000 IU of vitamin D in the fall, and for the first time in 6 years I did not have a winter attack. I have been back smoking for over a year, and no sign of it so not conclusive in my case. As I mentioned earlier, an IV of dilaudid shuts it down completely for me, so it may not be hyperemeisis.
 
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