Marijuana-Induced Cyclic Vomiting

WRITTEN BY: Amy Loriaux

Trigger warning: If you are a bit squeamish about emesis (vomiting) then this article may not be for you. Otherwise, prepare yourself to learn about a particularly nasty symptom that is showing up more and more in states with legalized marijuana - cyclic vomiting syndrome (CVS). Of all of the many effects of marijuana you have heard about, this one seems the most disconcerting. A report recently published online in the Internal Medicine Journal by researchers from the Medical College of Wisconsin describes a disturbing trend. From 2010 to 2014 Colorado hospital admissions for CVS had nearly doubled. This is concomitant with the legalization of recreational marijuana in 2012.

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CVS is usually seen in children. These kids will show up to the emergency room several times a year following a bout of repetitive emesis that apparently comes out of nowhere. CVS is not a result of food poisoning or the stomach flu, although many patients are misdiagnosed their first time at the ER. However, there are a few curious characteristics that CVS patients share. For one, pediatric patients will tend to "grow out" of CVS, only to develop migraines as an adult. Another interesting one is the role of a hot shower. Hot showers seem to relieve the symptoms of nausea and hyperemesis (rapid vomiting) in patients with CVS.

Several theories have been put forth to explain the etiology of the disorder, with the most common being theory positing mechanisms involving a connecting pathway between the gut and central nervous system. Recently, however, another cause has been put forth: chronic marijuana use. With the increase in legalization across the country, there has also been a rise in the rates of CVS amongst chronic users. This syndrome seems to occur even in longtime smokers who have never experienced this side effect before. This marijuana-induced CVS has been given its own name: Cannabinoid hyperemesis syndrome (CHS).

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CHS was first described in 2004 by scientists out of Mt. Barker Hospital in Australia. In the journal, Gut, researchers described nine patients who were chronic marijuana smokers and had presented with symptoms of CVS. These symptoms resolved after the patients stopped using marijuana. As the report out of the Medical College of Wisconsin suggests, the rates of CHS are rising in states with relaxed marijuana laws. This is especially the case in Colorado, where recreational marijuana is legal. The exact mechanisms behind CHS are currently unknown, but it is a bit surprising given the documented antiemetic properties of marijuana. As legalization continues to travel across the states, hopefully a mechanism can be discovered, if not a treatment. As of yet, the only way to stop CHS is abstinence from marijuana. See the video below for more information.