Nine years symptom-free after quitting marijuana: a cannabinoid hyperemesis syndrome case | Research

The takeaway

A man with 16 years of uncontrollable vomiting and up to 15 scalding hot showers daily experienced complete, lasting resolution of all symptoms after stopping marijuana, with no recurrence over nine years.

Read this if you experience cyclical vomiting with cannabis use and want to know the long-term outlook.

Nine years symptom-free after stopping marijuana use

What the researchers found

A 44-year-old man with a long history of marijuana addiction had suffered from chronic abdominal pain and attacks of uncontrollable vomiting for 16 years. He developed a compulsion to take up to 15 scalding hot showers per day to relieve his symptoms. All previous treatments had failed.

Abstinence from marijuana led to rapid and complete resolution of all symptoms, including the compulsive hot showering behavior. The patient was followed for nine years after achieving abstinence, with no recurrence of symptoms.

This represented the longest published follow-up of cannabinoid hyperemesis syndrome, demonstrating that the prognosis is excellent when abstinence is maintained.

Why it matters

This case provided the first long-term follow-up data showing that CHS is fully and permanently reversible with sustained cannabis abstinence. The nine-year remission confirms that the condition is not self-perpetuating once the trigger is removed.

The numbers in context

16 years of symptoms. Up to 15 hot showers per day. Complete resolution upon marijuana abstinence. Nine years of follow-up with no recurrence.

How the study worked

Single case report with nine years of follow-up documenting the clinical course, treatment history, and long-term outcome of cannabinoid hyperemesis syndrome.

What this study cannot tell us

Single case report. The mechanism by which abstinence resolves CHS is not fully understood. Not all CHS patients may achieve this outcome. Publication bias favors positive outcomes.

How to read the evidence

Single case report. Valuable for the unprecedented nine-year follow-up but limited as individual experience.

When this study was published

Published in 2014.

The bigger picture

CHS remains underdiagnosed, partly because the mechanism is counterintuitive: a substance known for reducing nausea instead causing severe vomiting. Long-term follow-up data like this case helps clinicians make a stronger case to patients that abstinence will resolve their symptoms.

Questions still open

What is the relapse rate among CHS patients who attempt abstinence? Could reduced cannabis use (rather than complete abstinence) resolve symptoms? What is the mechanism behind the hot water bathing compulsion?

Common questions

Does cannabinoid hyperemesis syndrome go away permanently?

In this case, complete abstinence from marijuana led to full symptom resolution that lasted nine years with no recurrence. This is the longest follow-up published for CHS.

Why do people with CHS take hot showers?

The mechanism is not fully understood, but patients report that very hot water temporarily relieves their nausea. This patient took up to 15 scalding showers per day. The compulsion resolved completely along with the vomiting after quitting marijuana.

Read the original research

Case of cannabinoid hyperemesis syndrome with long-term follow-up.

World journal of clinical cases, 2(12), 930-3

View on PubMed ↗Publisher’s paper ↗

Citation

Cha, Jae Myung; Kozarek, Richard A; Lin, Otto S. (2014). Case of cannabinoid hyperemesis syndrome with long-term follow-up.. World journal of clinical cases, 2(12), 930-3. https://doi.org/10.12998/wjcc.v2.i12.930