Cannabinoid hyperemesis syndrome (CHS) is a condition characterized by frequent and intense nausea and vomiting. It’s not common, but when it happens, it can lead to serious complications if left untreated. CHS is linked to long-term, frequent cannabis use—often daily use over a long time.

Symptoms of cannabinoid hyperemesis syndrome 

The most common symptoms of CHS are centered around gastrointestinal distress:

  • Severe nausea
  • Vomiting multiple times in a short period
  • Intense abdominal discomfort or pain
  • Loss of appetite

The severity of these symptoms depend on the phase of CHS, of which there are three: prodromal, hyperemetic, and recovery. 

Prodromal phase

The prodromal phase is the first phase of CHS. Mild morning nausea, belly discomfort, and worry about vomiting. Eating is often normal. Some people use more cannabis, thinking it will help. This stage can last months or years and is most common in adults who have used marijuana since they were teenagers. 

Hyperemetic phase

The hyperemetic phase of CHS is when the characteristic symptoms occur: intense, repeated vomiting, severe nausea, belly pain, loss of appetite, weight loss, and dehydration. This is when most people seek medical care.

Recovery phase

CHS symptoms will eventually go away once the individual stops using cannabis. It can take months for symptoms to completely disappear, though they may start to lessen in as little as a few days after an absence of cannabis. Note that this reversal is not permanent and symptoms usually return if cannabis is used again.

What causes cannabinoid hyperemesis syndrome? 

The exact cause of cannabinoid hyperemesis syndrome is not yet known. 

Scientists think the cause of CHS is linked to the way cannabinoids are received by the body. Cannabinoids are the compounds in marijuana that cause mind-altering effects. In addition to having receptors in the brain, cannabinoid receptors can also be found in the spinal cord and gastrointestinal tract, known as the endocannabinoid system and change after extended activation. In the gut, those changes can slow the rate of stomach emptying and affect the muscle that lets food pass from the esophagus into the stomach. 

It’s an especially strange sickness since the main symptoms of CHS involve nausea and vomiting, but marijuana and other cannabis-based drugs are sometimes prescribed as a remedy for nausea.

Who’s at risk for CHS?

CHS most often shows up in people who use cannabis daily and for many years (often a decade or more before symptoms start). Young adults are a common group because they use cannabis more often. However, CHS is still an uncommon condition when compared with the number of people who use cannabis.

How is cannabis hyperemesis syndrome diagnosed?

While there’s no single test for CHS, doctors can diagnose Cannabis Hyperemesis Syndrome through its symptoms and by questioning a patient. For example, many who suffer from CHS find that hot showers or applying heat directly to the stomach can offer relief to symptoms — a strong indicator of CHS. Capsaicin cream (the active chemical in chili peppers) can also help in some cases.

Because CHS is a relatively new diagnosis, it’s sometimes mistaken for other conditions like cyclical vomiting syndrome, so being upfront and honest with the doctor about cannabis use helps make the right diagnosis faster.

Failing to diagnose and treat CHS in a timely manner can result in several health complications:

  • Dehydration
  • Electrolyte imbalance
  • Malnutrition
  • Tooth decay (due to stomach bile dissolving tooth enamel from frequent vomiting)
  • Choking
  • Esophagus damage

How is cannabis hyperemesis syndrome treated?

The only long-term solution to the condition is to stop using cannabis completely. Symptoms usually improve within days to weeks after quitting and don’t come back if cannabis is avoided. Otherwise, treating CHS means alleviating the symptoms. 

Some of the most common treatment options include:

  • IV fluids to fix dehydration and electrolytes.
  • Anti-nausea medicines
  • Pain medicine and stomach-protecting drugs
  • Sedatives for severe anxiety or restlessness
  • Pain relievers
  • Antihistimines
  • Hot showers or topical capsaicin for temporary relief

If you experience symptoms related to severe dehydration (dark colored urine, delirium, dizziness, sudden fatigue, rapid breathing, fainting), seek medical care immediately. 

How to prevent cannabis hyperemesis syndrome

The only proven way to prevent cannabis hyperemesis syndrome is not using cannabis. If you think you have CHS, stop cannabis and you will likely see a decrease in symptoms after a few days. 

Quitting may also bring other health benefits like better lung function, improved memory and sleep, and possibly lower risk of anxiety or depression for some people. If you’re ready to live your healthiest life, find a drug rehab near you today.