Cannabinoid Hyperemesis Syndrome

Definition: Cannabinoid hyperemesis syndrome (CHS) is a condition that causes repeated episodes of severe nausea, vomiting, and stomach pain in people who use cannabis heavily over a long period. A telltale sign is that hot showers or baths bring temporary relief. The only lasting cure is to stop using cannabis.

What Are the Symptoms of CHS?

CHS usually moves through three phases. The prodromal phase can last months or years and brings morning nausea and belly discomfort. The hyperemetic phase involves intense, repeated vomiting, often for 24 to 48 hours, along with abdominal pain and not wanting to eat. Many people take long, hot showers again and again to feel better. The recovery phase starts once cannabis use stops.

What Causes Cannabinoid Hyperemesis Syndrome?

The exact cause isn’t fully understood. Researchers think long-term, heavy exposure to THC overstimulates cannabinoid receptors in the endocannabinoid system, including CB1 receptors involved in nausea and gut movement. That’s why a plant that can ease nausea in some people can trigger severe vomiting in others.

Is CHS Dangerous?

It can be. Repeated vomiting can lead to severe dehydration, electrolyte problems, kidney injury, and damage to the esophagus. Very hot water can also cause burns. If you can’t keep fluids down, get medical care.

How Is CHS Treated?

In the hospital, treatment focuses on fluids and symptom relief, and some doctors use capsaicin cream on the skin. Standard anti-nausea drugs often don’t work well. Symptoms usually improve within days to weeks of quitting, and they tend to come back if you start again. If quitting is hard, it may be a sign of cannabis use disorder, and help is available.

Related terms: Cannabis Use Disorder, Tolerance Break, Endocannabinoid System, CB1 Receptor

Sources: Cleveland Clinic: Cannabinoid Hyperemesis Syndrome (CHS); StatPearls (NCBI Bookshelf): Cannabinoid Hyperemesis Syndrome.

This entry is for general education and isn’t medical advice.