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Cannabinoid Hyperemesis Syndrome: What You Need To Know

August 17, 2022

Cannabinoid Hyperemesis Syndrome: What You Need To Know

Marijuana is one of the most frequently used recreational substances across the globe, and while there are ways to use it responsibly, it does not come without a set of risks. Cannabinoid Hyperemesis Syndrome (CHS) is one of them.

Although it’s a rare condition, it is one that should be taken seriously. Here’s everything you need to know about Cannabinoid Hyperemesis Syndrome, including the causes, symptoms, treatments, and prevention steps.

What Is Cannabinoid Hyperemesis Syndrome?

Cannabis hyperemesis syndrome is a condition that is caused by frequent, daily, long-term use of marijuana. It is a rare disease that can present as repeated and severe bouts of vomiting. The commonality of CHS has risen in recent years due to the legalization and increased use of marijuana in younger adults.

Marijuana is filled with loads of different active substances, and THC (tetrahydrocannabinol) is a major component. This is the substance in marijuana that causes its hallucinogenic effects. It binds to endocannabinoid receptors in the brain that cause a “high,” among other effects.

While this is a major reason why people enjoy using marijuana, it can cause some complications. This is because your digestive tract also contains a number of receptors that THC binds to. Cannabis use has been known to affect the time it takes for the stomach to empty, as well as affect the way in which the esophageal sphincter works.

Long-term cannabis abuse can change the way that these cannabinoid receptors in the digestive tract respond and function, which can lead to symptoms of CHS. 

THC is just one type of cannabinoid, and so far, this seems to be the only one that is able to cause CHS. That means individuals who use CBD, or cannabidiol, are unlikely to experience the effects.

Not everyone who uses cannabis will experience CHS, but there are certain risk factors. Genetics, history of substance use or drug use, as well as gastrointestinal problems can increase the prevalence of CHS.

How Is CHS Diagnosed?

The primary tool your doctor will use to diagnose CHS is your symptoms. Your provider may ask you some questions to paint a clear picture of your cannabis usage. It’s important to be open and honest. 

Questions they might ask as part of the diagnostic criteria include:

  • How often do you use cannabis?
  • When do you feel nausea or start to vomit?
  • Do other factors lead to vomiting?
  • How long have you used cannabis?
  • Have you noticed any unexplained weight loss?
  • Do you take hot baths or showers to relieve symptoms?

Doctors might also use blood tests, CT scans, or endoscopies to rule out other possible causes of nausea.

Symptoms of CHS

The most telltale sign of CHS is repeated episodes of vomiting, usually without warning, up to five times per hour. This is also sometimes referred to as cyclic vomiting syndrome. However, the symptoms can come and go in waves. 

There are three phases of CHS:

Prodromal Phase

Most common in adults who have used cannabis since their teenage years, this phase is marked by abdominal pain, nausea, or fear of vomiting. 

Individuals are usually able to maintain normal eating patterns at this time, and they may even use more marijuana to curb the feelings of nausea. This phase can last for months or years.

Hyperemetic Phase

This phase usually lasts for 24-48 hours. During this time, marijuana users have overwhelming and recurrent bouts of vomiting and nausea. They may also feel side effects like abdominal pain, decreased food intake, weight loss, or symptoms of fluid loss (dehydration) because of repeated vomiting.

Many individuals self-learn to take hot showers throughout the day to reduce nausea. This may be because of the ways that parts of the brain regulate temperature and vomiting. But this is also often the point at which individuals seek medical assistance or request emergency medicine because of the recurrent vomiting.

This phase may continue until a person stops using marijuana. At that point, the next phase begins.

Recovery Phase

People in the recovery phase cease to use marijuana completely. Gradually, symptoms lessen until they disappear completely. Symptoms may return if an individual uses marijuana later on.

How Is CHS Treated?

The only way to “treat” CHS is to stop using marijuana. 

Some individuals might need drug rehabilitation in order to help quit, while cognitive behavioral therapy is enough for some. Your symptoms should stop once you quit using marijuana. Some doctors may prescribe benzodiazepines, antipsychotics like haloperidol, antiemetics like metoclopramide or ondansetron, and medicines for mental health in the treatment of cannabinoid hyperemesis syndrome.

If you’ve had severe vomiting, there is a high likelihood that you are also lacking the necessary electrolytes and hydration necessary for proper functioning. A healthcare professional might prescribe medicines to decrease vomiting, or they might use an intravenous fluid replacement to help with dehydration.

If you’re simply dehydrated, The I.V. Doc is a telehealth service that comes to you. One of our highly trained nurses will consult with you prior to treatment, and then they’ll come to your home to hook you up to an I.V. specially formulated to help rehydrate you with vital fluids and nutrients.

The intravenous route is the fastest way to deliver vital fluids, electrolytes, medications, and vitamins to the body. Fluid is absorbed into the bloodstream with 100% efficiency compared to 50-60% with oral intake. This can help your symptoms of CHS improve much more quickly compared to simply drinking water alone.

We bring professional infusions to you. Schedule your hydration service appointment now to help with the effects of dehydration and more. 

Can CHS Be Prevented?

The only way to truly prevent CHS is by not using marijuana in any form. Smoking or ingesting marijuana can affect the digestive tract in the same way. It can also occur without warning in individuals who have used marijuana regularly for years, as it can take a long time to develop. Cannabis users should stop using the substance in order to prevent symptoms.

Complications of CHS

Severe, prolonged vomiting can lead to dehydration in addition to other complications. 

If untreated, a lack of electrolytes and fluids can lead to:

  • Muscle spasms and weakness
  • Seizures and other nervous system complications
  • Shock
  • Heart rhythm abnormalities
  • Kidney failure
  • Ulcers or erosion of the esophagus

Can CHS Be Treated At Home?

The treatment of cannabinoid hyperemesis syndrome can be done from your own home with the help of telehealth services. 

First, stop using marijuana if you begin feeling nauseous or start vomiting, as this is the only way to truly stop CHS.

Many individuals take hot showers or baths to help with nausea. This won’t treat your CHS, but it can make you feel better. Just be careful, because hot water can actually cause you to sweat, which can lead to further dehydration.

Some doctors might recommend that you take some over-the-counter medications from home to alleviate the symptoms. Antihistamines, capsaicin creams for pain relief in the abdominal area, and pain relievers like ibuprofen are just a few examples that are generally safe to take in order to temporarily soothe the symptoms of CHS.

When Should You See a Doctor for CHS?

Most people with CHS start to see relief from their symptoms within 10 days after quitting. 

However, if you start to feel symptoms of severe dehydration, or if your vomiting persists to the point you are only vomiting stomach bile or have a hard time breathing, it is imperative to go to your nearest emergency department. You should not self-diagnose CHS due to its rarity and because of the many, many other potential causes of your nausea and vomiting. 

Signs of severe dehydration include:

  • Irritability, disorientation, or changes in sleep
  • Delirium or dizziness
  • Rapid breathing or quickened heart rate
  • Syncope, or fainting
  • Severe nausea

In Conclusion

Cannabinoid Hyperemesis Syndrome (CHS) is a rare disorder caused by frequent and prolonged marijuana use. It is marked by persistent, severe vomiting that often does not go away until the use of cannabis subsides.

Excess vomiting is the main symptom of CHS, but abdominal pain, dehydration, nausea, or fatigue are often co-occurring symptoms due to fluid loss from the vomiting. You can usually alleviate your symptoms by quitting cannabis, but if symptoms worsen, you should seek emergency care.

Dehydration can lead to a slew of other health complications, so restoring lost electrolytes is essential. Intravenously infused fluids can absorb into your body immediately for quick, meaningful effects. 

Let the experts at The I.V. Doc bring specialized IV infusions right to your door so you can start feeling better in no time. Make an appointment today.


Cannabinoid Hyperemesis Syndrome | Cedars-Sinai.

Cannabis Hyperemesis Syndrome: What Is It, Symptoms & Treatment | Cleveland Clinic

Dehydration - Symptoms and causes | The Mayo Clinic

Cannabinoid Hyperemesis Syndrome | PMC

Addiction Withdrawal Symptoms | Healthdirect

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