Cannabis Hyperemesis Syndrome (CHS): Symptoms, Causes & Prevention
Medical cannabis has made huge strides over the last decade. Access to both medical and recreational cannabis has increased state-by-state, local markets are able to accurately test their products so customers can know what they’re ingesting, and products are increasing in potency everyday. But alongside a rise in THC potency, we’ve also seen the beginnings of a new condition some cannabis users develop–Cannabis Hyperemesis Syndrome, or CHS. Characterized by heavy bouts of vomiting and retching, often multiple times a day, abdominal pain, and severe nausea, stoners all over are becoming more wary of CHS, and trying anything they can to prevent developing it. In the midst of news about this new condition, we’re here to let you know how it develops, and what steps you can take to reduce your likelihood of developing it.
What causes CHS?
The exact cause of CHS is not yet fully understood. Current research suggests that it may be linked to the way cannabis affects the body’s digestive and stress-response systems. CHS is rare and doesn’t happen to everyone, as everyone’s endocannabinoid system is different. However, certain high-THC cannabis products—such as dabs, wax, and vapes (concentrates)—may increase the risk, particularly for individuals who consume cannabis multiple times daily or in large amounts. It's also been seen that modes of consumption that are most common for CHS patients are vapes, dabs, and flower. People who exclusively used vapes were at highest risk of developing CHS, closely followed by dabs and high-THC flower smokers, but those who prefer flower were slower to develop CHS. Edibles consumers were the least likely to develop CHS.
Before you start googling symptoms though, it’s important to mention that CHS is very rare–even most daily users will never develop it. One of the difficulties of CHS is that the symptoms can be similar to many other conditions, and as medical cannabis patients, often when we feel nausea, we reach to cannabis for relief—which only exacerbates the CHS once it’s developed. An important thing to consider are your risk factors for CHS, and the highest risk factors include:
Long term (10+ years) cannabis use, especially multiple times a day
Long term use of high THC potency products (+30% THC flower, +70% THC Vapes)
Why are we seeing CHS pop up nowadays? As mentioned in our previous blog post, Not Your Grandpa’s Weed: THC Levels through the Years, demand for higher THC pushed breeders to grow increasingly higher THC flower, skyrocketing average potency from 4% in the early 2000’s to over 30% THC in some cases. And even though cannabis is medically beneficial, like any other medicine, dosage is paramount in therapeutic treatment.
The Stages of CHS: Prodromal, Hyperemetic, Recovery
Symptoms of CHS and their severity depend on the phase of the syndrome:
Prodromal phase: This phase is most common in adults who have used cannabis since adolescence. You may have abdominal pain or morning nausea. You may also fear throwing up but never actually vomit. This phase can last for months or years. If you notice these prodromal symptoms, it’s highly encouraged to cut back on cannabis use–either to switch to lower THC products, decrease frequency, or even to go on an extended tolerance break until symptoms cease. Cannabis users who can abstain during the prodromal phase can often prevent full blown CHS, which can often only be remedied by full cessation of cannabis use.
Hyperemetic phase: This is the main, defining phase of CHS. It usually lasts 24 to 48 hours and involves overwhelming, recurrent vomiting. You may start compulsively bathing and avoid certain foods or purposefully restrict your food intake to prevent vomiting. Patients often state that hot baths and showers help alleviate the severity of symptoms, leading to compulsive bathing.
Recovery: During recovery, you need to cease using cannabis (even in small amounts). Even small amounts can trigger another hyperemetic episode When you’re in the recovery phase, symptoms lessen over a few days or months. Eventually, they completely disappear.
Full blown CHS can be identified by the following symptoms:
Persistent morning nausea
Nausea at certain foods, typically anything high in terpenes
Persistent and strenuous vomiting or retching, can happen up to 5x an hour
Severe abdominal pain
Loss of appetite
How to Prevent CHS
Like many things, to look forward, we must look back–specifically, at lower THC potencies and fuller cannabinoid profiles. Historically, most naturally grown cannabis has hovered between 1-4% THC, with a full spectrum of cannabinoids and terpenes to enhance the therapeutic effects. Now while you don’t have to go as low as those percentages, even dipping down to potencies closer to 20% or below can be a great way to reduce your risk for developing CHS. Switching out vapes for flower is a great way to lower your THC intake as well. But the best way to prevent CHS is by taking regular tolerance breaks, especially if it can be at least 2-4 weeks at a time. While a tolerance break might be the last piece of advice you wanna receive, taking a few weeks off from smoking is definitely better than completely ceasing usage the way you would in CHS recovery.
If you’re looking to try a fresh new low-THC flower strain without sacrificing quality, look no further than Alt Sol’s Tiger Rose and Choof’s Chocobow.
Tiger Rose is a bright, citrusy hybrid that offers giggly creativity with a grounded energy, and a taste that’s reminiscent of nostalgic fruit candies. Born of a cross between Blood Orange and Topanga Zkittlez, this strain will melt away stress while keeping you smiling. A fast favorite among staff, we know you’ll love it just as much as we do.
Where Tiger Rose is bright and citrusy, Chocobow is a mellow, sweet gourmand for any chocolate lover. This cross of Chocolope Kush and Rainbow Belts 2.0 creates a relaxing, smooth experience for any smoker. Sweet, chocolatey, doughy notes blend together beautifully as you puff on this sweet treat, giving you a cozy body high without sacrificing mental uplift and creativity.
Swing by Green Theory to pick up these strains, and more!
