Cannabinoid hyperemesis syndrome (CHS) is a condition that affects some people who use cannabis frequently over a long period of time. If you do not completely stop cannabis use, then you may return to the prodromal stage after the recovery stage and repeat the symptoms cycle. During the recovery stage, the nausea and vomiting improve over the course of days to weeks. CHS causes cyclic vomiting (repeated episodes of throwing up) and severe nausea that can lead to hospitalization from dehydration. Many patients are hesitant to consider cannabis as the cause of their symptoms, which can delay diagnosis and hinder further research. Chronic cannabis use and its health complications could impact an individual’s long-term productivity, education, and career, leading to a broader economic burden on society.

For people who’ve turned to marijuana as a source of comfort or healing, discovering that it might be the very thing making them sick can be both baffling and frustrating. When she perfected a method for making cannabis oil, other patients began to seek her out. Cannabinoid Hyperemesis Syndrome (CHS) is a paradoxical, underrecognized, and debilitating condition that affects a subset of long-term cannabis users. Daily, long-term cannabis users — especially those using high-THC concentrates.

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Endocannabinoids play their part in allostasis by promoting recovery from stress and further bring back homeostasis of the neurotransmitters, neurohormones, and neuropeptides . Variations in genes encoding enzymes like CYP2C9, CYP2C19, and CYP3A4 can lead to an excess accumulation of cannabinoid metabolites, potentially triggering vomiting. Chronic cannabis users tend to have significant THC reserves in their fat tissue, which can be mobilized during stressful situations. THC, the principal exogenous cannabinoid in cannabis, is metabolized in the liver through oxidative and hydroxylation reactions by the CYP2C enzyme subfamily . Some researchers have proposed compulsive bathing or showering in hot water be considered a mandatory diagnostic criterion for CHS, as this behavior appears to alleviate symptoms. For CHS and CVS to be considered separate entities, patients must exhibit different clinical characteristics, affect different populations, or respond to treatments in divergent ways.

Symptoms persist as long as cannabis use continues. Support groups, counseling, and education can help patients regain control of their lives. Not everyone who uses cannabis develops CHS. While the condition has only been formally recognized in the last two decades, reports suggest that CHS is becoming more common as cannabis potency and use frequency rise. If you’ve ever searched “CHS symptoms,” “symptoms of CHS,” or “CHS disease symptoms,” you’re likely looking for answers about a confusing and often misunderstood condition. This article is a complete guide, designed to help you understand everything about CHS symptoms, how they progress, how to manage them, and what steps can be taken to prevent recurrence.

• Because nausea and vomiting are common complaints, CHS symptoms are often misdiagnosed.
• Severe CHS episodes require emergency treatment for dehydration.
• The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana).

They often confuse CHS with cyclical vomiting disorder. They find that doing so eases their nausea. In between these episodes are times without any symptoms. That may lead to antinausea effects at first. In the brain, marijuana often has the opposite effect of CHS.

This rise may, in part, be due to recognition bias, as emergency department (ED) physicians fail to recognize cyclic vomiting in more than 80% of cases . The development of a validated CHS diagnostic tool, potentially incorporating biomarkers like cannabinoid metabolites or genetic polymorphisms, could revolutionize early detection and management. The development of such guidelines would not only benefit clinicians but could also improve patient outcomes by ensuring timely and accurate treatment. While the literature on these exact criteria is sparse, consistently heavy use for long periods of time, makes CHS as a result of marijuana use much more likely. The lack of significant diagnostic findings in CHS patients underscores the importance of a thorough patient history and clinical suspicion. The absence of specific biomarkers for CHS means that physicians must rely primarily on clinical history, which can be challenging when the patient does not openly disclose cannabis use or when cannabis use is intermittent.

Why does CHS happen?

These can last months or years before the severe vomiting phase. Because nausea and vomiting are common complaints, CHS symptoms are often misdiagnosed. Recognizing the cycle — nausea, vomiting, and hot bathing — is key to diagnosing CHS.” It’s celebrated for its medical benefits, including pain relief, improved sleep, and reduced nausea. Millions of people use it to ease stress, improve sleep, reduce chronic pain, or simply to relax. The only proven way to prevent cannabis hyperemesis syndrome is to avoid cannabis (marijuana).

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The only definitive treatment for CHS is stopping cannabis use. During this stage, hot showers and baths can help with symptoms. Cannabinoid hyperemesis syndrome (CHS) is a potential side effect of long-term and frequent cannabis use. Moving forward, physicians should be aware of rising cannabis use and identify potential CHS cases to ensure proper treatment and investigation. Given the rise of CHS cases in regions with legalized cannabis markets, public health agencies should prioritize research funding to fill these gaps and inform future policy.

• For example, elevated serum cannabinoid levels or certain patterns of urinary metabolites could help confirm chronic cannabis use, though further research is needed to validate these approaches.
• Instead of providing relief from nausea and digestive issues, cannabis triggers severe nausea, vomiting, and abdominal pain.
• Long-term recovery, however, may require a more comprehensive approach, especially if you’re struggling with withdrawal symptoms or the emotional side of quitting.
• The only known treatment to permanently get rid of CHS is to stop cannabis use completely.
• If they don’t, their symptoms will likely come back.

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If you have CHS and struggle to quit, seek help for cannabis use disorder. Quitting cannabis can be challenging for frequent consumers. In most cases, once someone with CHS stops using cannabis, improvement usually happens quickly.

As the condition is tied closely to long-term cannabis use, comprehensive patient interviews should include inquiries about frequency, potency, and duration of cannabis use, as well as the onset and progression of symptoms. This often leads to misdiagnosis and delayed treatment that could otherwise alleviate symptoms. Patients may report that hot water alleviates symptoms, causing some to spend several hours in the shower . Notably, the median age for cannabis initiation in these patients is 16, suggesting that early cannabis use may play a role in CHS development. CHS is primarily induced by chronic cannabis consumption, with no identifiable organic cause, and the condition is typically managed through the cessation of cannabis use.

How CHS Symptoms Progress Over Time

Public health policies could include mandatory inclusion of warnings on cannabis product labels about the your ultimate biofeedback therapy toolkit potential for CHS, especially for frequent users, and guidance on safe consumption. Hospitals and emergency departments, especially in regions with high cannabis use, are likely to see a rise in patients presenting with the characteristic symptoms of CHS. This barrier to disclosure could result in delayed diagnosis of CHS and other cannabis-related health issues, potentially leading to prolonged suffering or more severe complications. Public health campaigns should not only raise awareness about cannabis-related health risks, but also focus on the specific symptoms and potential long-term consequences of cannabis use. Opioids may exacerbate CHS symptoms due to their association with bowel dysfunction, and they could also potentially lead to opioid dependence in chronic users .

Hyperemetic Stage

Most CHS patients present to the emergency department multiple times, often undergoing various diagnostic tests, including lab work and advanced imaging, which typically yield negative results. Moreover, cannabis legalization has introduced higher-potency products to the market, which may be a significant factor contributing to the rising incidence of CHS. The general consensus among studies from states that have legalized marijuana is that cases of CHS presenting at hospitals have doubled post-legalization. Emphasis was placed on studies that reported on demographic information, symptom patterns, diagnostic criteria, and treatments.

The only cure for CHS is to stop using cannabis. You may need to go to the hospital for severe CHS. But not every person who uses marijuana, even long-term use, develops CHS.

In this phase, patients frequently experience intractable nausea and vomiting that is unresponsive to conventional antiemetic medications . A comparison study further questions the specificity of this symptom, revealing that 48% of CVS patients who do not use cannabis report relief from hot baths, compared to 72% of cannabis users . While clinical features such as chronic cannabis use, intractable vomiting, and relief with hot baths are commonly reported, these are not pathognomonic. Despite negative workups, physicians must consider CHS when standard treatments fail and patients continue to present with persistent symptoms related to cannabis use. The studies included focused on individuals diagnosed with CHS, as well as those with comparable conditions such as CVS, and chronic cannabis users exhibiting symptoms similar to CHS. Diagnosing CHS can be tricky, especially because many people—and even some medical professionals—don’t immediately connect the dots between the symptoms and long-term cannabis use.

Many patients initially don’t connect their symptoms with cannabis, because marijuana is widely known as an anti-nausea drug. Instead of providing relief from nausea and digestive issues, cannabis triggers severe nausea, vomiting, and abdominal pain. Whether you’re a patient, caregiver, healthcare provider, or simply curious, this resource provides clarity and answers. Talk to your healthcare provider or an addiction counselor. Healthcare providers mainly diagnose CHS based on your symptoms, medical history and history of substance use.

What is the treatment for cannabinoid hyperemesis treatment?

The only treatment identified to fully resolve the symptoms of CHS is cannabis cessation. Genetic studies may possibly reveal that long-term cannabis use triggers symptoms in patients genetically predisposed to developing CVS . Since the Department of Justice issued a memo that it would not prosecute marijuana users and sellers who complied with state law in 2009, hospital discharges for compulsive vomiting have increased by 8% annually . For example, elevated serum cannabinoid levels or certain patterns of urinary metabolites could help confirm chronic cannabis use, though further research is needed to validate these approaches.

As more people use cannabis daily, more cases of CHS are being recognized by doctors. This suggests CHS is not extremely rare among people who use cannabis frequently. Another hypothesis involves the body’s heat-sensing pathway (the TRPV1 receptors), since hot baths and capsaicin (which activates TRPV1) often relieve symptoms.