Nausea & Vomiting

Medicinal Cannabis and Nausea & Vomiting

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One of the first instances where medical cannabis was accepted and integrated into medical practice, was for nausea and vomiting. This was initially driven by cancer patients who were undergoing chemotherapy that oftentimes causes torturous side effects including, but not limited, to severe nausea and vomiting. Some cancer patients and others experiencing nausea and/or vomiting as a result of medications or disease states have found relief when prescribed medical cannabis.

What situations can medical cannabis reduce nausea and vomiting?

Nausea and vomiting are common side effects of many conditions and medications. In the clinical research available it is chemotherapy or cancer-induced nausea and vomiting that is most commonly discussed. Yet another instance where medical cannabis is used frequently is in palliative care.

Medical cannabis and palliative care

As we age, changes in our digestion and communication between the gut and the brain can result in more regular occurrences of nausea and vomiting. Medical cannabis is increasingly used in other situations for palliative care and in some cases has proven to be successful in reducing nausea and vomiting for these patients in clinical trials.

Some individuals, especially in older ages groups, are hesitant to engage in medical cannabis treatments due to decades of stigmatisation. However, it is possible to be prescribed medical cannabis without the experience of intoxication or feeling high that is attributed to the cannabinoid THC.

A number of commonly prescribed medications can cause nausea and vomiting. For example, pharmaceutical drugs used to treat anxiety and depression, like SSRIs, can often lead to the side effect of nausea or vomiting for patients. Not only can medicinal cannabis potentially reduce this side effect, but may also contribute to the improvement of anxiety, sleep and mental health.

How does medical cannabis reduce nausea and vomiting?

Medical cannabis and synthetic cannabinoids are believed to act on the part of the brain that controls the vomiting reflex. They can also have an impact on the cascade of hormones that triggers or relaxes the sensation of nausea.

Additionally, cannabinoids and endocannabinoids (cannabis-like compounds made within our bodies) also have influence over the vagus nerve. The vagus, or vagal, is a superhighway for information from the gastrointestinal tract to the brain. On this vagus nerve highway are plenty of cannabinoid receptors, so when medicinal cannabis is ingested, it can act upon this superhighway to reduce the sensation of nausea and prevent signals that promote vomiting.

What medicinal cannabis formulation might work with vomiting and nausea?

THC is the main cannabinoid associated with reducing nausea and vomiting and increasing appetite in patients. Despite this, medical cannabis formulations including the other major cannabinoid CBD, and minor cannabinoids may provide greater relief when administered together. This due to what is known as the Entourage Effect where cannabinoids act synergistically, having a greater effect together than they would in isolation.

For patients who don’t want THC included in their treatment, low-doses of CBD are believed to reduce nausea, while high doses can have the opposite effect.

Decreasing nausea and vomiting for cancer patients

In many circumstances, current pharmaceutical medications are effective at reducing nausea or vomiting but fail to improve both effectively. This can mean patients are on multiple medications just to treat one of the side effects of their cancer treatment.

In terms of chemotherapy, difficult-to-treat manifestations of nausea and vomiting, as well as anticipatory nausea, can impact patients in the days and hours preceding the chemotherapy treatment. This anticipatory experience and the manifestation of acute or delayed nausea and vomiting are not often well managed by currently available treatments. Fortunately, researchers have been studying the effects of cannabinoids on cancer and chemotherapy-induced nausea and vomiting since the 1970s. Studies repeatedly show that cannabis medicines and synthetic cannabinoids are as effective, if not more so than conventional anti-nausea or anti-emetic pharmaceuticals.

Why is reducing nausea and vomiting with medical cannabis useful?

During toxic treatments like chemotherapy, in palliative care or other diseases like IBD, where nausea and vomiting impacts quality of life and food intake, the lack of nutrition and adequate energy consumption can have dramatic negative impacts on patients. In some cases, the lack of nutrients and energy can increase the toxicity of medications and potentially accelerate disease progression.

By reducing nausea and vomiting with medical cannabis, patients can be encouraged to eat more to sustain their energy and dietary needs, which can have positive flow-on effects for treatment outcomes and patients quality of life.

Medical cannabis treatments for nausea and vomiting

Medical cannabis treatments come in a wide variety of delivery options. This can include oils, capsules, patches, sprays and more. In Australia, oils are most commonly prescribed, yet medical doctors and researchers are keenly awaiting investigations into which types and delivery forms of cannabis medicines are most effective for nausea and vomiting.

Knowing the right dose and formulation for medicinal cannabis

Doses and formulations for medical cannabis can differ greatly. Both THC and CBD may be able to aid some patients in reducing nausea and vomiting in varying doses. Thus it is important for patients to be attended to by a medical doctor with an understanding of how these cannabinoids and the endocannabinoid system work to reduce nausea and vomiting.

Appropriate formulations, dosing and treatment regimes are most important to achieve the best outcomes for each individual being prescribed medical cannabis. Experienced medical cannabis doctors, like those at CA Clinics, work diligently to provide a personalised and effective medicinal cannabis treatment to reduce nausea and vomiting.