Cannabinoid Hyperemesis Syndrome on the rise in Africa

December 26, 2016

Cannabinoid hyperemesis syndrome also known as CHS disease, is a condition affecting frequent marijuana smokers and African countries are no exception according to a new study in my possession. Given the high prevalence of chronic cannabis abuse in Africa, clinicians need to be more attentive to the clinical features of this under-recognised condition. In some of the cases researchers identified, a South African sufferer had been smoking marijuana daily and in heavy doses for seven years. This eventually led to bouts of vomiting lasting four hours daily, and this was worse after meals.  As with South African cases, the young man initially turned to compulsive hot bathing behaviour to relieve the symptoms but he was not cured until he gave up smoking cannabis altogether. A Lusaka based drug expert and emergency ward doctor told your blogger that he had seen three cases of the illness and it was possibly also under reported by sufferers who fear being arrested by security agencies since marijuana is illegal in Zambia.  “We’re probably seeing the tip of the iceberg in the health departments. It’s probably far more common but far milder in the broader rural community,” she added. Little is known in Africa about how cumulative cannabis use could lead to vomiting and, particularly, why sufferers would find some relief in hot bathing. That’s a distinct and unanimously recurrent feature of this condition, and health experts in the continent mostly don’t know why. Grown men and women, screaming in pain, sweating profusely, vomiting every 30 seconds and demanding to be allowed to use the shower. It’s a very dramatic presentation. Another health expert told your blogger the condition had been identified in a small number of cannabis users but in the medical fraternity across Africa it is now considered to be a real condition.

It is not unusual for there to be significant mental and physical health complications with this level of cannabis use according to the experts. To make it worse for those affected, CHS disease is missed because either doctors don’t know about it or sufferers aren’t willing to admit to using an illicit drug. According to the study, the disease is characterised by vomiting, nausea, severe gastrointestinal discomfort, and compulsive bathing, although it may be preceded by a period of milder symptoms like morning nausea, consistent urges to vomit, and abdominal pain. In the past, researchers noticed a commonality among patients experiencing cyclical vomiting symptoms with chronic cannabis use. In the study focusing on Africa, eight out of ten subjects who abstained from cannabis resolved their cyclical vomiting symptoms and the other two participants refused to abstain and their symptoms continued. In African countries where marijuana use is illegal, cannabinoid hyperemesis syndrome mostly goes misdiagnosed. Many health professionals surveyed mistake it for another very similar health condition known as cyclic vomiting syndrome, which has identical symptoms but is not associated with weed smoking. According to the research on the condition which mainly focused on five key marijuana markets in Africa namely Nigeria, Ghana, South Africa, Ethiopia and Kenya, it takes 36 months of pot smoking before signs of CHS disease begin to manifest. Even then, symptoms do not become severe until at least after five to ten years of frequent marijuana use. If the illness remains untreated, patients can experience dehydration and kidney failure. However, the solution for CHS disease is as simple as it can be. Researchers noted that symptoms of the condition go away within days after a patient stops smoking cannabis.

Contador Harrison