Unlike alcohol drinkers, cannabis users usually don’t find themselves throwing up in the bushes, or waking up with a hangover. Recently, though, some consumers have been diagnosed with cannabinoid hyperemesis syndrome (CHS), a little-known illness that causes severe vomiting.
“I woke up with a moderate stomachache … I went downstairs and it continued to get worse and then nausea began,” said Ray McKee, who was diagnosed with CHS in June 2018.
CHS is fairly rare and has only been diagnosed in people who use cannabis regularly for extended amounts of time.
McKee describes his cannabis use as “pretty regular” over 12 years. His usage increased after he retired in 2018.
“I treated every day like the weekend,” he said. his increase led to his first and so far only bout with CHS.
Mark Collins, owner of Wicked Weed, a cannabis producer in Airway Heights, prefers to dab cannabis or eat edibles. But starting in 2017, it didn’t matter how he used it; the result wasn’t pretty.
“If I eat too much THC, I will wake up in the middle of the night a cold sweat, then I’ll be in the bathroom until everything is out of my body,” he said, likening the experience to food poisoning. “If I dab, I wake up with vomiting.”
When the symptoms first started, Collins had no clue that cannabis was the cause. While using cannabis stimulates the appetite for most people, and some cancer patients even use it to reduce nausea associated with chemotherapy treatments, Collins was so sick that he lost 65 pounds from throwing up and being too nauseous to eat.
“My doctor was telling me it was acid reflux. I did a lot of reading and came across this Reddit article on CHS. So I took a break from using cannabis. I had a birthday coming up so I thought I would try it again and I got sick again,” Collins said. Medical professionals were also uncertain in identifying the cause of McKee’s problems.
“They gave me an EKG, a CT scan of my lower extremities and a full exam and said they found nothing wrong with me,” he said. “But I was feeling no better. And they had given me two different anti-nausea meds. The doctor said, based on that, he can only pin it on cannabis toxicity. He said they had been seeing an increase in cases over the past four years and I had the classic symptoms.”
What an “increase in cases” means is not currently clear. When asked about CHS, officials at the Spokane Regional Health District provided materials from their “Weed to Know” campaign that say the health district will be working closely with area healthcare providers about diagnosing this illness in the future.
The health district’s materials describe compulsive bathing as one of the symptoms of CHS, which Collins says was used more as a treatment for him.
“Hot showers are the only thing that helps,” he said. “Did you ever get drunk and have to step outside in the cold and have a cup of coffee to stop the feeling of being sick? That’s the effect the hot water has.” Researchers aren’t sure why showers help, but suspect that the heat stimulates nerve endings in the abdomen.
For McKee, the only thing that has worked is reducing his marijuana use.
“I had words with the nurse about how shocked I was about being sent home feeling as bad, if not worse, as when I came in,” he said. The doctor told McKee there is no treatment except to treat the symptoms.
“I guess the only symptom he hadn’t treated was my irritability … he had the nurse give me an anti-anxiety med. Twenty minutes later, I felt so much better,” McKee said.
Collins is worried that enough people don’t realize what is happening to them to effectively deal with the syndrome.
“I personally think more people suffer from it that don’t know about it,” he said.
While most medical experts consider chronic marijuana use to be mostly harmless physically, repeated vomiting can cause gastrointestinal distress, weight loss and other complications.
McKee agrees there isn’t a lot of common knowledge about CHS.
“The doctor told me their biggest problem with this is repeat customers,” he said. “When they give them (patients) the diagnosis, they don’t believe it’s a thing.”
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