What is Cannabinoid Hyperemesis Syndrome (CHS)?

Cannabinoid Hyperemesis Syndrome (CHS) is a rare but serious condition characterized by cyclic episodes of severe nausea, vomiting, and abdominal pain in chronic cannabis users. First identified in 2004, CHS typically affects individuals who have used cannabis regularly for months or years, with studies showing it predominantly impacts users who consume cannabis daily or near-daily. The syndrome occurs in three distinct phases: prodromal (early warning signs including mild nausea and abdominal discomfort), hyperemetic (acute phase with severe vomiting, often lasting 24-48 hours), and recovery (symptom resolution after cannabis cessation). A hallmark characteristic of CHS is compulsive hot bathing or showering, which temporarily relieves symptoms in approximately 90% of cases. Research indicates CHS affects an estimated 2-3% of regular cannabis users, though exact prevalence rates remain unclear due to underdiagnosis and misdiagnosis. Emergency department visits related to CHS have increased significantly in states with legal cannabis, with Colorado reporting a 3-fold increase in cyclic vomiting cases after recreational legalization. The exact mechanism behind CHS is not fully understood, but theories suggest it involves dysregulation of the endocannabinoid system, particularly CB1 receptors in the gastrointestinal tract and hypothalamus. High-potency THC products may increase risk, as modern cannabis contains significantly higher THC concentrations (averaging 15-25%) compared to historical levels (3-5% in the 1990s). Treatment primarily involves complete cannabis cessation, which typically resolves symptoms within days to weeks. Supportive care includes IV fluids, antiemetics, and topical capsaicin cream. There is no cure other than cannabis discontinuation. **Disclaimer**: This information is for educational purposes only and should not be considered medical advice. Individuals experiencing severe vomiting or abdominal pain should seek immediate medical attention. Cannabis users concerned about CHS should consult healthcare professionals for proper diagnosis and treatment.