Cannabinoid hyperemesis syndrome (CHS), or cannabis hyperemesis syndrome, is caused by long-term cannabis (marijuana) use. Hyperemesis means severe vomiting. People who have CHS experience repeated and severe bouts of nausea, vomiting, dehydration and stomach pain.
Cannabinoids are found in the cannabis plant and bind to cannabinoid receptors found in our brains, gastrointestinal tracts and immune cells. Cannabinoids include tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabigerol (CBG).
There are three phases that CHS cycles through:
- Prodromal – Nausea and vomiting following long-term cannabis use. This often leads to a person using more cannabis to reduce the nausea
- Hyperemetic – Triggered by increased cannabis use, nausea, abdominal pains and vomiting increase
- Recovery – Once a person stops using cannabis, symptoms may take several weeks to decrease and disappear until they begin using again, which starts the cycle over
You might have CHS if you:
- Use cannabis daily over a long period of time
- Have severe and repeated nausea and vomiting, often more than 5 times an hour
- Experience severe pain in your stomach area
- Feel relief of your symptoms after taking a hot shower
CHS is more than just a side effect of cannabis. If left untreated, the condition can cause serious health complications and lead to:
- Repeat visits to the emergency room
- Dehydration from severe, prolonged vomiting could lead to a hospital stay
- Electrolyte problems in your blood
- “Scromiting” - screaming and vomiting from episodes of violent vomiting
- Permanent tooth enamel corrosion
Rare complications can occur, including:
- Muscle spasms or weakness
- Seizures
- Heart rhythm abnormalities
- Kidney failure
- Shock
- In very rare cases, brain swelling (cerebral edema)
There is no single test for CHS. If you are experiencing severe vomiting or other concerning symptoms, contact your health care provider. As many other health problems could lead to repeated vomiting, it’s important to discuss your complete health history, including your cannabis use, with any provider you see for your symptoms. This will help ensure you get the help and care you need.
Quitting cannabis use is the only way to get better if you have CHS. Symptoms almost always come back if you use marijuana again. Contact your health care provider if you suspect you might have CHS or for information on treatment options for cannabis use disorder.