People with suspected cannabinoid hyperemesis syndrome remain skeptical about the diagnosis

Twenty-four participants with chronic cannabis use and cyclic vomiting attributed their symptoms to food, alcohol, stress, and GI issues rather than cannabis. Many relied on at-home internet research to understand their condition. Clinical treatment focused on cannabis cessation, but patients felt this failed to acknowledge the difficulty of quitting and the therapeutic benefits they perceived from cannabis.

Semi-structured interviews with 24 participants recruited from a prospective cohort of patients presenting to Rhode Island emergency departments with cyclic vomiting and chronic cannabis use. Thematic analysis using NVivo.

CHS diagnosis requires accepting that a substance many use for nausea relief is actually causing nausea. Understanding patient skepticism can help clinicians communicate more effectively and develop support strategies beyond simple cessation advice.

The disconnect between clinical understanding of CHS and patient experience highlights the need for patient-centered approaches that acknowledge the complexity of chronic cannabis use while providing evidence about the condition.

Small qualitative sample from one state. Participants may not have had confirmed CHS (diagnosis was clinical). Self-selection may have favored those more willing to discuss cannabis use.