Medical Marijuana and the treatment of nausea

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Nausea is an incredibly uncomfortable symptom which can be associated with a wide variety of conditions and medications. Recently, cannabis has received a lot of attention as a possible form of relieving nausea, especially that caused by chemotherapy and HIV treatments. But how exactly do cannabinoids have antiemetic effects on the body?

UNDERSTANDING NAUSEA

Nausea is typically described as an uneasy feeling that you need to vomit. While nausea can lead to vomiting, a person can also feel nauseas without actually vomiting. Nausea can be accompanied by other symptoms, like lightheadedness and stomach pain.

Nausea is usually experienced as a symptom of another underlying condition or as a side-effect of medication or medical treatments. Some conditions that commonly cause nausea include:

  • Gastric conditions like gastroenteritis or gastroparesis.
  • Mental health conditions like anxiety and depression.
  • Food poisoning.
  • Viral and bacterial infections.
  • Motion sickness or disequilibrium.
  • Some medications and treatments that can cause nausea include:
  • Antibiotics.
  • Antidepressants.
  • Chemotherapy.
  • Narcotic pain relievers like morphine.
  • Medications/treatments used to treat HIV/AIDS, including ART, NRTIs, PIs, and more.

Nausea is an uncomfortable symptom and can affect a person’s concentration. It can also cause anxiety or a fear of vomiting. When accompanied by vomiting, patients are at a greater risk of other health issues, including dehydration, electrolyte imbalances, vitamin depletion, weight loss, and damage to the esophagus and lungs.

SEVERE AND INTRACTABLE NAUSEA: WHEN NAUSEA BECOMES CHRONIC

We can see that nausea is an accompanying symptom of a wide variety of conditions that usually goes away once the root cause or underlying condition has been dealt with. But that’s not always the case.

For some patients, nausea can be severe and hard-to-treat. In these cases, it is usually referred to as chronic, severe, or intractable. When this is the case, the nausea itself goes from being a symptom to a condition of its own.

Chronic nausea is a very complicated condition and often has no clear underlying causes. Hence, treating the condition requires a healthcare professional to work closely with a patient to assess everything from their clinical history to their dietary choices to find out how to best treat their symptoms.

In some extreme cases, chronic, severe, and intractable nausea can cause other more serious health issues like depression and anxiety, especially if the condition interferes with a person’s day-to-day life.

NAUSEA REMEDIES AND MEDICATIONS

There are a wide variety of treatments available for nausea. These include both medication and natural remedies.

Natural nausea remedies include:

  • Ginger
  • Peppermint
  • Acupuncture
  • Aromatherapy

Antiemetic medications include:

  • Meclizine and scopolamine. Used to treat nausea caused by motion sickness or vertigo.
  • Metoclopramide, prochlorperazine, and chlorpromazine. Used to treat nausea caused by migraine headaches.
  • Ondansetron is used to treat nausea caused by gastroenteritis.
  • Pyridoxine and doxylamine are commonly used to treat nausea during pregnancy.

CANNABIS AND NAUSEA

A growing body of research is showing that medical cannabis can be an effective antiemetic for some patients, especially those suffering from nausea and vomiting caused by chemotherapy and HIV/AIDS treatment/medications.

Cannabinoids are known to stop the binding of serotonin neurotransmitters and dopamine in the brain, a process that is also involved in chemotherapy-induced nausea and vomiting (CINV).

Cannabinoid receptors have also been found in parts of the brain and gastrointestinal tract and, when activated by cannabinoids, produce anti-emetic effects that can help deal with the excruciating symptoms caused by CINV.

Some of the studies looking into the role of cannabinoids in managing nausea and vomiting were conducted over 40 years ago. In 1975, for example, the New England Journal of Medicine published the results of a double-blind study examining the efficacy of THC as an antiemetic.

The study found that oral THC had significant antiemetic effects and was effective at reducing nausea caused by chemotherapy agents.

Research has also looked at synthetic cannabinoids like dronabinol and nabilone (two synthetic compounds designed to mimic the effects of THC) and their ability to reduce nausea.

In 1985, the US Food and Drug Administration approved both drugs for the treatment of nausea induced by chemotherapy, which helped to legitimize cannabis’ role as an antiemetic. Since then, more than 30 clinical trials have shown that cannabinoids like those found in dronabinol and nabilone are effective at treating CINV.

New research also shows that cannabinoids like THC and CBD also help treat nausea caused by other medications and treatments, especially those used in the treatment of HIV/AIDS.

Antiretroviral therapy (or ART) is the most common form of treatment for HIV/AIDS and is renowned for producing severe nausea and vomiting similar to that induced by chemo. Like with CINV, nausea and vomiting induced by ART can also lead to serious health complications like a loss of appetite, gradual weight loss, and wasting syndrome.

Medical marijuana patients dealing with nausea and vomiting generally choose to vaporize or smoke cannabis as this is the fastest way to introduce cannabinoids into the system. Using edibles, tinctures, or any other form of cannabis that has to pass through the digestive track can take up to 45 minutes to take effect.

CANNABIS: A NEW ALTERNATIVE TO TRADITIONAL NAUSEA TREATMENTS

It is important to note that cannabis isn’t a miracle cure for nausea. In fact, most clinical trials studying cannabinoids as antiemetics have listed that medicinal cannabis can produce a wide variety of side effects, including drowsiness, fatigue, euphoria, drops in blood pressure, anxiety and paranoia, and hallucinations.

For some patients, these side effects may be just as hard to deal with as those of other antiemetic medications. Some may also find that medical cannabis doesn’t provide them with an adequate level of relief.

Regardless, there is solid body of evidence to prove that cannabis can work as an antiemetic and, despite its adverse effects, is a safe form of treatment. This is important because it means patients suffering from nausea and vomiting (regardless of the cause) have another alternative to turn to for relief.

Many states in the US have already listed nausea as a qualifying condition for medical marijuana patients and hopefully more will follow.

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