Down with the (CHS) Sickness

Cannabinoid hyperemesis syndrome (CHS) is a condition that leads to severe repeated vomiting. The solution sounds simple enough: Abstain from cannabis. However, interviews with CHS patients suggest that chronic cannabis users are not always receptive to their diagnosis (though they didn’t quite put it like that; we’ll avoid repeating the words in the title of the paper) – nor are they too keen on the suggested recommendations.

The researchers analyzed the responses from 24 patients – all chronic cannabis users suffering from cyclic vomiting – using qualitative data management and analysis software NVivo. The results showed that 88 percent of participants used cannabis more than once per day, with primary methods including blunts, bongs, and joints. But, more interestingly, the researchers discovered that many participants were uncertain if their symptoms were related to cannabis; instead, they suggested their cyclic vomiting may be related to food and alcohol, stress, or existing gastrointestinal issues.

“I do understand why one would think that that’s what I’m going through, but I’m not sure if it’s quite it,” said one 30-year-old female participant, known in the study as “Tamara.”

Another participant, 43-year-old “Aaron,” pointed to stress as a trigger: “It seems like there’s no rhyme or reason to it. You could smoke for, you know, three, four weeks, be absolutely fine, and then take a hit one day and then that’s it, you’re just sick. Or sometimes you don’t even take a hit, you just get sick. I want to say that stress is a major trigger for me […] so If I get bombarded with jobs at work, or who knows, maybe I get a lot of stress that particular day.”

Additionally, the majority of participants thought that clinical recommendations failed to understand the complexity of quitting cannabis use. “Ellie” – a 24-year-old woman – said, “They’re not treating me like I’m someone sick in the hospital. They look at me like I’m in withdrawal from drugs.”

The researchers concluded by calling for additional clinical and non-clinical treatment options to better support people with chronic cannabis use and cyclic vomiting.