An Estimated 7.2 Million Americans May Have Cannabinoid Hyperemesis Syndrome | Research

The takeaway

Among the 40+ million US adults who use cannabis daily, nearly 18% reported symptoms consistent with cannabinoid hyperemesis syndrome — yet only 11.5% of those with symptoms had ever been diagnosed, suggesting massive underrecognition.

Emergency physicians, gastroenterologists, primary care providers, daily cannabis users, and public health officials.

What the researchers found

Among daily cannabis users (15.2% of adults, ~40 million), 17.8% reported CHS-like symptoms (severe nausea, vomiting, or abdominal pain), translating to an estimated 7.2 million US adults (2.7% national prevalence). Only 11.5% of symptomatic individuals had received a CHS diagnosis from a provider.

Why it matters

CHS is frequently dismissed or misdiagnosed, leading to unnecessary ER visits and costly workups — this study reveals it affects millions and is overwhelmingly underdiagnosed.

The numbers in context

N=7,034; 15.2% daily cannabis use (~40M adults); 17.8% of daily users report CHS symptoms; ~7.2M affected (~2.7% national prevalence); only 11.5% diagnosed; symptomatic users: younger, more female, non-White, lower income, less educated

How the study worked

Nationally representative cross-sectional survey (National Firearms, Alcohol, Cannabis, and Suicide survey, 2025) of 7,034 US adults, assessing CHS symptoms, cannabis use patterns, and diagnostic history.

What this study cannot tell us

Self-report symptoms may overestimate CHS (other causes of nausea/vomiting not excluded); cross-sectional design; survey-based diagnosis proxy; 'daily use in past 5 years' threshold may include former daily users; preprint pending peer review.

How to read the evidence

Large nationally representative survey provides the first population-level CHS prevalence estimate, though symptom-based definition without clinical confirmation may overcount cases.

When this study was published

Published 2026 (preprint); 2025 survey data.

The bigger picture

With an estimated 7.2 million Americans affected and fewer than 12% diagnosed, CHS represents one of the most underrecognized consequences of the expanding cannabis market.

Questions still open

Why are 88.5% of CHS cases undiagnosed? Would provider education reduce diagnostic delays? Could product labeling warnings about CHS risk reduce incidence? Does CHS prevalence vary by consumption method?

Common questions

How common is cannabinoid hyperemesis syndrome?

This national survey estimates that about 17.8% of daily cannabis users — approximately 7.2 million US adults — experience CHS symptoms, making it far more common than previously recognized.

Why is CHS often undiagnosed?

Only 11.5% of people with CHS-like symptoms had received a diagnosis, suggesting that both patients and providers often don't connect severe nausea and vomiting with heavy cannabis use — leading to repeated ER visits and unnecessary testing.

Read the original research

Prevalence and Correlates of Symptoms of Cannabinoid Hyperemesis Syndrome in the United States.

medRxiv : the preprint server for health sciences

View on PubMed ↗Publisher’s paper ↗

Citation

Ilgen, Mark A; Price, Amanda M; Goldman, Paula; Hicks, Brian M. (2026). Prevalence and Correlates of Symptoms of Cannabinoid Hyperemesis Syndrome in the United States.. medRxiv : the preprint server for health sciences. https://doi.org/10.64898/2026.01.25.26344780