Nabilone successfully treated severe nausea from cannabis withdrawal | Research

The takeaway

A 20-year-old woman with protracted nausea and vomiting from cannabis withdrawal was successfully treated with nabilone, a synthetic cannabinoid, highlighting an uncommon withdrawal symptom.

Read this if you experience severe nausea after stopping cannabis and want to understand whether this is a withdrawal symptom.

Nausea and vomiting from cannabis withdrawal is not in DSM-5 but does occur

What the researchers found

A 20-year-old woman developed protracted nausea and vomiting after abruptly stopping chronic cannabis use. This presentation was notable because nausea and vomiting are not included in the DSM-5 diagnostic criteria for cannabis withdrawal syndrome and represent an uncommon symptom pattern.

The patient was successfully treated with nabilone, a synthetic cannabinoid approved for chemotherapy-related nausea. This approach is consistent with growing evidence supporting agonist replacement therapy for cannabis withdrawal, similar to nicotine replacement for smoking cessation.

Why it matters

This case expanded the recognized symptom profile of cannabis withdrawal to include protracted nausea and vomiting, a presentation that could be confused with cannabinoid hyperemesis syndrome (which occurs during active use, not withdrawal). The distinction has opposite treatment implications.

The numbers in context

One patient, age 20. Protracted nausea and vomiting secondary to cannabis withdrawal. Successfully treated with nabilone.

How the study worked

Single case report documenting a 20-year-old woman with cannabis withdrawal presenting as protracted nausea and vomiting, treated with nabilone.

What this study cannot tell us

Single case report. The protracted nausea presentation may be rare. Long-term outcomes were not reported. Cannot generalize to all withdrawal patients.

How to read the evidence

Single case report. Highlights an uncommon symptom presentation and treatment approach.

When this study was published

Published in 2014.

The bigger picture

Cannabis withdrawal can cause both the commonly recognized symptoms (irritability, sleep disturbance, appetite loss) and less typical presentations like severe nausea. The successful use of nabilone adds to the evidence for synthetic cannabinoid agonist therapy for withdrawal management.

Questions still open

How common is nausea as a cannabis withdrawal symptom? Should nausea and vomiting be added to the DSM criteria for cannabis withdrawal? Would nabilone be effective for other withdrawal symptoms beyond GI complaints?

Common questions

Can stopping cannabis cause nausea?

This case showed that abruptly stopping chronic cannabis use can cause protracted nausea and vomiting. While this is not included in the official DSM-5 withdrawal criteria, it represents a recognized uncommon presentation.

How is this different from cannabinoid hyperemesis syndrome?

CHS causes vomiting during active cannabis use. This was the opposite: nausea from stopping cannabis. The distinction matters because CHS requires cannabis cessation, while withdrawal nausea may benefit from temporary cannabinoid replacement therapy.

Read the original research

Nabilone therapy for cannabis withdrawal presenting as protracted nausea and vomiting.

BMJ case reports, 2014

View on PubMed ↗Publisher’s paper ↗

Citation

Lam, Philip W; Frost, David W. (2014). Nabilone therapy for cannabis withdrawal presenting as protracted nausea and vomiting.. BMJ case reports, 2014. https://doi.org/10.1136/bcr-2014-205287