CHS

What is Cannabinoid hyperemesis syndrome (CHS)? 

Your symptoms have been assessed by a qualified health care practitioner and you have been diagnosed to have CHS. 

CHS is a condition that leads to repeated and severe bouts of vomiting. It is rare and only occurs in daily long-term users of cannabis (pot/marijuana). 

What is causes CHS? 

• Cannabis has several active substances. These include THC and related chemicals. These substances bind to molecules found in the brain. That causes the drug "high" and other effects that users feel. 

• THC has anti-nausea (anti-sickness) effects; this is why cannabis is sometimes prescribed for nausea caused by cancer treatments. 

• However, if you use it over a long period of time, cannabis seems to have the opposite effect on the digestive system and makes you more likely to feel and be sick. 

• Research is being carried out to explain why only some long-term users of cannabis experience CHS. 

What are the symptoms? 

Those who use cannabis daily for a long period may develop the following before the syndrome: 

• Long-term early morning nausea 

• Abdominal discomfort (tummy pain) 

• Fear of vomiting 

Once the syndrome starts, a person will experience: 

• Repeated episodes of vomiting 

• Ongoing nausea (feeling sick) 

• Reduced food intake and weight loss 

• Dehydration 

• Frequent long and hot showers or baths to ease symptoms 

How is CHS treated? 

In the emergency department, the treatment will consist of: 

• IV (intravenous) fluid replacement for dehydration 

• Anti-sickness medicines 

• Occasionally blood tests and other investigations are required 

Symptoms will often ease after a day or two, unless cannabis is used again. 

To fully recover, you will need to stop using cannabis all together. Some people may need support from substance misuse and addiction services to help them quit. If you stop using cannabis, your symptoms should not come back. 

What are the possible complications of CHS? 

Very severe, prolonged vomiting may lead to dehydration. It may also lead to electrolyte problems in your blood. If left untreated, these can cause rare complications, such as: 

• Muscle spasms or weakness 

• Seizures 

• Kidney failure 

• Heart rhythm abnormalities Brain swelling (cerebral oedema) 

What can I do to prevent CHS? 

Only stopping cannabis use completely will prevent CHS. Cutting down your use will not get rid of CHS. You may not want to believe that cannabis may be the underlying cause of your symptoms. 

This might be because you have used it for many years without having any problems, but CHS can take several years to develop. 

Where to get help for drug use 

Below are some of the services available to help you quit cannabis and other drugs based on where you live. 

ADAPT 

01592321321 

Smart Recovery online  - smartrecovery.org.uk 

Clued Up Project (support people aged 16- 25 years affected by substance use)  

01592 858248 

www.cluedup-project.org.uk 

Drugs Alcohol & Psychotherapies Limited (DAPL) (One-to-one Motivational interview) 

01333 422277 

www.dapl.net 

FASS Community Drug Service 

01592 321321 

FIRST (Fife 

Intensive 

Rehabilitation 

Substance Misuse Team) 

01592 585960 

enquiries@firstforfife.co.uk 

For more information on choosing the most appropriate service for your health needs pick up a booklet or visit https://www.nhsfife.org/services/know-who-to-turn-to/