Marijuana use is being linked to severe vomiting

By KIMBERLEE ECKHART, RN DCMH Obstetrical Nurse


There are plenty of studies that discuss the benefits of marijuana use. New literature links cannabis to the improvement of many diseases, including the use of marijuana to alleviate the symptoms of nausea in chemotherapy patients. Paradoxically, there is a newly discovered link to marijuana use known to cause extreme nausea and profuse vomiting.

Cannabinoid Hyperemesis Syndrome (CHS) was first recognized in 2004 in Australia. It is characterized by severe vomiting cycles, excessive thirst and abdominal pain. A bizarre trait found in these patients is their desire to get into a bath or shower and stay there for hours. Patients describe some relief while being in the water. As an obstetrical nurse, I have seen patients obsess about the bathtub; they will get in and out of the water for 5-10 minutes every 45 minutes, sometimes refusing to empty the water.

With pregnant patients, CHS is often confused with hyperemesis gravidarum, which is extreme nausea and vomiting associated with pregnancy. Also, CHS can be easily misdiagnosed as a gallbladder issue.

CHS is caused by the chronic and daily use of cannabis. With marijuana's legalization in Colorado, health care providers are getting a more truthful medical history from patients. The patients may willingly admit to marijuana use, therefore, increasing the likelihood of a correct diagnosis.

Two enormous hurdles exist: 1) CHS is often characterized by a vehement denial of the patient to accept that their marijuana use is the cause, and 2) the patient often does not admit to his family that he uses marijuana. This puts the health care providers in a predicament with confidentiality laws and proceeding with a treatment plan.

Traditional anti-nausea medications seem to be less effective in CHS, and in pregnancy, the choices are further limited. The only clear treatment is the abstinence of marijuana use and rehydrating the patient with intravenous fluids. Stopping marijuana use may lead to a reduction in symptoms in 12 hours but can take up to threeweeks for total relief.

Often, severe denial of the cause of their vomiting or embarrassment keeps patients from seeking treatment. Severe dehydration or unrelenting vomiting often brings a patient to the emergency room; however, without seeking addiction treatment the cycle will likely repeat itself in a few months.

There is no current information available to why certain users develop Cannabinoid Hyperemesis Syndrome. Abstinence from marijuana use is the only long-term solution.