Three deaths linked to cannabinoid hyperemesis syndrome | Research

The takeaway

Three young adults with histories of chronic cannabis use and cannabinoid hyperemesis syndrome (CHS) died, with CHS attributed as the cause of death in two of the three cases.

Heavy cannabis users, emergency medicine professionals, and anyone wanting to understand CHS risks.

CHS attributed as cause of death in 2 of 3 cases

What the researchers found

A 27-year-old female, 27-year-old male, and 31-year-old male with histories of cyclical nausea, vomiting, chronic cannabis use, and negative workups all died. CHS was determined to be the cause of death in two cases and a contributing factor in the third.

Why it matters

CHS is often dismissed as uncomfortable but not dangerous. These cases demonstrate that in rare circumstances, CHS can be fatal, underscoring the importance of recognizing it early in emergency settings.

The numbers in context

3 deaths reported. All decedents were ages 27-31. All had postmortem blood positive for THC. CHS was the attributed cause of death in 2 of 3 cases.

How the study worked

Case report of three forensic cases, including clinical history, postmortem toxicology revealing THC in blood, and autopsy findings.

What this study cannot tell us

Case reports cannot establish prevalence or risk factors. Only three cases were described, and the exact mechanism of death in CHS remains unclear.

How to read the evidence

Preliminary: case report of three individuals with no control group or population-level data.

When this study was published

Published in 2019.

The bigger picture

As cannabis use increases, CHS cases are rising. While most episodes resolve with cessation, fatal outcomes, though rare, highlight that severe CHS requires serious medical attention.

Questions still open

What is the mechanism by which CHS leads to death? How common are fatal CHS cases relative to total CHS diagnoses? Are there warning signs that distinguish life-threatening CHS episodes?

Common questions

What is cannabinoid hyperemesis syndrome?

CHS is a condition affecting chronic cannabis users characterized by repeated episodes of severe nausea, vomiting, and abdominal pain. It often includes compulsive hot bathing behavior and typically resolves only with cannabis cessation.

How rare are fatal CHS cases?

Fatal CHS cases are considered very rare, but exact numbers are unknown. CHS is likely underdiagnosed, meaning some deaths may go unattributed.

Read the original research

Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases.

Journal of forensic sciences, 64(1), 270-274

View on PubMed ↗Publisher’s paper ↗

Citation

Nourbakhsh, Mahra; Miller, Angela; Gofton, Jeff; Jones, Graham; Adeagbo, Bamidele. (2019). Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases.. Journal of forensic sciences, 64(1), 270-274. https://doi.org/10.1111/1556-4029.13819