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Approximately 9% of individuals who use cannabis report dependence at some point in their use 5. Cannabis can paradoxically act as an antiemetic during acute ingestion at low doses, whereas persistent high-dose ingestion could result in vomiting, a behavior similar to cyclical vomiting 6. It is unclear whether the increased legalization of cannabis has also contributed to these findings, but this certainly could be a possibility.
While marijuana seems to bring on nausea in the stomach, in the brain it usually has opposite effect. When cannabinoids bind with brain receptors, they tend to prevent nausea and vomiting. Cannabis has long been tied to the infamous “munchies,” that irresistible urge to raid the fridge after a few puffs. Yet, its relationship with appetite and digestion is far more nuanced, offering potential benefits for weight management, digestive comfort, and overall wellness. This complexity arises from the endocannabinoid system (ECS), a network of receptors and signaling molecules that regulates hunger, metabolism, and gut function. Through compounds like THC, CBD, and THCV, along with aromatic terpenes, cannabis can stimulate or suppress appetite, ease nausea, or support a healthy gut microbiome.
The frequency and prevalence of CHS change in accordance with the doses of tetrahydrocannabinol and other cannabinoids in various formulations of cannabis. CHS is unique in presentation, because of the cannabis’s biphasic effect as anti-emetic at low doses and pro-emetic at higher doses, and the association with pathological hot water bathing. In this narrative review, we elaborate on the role of the ECS, its management, and the identification of gaps in our current knowledge of CHS to further enhance its understanding in the future.
The CHS recovery phase starts when you stop your marijuana use. When you do this, your symptoms usually start to go away in few days to a few months. Over time, the symptoms will go away completely unless you start to use again. One 2018 study found that 32.9% of self-reported frequent marijuana users who’d gone to the emergency room (ER) had symptoms of CHS.
The extract of the plant cannabis sativa has been reported to be used for decades in the control of pain and cramps, according to the Chinese literature 1. Recognition of the function of the endocannabinoid system (ECS) was a breakthrough in explaining the effects of cannabis on different organs, at least in part 2. The primary psychoactive component of cannabis is tetrahydrocannabinol (THC). These advances enhanced the understanding of cannabinoid (CB) receptors, which led to a better appreciation of the role of cannabis in inflammation, seizures, emesis, and as an appetite stimulant. There is a growing body of research showing the benefit of cannabis in the aforementioned disorders, and its legalization will further augment research on understanding its critical role in new drug developments 3,4. However, these changes also come with substantial risks regarding its adverse effects, such as paradoxical hyperemesis, intoxication and behavioral changes (anxiety, panic attacks, and psychoactive changes).
Scientists do not know much about the function of the CB2 receptors. On the basis that only a small number of regular and long term users of marijuana develop CHS, some researchers suggest that genetics might play a role. Other researchers theorize that the effects of marijuana can change with chronic use. They also experience episodes of vomiting that return every few weeks or months. While both CHS and Cyclic Vomiting Syndrome (CVS) cause severe vomiting, their causes differ.
This is normally when people go see a doctor to find out what is causing these problems. They start to feel better when they stop using marijuana but can feel bad if they use it again. The primary modes of psychosocial intervention in cannabis use disorder are CBT and motivational approaches, which include the importance of the individual or the social environment. More specifically, CBT and relapse prevention approaches primarily focus on the identification and management of thoughts, as well as external triggers, that lead to its use.
One possible treatment option involves the use of benzodiazepines, such as lorazepam, to control nausea and vomiting. Benzodiazepines are controlled substances that people must use with caution, particularly those with a history of drug use. The first reports came from doctors treating regular users of marijuana for nausea and vomiting in South Australia. Through a holistic and individualized treatment regimen, healthcare providers can navigate the challenges of CHS, offering hope and relief to those affected by this puzzling condition.
Carnett’s sign refers to pain elicited by tensing the abdominal muscles or performing a straight leg raise. Lidocaine Alcoholics Anonymous patches have been proposed as a means to relax the rectus muscle, potentially alleviating abdominal pain during acute flares 91. TRPV1, transient receptor potential cation channel subfamily V member 1; TCA, tricyclic antidepressant; CB, cannabinoid; CTZ, chemoreceptor trigger zone. In one small study of eight patients hospitalized with CHS, four of the five who stopped using weed recovered from CHS.
Abdominal pain management in CHS should focus on treatment that avoids G.I. Both CVS and CHS are complex gastrointestinal conditions influenced by several entities, including genetic, environmental, and lifestyle factors. While their genetic underpinnings are still not fully understood, research has suggested potential genetic predispositions for each.
Additionally, interactions between dopamine and CB1 signaling pathways may contribute to haloperidol’s effectiveness in treating CHS 79. Sympathetic and parasympathetic systems play interlinked roles in emesis. The chemoreceptor trigger zone sends signals via the efferent vagus nerve, triggering responses in the parasympathetic and sympathetic nervous systems. This activation leads to the emetic reflex, which includes increased salivation, deep breathing, glottis closure, pyloric sphincter relaxation, retroperistalsis, and abdominal muscle contraction.
The CVS has strong links to mitochondrial dysfunction and neurobiological pathways related to https://ecosoberhouse.com/article/signs-and-symptoms-of-alcohol-dependence/ migraine, while CHS is primarily influenced by chronic cannabis use and endocannabinoid system dysfunction. Understanding these primary differences in the pathophysiology between these two disease entities is crucial for clinicians when diagnosing, especially since they share overlapping gastrointestinal symptoms. However, chronic cannabis use may lead to CHS demonstrating its complex dual effects 10,20.
2 de diciembre de 2020
Publicado en: Sober living