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July 2021

Chili Pepper Chemical Might Help Cannabinoid Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome (CHS) is a growing concern in emergency departments across the nation. It suddenly occurs in some chronic cannabis users with no warning. Patients become overwhelmed with severe bouts of nausea and vomiting, and they often have a strong desire to take scalding hot showers for relief. Typical anti-nausea medicine usually doesn’t help. But new research suggests capsaicin, a chemical found in chili peppers, might actually provide some relief. Here’s what we know so far.

Capsaicin is the active chemical in the capsicum plant. It’s believed that the desensitization of certain receptors in the nervous system might play a role in CHS. Blocking these receptors might provide relief. This is the same reason that capsaicin is used in other conditions, including diabetic neuropathy and pain. New early clinical research shows that applying 5 grams of a cream containing capsaicin 0.1% to the stomach slightly reduces nausea within 1 hour in patients with CHS. Nausea went away completely for 29% of patients using capsaicin compared to none of the patients receiving placebo. Other research in this area has been inconclusive, so larger-scale studies are still needed. Even so, applying capsaicin topically has a low risk for side effects compared to other treatments used for CHS, including antipsychotics and benzodiazepines. It’s also a low-cost treatment that patients might be able to administer themselves at home.

While this new research is promising, emphasize to patients that the only long-term treatment for CHS is stopping cannabis use entirely. This means all cannabinoid products, including CBD. It’s not entirely clear why some people suddenly react to cannabis this way, but CHS can lead to serious complications – even death. Counsel all patients who are considering cannabis use about this possible risk.

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