Table of ContentsView AllTable of ContentsCausesHow Common Is It?SymptomsIts Three StagesTreatmentAt-Home RemediesTimeline to Feeling BetterHealth ComplicationsPreventionSeeking Emergency Care
Table of ContentsView All
View All
Table of Contents
Causes
How Common Is It?
Symptoms
Its Three Stages
Treatment
At-Home Remedies
Timeline to Feeling Better
Health Complications
Prevention
Seeking Emergency Care
Cannabinoid hyperemesis syndrome (CHS) is a rare problem that causes constant vomiting. It is linked with the long-term use ofcannabis(marijuana).
The exact reason that this problem occurs is not clear. It happens after years of using cannabis many times a week. Symptoms evolve in phases. They can begin as mild problems that make you feel sick in the morning. Belly pain and a sense that you are going to vomit are also common.
With the continued use of cannabis and a lack of treatment, symptoms become more intense. Problems with keeping food and water down can lead todehydration. This leads to a risk of more severe organ problems. The only treatment known to cure CHS is to stop using cannabis and not resume its use.
This article describes the causes, symptoms, and stages of CHS. It also describes how CHS is diagnosed and treated.
Alexandre Morin-Laprise / Getty Images
What Causes Cannabinoid Hyperemesis Syndrome (CHS)?
Since there are so many active chemicals in cannabis, the exact cause ofcannabinoidhyperemesis syndrome is unknown. Substances likeTHC (tetrahydrocannabinol)and other chemicals in cannabis bind to molecules in your brain to trigger the “high” that can occur when using cannabis products.
THC and other chemicals in cannabis also bind to molecules in your digestive tract. These chemicals can change the time it takes your stomach to empty food.
At low doses, the effect of cannabis on your brain can have an antiemetic effect that suppressesnauseaand vomiting. However, with repeated use in some people, it can have the opposite effect on the digestive tract. This results in the persistentvomiting and nauseacharacteristic of CHS.
How Is Marijuana Used?
How Common Is CHS?
CHS is considered rare. It is often described as a syndrome that affects only a small portion of people who are heavy, chronic cannabis users. However, research suggests that it could be far more prevalent and may continue to increase due to factors like the legalization of marijuana and the increased use of medical marijuana.
In one study of frequent cannabis users with potential CHS symptoms, 33% of participants met the definition of CHS. When expanded to the general U.S. population, research indicates that about 2.75 million Americans annually may experience CHS.
Since CHS is a fairly new syndromel first described in 2004, it often remains unrecognized during a clinical diagnosis. This further complicates the process of identifying how commonly CHS occurs. For some people, it can take up to nine years to diagnose CHS from the onset of symptoms.
Understanding Cannabinoids and Their Medical Uses
CHS Symptoms
CHS symptoms typically occur in chronic, frequent cannabis users. These symptoms generally involve the following conditions:
Marijuana Abuse and Addiction: Know the Signs
The Three Stages of CHS
Symptoms of CHS are usually spread over three phases. They start mild then become worse over time, usually within the following phases:
Prodromal Phase
The prodromal phase of CHS can involve mild symptoms that last for months or years. During this time, people may increase cannabis use as a means to treat the recurring nausea. The main symptoms during this phase include the following:
Hyperemetic Phase
The hyperemetic phase of CHS involves symptoms that continue from the prodromal phase and worsen. People with CHS will most likely seek medical care for their symptoms during this phase. The most common symptoms during the hypermetric phase include the following:
People in the hyperemetic phase can take up to 12 hot showers or baths during the day to relieve symptoms. The practice may become compulsive. The hot temperatures may provide some relief as they affect your hypothalamus, the part of your brain that regulates both vomiting and your internal body temperature.
Recovery Phase
While it is possible to return to feeling normal during the recovery phase, research indicates that symptoms recur if cannabis use resumes.
How CHS Is Diagnosed
There is no diagnostic test to confirm CHS. Since its symptoms are easily confused with other conditions, it can take about one to two years before people who seek medical help with CHS get an accurate diagnosis.
People diagnosed with CHS tend to be in their late teens or 20s. The diagnostic criteria for cannabinoid hyperemesis syndrome include the following:
Compulsive hot showering or bathing may be critical in distinguishing CHS from CVS and other conditions with similar symptoms. Studies show that between 90% to 100% of people with CHS use hot showering or bathing to relieve symptoms. Researchers have proposed that this behavior may be included in the diagnostic criteria for CHS.
CHS is often confused with cyclic vomiting syndrome (CVS), which causes cycles of nausea and vomiting balanced with periods of feeling normal, similar to CHS. Other conditions that can mimic symptoms of CHS include the following:
To make a diagnosis, your healthcare provider will conduct a thorough physical examination and ask you about your past health and current symptoms. It’s helpful to volunteer your history of cannabis use with your provider if you are not asked about it.
As your healthcare provider seeks a diagnosis for your symptoms, you may have one or more of the following tests:
How to Talk to Your Doctor About Marijuana
How Is CHS Treated?
Ceasing and abstaining from the use of cannabis is the only treatment that relieves and prevents symptoms of CHS, according to a systematic review on CHS management.
Other treatments can include the following:
Can You Treat CHS Symptoms at Home?
Treating CHS symptoms at home is most effective if you stop using marijuana. You may also get temporary relief from the following at-home treatments:
If symptoms persist and you continue to use cannabis, you may experience more severe problems that require hospitalization for treatment.
How Soon After CHS Will I Feel Better?
After stopping cannabis use, symptoms typically start to disappear within one to two days though individual results can vary. However, symptoms almost always return if you resume using marijuana.
What Are the Health Complications of CHS?
The repeated vomiting that occurs with CHS can lead to issues such as dehydration and electrolyte problems in your blood. Without treatment, the vomiting is likely to continue, and these conditions can lead to the following health complications:
Treatment that helps prevent dehydration and loss of electrolytes can help reduce your risk of many of these problems.
Can You Prevent CHS?
The only way to prevent CHS is to avoid using any form of marijuana. This condition develops after several years of cannabis use. It’s still possible to develop CHS if you use cannabis for many years without having any problems.
Chronic cannabis use is the primary risk factor for developing CHS. Using cannabis for a prolonged period increases your risk of this condition. While any amount of long-term cannabis use can lead to CHS, daily cannabis use seems to be more likely to cause CHS than using it less often.
Cannabinoid Hyperemesis Syndrome (CHS) and Marijuana Use
When to Seek Emergency Medical Help
Prolonged, untreated CHS can lead to chronic dehydration that robs your key organs of the fluids and nutrients they need to maintain your well-being. Seek emergency medical help or call 911 if you have any of the following symptoms:
Summary
Cannabinoid hyperemesis syndrome (CHS) is a somewhat rare problem that involves severe bouts of vomiting. It is more common among those who use cannabis daily for years. As more states make recreational use of cannabis legal, it is thought that this problem will become more common.
While symptoms begin as mild, they can intensify and increase your risk of severe problems. As a somewhat new problem, CHS is often mistaken for other problems with the same symptoms. When combined with the fact that people may not reveal they use cannabis, getting the right diagnosis can take years.
Research is ongoing on the exact way that cannabis triggers this problem. In the meantime, the best way to relieve CHS symptoms is to stop using the drug. Symptoms can recur if you resume its use.
Contact your healthcare provider if you suspect you have CHS. This can help you avoid more severe problems as your body is robbed of food and water from constant vomiting.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Gastroenterology.Cannabinoid hyperemesis syndrome (CHS) and the cyclic vomiting syndrome (CVS) in adults.Cedars Sinai.Cannabinoid hyperemesis syndrome.DePuy A, Andres J.Cannabinoid hyperemesis syndrome.US Pharm. 2016;41(12):HS16-HS19.Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1111/bcpt.12962Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1155/2014/167098Pergolizzi Jr. JV, LeQuang JA, Bisney JF.Cannabinoid hyperemesis.Medical Cannabis and Cannabinoids. 2018;1(2):73-95. doi:10.1159/000494992American Nurse.Cannabinoid hyperemesis syndrome explained.Sandhu G, Smith S, Stephenson K, et al.Prevalence of cannabinoid hyperemesis syndrome and its financial burden on the health care industry.Proc (Bayl Univ Med Cent). 34(6):654-657. doi:10.1080/08998280.2021.1937874Klembczyk K, Calihan J, Alinsky R.Diagnosis and treatment of cannabinoid hyperemesis syndrome.Contemporary Pediatrics. April 2022;39(3).Chocron Y, Zuber JP, Vaucher J.Cannabinoid hyperemesis syndrome.BMJ. 2019;366:l4336. doi:10.1136/bmj.l4336Partnership to End Addiction.Cannabinoid hyperemesis syndrome.Zannese K.Clues emerging to mysterious cannabinoid hyperemesis syndrome.CMAJ. 2022;194(46):E1576-E1577. doi:10.1503/cmaj.1096027Kaiser Permanente.Cannabis hyperemesis syndrome: Care instructions.University of Arizona Center for Toxicology and Pharmacology Education and Research.Cannabinoid hyperemesis syndrome.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Gastroenterology.Cannabinoid hyperemesis syndrome (CHS) and the cyclic vomiting syndrome (CVS) in adults.Cedars Sinai.Cannabinoid hyperemesis syndrome.DePuy A, Andres J.Cannabinoid hyperemesis syndrome.US Pharm. 2016;41(12):HS16-HS19.Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1111/bcpt.12962Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1155/2014/167098Pergolizzi Jr. JV, LeQuang JA, Bisney JF.Cannabinoid hyperemesis.Medical Cannabis and Cannabinoids. 2018;1(2):73-95. doi:10.1159/000494992American Nurse.Cannabinoid hyperemesis syndrome explained.Sandhu G, Smith S, Stephenson K, et al.Prevalence of cannabinoid hyperemesis syndrome and its financial burden on the health care industry.Proc (Bayl Univ Med Cent). 34(6):654-657. doi:10.1080/08998280.2021.1937874Klembczyk K, Calihan J, Alinsky R.Diagnosis and treatment of cannabinoid hyperemesis syndrome.Contemporary Pediatrics. April 2022;39(3).Chocron Y, Zuber JP, Vaucher J.Cannabinoid hyperemesis syndrome.BMJ. 2019;366:l4336. doi:10.1136/bmj.l4336Partnership to End Addiction.Cannabinoid hyperemesis syndrome.Zannese K.Clues emerging to mysterious cannabinoid hyperemesis syndrome.CMAJ. 2022;194(46):E1576-E1577. doi:10.1503/cmaj.1096027Kaiser Permanente.Cannabis hyperemesis syndrome: Care instructions.University of Arizona Center for Toxicology and Pharmacology Education and Research.Cannabinoid hyperemesis syndrome.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American College of Gastroenterology.Cannabinoid hyperemesis syndrome (CHS) and the cyclic vomiting syndrome (CVS) in adults.Cedars Sinai.Cannabinoid hyperemesis syndrome.DePuy A, Andres J.Cannabinoid hyperemesis syndrome.US Pharm. 2016;41(12):HS16-HS19.Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1111/bcpt.12962Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1155/2014/167098Pergolizzi Jr. JV, LeQuang JA, Bisney JF.Cannabinoid hyperemesis.Medical Cannabis and Cannabinoids. 2018;1(2):73-95. doi:10.1159/000494992American Nurse.Cannabinoid hyperemesis syndrome explained.Sandhu G, Smith S, Stephenson K, et al.Prevalence of cannabinoid hyperemesis syndrome and its financial burden on the health care industry.Proc (Bayl Univ Med Cent). 34(6):654-657. doi:10.1080/08998280.2021.1937874Klembczyk K, Calihan J, Alinsky R.Diagnosis and treatment of cannabinoid hyperemesis syndrome.Contemporary Pediatrics. April 2022;39(3).Chocron Y, Zuber JP, Vaucher J.Cannabinoid hyperemesis syndrome.BMJ. 2019;366:l4336. doi:10.1136/bmj.l4336Partnership to End Addiction.Cannabinoid hyperemesis syndrome.Zannese K.Clues emerging to mysterious cannabinoid hyperemesis syndrome.CMAJ. 2022;194(46):E1576-E1577. doi:10.1503/cmaj.1096027Kaiser Permanente.Cannabis hyperemesis syndrome: Care instructions.University of Arizona Center for Toxicology and Pharmacology Education and Research.Cannabinoid hyperemesis syndrome.
American College of Gastroenterology.Cannabinoid hyperemesis syndrome (CHS) and the cyclic vomiting syndrome (CVS) in adults.
Cedars Sinai.Cannabinoid hyperemesis syndrome.
DePuy A, Andres J.Cannabinoid hyperemesis syndrome.US Pharm. 2016;41(12):HS16-HS19.
Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1111/bcpt.12962
Habboushe J, Rubin A, Liu H, Hoffman RS.The prevalence of cannabinoid hyperemesis syndrome among regular marijuana smokers in an urban public hospital.Basic Clin Pharmacol Toxicol. 2018;122(6):660-662. doi:10.1155/2014/167098
Pergolizzi Jr. JV, LeQuang JA, Bisney JF.Cannabinoid hyperemesis.Medical Cannabis and Cannabinoids. 2018;1(2):73-95. doi:10.1159/000494992
American Nurse.Cannabinoid hyperemesis syndrome explained.
Sandhu G, Smith S, Stephenson K, et al.Prevalence of cannabinoid hyperemesis syndrome and its financial burden on the health care industry.Proc (Bayl Univ Med Cent). 34(6):654-657. doi:10.1080/08998280.2021.1937874
Klembczyk K, Calihan J, Alinsky R.Diagnosis and treatment of cannabinoid hyperemesis syndrome.Contemporary Pediatrics. April 2022;39(3).
Chocron Y, Zuber JP, Vaucher J.Cannabinoid hyperemesis syndrome.BMJ. 2019;366:l4336. doi:10.1136/bmj.l4336
Partnership to End Addiction.Cannabinoid hyperemesis syndrome.
Zannese K.Clues emerging to mysterious cannabinoid hyperemesis syndrome.CMAJ. 2022;194(46):E1576-E1577. doi:10.1503/cmaj.1096027
Kaiser Permanente.Cannabis hyperemesis syndrome: Care instructions.
University of Arizona Center for Toxicology and Pharmacology Education and Research.Cannabinoid hyperemesis syndrome.
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