r/Marijuana 2d ago

My(25f) boyfriend(27) can't smoke Advice

I smoke a lot, generally I clear a gram of wax every 5-6 days if I'm conservative. My boyfriend is a complete sweetheart, and doesn't mind hanging out with me when I bake up, but he has Cannabis Hyperemesis Syndrome and can't smoke anything without puking. I can tell he really misses it and I wish he could enjoy it too.

I was wondering if anyone knew of a safe, legal alternative. He's said he can take a hit of a cart once in a while but if he overdoes it he ends up puking anyway. Drinking isn't something either of us are big fans of, so that's out. I don't think either of us need substances to enjoy ourselves but I was wondering if anyone has advice on this topic, it would still be nice if I could have something for him to enjoy too. Thanks to anyone who replies 💜

10 Upvotes

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u/Illustrious-Golf9979 2d ago edited 2d ago

So I over breakfast have been reading about his condition. It is a rare condition That is growing in line with cannabis movement, but unfortunately It is basically a genetic allergic reaction to Cannabinoids building up in fat deposits. This isn't a "oh, I smoke, and I feel nausea."

Symptoms can last for a week straight of hell.

From what i've read, unfortunately, based on biology, there is no real safe way for him to consume cannabis. We aren't even sure what chemical causes it and know very little about the mechanisms. It tends to show up 1 to 5 years after chronic use. The only real option they give is abstinence. You can use capsaicin to treat his symptoms. Hot showers.

It seems that the symptoms come from a buildup, so aside from lowering body fat and extreme low doses very sparingly, there is not much that can be done for him. I'm so sorry that that's the case. The idea of having this happen to me makes me want to cry.

I will keep reading up on it today, and if I find anything that can help, I promise you I'll send it your way.

I compiled a few peer reviewed articles and Prompted it to organize it to give you a better understanding of what you are dealing with. You should see it somewhere on this thread.

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u/cannadaddydoo 2d ago

There’s some speculation it’s from pesticides and other agricultural chemicals used in big grows. I don’t know if it’s true or not-but my adult son has issues pretty often whenever he smokes something I didn’t grow. Not a scientific study-it could be in his head-but I’ve know some others that have noticed fewer negatives with their homegrown than other sources.

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u/Illustrious-Golf9979 2d ago

I believe that. Until we have more stringent lab protocols, It's an issue that will continue in an industry that's seven years old in this state.

Edit: I live in Pennsylvania. I forgot what I was responding to lol

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u/bigpapajayjay 2d ago

It’s likely that most people who think they have CHS probably more than likely do not and are possibly experiencing symptoms of Eosinophilic esophagitis. EOE can present exactly like CHS and EOE can be caused by environmental factors as well as food allergies and allergens in general. Such as pesticides and other chemicals used in growing marijuana and hemp as well as a plethora of other foods that are grown.

I suggest you look into Eosinophilic esophagitis so you can give better information and let people know they need to be seeing a doctor for proper diagnosis instead of just reading some thread on Reddit and diagnosing themselves. An endoscopy with a biopsy should be a test that anyone who is suspected of potentially having CHS should have as it would also rule out the potential of having Eosinophilic esophagitis.

I’ve been diagnosed and dealing with this autoimmune disease for nearly a decade with loads of doctor appointments. So I’m not just reiterating things I’ve read online.

Certain strains of weed will cause my Eosinophilic esophagitis to react which someone else would misinterpret as CHS but it is not.

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u/Illustrious-Golf9979 2d ago edited 2d ago

I didn't diagnose anything, He already is diagnosed by a physician. I'm not sure how you can imply what you are while that's the case.

I compiled peer reviewed medical articles and direct experiences from people dealing with this. I'm glad you're putting your two cents in, But instead of attacking me, you should focus on helping her. She's not asking If he has it, She's asking what she can do to help. Sounds like to me you're just suggesting he doesn't really have this disease. For whatever reason.

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u/bigpapajayjay 2d ago

Nobody said you diagnosed anything? What? I said that Eosinophilic esophagitis presents almost exactly like CHS and you should also present with studies on that rather than just CHS so other people don’t try to diagnose themselves.

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u/Illustrious-Golf9979 2d ago

I think maybe you should read everything I posted because I addressed all of that directly. In all fairness, it was in two different threads.

I addressed the fact that there were multiple diseases that mirror the symptoms.

The fact remains Shes not looking for a diagnosis. She's looking to treat an already made one.

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u/bigpapajayjay 2d ago

That’s nice and all and I certainly read that part but as someone who suffers from Eosinophilic esophagitis and was misdiagnosed with CHS for the longest, I’m quite aware about what I’m talking about.

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u/Illustrious-Golf9979 2d ago

I in no way would ever suggest that I would know more about this than you.

I never suggested that. I openly stated that wasn't the case. I believe everything you're saying and I have no reason to doubt any of it.

Please. Just take a breath. I understand your point and i'm not arguing against it.

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u/Indigoez 2d ago

Thank you so much, you're incredible.

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u/Illustrious-Golf9979 2d ago

I'm just trying to help, my thoughts are with you both!

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u/MyGlassHalfFool 2d ago

Idk sometimes i’m the same and can’t smoke at all, I don’t like drinking at all, I don’t smoke nic, and i’m too scared to try anything else lol Im pretty content with doing nothing though(as far as getting high), I have a pretty good time sober so Im sure your bf really isn’t looking for anything either tbh

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u/Indigoez 2d ago

I'm sure he isn't either but it would be a nice surprise sometime I think 🥺 idk this is the first guy I've been with who treats me right so I wanna be extra for him😇 if there's not a good alternative that's okay.

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u/MyGlassHalfFool 2d ago

sex is the nice high tbh and good head 🤷‍♂️

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u/Indigoez 2d ago

Oh believe me he's getting PLENTY🤭

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u/440weedluver 5h ago

Could you provide proof of this claim🤣😆

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u/Indigoez 4h ago

Fansly.com/sith_holocrons lol, I'll get him signed up next weekend and then we're gonna make content together ;3 bear in mind I am a trans girl if that's not your thing.

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u/Illustrious-Golf9979 2d ago

Rso or troches? Patches? Creams? There is a million ways to enjoy cannabis!

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u/Indigoez 2d ago

Idk, I know the only weed he can enjoy without puking is a distillate cart and he has to be REALLY conservative

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u/Illustrious-Golf9979 2d ago

I posted a bunch of info For you after researching during breakfast. I used a few apps to compile and propagate the info Into something you can digest. I pray, it helps. Let me know when you read it.

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u/sion006 2d ago

MDMA

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u/Indigoez 2d ago

We do rave... He doesn't partake in most party drugs though. I'm thinking about trying to score some, or some psychs for him, but I wanted to see if there was something less intense/more legal he could enjoy🥺

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u/sion006 2d ago

Can he handle gummy’s? Even 5-10mg wouldn’t b bad

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u/AbstractMirror 2d ago

I know nothing about that syndrome, but is it possible he could use edibles? Or is it any form of taking in cannabis affects him

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u/HighOnGoofballs 2d ago

Absolutely not for edibles

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u/Indigoez 2d ago

Edibles are the absolute worst thing, tbh I get sick when I take em too, I just don't scromit.

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u/AbstractMirror 2d ago

I also don't like edibles I prefer smoking, was just wondering if for his case that works. Sorry to hear that!

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u/Illustrious-Golf9979 2d ago edited 2d ago

Cannabis Hyperemesis Syndrome (CHS): Summary Report

Definition and Common Characteristics

CHS is a form of hyperemesis (severe vomiting) associated with prolonged cannabis use. While there is no official diagnostic criteria, common characteristics include:

  • Age under 50 at symptom onset
  • Regular cannabis use for over 1 year (at least weekly)
  • Severe cyclical nausea and vomiting recurring over months
  • Abdominal pain
  • Symptom resolution upon stopping cannabis use
  • Compulsive hot showering/bathing that provides relief
  • Resistance to traditional anti-nausea medications
  • Weight loss

Case Characterization

Based on 29 case reports covering 36 unique individuals: - Age range: 15-47 years - Usage frequency: Majority (58%) used cannabis daily - Duration of use: 36% used for 10+ years, 25% used for 1-10 years

Treatment Approaches and Effectiveness

Pharmacological Treatments

Most commonly tried medications included: - Antiemetics (most frequently tried but often failed) - Antipsychotics - Anti-reflux medications - Hydration therapy

Key finding: No pharmacological treatment provided complete symptom relief consistently.

Behavioral Treatments

Most effective approaches: 1. Hot showers/baths (100% success rate in documented cases) 2. Behavior modification (68% success rate) - Including cannabis reduction - Complete cessation - Switching cannabis formulations

Less successful approaches: - Cognitive behavioral therapy - Drug rehabilitation - Motivational enhancement therapy

Clinical Implications

Risk Assessment

  • All documented cases were under 50 years old
  • Most frequent users (daily consumption) showed highest risk
  • Failed response to antiemetics may indicate CHS

Management Recommendations

  1. Consider CHS in young adults with unexplained cyclic vomiting
  2. Recommend hot showers/baths for immediate symptom relief
  3. Advise behavior modification regarding cannabis use
  4. Use validated cannabis risk screening tools for assessment
  5. Provide patient education about CHS risks 6.Long-term treatment of CHS is abstinence from cannabis, but acute symptomatic management has been a struggle for many clinicians. The present report highlights the use of haloperidol as an agent that successfully and safely treats the unrelenting symptoms of CHS.

Research Status

  • Mechanism remains unclear, though theories involve:
    • THC binding to brain receptors in vomiting center
    • Potential genetic mutations affecting cannabinoid metabolism
  • Further research needed for formal diagnostic criteria
  • More guidance needed on risk communication

Recent Developments

The US Surgeon General (2021) issued warnings about: - CHS risk in chronic cannabis users - Special caution needed with edibles due to delayed effects - Potential overconsumption risks

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u/PrizeConsistent 2d ago

Thank you!

I find the hot showers thing kind of ridiculous though. I thought most people took hot showers to help all kinds of stomach aces? I've done it for stomach bugs, migraine nausea, celiac, literally any stomach ache I get. A hot shower always helps :,).

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u/Normal-Emotion9152 2d ago

Let him try smoking or vaping cbd flowers in really small doses. Does he have a science background and is he good with math? If so he can find a dose after he reaches his tolerance break point that he can slowly enjoy at small doses. I had a similar problem and used my science skills to still have a small amount of THC while not hitting that wall. Everyone is different from what their body can take some informal qualitative analysis can help a lot. Good luck.

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u/kryodusk 2d ago

Video games.

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u/scrimmerman 2d ago

When you speak of drinking, I’m assuming alcohol. So have you or your boyfriend ever tried any cannabis infused drinks if available in your area? I’m a flower guy myself and don’t really use these, but I have friends that enjoy the same ones sold at local cannabis stores and enjoy these immensely

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u/Indigoez 2d ago

Unfortunately edibles are the worst possible thing for him :/

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u/scrimmerman 2d ago

Well that’s a bummer. Sorry to hear. Best of luck to you both

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u/Illustrious-Golf9979 2d ago

I didn't diagnose anything, He already is diagnosed by a physician. I'm not sure how you can imply what you are while that's the case.

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u/Illustrious-Golf9979 2d ago

Clinical Guide: Treatment of Cannabis Hyperemesis Syndrome (CHS)

Key Clinical Features

  • Regular cannabis use (especially daily)
  • Cyclic nausea and vomiting
  • Diffuse abdominal pain
  • Relief with hot showers
  • Symptom resolution upon cannabis cessation
  • Higher prevalence in males (72.9%)

Disease Phases

1. Prodromal Phase

  • Duration: Months to years
  • Symptoms:
    • Diffuse abdominal discomfort
    • Morning nausea
    • Anxiety/agitation
    • Fear of vomiting
    • Autonomic symptoms (flushing, sweating, increased thirst)
    • Often increased cannabis use to self-treat

2. Hyperemetic Phase

  • Duration: 24-48 hours
  • Symptoms:
    • Multiple vomiting episodes
    • Severe diffuse abdominal pain

3. Recovery Phase

  • Begins with cannabis cessation
  • May require:
    • Bowel regimen
    • IV fluids
    • Electrolyte replacement
  • Resolution can take up to one month

Complications

Common Complications

  • Electrolyte abnormalities (especially hypokalemia)
  • Dehydration
  • Acute kidney injury
  • Muscle cramping/spasms

Life-Threatening Complications

  • Pneumomediastinum from esophageal rupture
  • Severe electrolyte derangements leading to:
    • Seizures
    • Arrhythmias

Treatment Approaches

First-Line Treatments

  1. Cannabis Cessation

    • Only definitive treatment
    • Requires counseling and support
    • May take weeks for full resolution
  2. Topical Capsaicin

    • Application areas: Arms, abdomen, back
    • Concentration: 0.025-0.15%
    • Frequency: Up to 3x daily
    • Benefits:
      • Low cost
      • Minimal side effects
      • Often effective in treatment-naive patients

Pharmaceutical Options

  1. Benzodiazepines

    • Examples: Lorazepam, Diazepam
    • Mechanism: GABA receptor agonism
    • Effects: Sedation, anxiolysis, muscle relaxation
  2. Antipsychotics

    • Primary option: Haloperidol
    • Mechanism: D2 receptor antagonism
    • Documented success in case reports
  3. Tricyclic Antidepressants

    • For long-term management
    • Not typically started in ED
    • Mechanism: Serotonin reuptake inhibition and antihistamine effects

Cautions

  • Avoid opiates
  • Monitor for QT prolongation with certain medications
  • Watch for respiratory depression
  • Consider drug interactions

Clinical Pearls

  1. Consider CHS in young patients with recurrent symptoms and negative workups
  2. Early recognition prevents unnecessary testing and treatment
  3. Hot showers/baths are a characteristic relief measure
  4. Traditional antiemetics often fail
  5. Frequency is increasing in areas with legal cannabis
  6. Complete cessation is the only definitive treatment

Differential Diagnosis Considerations

  • First presentations require ruling out:
    • Gallbladder disease
    • Intestinal pathology
    • Other toxicologic causes
    • Surgical emergencies
  • CHS is more likely with:
    • Chronic cannabis use
    • Previous negative workups
    • Characteristic symptom pattern
    • Relief with hot showers

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u/boolinmachine 2d ago

There’s nothing you can do unfortunately, once CHS has reached its final stage (which from the sounds of it he’s definitely in). There’s mostly no going back, his body has pretty much made itself allergic to weed. His best bet to ever smoke normally again would be to take a multiple year break and they try it again one day and see how it goes from there.

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u/Indigoez 2d ago

That's kinda what he's doing, he hasn't tried anything in months, even carts. Thank you for the comment💜

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u/Cohnman18 2d ago

Have your BF start slow with weak THC/CBD gummies, the Medical kind that I use, and slowly increase dosage to a mellow high WITHOUT stomach discomfort. May need a Pepcid AC with the gummies. Good Luck!

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u/Indigoez 2d ago

He can't enjoy even a 5mg gummy without puking, edibles are always a no go

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u/Indigoez 2d ago

And thank you💜

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u/Illustrious-Golf9979 2d ago

https://onlinelibrary.wiley.com/doi/10.1155/2016/3614053

This is from an experience of a patient who used a medication to effectively treat her symptoms:

Key Context About the Patient's Cannabis Use:

  1. Pattern of Use and Beliefs:

    • She believed cannabis was helping her symptoms
    • Reported that smoking marijuana was the only thing that gave her relief
    • Was using cannabis 2-3 times daily and had been increasing use over two years
    • Specifically stated she was unwilling to stop using cannabis
    • Classic CHS Pattern:
    • Her symptoms actually got progressively worse despite increased cannabis use
    • She showed the typical morning predominance of symptoms
    • Like many CHS patients, she didn't recognize cannabis as the cause of her problems
    • Treatment Journey:
    • Had tried multiple standard anti-nausea medications without success
    • Had undergone extensive medical testing to rule out other causes
    • Multiple drug screens had confirmed her ongoing cannabis use
    • The situation was becoming more severe, with symptoms now occurring throughout the day
    • Critical Decision Point:
    • Despite medical advice, she refused to consider cannabis cessation
    • This created a challenging treatment situation for her medical team
    • The doctors had to consider alternative treatments that would work while she continued cannabis use
    • This led to the novel approach of trying haloperidol in an outpatient setting
    • Treatment Compromise:
    • While cannabis cessation would have been the ideal treatment
    • The medical team worked with her reality - she wasn't going to stop using
    • They offered haloperidol as an alternative approach
    • She agreed to try this medication while continuing cannabis use
    • Treatment Compliance:
    • She was willing to take the haloperidol daily as prescribed
    • Took it for three weeks
    • Self-discontinued after symptom improvement
    • Unfortunately was lost to follow-up, so long-term outcomes are unknown

This case highlights a common challenge in treating CHS: patients often resist the idea that cannabis is causing their symptoms and are reluctant to stop using it. This makes it particularly important to have alternative treatment options available, even though complete cannabis cessation remains the most effective long-term solution.

The case is significant because it shows that even when patients aren't ready to stop cannabis use, there might be ways to help manage their symptoms. However, it's important to note this is just one case study, and any treatment decisions should be made in consultation with healthcare providers.

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u/Indigoez 2d ago

This research is honestly the best info I could have gotten, thank you for taking the time to look and compile what you could find. I think the best thing we can do is wait to try weed for a few years, in the meantime I know I can find other things :)

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u/Indigoez 2d ago

(for special occasions anyway)

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u/Illustrious-Golf9979 2d ago

I Hope I could help even in the slightest, My heart goes out to your boyfriend and you and I hope he can find some relief!

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u/Indigoez 2d ago

💜 me too, but I'm just happy I get to spend time with him, he tells me that's just as good as getting to smoke, but I wish I could wave a magic wand and cure him so he can do what he wants 😖 maybe time will cure it, if not and he can never smoke that's okay with me 🥺

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u/Illustrious-Golf9979 2d ago

Hey, you both got something special you can't buy with a special card or money so respect to both of you. Everything will work out like it's supposed to, just keep the faith!

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u/Indigoez 2d ago

🙏🥰

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u/Good-Photo7253 2d ago

Blue Lotus gives a relaxing buzz

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u/buzzingbuzzer 2d ago

Shrooms. They have a similar effect in lower doses.

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u/Small-feco 1d ago

Have him try microdosing shrooms.. If those go well do a regular dose some time to see if those are enjoyable

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u/OkFail9632 12h ago

OP what about a micro dose of clean mushrooms?! For a special occasion

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u/sirjohnny2672 2d ago

How about a Bible he can get high with Jesus

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u/Indigoez 2d ago

I think holding his breath till he's lightheaded might do more for him.