A clinical overview of cannabinoid hyperemesis syndrome

CHS is a paradoxical condition where chronic cannabis users experience cyclical intractable vomiting, uniquely relieved by hot showers or capsaicin, that resolves only with cannabis cessation.

Pergolizzi, Joseph V et al.·Medical cannabis and cannabinoids·2019·Moderate EvidenceReview
RTHC-02225ReviewModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

CHS presents as cyclical episodes of severe nausea and vomiting in long-term cannabis users, separated by asymptomatic periods. Unlike other cyclic vomiting syndromes, it responds to hot showers and topical capsaicin. Abstinence from cannabinoids causes resolution, sometimes within hours.

Key Numbers

Symptoms may require hospitalization. Resolution can occur within hours to days of cannabis cessation.

How They Did This

Narrative review of clinical literature on CHS, covering diagnosis, pathophysiology, symptom management, and clinical implications.

Why This Research Matters

Many clinicians and cannabis users are unaware of CHS. Patients often undergo unnecessary tests and procedures before receiving a correct diagnosis. With increasing cannabis legalization, CHS is expected to become more common.

The Bigger Picture

Cannabis is widely known for its anti-nausea properties, which makes CHS counterintuitive and contributes to diagnostic delays. As cannabis use normalizes, emergency departments need to consider CHS in the differential for cyclic vomiting.

What This Study Doesn't Tell Us

Narrative review without systematic methodology. The exact mechanism of CHS remains unknown.

Questions This Raises

  • ?What makes some chronic users develop CHS while others do not?
  • ?Could genetic factors determine susceptibility?
  • ?Why does capsaicin provide relief?

Trust & Context

Key Stat:
CHS resolves with cannabis cessation, sometimes within hours
Evidence Grade:
Moderate: narrative review of established clinical literature, but no systematic search or meta-analysis.
Study Age:
Published in 2019.
Original Title:
Cannabinoid Hyperemesis.
Published In:
Medical cannabis and cannabinoids, 1(2), 73-95 (2019)
Database ID:
RTHC-02225

Evidence Hierarchy

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

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Why do hot showers help CHS?

The exact mechanism is unclear, but it may involve TRPV1 receptor activation (the same receptor capsaicin targets), which could counteract the dysregulation caused by chronic cannabinoid exposure in the gut.

Can CHS come back after stopping?

CHS resolves with cessation and does not return as long as the person remains abstinent. However, resuming cannabis use typically triggers the cycle again.

Read More on RethinkTHC

Cite This Study

RTHC-02225·https://rethinkthc.com/research/RTHC-02225

APA

Pergolizzi, Joseph V; LeQuang, Jo Ann; Bisney, John F. (2019). Cannabinoid Hyperemesis.. Medical cannabis and cannabinoids, 1(2), 73-95. https://doi.org/10.1159/000494992

MLA

Pergolizzi, Joseph V, et al. "Cannabinoid Hyperemesis.." Medical cannabis and cannabinoids, 2019. https://doi.org/10.1159/000494992

RethinkTHC

RethinkTHC Research Database. "Cannabinoid Hyperemesis." RTHC-02225. Retrieved from https://rethinkthc.com/research/pergolizzi-2019-cannabinoid-hyperemesis

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.