CHS presents with recurrent vomiting, abdominal pain, and resistance to standard antiemetics in chronic marijuana users, with abstinence being the most effective treatment.
Read this if you work in emergency medicine and encounter patients with unexplained cyclic vomiting.
Standard antiemetics ineffective; abstinence is the best treatment
What the researchers found
This review for emergency nursing practitioners outlined the key features of CHS. Standard antiemetic treatments are ineffective, and narcotics given for abdominal pain may cause worsening rebound pain. The only reliably effective treatment is abstinence from marijuana.
The review referenced a 2004 Australian study that identified 19 chronic marijuana users presenting to an emergency department with recurrent vomiting and abdominal pain as the foundational description of the syndrome. The author predicted that marijuana legalization would increase the number of long-term users and consequently the number of CHS cases.
The review emphasized that advanced practice nurses need to include CHS in their differential diagnosis for patients presenting with recurrent nausea, vomiting, and abdominal pain.
Why it matters
Emergency nurses are often the first clinicians to evaluate patients with CHS. Recognition of the syndrome can prevent unnecessary testing, inappropriate treatment (which may worsen symptoms), and repeated emergency visits.
The numbers in context
Referenced 2004 study identified 19 chronic users with CHS. Standard antiemetics described as ineffective. Narcotics may cause rebound pain. Abstinence identified as the best treatment.
How the study worked
Narrative review and clinical guide for advanced practice nurses working in emergency settings, covering recognition, differential diagnosis, and management of CHS.
What this study cannot tell us
Narrative review for clinical practice rather than systematic research review. Based on limited published literature available at the time. Does not address the mechanism of CHS or predict individual risk.
How to read the evidence
Clinical practice review for nursing professionals based on limited case literature.
When this study was published
Published in 2015. CHS management protocols have evolved with increased clinical experience.
The bigger picture
As cannabis legalization expands the population of chronic users, CHS cases in emergency departments are expected to rise. Clinical education across disciplines, including nursing, is essential for timely recognition and appropriate management.
Questions still open
- What is the best acute treatment for CHS in the ED besides abstinence? How should nurses approach the conversation about marijuana cessation with CHS patients? Could screening tools be developed for early CHS identification?
Common questions
Why don't anti-nausea medications work for CHS?
What should emergency nurses know about CHS?
Read the original research
Cannabinoid hyperemesis syndrome.
Advanced emergency nursing journal, 37(2), 95-101
Citation
Heise, Lynn. (2015). Cannabinoid hyperemesis syndrome.. Advanced emergency nursing journal, 37(2), 95-101. https://doi.org/10.1097/TME.0000000000000062
Explore the wider topic
- Physical vs Psychological Cannabis Dependence: What Science Actually Shows
- The Gap Between Cannabis Perception and Science: Why What We Believe Outpaces What We Know
- Cannabis Use Disorder: Am I Addicted? Self-Assessment Guide
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- Is Weed Addictive? What the Research Actually Shows
- Is Cannabis Addictive? What the DSM-5 and Brain Science Say
- Quitting Weed and Alcohol Together: What to Know About Dual Cessation
- Is Rehab Necessary for Weed? An Honest Assessment
- Signs You May Have Cannabis Use Disorder: An Honest Self-Assessment
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