Treating Nausea with Medical Marijuana in Ohio

Medical marijuana recommendations are becoming increasingly common for patients across the country in medical marijuana-legal states. One of the most common uses of the plant is to fight the nausea that accompanies many of the qualifying conditions, such as HIV/AIDS and cancer. In this article, we will go over what nausea is, what causes it, and how medical marijuana can help those who suffer from it.

If you have more questions about medical marijuana and how it can help you, our team here at DocMJ is happy to help! You can find a nearby licensed Ohio marijuana doctor in Ohio by visiting us online at https://docmj.com/ohio/. We also offer a quick online eligibility survey where you can find out if you pre-qualify for an Ohio medical marijuana recommendation.

What is Nausea?

Nausea is the feeling of unease or queasiness in your stomach before you vomit. However, nausea and vomiting are not totally linked. It is possible to feel nausea without vomiting, sometimes for many hours. Nausea is also known as a “non-specific” symptom, meaning it can be caused by many different things. These can include physical causes, such as pregnancy, food poisoning, and gastrointestinal problems, and mental causes, like anxiety and depression.

Specific forms of nausea also exist, the most well-known being CINV (chemotherapy induced nausea and vomiting). CINV is one of the most hated chemotherapy side effects and is rated as the number one most distressing consequences of the treatment, above both vomiting and hair loss [3].

It is hypothesized that the serotonin receptor 5-HT3 is a key player in CINV. The proposed mechanism is as follows; chemotherapy causes the release of serotonin by some cells in the body, the serotonin binds to the 5-HT3 receptors which then send a signal to the brain, this signal is then processed in the area of the brain responsible for nausea and vomiting and another signal is sent to the abs, stomach, and diaphragm, triggering vomiting [1].

Following this, if the receptors were blocked, then the patient would no longer feel the urge to vomit, and this is true! By giving chemotherapy patients 5-HT3 blockers along with an anti-inflammatory drug, vomiting was reduced by seventy percent [2]. However, it was found that this was less effective at controlling nausea in these patients, specifically conditioned and delayed nausea common in those undergoing chemotherapy.

Can Medical Marijuana Treat Nausea?

Many drugs that are used to treat nausea based on marijuana are already in use [4]. One of the first of these synthetic drugs was nabilone, and it was produced to help treat CINV. Nabilone is a synthetic version of THC, much like dronabinol, which is also used to fight nausea in AIDS patients. Several studies comparing THC to non-marijuana based anti-emetics found comparable, and sometimes favorable, outcomes [5][6].

A different form of THC (delta-8-THC) was also studied. When this form of THC was given to pediatric cancer patients prior to and following chemotherapy, it was found that vomiting was completely prevented [7]. Side effects from the drug were also found to be non-significant.

In 2007, another study comparing THC and other medications was done. Dronabinol and ondansetron were given either separately of in conjunction, and the results were compared against a placebo. The study found that the two drugs had similar efficacy, and both were much more effective than the placebo. Interestingly, when both drugs were given, they were found to be less effective than either given singularly, but not significantly so [8].

How does Medical Marijuana Treat Nausea?

It would seem as though marijuana is an effective treatment for nausea, but we haven’t yet seen the mechanism of action. Thanks to the discovery of, and recent research on, the endocannabinoid system, we have a top suspect.

The endocannabinoid system is a combination of the endocannabinoids produced in the body and the cannabinoid receptors found throughout the central and peripheral nervous system. The cannabinoids in marijuana bind to these receptors, producing a wide variety of effects, including both mental and physiological. Because of the reach of the system, it has become a common target for research for many different diseases and conditions. More information on cannabinoids, the endocannabinoid system, and research on the system can be found on the DocMJ blog.

In the brain, there are specific sections responsible for controlling vomiting. In these areas, it is believed that cannabinoid receptors play a role in modulating the body’s vomiting response. By acting on these receptors, THC may be lowering the nausea felt by the user [9]. It is also thought that cannabinoid receptors influence the 5-HT receptors previously mentioned. It has been found that certain cannabinoids may block the receptors from their ligands, keeping the chain-reaction from occurring [10]. Cannabinoids may also slow or inhibit the production of the receptor’s ligand specifically [11].

Other than THC, CBD has also been found to be an effective antiemetic. CBD, however, does not cause this by acting on the cannabinoid receptors, and may instead bind to the 5-HT receptors directly [12]. In rats, this has also been shown to occur directly in the brain area responsible for vomiting.

For anticipatory nausea (also known as conditioned nausea, which is a learned response to certain stimuli), cannabinoids may also provide relief, but be less effective. When the anti-nausea drugs were given during the chemotherapy session, anticipatory nausea was reduced [13]. If the same drugs (5-HT blockers) were given after the patient was exposed to the cues that trigger nausea, they would be ineffective, because the response is conditioned. So, in the case of conditioned nausea, it is best to administer the drugs before nausea can occur.

Summary

Medical marijuana may be an effective tool for preventing nausea. There is a suspected mechanism of action with a solid research backing, and many users are already experiencing positive results. Marijuana may be especially useful to those with repeated experiences with nausea, such as chemotherapy and HIV/AIDS patients. As always, please speak with a licensed Ohio marijuana doctor about any concerns you may have before consuming medical marijuana in any form.

Resources

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876280/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165951/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC212194/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697681/

[5] https://www.ncbi.nlm.nih.gov/pubmed/6318262/

[6] https://www.ncbi.nlm.nih.gov/pubmed/3010011/

[7] https://www.ncbi.nlm.nih.gov/pubmed/7776837/

[8] https://www.ncbi.nlm.nih.gov/pubmed/17355735/

[9] https://www.ncbi.nlm.nih.gov/pubmed/11606489/

[10] https://www.ncbi.nlm.nih.gov/pubmed/12381672/

[11] https://www.ncbi.nlm.nih.gov/pubmed/11698100/

[12] https://www.ncbi.nlm.nih.gov/pubmed/16258853/

[13] https://www.ncbi.nlm.nih.gov/pubmed/8180031/

Dr. Jack Rothman

Dr. Rothman is a diplomate of the American Board of Obstetrics and Gynecology.  He has received multiple special awards and recognitions, including Physician of the Year, from the Pinellas County Medical Association (2014 – 2015) and the President’s Service Award from the Pinellas County Medical Society.

He attended medical school at State University of New York Upstate Medical Center in Syracuse, New York, where he also completed his Obstetrics and Gynecology residency. In addition to practicing medicine, Dr. Rothman’s professional career includes being an Assistant Professor at the University of South Florida and Clinical Instructor at the University of Tampa’s College of Nursing.

Dr. Rothman received his Florida Medical Marijuana Physicians Certification in 2016 and was one of the first recommending physicians through DocMJ in the state and is loved by many of those early patients today.