Cannabis Hyperemesis Syndrome: A Growing Problem with Rising Cannabis Potency

This comprehensive review found that 40-80% of cyclic vomiting syndrome (CVS) patients use cannabis. CHS is characterized by daily or near-daily cannabis use for over 2 years, cyclic vomiting, and hot-water bathing for relief. The distinction from CVS is challenging, as hot bathing is also reported by ~50% of CVS patients. Key treatment barriers include patient skepticism about cannabis causing symptoms, perceived benefits of cannabis, and lack of effective alternatives. Cannabis abstinence remains the cornerstone of CHS management.

Comprehensive narrative review of cannabis use patterns in the US and their relationship to CHS and CVS, including diagnostic criteria, pathophysiology, management, and knowledge gaps.

As cannabis potency has risen dramatically, CHS is becoming more common and is a significant contributor to emergency department visits and hospitalizations. The paradox that an antiemetic substance causes vomiting remains clinically challenging.

CHS represents an ironic consequence of cannabis normalization: a substance known for reducing nausea becomes the cause of severe, recurrent vomiting in heavy users, and the very patients affected are often the last to accept this connection.

Narrative review without systematic methodology. CHS vs CVS distinction remains debated. Exact prevalence of CHS is unknown. No randomized trials of CHS-specific treatments beyond cannabis cessation.