ER Patients with Cannabinoid Hyperemesis Had High Pain, Anxiety, and Repeat Visit Rates

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.

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.

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.

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.

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.