Among 18 ER patients with cannabinoid hyperemesis syndrome, pain severity averaged 6.4/10, 72% had prior CT scans, anxiety scores were elevated, and nearly 17% returned to the ER within 30 days.
Emergency physicians, gastroenterologists, CHS patients
What the researchers found
In a pilot study of 18 CHS patients (mean age 34, 56% female), pain severity was high (mean triage score 6.4/10) and pain significantly interfered with daily activities (PROMIS T-score 62.2). Anxiety risk was elevated (PROMIS T-score 56.1). CT imaging had been performed in 72.2% of patients in the past five years, suggesting extensive prior workup. Opioids were administered in 22.2% of cases. Three patients (16.7%) returned to the ER within 30 days.
Why it matters
This is one of the first studies to characterize patient-reported outcomes in CHS beyond just vomiting. The high anxiety scores, significant pain interference, and repeat visit rates paint a picture of a condition with broad impact on quality of life, not just GI symptoms.
The numbers in context
18 patients; mean age 34; 55.6% female; mean pain score 6.4/10; PROMIS anxiety T-score 56.1; pain interference T-score 62.2; 72.2% had prior CT; 22.2% received opioids; 16.7% returned within 30 days
How the study worked
Prospective observational pilot study at one academic center and one community affiliate. Enrolled 18 adult ED patients with prior CHS diagnosis and current symptoms. Collected patient-reported outcomes (PROMIS-29), chart data on imaging and medications, and 30-day/12-month follow-up.
What this study cannot tell us
Very small pilot sample (N=18). Single geographic area. Selection bias from requiring prior CHS diagnosis. No control group. Cannot determine whether anxiety is a cause or consequence of CHS episodes.
How to read the evidence
Preliminary: very small pilot study without control group, demonstrating feasibility and characterizing patient-reported outcomes.
When this study was published
2025 publication
The bigger picture
CHS is often dismissed as a self-inflicted condition, but the documented burden on patients and healthcare resources supports treating it as a chronic condition requiring ongoing management strategies beyond simply advising cannabis cessation.
Questions still open
- Would targeted anxiety management improve CHS outcomes?
- Could a CHS-specific care pathway reduce the 72% CT scan rate?
Read the original research
Pilot Study Measuring Patient Reported Outcomes in Cannabinoid Hyperemesis Syndrome (CHS) patients treated in the Emergency Department.
Clinical and experimental emergency medicine
Citation
Heidish, Ryan; Loganathan, Aditya; Bolden, Taylor; Cooper, Ziva; Barshay, Meylakh; Lagunzad, Isabella; Meltzer, Andrew C. (2025). Pilot Study Measuring Patient Reported Outcomes in Cannabinoid Hyperemesis Syndrome (CHS) patients treated in the Emergency Department.. Clinical and experimental emergency medicine. https://doi.org/10.15441/ceem.25.032
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