Cannabinoid Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome causes episodes of nausea and vomiting in long-term marijuana users. People with the condition compulsively bathe or shower in hot water to help relieve the symptoms.
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Cannabinoid hyperemesis syndrome (CHS) is characterized by repeated and extreme vomiting that results from long-term, excessive cannabis use. Although rare, the condition has become more prevalent as more states legalize medical marijuana.

According to a 2015 study published in the journal Academic Emergency Medicine, emergency cases of CHS in two Colorado hospitals have nearly doubled since 2009.

A number of people with CHS undoubtedly remain undiagnosed. This is because many doctors are unaware of the syndrome and because individuals rarely want to admit to using marijuana, an illegal substance in the United States.

Causes of Cannabinoid Hyperemesis Syndrome

Chronic marijuana use can lead to cannabinoid hyperemesis syndrome. The disorder typically occurs in heavy marijuana users rather than those who use the drug casually. But research associated with CHS is limited.

The disorder confuses many medical experts because the primary ingredient in marijuana, THC, has anti-nausea effects. In fact, the cannabinoid medications dronabinol and nabilone have been approved by the Food and Drug Administration to treat nausea caused by chemotherapy.

But long-term marijuana use can produce contradictory effects. And repeated cannabis use can trigger bouts of nausea and vomiting in some people.

Research on the syndrome is ongoing. According to St. Luke’s Health System, experts are still trying to figure out why CHS occurs in some heavy marijuana users and not others. Risk factors for the disorder are unknown.

The condition is not associated with any particular method of marijuana use, but it may be becoming more prevalent because marijuana is more potent than ever.

Some theorize that using cannabis strains rich in THC for an extended period of time increases a person’s risk for the disorder. In states where recreational marijuana is legal, some brands of marijuana contain up to 30 percent THC.

Symptoms of Cannabinoid Hyperemesis Syndrome

People with CHS describe their symptoms as overwhelming and incapacitating, according to a 2011 study published in the journal Current Drug Abuse Reviews.

Symptoms of cannabinoid hyperemesis syndrome often include:

  • Severe abdominal pain
  • Bloating
  • Nausea
  • Excessive vomiting
  • Profuse sweating
  • Weight loss
  • Diarrhea
  • Dehydration

The condition can lead to dehydration or kidney failure caused by excessive vomiting. In extreme cases, brain swelling, muscle spasms, heart rhythm abnormalities, shock or seizures can occur. CHS symptoms often subside within two days, although some effects persist for several weeks.

Stages of Cannabinoid Hyperemesis Syndrome

The most intense symptoms of CHS take time to occur. People with the disorder often feel cyclic periods of nausea for months or years. When vomiting occurs, it can last for up to a week. But most symptoms subside in a couple days if no marijuana is used.

CHS comprises three phases: prodromal, hyperemetic and recovery.

Prodromal Phase

The prodromal phase can last several years. This stage is characterized by abdominal discomfort, early morning nausea and a fear of vomiting. During this time, people maintain normal eating patterns and continue using marijuana for its perceived anti-nausea effects.

Hyperemetic Phase

In the hyperemetic phase, individuals experience mild abdominal pain, dehydration, weight loss and intense nausea and vomiting. The vomiting occurs without warning up to five times per hour. This phase generally lasts about 48 hours.

Recovery Phase

The recovery phase occurs when individuals cease marijuana use. They then regain weight and resume normal bathing and eating habits. This stage can last for days, weeks or months if no marijuana is used.

It is important to seek medical attention if you experience severe vomiting, dehydration or weight loss caused by marijuana use. Medical experts can ease distressing symptoms and expedite the recovery stage.

Treatment for Cannabinoid Hyperemesis Syndrome

Hot bathing has been shown to relieve abdominal pain, nausea and vomiting in people with cannabinoid hyperemesis syndrome. A 2017 report published in the journal German Medical Science showed that 60 percent of people with the disorder reported that hot bathing reduced CHS symptoms.

Treatment for cannabinoid hyperemesis syndrome often involves supportive therapy with intravenous fluids and anti-emetic medications. During the hyperemetic phase, IV fluids might include lorazepam, proton pump inhibitors, and sodium chloride solution.

The most effective way to prevent cannabinoid hyperemesis syndrome is to reduce or avoid marijuana use. However, this may be difficult for individuals with a marijuana addiction. People addicted to cannabis compulsively seek the drug despite the consequences.

People struggling with cannabinoid hyperemesis syndrome may have a severe marijuana use disorder. If you think cannabis use is affecting your life, contact a rehab center for marijuana abuse. These facilities can assist you in overcoming substance abuse and living a healthy, drug-free life.

Medical Disclaimer: aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Matt Gonzales
Content Writer,
Matt Gonzales is a writer and researcher for He graduated with a degree in journalism from East Carolina University and began his professional writing career in 2011. Matt covers the latest drug trends and shares inspirational stories of people who have overcome addiction. Certified by the Centers for Disease Control and Prevention in health literacy, Matt leverages his experience in addiction research to provide hope to those struggling with substance use disorders.

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