Cannabis and Nausea and Vomiting
Nausea is commonly defined as an uneasiness of the stomach that often comes before vomiting. It is a complex neurological phenomenon that can be cause by a wide range of illnesses, as well as external stimuli, such as smells and chemotherapy.
A substantial body of evidence supports the use of cannabis medicines in the treatment of acute nausea and in anticipatory nausea. You can find a list of studies that support this at ProjectCBD.org here: https://www.projectcbd.org/condition/35/Nausea
In the mid 1970's, the inability to control nausea and vomiting among chemotherapy patients encouraged oncologists to explore the use of cannabis and its derivatives.
In 1975, a study in the New England Journal of Medicine found that THC effectively reduced vomiting during treatments within a study group of patients receiving different antitumor drugs. This study was prompted by anecdotal accounts that smoking cannabis reduces nausea and vomiting associated with chemotherapy.
By 1991, 63% of oncologists affirmed that the efficacy of cannabis for chemotherapy-induced nausea. * Study Here
Recent research reveals that the sensation of nausea is regulated by the endocannabinoid system. THC reduces nausea through the CB1 receptors. CB1 receptors are abundant throughout the brain, and both CB1 and CB2 receptors are present in the peripheral organs that can produce the stimuli resulting in nausea, such as the gastrointestinal tract or the inner ear. It is believed that CBD regulates nausea through 5HT1 receptors.
The first rule for the treatment of any medical or psychological illness is to look for reversible causes. More than half of reversible causes associated with nausea and vomiting are related to medications, most of which are opioid pain medications. Opioid rotation, dose reduction, or discontinuation (perhaps assisted with medical cannabis) may solve the problem. Do not change or discontinue opioid use without the supervision of a trusted physician.
Recently the use of CBD, the non-psychoactive cannabinoid, has been shown in animal models to be extremely effective as both an anti-nausea and antiemetic.
Chronic nausea is often attended by anxiety, and CBD has been proven in small human studies to be helpful.
Cannabis is an established treatment, and it is unique in that it may also stimulate appetite. One study of orally administered THC with cancer noted pain relief as well as improved appetite.
A small study found that using a cannabis medicine with equal 1:1 ratios of THC and CBD in an oromucosal spray was highly effective. The cannabinoid CBD and its acid form CBDA are effective in treating acute and anticipatory nausea.
Pregnant or nursing women should not use cannabis medicines for treating nausea or vomiting without consulting a trusted physician.
Dosing Cannabis for Nausea and Vomiting:
Oral and sublingual cannabis are both quite effective, with oral providing the longer-lasting effects. When THC-based cannabis medicines are to be used for combating chemo-induced nausea, the effective dose of THC for nausea can cause intoxication, so it is often helpful to start with a small dose and increase it over a week or two to the likely effective dose range.
A 10:1 or higher ratio of CBD:THC is recommended. Many patients prefer approximately 10-12 mg two to three times a day to overcome nausea.
If nausea is expected from an upcoming chemotherapy treatment, it is best to start two weeks before and slowly titrate up to 10 mg, then take 10 mg two to three hours before the chemo treatment, and then every four hours as needed.
Appetite stimulation tends to occur with smaller doses of THC, typically 2.5-5 mg of THC an hour before meals should help.
Avoid cannabis flowers rich in Pinene (a terpene) such as Blue Dream which may support memory of anticipatory cues.
For more information and studies that support Cannabis as a treatment option for Nausea and Vomiting, here are some helpful links:
Information about Cannabis and Nausea and Vomiting (as well as other conditions, illnesses, or diseases that cannabis may be able to help with) is taken from my favorite book...
Cannabis Pharmacy; The Practical Guide to Medical Marijuana
By: Michael Backes, fwd by Andrew Weil, M.D., and Jack McCue, M.D. medical editor.
