What Is Cannabinoid Hyperemesis Syndrome?

Cannabinoid hyperemesis syndrome CHS) is a rare condition that leads to severe amounts of vomiting that occurs for daily long-term marijuana users.

What are the symptoms of CHS?

CHS can cause severe abdominal pain, nausea and vomiting. According to a report by Current Drug Abuse Reviews, in nearly all cases of CHS there is a delay between the time of heavy usage of marijuana to the time CHS symptoms are felt.

Most patients who have shown signs of CHS admit they would smoke as much as three to five times a day.

What are the three stages of CHS?

Prodromal phase: the earliest signs of CHS include early morning nausea, a fear of vomiting, and abdominal discomfort. Symptoms are typically mild during this stage.

The hyperemetic phase: this is considered the acute and intensified stage of this condition and consists of incapacitating nausea and profuse vomiting. Most patients complain of mild abdominal pain, dehydration and weight loss.

One interesting aspect of this condition is that patients have reported that they feel immediate relief by taking a hot shower.

According to American Addiction Centers, “Researchers have noted that nausea and vomiting of CHS seems to be somewhat alleviated by hot temperatures. There is speculation that the brain’s ability to regulate the body’s core temperature is disrupted by the hyperemesis and other effects, and the hot baths provide a soothing effect. However, this effect is only temporary, and patients report feeling sick again within minutes of getting out of the bath or shower.”

The recovery phase: The recovery stage begins once a patient discontinues marijuana use completely. Typically when this is done, patients can recover. The recovery time for this phase can often take months or years.

Can you die from CHS?

Rarely. CHS causes severe abdominal pain and vomiting which can result in dehydration. Dehydration is linked to kidney failure that medical experts refer to as as cannabinoid hyperemesis acute renal failure, and in severe cases, death can occur.

In 2018, a 17 year old boy died from from cannabinoid hyperemesis syndrome. According to the medical examiners report, the teen's kidneys were shutting down and his liver wasn't functioning properly. He was also severely dehydrated.

Diagnosing CHS

Unfortunately, since there is such little information available about cannabinoid hyperemesis syndrome, many doctors have a hard time diagnosing patients.

According to Dr. Joseph Habboushe, an assistant professor of emergency medicine at New York University Langone/Bellevue Medical Center, “Doctors aren’t thinking about it. Patients show up to the ER at an average of seven times before they’re diagnosed and have it for many years before it’s diagnosed.”

As more states expand marijuana legalization, it's imperative heavy marijuana users are aware of the symptoms of CHS so they can inform their healthcare provider. Currently, doctors don't have guidelines on how to manage this illness.

Treating CHS

CHS is a newly identified condition, so little is known about the long and short term effects it can have on the human body. According to David Breston, a drug attorney in Houston, “It is imperative for individuals who are showing symptoms of CHS to stop marijuana use immediately and contact a doctor or health expert.”

In some cases, a doctor might provide hydration in the form of intravenous (IV) solutions to a patient if they are showing signs of dehydration.

If abdominal pain is present, they may provide a patent with a pain reliever. Complications from cannabinoid hyperemesis syndrome can be severe if left untreated. You can prevent this condition by not consuming marijuana in any form.

SAMHSA’s National Helpline – 1-800-662-HELP (4357)

For immediate assistance on how to stop smoking, contact the Substance Abuse and Mental Health Services Administration 24/7, 365-day-a-year for treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.