Cannabis hyperemesis syndrome appeared after a chronic user stopped cannabis while traveling to a country with stricter laws
A 33-year-old daily cannabis user developed severe cannabis hyperemesis syndrome about a week after stopping use due to travel, with symptoms overlapping withdrawal and resolving within 10 days on a combination of tramadol, promethazine, and mirtazapine.
Quick Facts
What This Study Found
CHS symptoms (severe vomiting, abdominal pain, fever) emerged approximately one week after cessation of daily cannabis use, with standard anti-emetics (ondansetron) failing. The patient also had anxiety, depression, and brain fog consistent with cannabis withdrawal. A combination of tramadol, promethazine, and mirtazapine as outpatient treatment led to full recovery within 10 days.
Key Numbers
33-year-old male. Daily cannabis user for several years. Symptoms began approximately 1 week after stopping. Ondansetron was ineffective. Full recovery within 10 days on tramadol, promethazine, and mirtazapine.
How They Did This
Single case report of a 33-year-old male chronic daily cannabis user who stopped using due to travel to a country with stricter cannabis laws.
Why This Research Matters
This case highlights that CHS can emerge after cannabis cessation, not just during active use, and can overlap with withdrawal symptoms. The successful treatment combination offers an alternative when standard anti-emetics fail.
The Bigger Picture
The overlap between CHS and cannabis withdrawal suggests these may be related manifestations of the same underlying dysregulation, and clinicians should consider both diagnoses when chronic cannabis users present with GI symptoms after cessation.
What This Study Doesn't Tell Us
Single case report. Cannot generalize treatment response to other patients. Patient also used tobacco and alcohol, which were continued. Exact cannabis doses and duration not quantified.
Questions This Raises
- ?How often does CHS present during cessation rather than active use?
- ?Is the tramadol-promethazine-mirtazapine combination effective in other CHS cases?
Trust & Context
- Key Stat:
- CHS emerged after cessation, not during active use
- Evidence Grade:
- Single case report. Illustrative but cannot establish treatment efficacy or generalizability.
- Study Age:
- 2024 study
- Original Title:
- Cannabis Hyperemesis Syndrome in a Recently Abstinent Chronic User: Assessment and Intervention.
- Published In:
- Consortium psychiatricum, 5(1), 27-32 (2024)
- Database ID:
- RTHC-05290
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
Can CHS happen after stopping cannabis?
This case and others suggest yes. While CHS is typically associated with active chronic use, symptoms can emerge or worsen shortly after cessation, possibly overlapping with the withdrawal syndrome.
Why did standard anti-nausea medication not work?
CHS is notoriously resistant to conventional anti-emetics like ondansetron. The mechanism of CHS-related vomiting differs from typical nausea and may involve cannabinoid receptor dysregulation in the gut and brain that these medications do not address.
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Cite This Study
https://rethinkthc.com/research/RTHC-05290APA
Ei Sherif, Yasmine; Gouher, Sariah; Abualhab, Mutaz Mohsin; El-Khoury, Joseph. (2024). Cannabis Hyperemesis Syndrome in a Recently Abstinent Chronic User: Assessment and Intervention.. Consortium psychiatricum, 5(1), 27-32. https://doi.org/10.17816/CP15473
MLA
Ei Sherif, Yasmine, et al. "Cannabis Hyperemesis Syndrome in a Recently Abstinent Chronic User: Assessment and Intervention.." Consortium psychiatricum, 2024. https://doi.org/10.17816/CP15473
RethinkTHC
RethinkTHC Research Database. "Cannabis Hyperemesis Syndrome in a Recently Abstinent Chroni..." RTHC-05290. Retrieved from https://rethinkthc.com/research/ei-2024-cannabis-hyperemesis-syndrome-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.