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Study breakdown

People diagnosed with cannabinoid hyperemesis syndrome often contested the diagnosis because of positive beliefs about cannabis

QualitativePreliminary evidence
The takeaway

In interviews with 24 people with CHS, positive perceptions of cannabis led many to contest their diagnosis and resist abstinence recommendations, instead trying alternative consumption methods or dose reductions.

Emergency physicians, gastroenterologists, and clinicians who encounter CHS patients who may resist diagnosis.

N = 24 patients contested diagnosis

What the researchers found

Participants contested CHS diagnoses because they believed cannabis was beneficial and helped with nausea, that claims about cannabis harms were part of medical conspiracy, and that their symptoms differed from CHS descriptions. They resisted abstinence by trying new routes of administration, different cannabis types, reduced frequency, or substituting other substances.

Why it matters

CHS diagnoses are increasing alongside rising cannabis use and potency. Understanding why patients resist diagnosis and treatment can help clinicians communicate more effectively with patients who hold strong positive beliefs about cannabis.

The numbers in context

N = 24 self-reported CHS patients. Participants described multiple strategies to continue cannabis use: new administration routes, specific cannabis types, reduced amounts or frequency, and substance substitution.

How the study worked

Qualitative study using semi-structured interviews with 24 individuals who self-reported having cannabinoid hyperemesis syndrome, analyzed through a narrative framework examining how symbolic meanings of cannabis shaped diagnosis and treatment experiences.

What this study cannot tell us

Self-reported CHS diagnosis without clinical confirmation. Small sample recruited through convenience/snowball sampling. Qualitative design cannot quantify how widespread these attitudes are among CHS patients.

How to read the evidence

Small qualitative study providing rich descriptive data on patient perspectives, but cannot establish prevalence of these attitudes or generalize broadly.

When this study was published

2025 publication

The bigger picture

This study illustrates a broader challenge in healthcare: when patients strongly identify with a substance or behavior, they may reject diagnoses that conflict with their beliefs. CHS is becoming a test case for how clinicians navigate patient autonomy and evidence-based treatment.

Questions still open

  • What communication strategies are most effective for clinicians discussing CHS with patients who hold strong pro-cannabis beliefs? Do alternative consumption methods actually prevent CHS recurrence?

Common questions

Why did CHS patients resist their diagnosis?
Three main reasons: they believed cannabis was beneficial and helped nausea (the opposite of what CHS involves), they saw cannabis harm claims as part of a broader medical stigma or conspiracy, and they believed their symptoms did not match CHS descriptions.
What did patients do instead of quitting cannabis?
They tried switching administration routes (edibles, vaping), using only certain cannabis types, reducing amount or frequency, or substituting other substances, rather than following the recommended treatment of complete abstinence.

Read the original research

Contesting Cannabinoid Hyperemesis Syndrome: How Narratives of Cannabis Shape Diagnosis Contestation and Treatment Resistance.

Qualitative health research, 35(8), 876-886

Citation

Copes, Heith; Webb, Megan; Valles, Jessica. (2025). Contesting Cannabinoid Hyperemesis Syndrome: How Narratives of Cannabis Shape Diagnosis Contestation and Treatment Resistance.. Qualitative health research, 35(8), 876-886. https://doi.org/10.1177/10497323241279079