- If you be illin' from herb, some doctors say try a hot shower, or just say no.
After 20 years of working with people seeking to use cannabis to address medical conditions, illness and injuries, treating nausea is among the top three reasons people say they use it. Those undergoing chemo and radiation treatments also use it to treat their vomiting, that along with severe nausea, can be a common side effect. Much as there are no atheists in foxholes, there are no prohibitionists when vomiting—moving many to change their minds after experiencing that benefit of cannabis for themselves or a loved one.
The relief of menstrual cramps is also well documented, and for many women it's their first experience with medicinal cannabis use. Pain relief is the most common goal of medicinal users, with 89 percent of Oregon Medical Marijuana Program patients in 2016 listing "severe pain" as their qualifying condition.
Meanwhile, it's rather surprising that there's a condition identified with increased frequency among some cannabis users that results in severe nausea, cramps and vomiting. And the way doctors suggest those suffering cure it? By ceasing their use of cannabis.
It's called Cannabinoid hyperemesis syndrome, first described in 2004 in Australia, when 19 patients, found to be regular cannabis users, were experiencing cramps, nausea and repetitive vomiting for no discernable reason, except they used cannabis.
The papers I have read about CHS don't offer specifics about the cannabis use—how often, how much, which strains, was it lab tested for cleanliness, and what delivery system was being used (joint, bong, vaporizer, etc). One paper said the patient consumed "at least one cannabis bud daily for the past three years." But the initial Australian study simply uses the language "chronic cannabis abuse." (And no, it's not "Chronic" in the Dr. Dre sense, smart mouth).
The best description of use I found was by Dr. Kennon Heard, a professor of emergency medicine and medical toxicology and pharmacology at the University of Colorado School of Medicine, who told NPR, "Essentially, patients who use marijuana very frequently for long periods of time—usually at least six months, probably most of them have been using for several years—develop sort of intractable abdominal pain and vomiting that sort of comes and goes over the course of days to weeks." He says that it's on the rise, with his office seeing one to two patients a day, and his belief that there are many more who never seek medical attention.
He later told an interviewer that he believes, "The most likely cause is people using marijuana frequently and in high doses have changes in the receptors in their body, and those receptors become dysregulated in some way, and it starts causing pain."
Those suffering with CHS frequently find relief by taking hot showers and baths. The hot water is believed to activate a receptor in the abdomen that helps symptoms. As Dr. Jordan Tishler, who's Harvard trained and operates a cannabis clinic in Massachusetts told Newsweek, those showers and baths are "the only feature that definitively points to CHS."
Doctors now think they've found a quick fix when that treatment isn't available: capsaicin cream. The easy-to-find, over-the-counter topical analgesic creams used in the studies were between .0025 percent and .0075 percent capsaicin, and were applied to the abdomen. The capsaicin has a similar effect as the hot water on the aforementioned receptor.
What doctors most commonly recommend is that those with CHS simply stop smoking cannabis—not received with much enthusiasm by those who find it counterintuitive that something which has relieved these symptoms in other instances is now causing those same symptoms. Plus, cannabis is still great for other things such as stress relief, and that's a difficult thing to give up, or trade in for something more commonly used, such as alcohol. Those afflicted with CHS need to weigh the benefits and risks of cannabis use for themselves.