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Cannabinoid Hyperemesis Syndrome

Capsaicin Cream for Temporary Relief of Cannabinoid Hyperemesis Syndrome (CHS) Symptoms

Cannabinoid hyperemesis syndrome (CHS) is a condition characterized by chronic marijuana use and recurrent episodes of nausea, vomiting, and abdominal pain. If you’ve been recently diagnosed with CHS, or if you suspect you may be having a CHS episode, it may be worth exploring options to provide temporary relief. Remember to consult your healthcare provider before beginning any treatment.

A growing body of research supports topical capsaicin’s ability to safely reduce abdominal pain and vomiting in persons with CHS. Individuals who show signs of CHS tend to compulsively bathe in hot water to relieve CHS symptoms which can include abdominal pain and vomiting. Like hot baths or showers, topical capsaicin produces a strong heat sensation and acts as a potent TRPV1 agonist, helping to reduce the gastrointestinal symptom complex associated with CHS.

A 2020 study led by Diana Dean, M.D., an emergency medicine physician, explored a .1% capsaicin cream’s ability to improve symptoms of CHS. The double-blind, placebo-controlled study enrolled 30 participants. 17 participants received 0.1% capsaicin cream and 13 participants received a placebo cream (moisturizer without capsaicin). The cream was applied to the abdomen. Neither the researchers, medical professionals, nor patients knew which cream was being used for which patients. The intensity of nausea on a scale of 1 to 10 was measured after application.

Researchers found a significant reduction in nausea in the capsaicin group after 60 minutes. Slightly less than half of the participants receiving topical capsaicin cream reported a reduction in nausea, and about 29% had a complete resolution of nausea. One person developed skin irritation and could not tolerate the topical capsaicin cream (when using capsaicin cream, skin irritation should be monitored – getting it in the eyes or mouth should be avoided and hands should be washed after application).

A 2021 study led by Vivian Kum, PharmD, corroborated Dean’s findings. That study enrolled 201 persons who presented to an emergency department and found that significantly more patients in a capsaicin group experienced symptom relief. Time to discharge was also shorter for persons with CHS who received topical capsaicin compared to patients who did not.

Larger studies are needed to definitively ascertain capsaicin’s potential efficacy, including as a therapy applied shortly following diagnosis of CHS in an emergency room setting.

Individuals with CHS may require hospitalization in order to maintain hydration while their nausea and vomiting persist. While capsaicin and other anti-emetic or anti-nausea medications may make sense as treatments for CHS, the hard reality is that they aren’t solving the underlying issue. At the end of the day, the only proven way to treat CHS is to stop using marijuana, and permanent cessation of marijuana use leads to the only assured cure.

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