Nausea is among the conditions that medical cannabis is most commonly used to treat, especially among patients undergoing chemotherapy for cancer. However, there is some evidence that cannabis products may also help to alleviate other forms of nausea, including vertigo and motion sickness.
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Cannabis And Nausea: What's The Evidence?
As always, claims about the efficacy of cannabis in treating any medical condition should be backed up with placebo-controlled clinical trials. Unfortunately, however. many aspects of cannabis science are still highly under-researched, with few proper studies to cite.
To date, most of the evidence for the antiemetic properties of the cannabis plant and its chemical components comes from studies on those suffering from chemotherapy-induced nausea. In one such study, 83 per cent of patients found that using cannabis was more effective than a placebo at reducing their queasiness following a round of cancer treatment[i].
Based on these findings, the US Food and Drug Administration (FDA) has approved several products for the treatment of nausea in chemotherapy patients. Dronabinol and Nabilone, for instance, are both essentially just delta-9-tetrahydrocannabinol (THC) and are now widely used to help control feelings of sickness in this population.
There's also a small amount of evidence to suggest that cannabinoids may attenuate nausea in other groups of people too. For instance, one recent study involving 886 participants found that 96.4 per cent of those who used cannabis to treat nausea experienced symptom relief in as little as five minutes. On average, nausea levels dropped by 3.85 points on a scale of zero to ten[i].
Breaking down the data, the study authors found that smoking joints was associated with greater symptom relief than vaping or using pipes. Cannabis flower and concentrates were also found to be more effective than edibles or tinctures, while products containing higher levels of THC and lower concentrations of cannabidiol (CBD) were rated as the most therapeutic for nausea.
Those who smoked flower also reported greater relief when using sativa or hybrid cultivars, with indica strains apparently less effective.
Summing up their findings, the researchers point out that "even though the cannabis plant has been used to treat nausea for millennia, few studies have measured real-time effects of common and commercially available cannabis-based products." With medical cannabis now a significant component of many people's healthcare, it's high time for more research on this topic.
How Might Cannabis Treat Nausea?
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It's well known that the endocannabinoid system (ECS) plays a significant role in regulating feelings of nausea. In particular, the endocannabinoid receptor one (CB1) is pivotal in determining whether we feel woozy or not. When activated, CB1 receptors suppress the urge to vomit, while blocking these receptors results in some rather uncomfortable sensations – and sometimes a lot of mess.
Though the human body doesn't produce THC, it does create an endocannabinoid called anandamide. Like THC, anandamide has a high affinity for CB1 receptors and generates most of its effects by interacting with these binding sites.
To test this compound's role in treating nausea, researchers put volunteers through a series of parabolic flight manoeuvres, recreating the infamous "vomit comet" that astronauts are subjected to as part of their training. When analyzing participants' blood samples, the study authors found that those who experienced the greatest amount of motion sickness had the lowest levels of anandamide. In contrast, those who suffered the least displayed elevated levels of this key cannabinoid[i].
This suggests that activating CB1 receptors may help treat nausea, providing some indirect insight into the soothing effects of THC, which, as most cannabis users know, binds primarily to these receptors.
Motion sickness aside, some people who suffer from vertigo may also experience extreme nausea. Common symptoms of vertigo include loss of balance, lightheadedness, vomiting, and generally feeling somewhat discombobulated.
While the condition is complex and multi-faceted, it's likely to be at least partially caused by errant functioning in brain regions such as the cerebellum and vestibular nucleus complex (VNC), both of which help to regulate balance. Intriguingly, these two brain structures contain high concentrations of CB1 receptors.
Unfortunately, no proper studies have been conducted regarding the impact of THC on vertigo, although there are certainly grounds to speculate that the cannabinoid may be able to help.
As for CBD, it's unlikely that the compound treats nausea in the same way as THC, since it doesn't have a strong affinity for CB1 receptors. However, studies have suggested that CBD may regulate the release of the neurotransmitter serotonin in parts of the forebrain[i]. Commonly associated with mood, serotonin is actually a multi-functional compound and can contribute to feelings of nausea.
It's also worth noting that CBD inhibits the action of an enzyme called fatty acid amide hydrolase (FAAH), which breaks down anandamide. The use of CBD oil or other products containing this cannabinoid may therefore enable users to boost their anandamide levels, which could lead to reductions in nausea.
Sadly, there's not much proper research on actual humans to test this theory, although a few small studies have hinted at CBD's anti-nausea properties. For example, a recent analysis of 117 children with treatment-resistant epilepsy found that CBD reduced dizziness, anxiety, confusion and vomiting[i].
The Final Verdict
Nausea can majorly impact a person's quality of life, so finding a treatment that works is imperative for those who regularly suffer from queasiness. For many, cannabis might be the answer, although without more rigorous studies, it's impossible to say with any certainty if the plant and its cannabinoids will work for everyone.
It's also important to remember that some people may experience nausea as one of the side effects of using cannabis. For instance, dizziness can sometimes occur due to changes in blood pressure or heart rate, both of which are associated with THC. Those with low blood pressure, irregular heartbeat, or other conditions involving the blood vessels or cardiovascular system might therefore find that cannabis has a detrimental effect.
Despite the wealth of anecdotal evidence supporting the use of cannabis for the treatment of nausea, it's important not to self-medicate for any condition without first consulting a healthcare professional. Those suffering from grogginess should therefore speak to a doctor before giving cannabis a try.
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[1] Grimison P, Mersiades A, Kirby A, Lintzeris N, Morton R, Haber P, Olver I, Walsh A, McGregor I, Cheung Y, Tognela A, Hahn C, Briscoe K, Aghmesheh M, Fox P, Abdi E, Clarke S, Della-Fiorentina S, Shannon J, Gedye C, Begbie S, Simes J, Stockler M. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. Ann Oncol. 2020 Nov;31(11):1553-1560. - https://pubmed.ncbi.nlm.nih.gov/32801017/
[2] Stith SS, Li X, Orozco J, Lopez V, Brockelman F, Keeling K, Hall B, Vigil JM. The effectiveness of common cannabis products for treatment of nausea. Journal of Clinical Gastroenterology. 2022 Apr 7;56(4):331-8.https://journals.lww.com/jcge/Citation/2022/04000/The_Effectiveness_of_Common_Cannabis_Products_for.8.aspx
[3] Choukèr A, Kaufmann I, Kreth S, Hauer D, Feuerecker M, Thieme D, Vogeser M, Thiel M, Schelling G. Motion sickness, stress and the endocannabinoid system. PloS one. 2010 May 21;5(5):e10752. - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0010752
[4] Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011 Aug;163(7):1411-22. doi: 10.1111/j.1476-5381.2010.01176.x. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165951/
[5] Hussain SA, Zhou R, Jacobson C, Weng J, Cheng E, Lay J, et al.. Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: a potential role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy Behav. (2015) 47:138–41. - https://www.sciencedirect.com/science/article/abs/pii/S1525505015001572
