About one-third of daily marijuana smokers in an ED survey met criteria consistent with cannabinoid hyperemesis syndrome
A survey of 155 daily marijuana smokers (20+ days/month) at an urban ED found that 32.9% met criteria consistent with cannabinoid hyperemesis syndrome, suggesting CHS may affect approximately 2.75 million Americans annually.
Quick Facts
What This Study Found
Researchers surveyed patients aged 18-49 at the oldest public hospital in the United States, screening for those who smoked marijuana at least 20 days per month.
Of 2,127 patients approached, 155 met the criteria of smoking 20 or more days per month. Among these frequent users, 32.9% (95% CI: 25.5-40.3%) met criteria for a phenomenon consistent with cannabinoid hyperemesis syndrome (CHS).
CHS classification was based on reporting nausea and vomiting combined with rating hot showers as 5 or more on a 10-point relief scale. Hot shower relief is considered a hallmark symptom of CHS that distinguishes it from other causes of cyclic vomiting.
Extrapolating to the general population, the researchers estimated that approximately 2.75 million Americans (95% CI: 2.13-3.38 million) may suffer annually from a phenomenon similar to CHS.
Key Numbers
2,127 patients approached, 155 met daily smoking criteria. 32.9% (95% CI: 25.5-40.3%) met CHS criteria. Estimated 2.75 million Americans annually (2.13-3.38 million). Used 20+ days/month as frequent use cutoff.
How They Did This
Cross-sectional questionnaire administered to a convenience sample of ED patients aged 18-49 at an urban public hospital. Screened for marijuana use 20+ days/month. CHS defined by nausea/vomiting plus hot shower relief rating of 5+/10. National prevalence extrapolated from sample.
Why This Research Matters
CHS has been considered rare, but this is the first study attempting to estimate its prevalence among heavy users. A 33% rate among daily smokers, if confirmed, would make CHS far more common than previously assumed and an important consideration for cannabis users and clinicians.
The Bigger Picture
Clinicians have long described CHS as rare or very rare without data to support that characterization. This prevalence estimate, while requiring validation, suggests CHS may be substantially underdiagnosed and that emergency department visits for cyclic vomiting in cannabis users should routinely consider CHS.
What This Study Doesn't Tell Us
Convenience sample from a single urban ED is not representative of all cannabis users. The CHS classification relied on a proxy measure (hot shower relief rating) rather than clinical diagnosis. Self-reported marijuana use frequency may be inaccurate. The national prevalence extrapolation from a single-site ED sample is speculative. The survey could not rule out other causes of nausea and vomiting.
Questions This Raises
- ?Would a clinical diagnosis of CHS confirm the 33% prevalence among daily users?
- ?What frequency and duration of use triggers CHS?
- ?Do specific cannabis products or consumption methods increase CHS risk?
Trust & Context
- Key Stat:
- 32.9% of daily marijuana smokers met CHS criteria; ~2.75 million Americans estimated affected
- Evidence Grade:
- Single-site convenience sample with proxy CHS classification provides moderate evidence on prevalence, though the estimate requires validation in larger, representative samples.
- Study Age:
- Published in 2018. Cannabis potency has increased since, potentially affecting CHS prevalence. Awareness and diagnosis of CHS have also improved.
- Original Title:
- The Prevalence of Cannabinoid Hyperemesis Syndrome Among Regular Marijuana Smokers in an Urban Public Hospital.
- Published In:
- Basic & clinical pharmacology & toxicology, 122(6), 660-662 (2018)
- Authors:
- Habboushe, Joseph, Rubin, Ada, Liu, Haoming(2), Hoffman, Robert S
- Database ID:
- RTHC-01671
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
How common is cannabinoid hyperemesis syndrome?
This study found 32.9% of people who smoke marijuana 20+ days per month met criteria consistent with CHS. If extrapolated nationally, approximately 2.75 million Americans may be affected. However, this was a single-site study and the estimate needs validation.
How was CHS identified?
Patients who smoked marijuana 20+ days per month and rated hot showers as 5 or more out of 10 for nausea/vomiting relief were classified as having CHS-consistent symptoms. Hot shower relief is considered a hallmark distinguishing feature of CHS.
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Cite This Study
https://rethinkthc.com/research/RTHC-01671APA
Habboushe, Joseph; Rubin, Ada; Liu, Haoming; Hoffman, Robert S. (2018). The Prevalence of Cannabinoid Hyperemesis Syndrome Among Regular Marijuana Smokers in an Urban Public Hospital.. Basic & clinical pharmacology & toxicology, 122(6), 660-662. https://doi.org/10.1111/bcpt.12962
MLA
Habboushe, Joseph, et al. "The Prevalence of Cannabinoid Hyperemesis Syndrome Among Regular Marijuana Smokers in an Urban Public Hospital.." Basic & clinical pharmacology & toxicology, 2018. https://doi.org/10.1111/bcpt.12962
RethinkTHC
RethinkTHC Research Database. "The Prevalence of Cannabinoid Hyperemesis Syndrome Among Reg..." RTHC-01671. Retrieved from https://rethinkthc.com/research/habboushe-2018-the-prevalence-of-cannabinoid
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.