An Estimated 7.2 Million Americans May Have Cannabinoid Hyperemesis Syndrome

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.

Ilgen, Mark A et al.·medRxiv : the preprint server for health sciences·2026·Strong EvidenceCross-Sectional
RTHC-08351Cross SectionalStrong Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Strong Evidence
Sample
N=7,034

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
Evidence Grade:
Large nationally representative survey provides the first population-level CHS prevalence estimate, though symptom-based definition without clinical confirmation may overcount cases.
Study Age:
Published 2026 (preprint); 2025 survey data.
Original Title:
Prevalence and Correlates of Symptoms of Cannabinoid Hyperemesis Syndrome in the United States.
Published In:
medRxiv : the preprint server for health sciences (2026)
Database ID:
RTHC-08351

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

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 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 More on RethinkTHC

Cite This Study

RTHC-08351·https://rethinkthc.com/research/RTHC-08351

APA

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

MLA

Ilgen, Mark A, et al. "Prevalence and Correlates of Symptoms of Cannabinoid Hyperemesis Syndrome in the United States.." medRxiv : the preprint server for health sciences, 2026. https://doi.org/10.64898/2026.01.25.26344780

RethinkTHC

RethinkTHC Research Database. "Prevalence and Correlates of Symptoms of Cannabinoid Hyperem..." RTHC-08351. Retrieved from https://rethinkthc.com/research/ilgen-2026-prevalence-and-correlates-of

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.