The Weed-Induced Disease That Makes You Throw Up and Take Scalding Hot Showers
This post originally appeared in VICE UK
Weed isn’t for everyone. Mind you, for most, the worst that could happen after a couple of tokes is that you’ll feel mildly dizzy, throw up a bit on your shoes or potentially be exposed to a Ben Harper singalong.
However, for a very small number of regular users, there’s a much more unpleasant consequence to contend with.
Cannabinoid Hyperemesis Syndrome—or “CHS”—is a condition associated with chronic cannabis abuse. Its three primary symptoms are nausea, abdominal pains and cyclical vomiting, an ailment where you retch or throw up far more often than you should (around six to 12 times an hour). So not really the desired effects when you’ve just spent £10 ($15) on a gram of leaves.
The word “cannabinoid” might ring a bell; it’s started to crop up a little more since people realized that weed is good for more than enhancing video games and passing the time at school. But if it still means nothing to you, here’s a very brief explanation: Cannabinoids are a class of chemical compounds, some of which occur naturally in the human body, with the rest found in cannabis and other plants. They’re also responsible for all the miracle stories you’ll have heard about medicinal marijuana: It’s the cannabinoids that help to treat everything from glaucoma to epilepsy.
Unfortunately, cannabinoids don’t react so well to CHS sufferers. And because there’s little understanding of why this is, the condition is often misdiagnosed. According to the testimonies of patients I read online, this usually leads to numerous visits to the hospital, endless CT scans, and all other kinds of tests that, more often than not, paint a picture of a perfectly healthy person who just happens to throw up a lot.
Even more confusingly, cannabis is increasingly being prescribed—or recommended online, if you don’t live in a weed-friendly place—as an anti-nausea drug. So how a substance known for its antiemetic properties (stopping you from being sick, essentially) is encouraging exactly what it’s supposed to prevent is difficult to explain.
A man, who doesn’t have CHS, smoking a bong. Photo by the author
The earliest study into CHS was in 2004, when 19 Australians were identified as having both a cyclical vomiting illness and a fondness for smoking weed as often as they possibly could. Of that 19, only nine patients ended up participating in the study. In seven of these cases, “cessation of cannabis abuse led to cessation of the cyclical vomiting.” In other words, when they stopped getting high, they stopped throwing up all the time. Which seems like a pretty black-and-white solution to the problem.
Weirdly, though, there was one anomaly that couldn’t be explained: patients had developed a habit of taking scaldingly hot showers or baths, as these apparently helped to relieve their symptoms.
Roughly 30 studies were conducted between 2004 and 2012, with most focusing on singular subjects. Yet it’s still not clear what it is that actually causes CHS (whether a cannabinoid build-up is to blame, or if it has something to do with cannabinoid receptors in the brain) or why the condition has suddenly appeared now, despite the fact that—according to meticulously researched internet chatter—people also definitely smoked cannabis before the year 2004.
In 2012, Dr. Douglas A. Simonetto conducted the largest study into CHS to date, with 98 patients all meeting the relevant criteria. However, his research only reinforced the idea that CHS is a thing that exists. That, if you smoke too much weed, you might experience nausea and cyclical vomiting (84 also reported abdominal pain), and that if you stop, so too will the symptoms (in the vast majority of cases, at least). He also found that around half the participants mitigated their symptoms by bathing in incredibly hot water.
One of Dr. Larry Mellick’s videos of a CHS patient
While looking into CHS I found a YouTube account belonging to Dr. Larry Mellick, a professor of pediatrics at Georgia Regents University in the United States. For the past year he’s been documenting CHS patients, one of whom addresses this compulsive bathing habit in the video above.
“It’s not like I needed a shower—it’s something I just did without knowing I was doing it,” he tells the camera. His sister chips in, saying he would shower four or five times a day in “steaming hot water.” Water that she “couldn’t stand being in, it was so hot.” No explanation is given as to why she was trying to shower with her brother.
The bathing thing appears in almost every report I’ve read on CHS. In fact, in one case, a patient unknowingly scalded their skin in a bid to ease their symptoms.
It’s unclear why the hot showers help, but one certainty—and a positive one at that—is that they can aid medical staff in diagnosing the problem, as well as helping sufferers to understand that they have the condition. “Usually, when one mentions the hot showers bringing relief to their symptoms, it’s the first time the patient begins to accept that this might be their diagnosis,” Dr. Mellick told me.
Dr. Larry Mellick
I spoke to Ben, a student from Bristol, who claimed to have diagnosed himself with CHS. After two or three years of smoking “at least seven grams a week,” he started to experience the symptoms of CHS in February of last year, “waking up, feeling really sick, having a shower, retching and occasionally puking,” as well as suffering abdominal pain.
After a couple of misdiagnoses, Ben realized that he might have been suffering from CHS, so flushed his weed and—dramatically—smashed his bong to pieces. After a week of not smoking, his symptoms started to decrease—a marked improvement on his life before he gave up.
“I was bedridden. I had no energy and my stomach pain was getting worse,” he told me. “But I’m now able to move around the house and get on with my day-to-day life.”
Greg De Hoedt (bottom) at this year’s 4/20 smoke-out in Hyde Park. Photo by the author.
Of course, we’re still no closer to understanding why exactly CHS starts to affect a cannabis user; thanks to years of prohibition, little research has been carried out into the effects of cannabis on the human body’s endocannabinoid system. However, speaking to Greg De Hoedt—president of the UK Cannabis Social Clubs—I discussed the possibility that the emergence of the condition has something to do with the fact it’s become far easier—if not the norm—to get your hands on super strength skunk.
“Stronger cannabis is available and takes up most of the market,” said Greg. “But people don’t realize they can get milder strengths. Safer access [to cannabis, coupled] with strain advice is the best reduction for this kind of side effect.”
This may be the case for some, but so far the evidence suggests that the best way to cure CHS is to just cut out smoking weed altogether. Of course, that isn’t always going to be the easiest thing to convince a patient to do. “I always thought, Weed’s good; weed’s a medicine,” said Ben. “I thought it was probably helping me in the long run, but it wasn’t.”
Dr. Mellick said something to the same effect. “On occasion, there is a degree of denial, and one has to convince the patient that their presentation is textbook.”
Cannabis is becoming more widely accepted, and—in my book, at least—that’s not a bad thing at all. As long as you don’t end up wasting your life away on hash and Homes Under the Hammer, there’s no real reason not to get high every now and again if that’s something you like to do.
But, like any drug, cannabis becomes far less enjoyable once you start abusing it. Especially if you manage to wreak havoc with your body’s chemistry and find yourself vomiting every time you smoke a spliff.
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Cannabinoid Hyperemesis Syndrome is a real thing that can happen to you if you smoke too much pot.
Super-strong weed is making people vomit every morning and some are ‘scromiting’
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Weed smokers are waking up in the morning feeling nauseated and having violent fits of vomiting, a doctor has warned.
Some of the attacks of vomiting are so violent that users around the world are ‘scromiting’ – screaming while vomiting – and having to go to hospital.
It could be linked to super-strong weed, a Canadian doctor has warned.
It’s called ‘cannabis hyperemesis syndrome’ and doctors warn that it happens with daily weed smoking, and is now one of the most common causes of nausea and vomiting in younger people.
Dr Christopher Andrews, Clinical Professor at the Cumming School of Medicine at the University of Calgary, said, ‘Patients typically have a history of daily cannabis use, often for years, before the onset of symptoms.
‘The precise cause of the disorder is unknown. Some speculate that chronic use may affect the functioning of the receptors for the active compounds in cannabis (called cannabinoids) in the body, while others suggest genetics of the user may play a role.
‘Researchers have reported the disorder all over the world, in both men and women. It does not appear to be due to contaminants in the cannabis, and does not appear to be an overdose-like reaction either.
‘However, as the strength of the cannabinoids in cultivated cannabis has grown cannabis hyperemesis syndrome has also become more common.’
The word ‘scromiting’ was invented by staff at emergency rooms across the US, who are seeing more and more people turn up yelling in pain and throwing up all over the place.
The illness is not properly understood, but it’s known that the only guaranteed way to stop it is for sufferers to give up smoking cannabis altogether. Some people also get temporary relief by taking a hot bath.
Chalfonte LeNee Queen, a 47-year-old from San Diego, has experienced this grim condition.
She said the pain was sometimes so bad that she ended up on the floor, retching and wracked with pain.
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‘I’ve screamed out for death,’ she told NPR.
‘I’ve cried out for my mom, who’s been dead for 20 years, mentally not realizing she can’t come to me.’
The illness strikes users who have been smoking regularly for a long time, with one study suggesting people would need to consume cannabis between three and fives time a day to develop CHS.
‘The syndrome was first described in 2004 by Allen and colleagues and is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting, and the learned behaviour of hot bathing,’ doctors wrote.
It’s been suggested that CHS is caused by a build-up of cannabinoids in the body over a long period of time.
This may affect the function of cannabinoid receptors in a part of the brain called the hypothalamus which regulates the digestive system and body temperature.
The cannabis magazine High Times gave the following description of the illness: ‘Often mistakenly called Cyclical Vomiting Syndrome, Cannabinoid Hyperemesis Syndrome is a rare form of cannabinoid toxicity that develops in chronic smokers.
‘It’s characterized by cyclic episodes of debilitating nausea and vomiting. People who suffer from the syndrome often find that hot showers relieve their symptoms, and will compulsively bathe during episodes of nausea and vomiting. Symptoms stop after cessation of cannabis use.’
Weed smokers are waking up in the morning feeling nauseated and having violent fits of vomiting, a doctor has warned. Some of the attacks of vomiting are so violent that…